Impact of distribution campaigns on the use and availability of long-lasting insecticide-treated nets in rural Guinea.

BACKGROUND

Despite ongoing efforts by both Guinean authorities and international stakeholders, malaria remains the leading public health challenge in Guinea, contributing to significant morbidity and mortality, especially among children under five. This study aimed to evaluate the effectiveness of distribution campaigns in increasing ownership and utilisation of long-lasting insecticide-treated nets (LLINs), to improve coverage among this high-risk population.

MATERIALS AND

METHODS

A cross-sectional, community-based survey of 34 villages in Guinea (May-August 2025) assessed household LLIN ownership and use. A total of 316 household data records were collected door-to-door by Peace Corps Volunteers and trained local health workers using Google Forms or printed surveys in local languages. Households with and without recent LLIN distribution campaigns were compared using non-parametric Mann-Whitney U tests.

RESULTS

Campaign presence was associated with increased household ownership of at least one LLIN, from 45.8% to 94.5% (p < 0.0001). Mean population access to LLINs saw a three-fold increase from 20.8% to 72.9% (p < 0.001). LLIN use among children under five doubled from 24.8% to 50.0% (p < 0.001), while adult use rose from 28.3% to 42.0% (p = 0.052) in campaign-exposed areas. At the household level, net density reached the target of 1.00 net per sleeping space (up from 0.00; p < 0.001). While median ownership reached 1.00 net per bed, the median number of nets actually hung was only 0.55, indicating that logistical success has not yet translated into universal deployment.

CONCLUSIONS

The LLIN distribution campaign was associated with substantially increased bednet ownership, population access, and use in Guinea, underscoring the critical role of such efforts by the Ministry of Health and international partners. However, underutilisation persists due to social, cultural, and practical barriers. Strengthening post-distribution support and targeted sensitisation campaigns is essential to ensure proper use and maximise protection for vulnerable populations.