{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:28:19Z","timestamp":1787027299809,"version":"build-2736575974"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T00:00:00Z","timestamp":1755734400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Long-lasting insecticidal nets (LLINs) are the main vector control tools and remain protective against malaria, even in the presence of high pyrethroid resistance. However, in sub-Saharan Africa, the estimated percentage of the population sleeping under LLINs is low. Hence, this qualitative study was conducted to explore perceptions about LLINs and the reasons for low LLIN use in southern Ethiopia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Qualitative cross-sectional study was conducted in southern Ethiopia. Study areas were selected based on low LLIN use following a quantitative survey. Seven focus group discussions (FGDs) with a total of 52 discussants were conducted. Data were managed manually using Microsoft Word and were analyzed thematically.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The themes that emerged were ownership of LLINs, perceived lifespan of LLINs, uses of LLINs, reasons for LLIN non-use, and recommendations. Participants indicated low LLIN coverage and interrupted maintenance supply. The pattern of LLIN utilization varied between groups, as some said it was improving while others said it was decreasing. The expected life span of LLINs reported varied from a minimum of 3\u202fmonths to a maximum of 3\u202fyears. Discussants from all FGDs described that the possibility of discarding or repurposing LLINs is high when it does not kill mosquitoes. Some discussants added the finding that ineffectiveness was worsened by exposing LLINs to direct sunlight to decrease suffocation. All FGD discussants agreed that the main reason for not using LLINs was a lack of awareness, which in turn caused negligence. Some groups in pastoralist areas added the perception that LLINs do not protect from malaria as a reason for non-use.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The low LLIN use and high repurposing practices were noted due to different reasons, including low awareness, negligence, ineffectiveness of LLINs in killing mosquitoes, and others. LLINs are repurposed mainly for covering different things and making ties. Continuous awareness creation activities and corrective measures might improve LLIN coverage and use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2025.1561037","type":"journal-article","created":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T05:28:15Z","timestamp":1755754095000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Reasons for low long-lasting insecticide-treated net use and repurposing: qualitative study from southern Ethiopia"],"prefix":"10.3389","volume":"13","author":[{"given":"Misganu","family":"Endriyas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mekidm","family":"Kassa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mintesinot","family":"Melka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agegnehu","family":"Gebru","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yilma","family":"Chisha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,8,21]]},"reference":[{"key":"ref1","volume-title":"World malaria report 2024","year":"2024"},{"key":"ref2","volume-title":"Annual perfromance report 2015 EFY","year":"2023"},{"key":"ref3","volume-title":"World malaria report 2022","year":"2022"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1186\/s12936-018-2183-y","article-title":"Effect of individual and community-level bed net usage on malaria prevalence among under-fives in the Democratic Republic of Congo","volume":"17","author":"Levitz","year":"2018","journal-title":"Malar J"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e1001088","DOI":"10.1371\/journal.pmed.1001088","article-title":"African malaria control programs deliver ITNs and achieve what the clinical trials predicted","volume":"8","author":"Eisele","year":"2011","journal-title":"PLoS Med"},{"key":"ref6","volume-title":"WHO recommendations for achieving universal coverage with long-lasting insecticidal nets in malaria control","year":"2017"},{"key":"ref7","volume-title":"National Malaria Guidelines","year":"2022"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"207","DOI":"10.1038\/nature15535","article-title":"The effect of malaria control on plasmodium falciparum in Africa between 2000 and 2015","volume":"526","author":"Bhatt","year":"2015","journal-title":"Nature"},{"key":"ref9","first-page":"564","article-title":"Insecticide-treated net use in sub-Saharan Africa: systematic review and meta-analysis","volume":"78","author":"Defo Tamgnoa","year":"2021","journal-title":"Ig Sanita Pubbl"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"940","DOI":"10.1186\/s12889-022-13347-x","article-title":"Factors associated with ownership and utilization of insecticide treated nets among children under five years in sub-Saharan Africa","volume":"22","author":"Konlan","year":"2022","journal-title":"BMC Public Health"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"468","DOI":"10.1186\/s12936-021-03976-9","article-title":"The effect of long-lasting insecticidal nets (LLINs) physical integrity on utilization","volume":"20","author":"Hiruy","year":"2021","journal-title":"Malar J"},{"key":"ref12","volume-title":"National malaria program monitoring and evaluation plan 2014\u20132020","year":"2014"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"94","DOI":"10.1186\/s12936-024-04909-y","article-title":"Low long-lasting insecticidal net use in malaria elimination areas in southern Ethiopia: results from community based cross-sectional study","volume":"23","author":"Endriyas","year":"2024","journal-title":"Malar J"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"1319","DOI":"10.1007\/s10508-012-0016-6","article-title":"Sample size policy for qualitative studies using in-depth interviews","volume":"41","author":"Shari","year":"2012","journal-title":"Arch Sex Behav"},{"key":"ref15","volume-title":"Qualitative research analysis. Nottingham: The NIHR RDS for the east midlands\/Yorkshire and the Humber","author":"Lacey","year":"2007"},{"key":"ref16","first-page":"72","article-title":"Framework analysis: a qualitative methodology for applied policy research","volume":"4","author":"Srivastava","year":"2009","journal-title":"JOAAG"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1186\/1471-2288-13-117","article-title":"Using the framework method for the analysis of qualitative data in multi-disciplinary health research","volume":"13","author":"Gale","year":"2013","journal-title":"BMC Med Res Methodol"},{"key":"ref18","volume-title":"The SAGE handbook of qualitative data analysis","author":"Flick","year":"2013"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1002\/nur.21768","article-title":"Characteristics of qualitative descriptive studies: a systematic review","volume":"40","author":"Kim","year":"2017","journal-title":"Res Nurs Health"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"2333393617742282","DOI":"10.1177\/2333393617742282","article-title":"Employing a qualitative description approach in health care research","volume":"4","author":"Bradshaw","year":"2017","journal-title":"Glob Qual Nurs Res"},{"key":"ref21","volume-title":"Research design: qualitative, quantitative, and mixed methods approaches","author":"Creswell","year":"2018"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"e0191191","DOI":"10.1371\/journal.pone.0191191","article-title":"Long lasting insecticidal bed nets ownership, access and use in a high malaria transmission setting before and after a mass distribution campaign in Uganda","volume":"13","author":"Wanzira","year":"2018","journal-title":"PLoS One"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"578","DOI":"10.1371\/journal.pone.0210578","article-title":"Low use of long-lasting insecticidal nets for malaria prevention in south-Central Ethiopia: a community-based cohort study","volume":"14","author":"Solomon","year":"2019","journal-title":"PLoS One"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1186\/s12936-023-04540-3","article-title":"Durability of long-lasting insecticidal nets (LLINs) in Ethiopia","volume":"22","author":"Hiruy","year":"2023","journal-title":"Malar J"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"1303","DOI":"10.1186\/s12889-019-7692-2","article-title":"Barriers of persistent long-lasting insecticidal nets utilization in villages around Lake Tana, Northwest Ethiopia: a qualitative study","volume":"19","author":"Malede","year":"2019","journal-title":"BMC Public Health"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1093\/trstmh\/trw019","article-title":"Effects of environmental factors and storage conditions on the performance of Olyset\u00ae plus against sand flies in WHO cone bioassays","volume":"110","author":"Karaku\u015f","year":"2016","journal-title":"Trans R Soc Trop Med Hyg"},{"key":"ref27","doi-asserted-by":"publisher","first-page":"371","DOI":"10.4269\/ajtmh.19-0249","article-title":"Quantifying seasonal variation in insecticide-treated net use among those with access","volume":"101","author":"Koenker","year":"2019","journal-title":"Am J Trop Med Hyg"},{"key":"ref28","volume-title":"Malaria elimination strategic plan: 2021\u20132025","year":"2020"},{"key":"ref29","volume-title":"National malaria elimination roadmap","year":"2017"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1561037\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,21]],"date-time":"2025-08-21T05:28:17Z","timestamp":1755754097000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2025.1561037\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,21]]},"references-count":29,"alternative-id":["10.3389\/fpubh.2025.1561037"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2025.1561037","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8,21]]},"article-number":"1561037"}}