Pooled prevalence of insecticide-treated nets utilization among pregnant women in Easten Africa: A Systematic review and meta-analysis

Background The World Health Organization (WHO) recommends insecticide-treated nets (ITNs) as a key strategy for malaria prevention during pregnancy. However, ITN usage among pregnant women in malaria-endemic regions, especially East Africa, remains low and inconsistent. To tackle this issue, a systematic review and meta-analysis were conducted to assess individual studies and provide a reliable estimate of ITN utilization in the region. The study also analyzes country-level trends, allowing for comparisons between nations. Ultimately, the review aims to determine the pooled prevalence of ITN use among pregnant women in East Africa. Methods We conducted a thorough literature search to identify studies on insecticide-treated bed net (ITN) utilization among pregnant women in East Africa. Our search included databases such as Medline/PubMed, Embase, Scopus, Science Direct, Epistemonikos, Google Scholar, and manual Google searches. We adhered to the PRISMA guidelines and applied predefined inclusion criteria to screen the studies. Heterogeneity was assessed using the Cochrane Q test and I² statistic. A random effects model was employed to estimate the pooled prevalence of ITN utilization among pregnant women in the region. Results The results from these 35 studies indicated that the overall prevalence of insecticide-treated net (ITN) utilization among pregnant women in East Africa was 51.69% (95% CI: 42.0%-61.0%). Subgroup analysis showed that South Sudan had the highest prevalence of ITN utilization at 89.0% Conclusions This review highlighted that a considerable number of pregnant women in East Africa are not utilizing insecticide-treated nets (ITNs). Furthermore, there is notable variation in ITN usage among pregnant women across different East African countries. These findings underscore the necessity for targeted, multicenter interventions to address these disparities.