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Table 2 Factors influencing bed net ownership and use among under-five children from a multilevel model (N = 2372a)

From: Predictors of mosquito bed net use among children under-fives in Ghana: a multilevel analysis of the 2019 malaria indicator survey

Characteristics

 

Adjusted model

Unadjusted model

Single level model

Multilevel (household)

Multilevel (community)

COR [95% CI]

P-value

AOR [95% CI]

P-value

AOR [95% CI]

P-value

AOR [95% CI]

P-value

Number of under 5 children in household

 1

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

 2

1.06 [0.84, 1.33]

0.644

0.84 [0.66, 1.09]

0.187

0.82 [0.59, 1.15]

0.261

0.78 [0.61, 0.99]

0.045

 3 + 

0.46 [0.31, 0.68]

 < 0.001

0.37 [0.27, 0.51]

 < 0.001

0.38 [0.23, 0.64]

 < 0.001

0.34 [0.21, 0.54]

 < 0.001

Sex of child

 Male

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

 Female

1.15 [0.94, 1.42]

0.172

1.23 [0.99, 1.53]

0.056

1.23 [0.99, 1.53]

0.064

1.20 [0.95, 1.51]

0.121

Child’s age

 0

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

 1

1.23 [0.96, 1.58]

0.108

1.11 [0.79, 1.57]

0.533

1.17 [0.83, 1.64]

0.378

1.08 [0.81, 1.43]

0.611

 2

1.00 [0.72, 1.37]

0.980

0.87 [0.61, 1.25]

0.459

0.89 [0.65, 1.21]

0.460

0.86 [0.60, 1.22]

0.393

 3

0.97 [0.71, 1.32]

0.830

0.91 [0.65, 1.27]

0.585

0.90 [0.65, 1.24]

0.516

0.88 [0.64, 1.20]

0.414

 4

0.81 [0.60, 1.08]

0.147

0.69 [0.49, 0.99]

0.042

0.70 [0.50, 0.98]

0.035

0.64 [0.46, 0.89]

0.008

Education

 No education

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

 Primary

1.11 [0.67, 1.84]

0.696

1.12 [0.77, 1.63]

0.556

1.08 [0.65, 1.78]

0.775

1.07 [0.59, 1.94]

0.821

 Secondary

0.98 [0.62, 1.56]

0.933

1.26 [0.88, 1.80]

0.202

1.20 [0.73, 1.97]

0.477

1.29 [0.72, 2.32]

0.385

 Higher

0.65 [0.30, 1.40]

0.270

1.34 [0.74, 2.44]

0.335

1.29 [0.53, 3.16]

0.581

1.26 [0.54, 2.90]

0.592

Respondents age

  < 25

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

 25–34

0.82 [0.57, 1.17]

0.262

1.13 [0.82, 1.55]

0.449

1.07 [0.71, 1.60]

0.759

1.16 [0.72, 1.88]

0.534

 35–44

0.84 [0.56, 1.26]

0.390

1.25 [0.87, 1.80]

0.234

1.23 [0.76, 1.97]

0.397

1.30 [0.72, 2.36]

0.389

 45 + 

0.65 [0.32, 1.35]

0.249

0.98 [0.53, 1.80]

0.938

1.15 [0.50, 2.64]

0.735

1.01 [0.44, 2.35]

0.978

Region

 Western

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

 Central

0.58 [0.33, 1.04]

0.068

0.68 [0.44, 1.05]

0.084

0.68 [0.32, 1.42]

0.306

0.78 [0.40, 1.52]

0.468

 Greater Accra

0.17 [0.09, 0.31]

 < 0.001

0.27 [0.16, 0.45]

 < 0.001

0.22 [0.11, 0.47]

 < 0.001

0.27 [0.14, 0.53]

 < 0.001

 Volta

0.83 [0.44, 1.54]

0.544

0.71 [0.42, 1.22]

0.217

0.69 [0.30, 1.57]

0.380

0.97 [0.50, 1.89]

0.923

 Eastern

0.35 [0.16, 0.77]

0.009

0.44 [0.28, 0.70]

 < 0.001

0.42 [0.21, 0.85]

0.015

0.48 [0.24, 0.96]

0.039

 Ashanti

0.55 [0.29, 1.02]

0.058

0.62 [0.39, 0.96]

0.034

0.57 [0.30, 1.08]

0.086

0.69 [0.36, 1.34]

0.276

 Brong Ahafo

0.78 [0.39, 1.56]

0.477

0.74 [0.47, 1.16]

0.190

0.68 [0.35, 1.30]

0.240

0.96 [0.46, 2.01]

0.910

 Northern

0.39 [0.22, 0.68]

0.001

0.39 [0.24, 0.63]

 < 0.001

0.34 [0.16, 0.73]

0.005

0.45 [0.21, 0.97]

0.041

 Upper east

0.83 [0.43, 1.62]

0.590

0.61 [0.37, 0.99]

0.043

0.59 [0.27, 1.30]

0.190

0.72 [0.36, 1.44]

0.349

 Upper west

1.63 [0.91, 2.89]

0.097

1.40 [0.83, 2.35]

0.205

1.58 [0.75, 3.35]

0.229

1.57 [0.77, 3.21]

0.214

Residence

 Urban

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

 Rural

2.54 [1.83, 3.53]

 < 0.001

1.57 [1.20, 2.06]

0.001

1.58 [1.10, 2.26]

0.012

1.88 [1.24, 2.84]

0.003

Religion

 Christian

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

 Islam

0.85 [0.59, 1.23]

0.378

0.96 [0.69, 1.36]

0.837

0.90 [0.58, 1.39]

0.622

1.19 [0.77, 1.86]

0.434

 Other

1.70 [0.92, 3.12]

0.088

1.46 [0.77, 2.76]

0.243

1.54 [0.66, 3.63]

0.318

1.45 [0.74, 2.82]

0.277

Wealth

 Poorest/poor

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

 Middle

0.63 [0.45, 0.89]

0.008

0.52 [0.36, 0.74]

 < 0.001

0.44 [0.26, 0.76]

0.003

0.53 [0.32, 0.88]

0.014

 Rich/richest

0.36 [0.24, 0.53]

 < 0.001

0.40 [0.26, 0.60]

 < 0.001

0.34 [0.19, 0.61]

 < 0.001

0.47 [0.26, 0.85]

0.013

Access to water

 Improved

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

 Unimproved

1.66 [1.23, 2.24]

0.001

1.22 [0.93, 1.59]

0.150

1.26 [0.89, 1.78]

0.199

1.35 [0.94, 1.94]

0.102

Access to toilet facility

 Improved

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

 Unimproved

0.58 [0.41, 0.80]

0.001

0.78 [0.61, 1.01]

0.056

0.77 [0.52, 1.13]

0.180

0.72 [0.50, 1.05]

0.088

Main floor material

 Cement

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

 Floor carpet

0.64 [0.46, 0.89]

0.009

0.96 [0.70, 1.31]

0.796

0.94 [0.60, 1.48]

0.805

0.87 [0.54, 1.41]

0.582

 Other

0.90 [0.59, 1.37]

0.629

0.93 [0.69, 1.27]

0.661

0.91 [0.61, 1.37]

0.651

0.91 [0.57, 1.45]

0.696

Main wall material

 Cement blocks/bricks

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

 Wood

2.02 [1.05, 3.87]

0.035

2.85 [1.34, 6.05]

0.006

2.52 [0.85, 7.47]

0.095

3.21 [1.18, 8.74]

0.022

 Other

1.57 [1.04, 2.36]

0.033

1.16 [0.86, 1.58]

0.331

1.17 [0.73, 1.88]

0.504

1.07 [0.64, 1.79]

0.807

Age of household head

  < 25

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

 25–34

0.51 [0.24, 1.11]

0.090

0.70 [0.37, 1.30]

0.257

0.80 [0.34, 1.88]

0.605

0.62 [0.23, 1.64]

0.333

 35–44

0.49 [0.22, 1.09]

0.078

0.72 [0.38, 1.36]

0.313

0.77 [0.31, 1.88]

0.562

0.59 [0.19, 1.82]

0.358

 45 + 

0.44 [0.21, 0.92]

0.029

0.55 [0.30, 1.01]

0.055

0.59 [0.25, 1.41]

0.233

0.47 [0.18, 1.23]

0.122

Covered by health insurance

 No

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

 Yes

1.08 [0.85, 1.38]

0.515

1.18 [0.94, 1.48]

0.157

1.13 [0.82, 1.56]

0.442

1.24 [0.94, 1.63]

0.136

Heard malaria messages on radio

 No

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

 Yes

0.83 [0.60, 1.14]

0.255

0.83 [0.63, 1.08]

0.161

0.80 [0.58, 1.12]

0.202

0.92 [0.66, 1.27]

0.605

Heard malaria messages on TV

 No

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

 Yes

0.68 [0.52, 0.89]

0.006

1.16 [0.89, 1.52]

0.270

1.28 [0.90, 1.82]

0.162

1.23 [0.87, 1.73]

0.237

Number of persons per mosquito net

  ≤ 2 persons per net

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

1.00 [reference]

 

  > 2 persons per net

0.55 [0.42, 0.72]

 < 0.001

0.57 [0.45, 0.72]

 < 0.001

0.48 [0.35, 0.64]

 < 0.001

0.52 [0.37, 0.73]

 < 0.001

Random effect parameter analysis

 Child level variance

  

π2 /3 ≈ 3.29

 

π2 /3 ≈ 3.29

 

π2 /3 ≈ 3.29

 

 Household level variance (95% CI)

    

0.63 [0.41, 0.98]

 

-

 

 Community level variance (95% CI)

    

-

 

0.57 [0.33, 0.96]

 

 AIC

  

2732.45

 

2666.144

 

2657.185

 

 BIC

  

2969.081

 

2908.547

 

2899.588

 

 AUROC (95% CI)

  

73.9 [71.8, 75.9]

 

79.7 [77.8, 81.5]

 

80.3 [78.5, 82.1]

 
  1. COR crude odds ratio, AOR adjusted odds ratio, CI Confidence interval, AIC Akaike information criteria, BIC Bayesian information criteria, AUROCC Area under the receiver operating characteristics curve
  2. aRestricted to households with at least one bed net
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