Table 1 Distribution of key findings

Admasie (2018) [22]

• Access to ITN (91.0%)

• Used previous night (37.2%)

• Observed ITN mounted (42.9%)

• Maternal and/or caregivers' age

• Family size and sleeping space

• Inadequate knowledge on the proper use of ITN

• Factors that influence ITN in under-5 were age of caretakers 31–44 years (AOR = 0.03, 95% CI 0.01–0.07), maternal age ≥ 45 years (AOR = 0.05, 95% CI 0.01–0.58), family size ≤ 5 members, (AOR = 11.23, 95% CI 4.31–29.24) and sleeping space ≥ 2, (AOR = 13.59, 95% CI 4.40– 41)

• Used ITNs for unintended purposes like raping over mattresses to protect from bugs, for grain and fruit carrying, to spread grains for the sunshine, room curtains, and fishing

Alemu (2018) [23]

• Accessed ITN through mass distribution (99.2%)

• Used ITN the previous night (91.9%, CI = 88.5–95%)

• prioritize children in ITN (91.9%)

• Perceived malaria risk of household head

• Houses built from cement

• Knowledge of the treatment of ITN

• Household heads determine the use of ITN (59.2%)

• Houses made from cement are 97.7% times less odd to use ITN

• People who do not know about malaria transmission are 90.8% times less likely to use ITN

• Some respondents (93.1%) did not treat the ITN

Finlay (2017) [25]

• Mean ITN ownership was 2 per household

• Received campaign ITN (70.1%)

• Utilisation (84.2%)

• Mass media and pre-campaign messages

• Receiving post-campaign visits

• Only 70.1% reported receiving two or more campaign LLINs during the 2019 distribution, as 13% could not have access

• There were critical weaknesses in the household registration and voucher distribution process, including charging "hidden fees"

Fokam (2017) [26]

• ITN ownership (63.5%)

• Slept under ITN the previous night (47.2%)

• Gender, age, and educational level of the household head

• ITN density in households

• Weather suitability of ITN like heat, suffocation

• ITN related factors like torn

• There was an association between ITN use and gender, educational levels of household head, environmental factors, and ITN density

• The primary sources of ITN were the free mass distribution (87.7%), antenatal clinic (7%), gifts (3.3%), and purchases (2.1%)

Moon (2016) [27]

• Households' ownership of ITN (64.3%)

• Under-5 sleep under ITN in 2010 (50%) and in 2014 (60%)

• Households headed by females and or having higher education

• Household size

• having electricity, and

• more considerable household monthly income,

• Travel time to a health facility

• Pregnant (58.6%) reported sleeping under ITN the previous night in 2010 compared to 68.4% in 2014

• As travel to health facility increases (1 h), 13% lower odds of sleeping under the ITN (OR 0.87: 95% CI 0.74–1.01, p = 0.07)

• Factors that influence the use of ITN in under-5 children were household size, female-headed households, and having electricity

Moscibrodzki (2018) [28]

• Households' ownership of at least one ITN (40%)

●ITN available to only (27%) of household members

• awareness of ITN benefit

• having under-5 child,

• Household size

• ITN obtained free

• The odds of an ITN correctly used (i.e., to sleep under) after adjusting for potential confounders were significantly lower for those obtained free

• Factors that influence utilization were awareness ITN benefit (OR = 1.72, 95% CI 1.11–2.68, p = 0.02), having under-5 (OR = 1.11 CI 0.99–1.25, p = 0.07), household size (OR = 1.05 CI 1..-1.20, p = 0.05)

• The odds of ITN being correctly used was significantly lower for those obtained free (OR = 0.33, 95% CI 0.21–0.51, p,0.01)

Nkoka (2019) [24]

• ITN use increase from 57.8% (95% CI 56.1–59.4) in 2010 to 69.0% (95% CI 67.4- 70.5) in 2015

• The educational level of the mother

• Residing in a female-headed household

• lack of ITN supply

• There was increased ITN usage among under-5 in the five years

• Residing in a female-headed household living in homes that had poor ITN supply significantly reduced odds of ITN usage

Gonahasa (2018) [30]

• ITN ownership (65.0%)

• Slept under ITN the previous night (39.5%)

• Time since the last campaign

• Household wealth

• Presence of under-5

• Age and gender of household heads

• In Uganda, ITN ownership, coverage, and use were all well below desired targets 2.5–4.5 years after the ITN distribution through a national campaign

• Household wealth and time since the last campaign were the strongest predictors of household ITN ownership

Israel (2018) [31]

• Ownership of at least one ITN (82.9%)

• Under-5 slept under ITN the previous night (58.6%)

• Formal education of caregivers

• knowledge about ITN

• Net color, size

• Free distribution

• The significant sources of information on ITN were mass media (94.2%)

• ITN protects against other insects' bites (99.8%)

• Some believe the free ITN is more effective than the ones purchased

• Some indicated ITN only comes in white color and gets dirty quickly

Simpson Nuwamanya (2018) [29]

• Owned ITN after free distribution (98.8%)

• Use ITN for under-5 (91.9%)

• Gender of household head

• ITN size, shape, worn-out, perceived poor quality, and allergic reaction to chemicals

• Insufficient sleeping space

• Environmental conditions

• Knowledge of household heads

• Ownership of LLIN was very high, and Parasitaemia among the under-5 was very low

• No childhood malaria episodes reported in the home in the last 12 months (OR = 1.69, 95% CI 1.02–2.83) were all associated with ITN use

• Persons who did not sleep under the ITN the previous night indicated lack of sufficient space to hang, perceived poor quality, not having enough ITN

Ruyange (2016) [33]

• Households owned at least one ITN (72.2%)

• Household size

• Employed and or educated mothers

• Children born to a married mother or mother living with a partner,

• Born to a mother who had 1–4 or more than four ANC visits

• Risk factors related to ITN non-use at the individual, household, and community levels include poverty, education, birth spacing, and antenatal clinic attendance

• Protective risk factors for ITN use included households with more than three ITN (0.39 [0.33–0.47]), mothers who attended 1–4 to antenatal clinics during pregnancy (0.45 [0.29–0.69]), more than four antenatal clinic visits during pregnancy (0.39 [0.21–0.70]), mothers married or living with a partner (0.43 [0.36–0.52]), educated mothers (0.77 [0.65–0.91]), and households in higher community wealth quintile (0.71 [0.59–0.84])

Tassew (2017) [21]

• Ownership of at least one ITN (89.9%)

• use ITN the previous night (85.1%)

• Two or more sleeping places

• knowledge that ITN prevents malaria

• Presence of a hanging ITN

• Walls of the house plastered or painted > 12monts ago

• Poor knowledge of the transmission and the symptoms of malaria and vector control measures to prevent malaria were associated with ITN use

• ITN were found to be out of use or in poor repair (30%)

Zalisk (2019) [32]

• Use of ITN were 40.5% in the highest wealth quartile 69.9% in the lowest wealth quartile (p < 0.0001)

• Adequate number of ITN

• Caregivers exposed to malaria information

• Residence

• Wealthy quartiles

• Caregiver exposure to ITN-related malaria messages improves the use of ITNs in under-5

• significant associations were not found between ITN use and sex or age of the child, caregivers' educational attainment or household ownership of a television