Household storm damage limits use of and access to insecticide treated bednets in Mozambique

Background: Cyclone Idai was one of the most destructive cyclones in the Southern Hemisphere. Malaria prevention is not part of cyclone response, but housing damage has been shown to increase malaria risk. Aim: To assess the extent to which housing damage led to insecticide treated net (ITN) damage, thus compounding malaria risk. Subjects and methods: A cross-sectional survey was conducted in Sussundenga village. This analysis focused on household damage and ITN use in the aftermath of Cyclone Idai. Generalised estimating equations logistic regression models were used to identify factors associated with ITN use. Results: Thirty-five percent (104 of 296) of participants reported not sleeping under an ITN the previous night. Sixty-one percent (64 of 104) of participants who reported not sleeping under an ITN indicated lack of access as the reason why. Minor household damage was associated with 0.34 (95% CI: 0.15–0.78) times lower odds of ITN use and destruction was associated with 0.23 (95% CI: 0.11–0.50) times lower odds of ITN use. Conclusion: We found that even minor household damage was associated with 70% decreased odds of ITN use. As severe storms become more frequent due to climate change, this is an area for further research to assist malaria control programs in their success.