@article{fdi:010081132,
  title = {{F}amily, social and cultural determinants of long-lasting insecticidal net ({LLIN}) use in {M}adagascar : secondary analysis of three qualitative studies focused on children aged 5-15 years},
  author = {{N}jatosoa, {A}. {F}. and {M}attern, {C}. and {P}ourette, {D}olores and {K}esteman, {T}. and {R}akotomanana, {E}. and {R}ahaivondrafahitra, {B}. and {A}ndriamananjara, {M}. and {H}arimanana, {A}. and {R}azafindrakoto, {J}. and {R}aboanary, {E}. and {A}ndrianasolo, {A}. and {R}ogier, {C}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {A}lthough it is accepted that long-lasting insecticidal net ({LLIN}) use is an effective means to prevent malaria, children aged 5 to 15 years do not appear to be sufficiently protected in {M}adagascar; the malaria prevalence is highest in this age group. {T}he purpose of this research is to summarize recent qualitative studies describing {LLIN} use among the {M}alagasy people with a focus on children aged 5-15 years. {M}ethods {Q}ualitative data from three studies on malaria conducted between 2012 and 2016 in 10 districts of {M}adagascar were analysed. {T}hese studies cover all malaria epidemiological profiles and 10 of the 18 existing ethnic groups in {M}adagascar. {A} thematic analysis was conducted on the collected data from semi-structured interviews, direct observation data, and informal interviews. {R}esults {A} total of 192 semi-structured interviews were conducted. {LLIN}s are generally perceived positively because they protect the health and well-being of users. {H}owever, regional representations of mosquito nets may contribute to {LLIN} lower use by children over 5 years of age including the association between married status and {LLIN} use, which leads to the refusal of unmarried young men to sleep under {LLIN}s; the custom of covering the dead with a mosquito net, which leads to fear of {LLIN} use; and taboos governing sleeping spaces for siblings of opposite sexes, which leads to {LLIN} shortages in households. {C}hildren under 5 years of age are known to be the most vulnerable age group for acquiring malaria and, therefore, are prioritized for {LLIN} use when there are limited supplies in households. {I}n contrast, children over 5 years of age, who are perceived to be at less risk for malaria, often sleep without {LLIN}s. {C}onclusions {P}erceptions, social practices and regional beliefs regarding {LLIN}s and vulnerability to malaria contribute to the nonuse of {LLIN}s among children over 5 years of age in {M}adagascar. {M}odifying {LLIN} policies to account for these factors may increase {LLIN} use in this age group and reduce disease burden.},
  keywords = {{M}alaria ; {LLIN} use ; {C}hildren over five ; {S}ociocultural factors ; {M}adagascar ; {MADAGASCAR}},
  booktitle = {},
  journal = {{M}alaria {J}ournal},
  volume = {20},
  numero = {1},
  pages = {168 [15 ]},
  year = {2021},
  DOI = {10.1186/s12936-021-03705-2},
  URL = {https://www.documentation.ird.fr/hor/fdi:010081132},
}