Insecticide-treated nets (ITNs) access-use has been pivotal monitoring indicator for malaria prevention and control, particularly in resource limited settings. The objective of the study was to compare ITN access-use based on universal household and population indicators and measures adapted to sleeping spaces. A cross-sectional study was conducted in five districts of Jimma Zone, Ethiopia, March, 2019. 762 HHs were sampled for the survey. Multi-stage followed by simple random sampling used. Monitoring and evaluation reference group’s (MERG’s) indicators were used for measuring ITN access-use. MERG’s indicators are each adapted ITN access-use to sleeping spaces. Household (ownership, saturation and sufficiency) and population access and household members’ status of last night sleeping under ITN compared based on the two models. Differences of estimates of ITN access-use based on the two methods reported as magnitude of over/under estimations, at p-value < 0.05. Based on MERG’s approach, the study revealed household (HH) based indicators as such: HH ownership of at least 1 ITN (92.6%), sufficiency of ITN for every two people in HH (50.3%), and saturation of ITN for every 2 people in HHs with any ITN (54.6%). Moreover, population based indicators were: population with ITN access (P3 = 78.6%), people who slept under ITN previous night (63.0%), people who slept under ITN among who accessed it (73.1%), ITN use-gap (26.9%). Equivalent indicators of HH ownership, sufficiency, saturation, and people accessed at where they actually slept, and people slept under ITN among those accessed at where they slept estimated at 71.3%, 49.4%, 69.3%, 66.3%, and 92.1%, respectively. MERG’s approach over-estimated ownership, people’s access, and behaviour-failures by 21.3%, 12.3%, 19.0%, respectively. Over-estimation occurred for reasons such as many sleeping spaces lack ITN and > 2 people actually slept per sleeping space. MERG’s universal indicators over estimated households and populations ITN access-use as a result of absence of measures capturing access-use values at spaces where people actually slept. Consequently, measures adapted to sleeping contexts revealed potential misdistributions practiced when the existing indicators are in use. Insertion of sleeping spaces into existing approach will be worthwhile and needs to be promoted as it improves curiosity in ITN distribution, produces closer estimates and prevents malaria prevention and control programmes from overlooking access-use challenges.

中文翻译：

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比较基于通用家庭和人口指标的杀虫剂处理蚊帐的使用情况与适用于埃塞俄比亚睡眠空间的措施

驱虫蚊帐 (ITN) 使用情况一直是疟疾预防和控制的关键监测指标，尤其是在资源有限的环境中。该研究的目的是比较基于通用家庭和人口指标以及适应睡眠空间的措施的 ITN 接入使用情况。2019 年 3 月，在埃塞俄比亚 Jimma Zone 的五个地区进行了横断面研究。调查抽样了 762 户家庭。多阶段，然后使用简单的随机抽样。监测和评估参考组 (MERG) 的指标用于衡量 ITN 接入使用情况。MERG 的指标均适用于 ITN 对睡眠空间的访问使用。基于两种模型的家庭（拥有、饱和和充足）和人口访问以及家庭成员昨晚在ITN下睡觉的状态进行了比较。基于两种方法的 ITN 接入使用估计的差异报告为高/低估计的幅度，p 值 < 0.05。根据 MERG 的方法，该研究揭示了基于家庭 (HH) 的指标，例如：HH 拥有至少 1 个 ITN (92.6%)、HH 每两个人的 ITN 充足率 (50.3%) 以及每 2 个 ITN 的饱和度家庭中使用任何 ITN 的人 (54.6%)。此外，基于人口的指标是：使用 ITN 的人口（P3 = 78.6%）、前一晚使用 ITN 的人数（63.0%）、使用 ITN 的人数（73.1%）、ITN 使用差距（26.9 %）。HH 所有权、充足性、饱和度和访问他们实际睡觉的地方的等效指标以及在他们睡觉的地方访问的人中使用 ITN 的人数估计分别为 71.3%、49.4%、69.3%、66.3% 和 92.1% . MERG 的方法分别将所有权、人员访问和行为失败高估了 21.3%、12.3% 和 19.0%。由于许多睡眠空间缺乏 ITN 以及每个睡眠空间实际睡了超过 2 人等原因，出现了高估。由于缺乏衡量人们实际睡觉的空间的接入使用价值的措施，MERG 对估计家庭和人口 ITN 接入使用的通用指标。因此，适用于睡眠环境的措施揭示了在使用现有指标时可能出现的错误分配。将睡眠空间插入现有方法将是值得的，需要推广，因为它提高了对 ITN 分发的好奇心，产生更接近的估计并防止疟疾预防和控制计划忽视获取使用方面的挑战。