Challenges of proper disposal of old long-lasting insecticidal nets and its alternative uses in rural south-eastern Tanzania

PLoS One. 2024 Feb 15;19(2):e0279143. doi: 10.1371/journal.pone.0279143. eCollection 2024.

Abstract

Introduction: Insecticide-treated nets (ITNs), specifically long-lasting insecticidal nets (LLINs), are the most commonly used, scalable, and cost-effective tools for controlling malaria transmission in sub-Saharan Africa. However, the multiple alternative uses of retired LLINs have been associated with poor disposal practices. The World Health Organization (WHO) has provided guidelines and recommendations for the proper management of worn-out LLINs. This study assessed the existing alternative uses and disposal practices of old LLINs.

Methods: An explanatory sequential mixed-methods approach was used to assess LLINs existing alternative uses, disposal practices, knowledge, and perceptions regarding WHO recommendations on proper disposal of old LLINs among stakeholders in Kilombero and Ulanga districts, south-eastern Tanzania. A survey questionnaire was administered to 384 participants. Furthermore, the study employed focus group discussions (FGD) and key informant interviews (KII) to elucidate responses regarding existing disposal practices, associated challenges, and alternative uses of LLINs. The insights derived from both study components were subsequently used for inferential analysis.

Results: The major challenge influencing the proper disposal of LLINs was limited awareness of how to properly dispose of them. Of the 384 people surveyed, 97.0% were not aware of the WHO recommendations for the proper disposal of old LLINs. All key informants were unaware of the WHO guidelines for proper disposal of old LLINs. The common methods used to dispose of LLINs were burning (30.7%), disposing them into garbage pits (14.8%), and alternative uses (12.2%). Of the 239 respondents with LLINs, 41.0% had alternative use, while 59.0% had no alternative use. The common alternative uses were ropes for tying or covering items (20.9%), garden fencing (7.5%), chicken coops (5.0%), and 7.5% for other minor alternative uses.

Conclusion: Strengthening awareness and education on proper LLIN disposal practices among community members and key stakeholders is essential for enhancing malaria control efforts and preventing environmental pollution.

MeSH terms

  • Humans
  • Insecticide-Treated Bednets*
  • Insecticides*
  • Malaria* / epidemiology
  • Malaria* / prevention & control
  • Mosquito Control / methods
  • Tanzania

Substances

  • Insecticides

Grants and funding

This work was supported by Ifakara Health Institute (IHI) Training Department, funding awarded to SJM as part of the MSc studentship award (Reference No: IHI/TC/BAG/2020/111). This work was also supported by the Consortium for Advanced Research Training in Africa (CARTA) awarded to EWK. CARTA is jointly led by the African by the Carnegie Corporation of New York (Grant No. G-19-57145), Sida (Grant No: 54100113), Uppsala Monitoring Center, Norwegian Agency for Development Cooperation (Norad), and by the Wellcome Trust [reference no. 107768/Z/15/Z] and the UK Foreign, Commonwealth & Development Office, with support from the Developing Excellence in Leadership, Training and Science in Africa (DELTAS Africa) programme. EWK was also funded by NIHR–Wellcome Trust Partnership for Global Health Research International Training Fellowship (Grant Number: 216448/Z/19/Z). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.