Utilization of insecticide-treated nets and factors influencing it among caregivers of children under five in Butiama district, Tanzania

<h2>Abstract</h2><h3>Background</h3> Malaria remains a leading cause of disease and death among children under five in Tanzania, particularly in Butiama, Mara, where its prevalence is high despite ongoing prevention efforts. This study aimed to determine the prevalence and factors influencing insecticide-treated net (ITN) use among caregivers in Butiama to enhance malaria prevention and child health outcomes. <h3>Methodology</h3> The study used a community-based cross-sectional design with multistage sampling to select 384 caregivers of children under five in Butiama District. Data were collected in April–May 2024 using a Swahili questionnaire on Kobo Toolbox. SPSS version 26.0 was used for analysis, including data cleaning, univariate descriptive statistics, bivariate analysis using chi-squared tests assessed relationships between categorical variables, and multivariate analysis to identify predictors at p < 0.05. <h3>Results</h3> Among the participants, 82.3 % owned a mosquito net, and 50.8 % used it the night before the study. Female participants were more likely to use ITNs than males (AOR = 3.572, P = 0.001), and those with primary education had higher odds of ITN use compared to those with no formal education (AOR = 2.281, P = 0.017). Knowledge of correct ITN use timing, especially starting immediately after delivery, was a strong predictor of usage (AOR = 2.918, P = 0.044). Self-employed were 36.6 % less likely to use ITNs compared to farmers and homemakers (AOR = 0.366, P = 0.037). <h3>Conclusion</h3> This study found ITN usage at 50.8 %, lower than the national average. Females, those with primary education, and individuals knowledgeable about appropriate usage timing were more likely to use ITNs. Targeted, gender-sensitive educational campaigns are needed to increase ITN adoption and improve malaria prevention.