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This study assessed LLIN use and associated factors in Thailand and Myanmar across diverse transmission contexts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed cross-sectional data from 13,459 individuals attending malaria service points in three districts in Thailand and two townships in Myanmar (2017\u20132024). LLIN use was categorized as daily, intermittent, or non-use. Logistic regression identified factors linked to non-regular use in each country. A directed acyclic graph (DAG) illustrated hypothesized causal pathways.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 3,062 participants in Myanmar, 16.9% reported intermittent or non-use. Higher odds were observed among individuals aged 5\u201314\u00a0years (aOR\u2009=\u20091.87, 95% CI: 1.29\u20132.75), 15\u201334\u00a0years (aOR\u2009=\u20093.42, 95% CI: 2.07\u20135.67), and\u2009\u2265\u200935\u00a0years (aOR\u2009=\u20094.42, 95% CI: 2.50\u20137.86), Rakhine ethnicity (aOR\u2009=\u20093.54, 95% CI: 2.76\u20134.57), residence in Paletwa (aOR\u2009=\u200920.9, 95% CI: 5.29\u2013109), uncertain malaria history (aOR\u2009=\u20098.03, 95% CI: 3.61\u201318.4), and\n                      <jats:italic>Plasmodium falciparum<\/jats:italic>\n                      infection (aOR\u2009=\u20092.87, 95% CI: 2.02\u20134.06). Among 10,397 participants in Thailand, 31.2% reported intermittent or non-use. Significant factors included older age (aOR\u2009=\u20092.73, 95% CI: 2.07\u20133.62 for 15\u201334\u00a0years), male sex (aOR\u2009=\u20091.73, 95% CI: 1.56\u20131.91), agricultural occupation (aOR\u2009=\u20091.42, 95% CI: 1.04\u20131.95), residence in Bannang Sata (aOR\u2009=\u200917.9, 95% CI: 14.4\u201322.4) or Saba Yoi (aOR\u2009=\u200934.4, 95% CI: 23.3\u201352.3),\n                      <jats:italic>P. falciparum<\/jats:italic>\n                      (aOR\u2009=\u20093.61, 95% CI: 1.71\u20137.78),\n                      <jats:italic>P. vivax<\/jats:italic>\n                      (aOR\u2009=\u20092.74, 95% CI: 2.38\u20133.17), and lower odds with uncertain malaria history (aOR\u2009=\u20090.49, 95% CI: 0.35\u20130.68).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Non-regular LLIN use was common and linked to demographic, occupational, and clinical factors. Context-specific strategies are needed to improve adherence and support malaria elimination goals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12936-026-05812-4","type":"journal-article","created":{"date-parts":[[2026,1,31]],"date-time":"2026-01-31T01:44:14Z","timestamp":1769823854000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Context-specific drivers of non-regular long-lasting insecticidal net use in the Greater Mekong Subregion"],"prefix":"10.1186","volume":"25","author":[{"given":"Pyae Linn","family":"Aung","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Piyarat","family":"Sripoorote","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myat Thu","family":"Soe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pattamaporn","family":"Petchvijit","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Poh Poh","family":"Aung","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaing Zin Zin","family":"Htwe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saranath","family":"Lawpoolsri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaranit","family":"Kaewkungwal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liwang","family":"Cui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel M.","family":"Parker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myat Phone","family":"Kyaw","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jetsumon","family":"Sattabongkot","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,1,31]]},"reference":[{"key":"5812_CR1","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1186\/s12936-024-04851-z","volume":"23","author":"G Manzoni","year":"2024","unstructured":"Manzoni G, Try R, Guintran JO, Christiansen-Jucht C, Jacoby E, Sovannaroth S, et al. 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