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Assessing bed net damage: comparisons of three measurement methods for estimating the size, shape, and distribution of holes on bed nets

Article scientifique 2017 Anglais

Résumé

BACKGROUND: Measuring the physical condition of long-lasting insecticidal nets (LLINs) under field conditions is of great importance for malaria control programmes to guide decisions on how frequently to replace LLINs. Current guidelines by the World Health Organization Pesticide Evaluation Scheme (WHOPES) propose a proportionate hole index (pHI) for assessing LLIN condition by counting the number of holes the size of a thumb, fist, head, and larger than a head. However, this method does not account for irregular hole shapes or exact hole sizes which could result in inaccurate decisions about when to replace LLINs. METHODS: LLINs were collected during a 2013 health facility-based malaria case control study in Machinga District, Malawi. To evaluate the accuracy of the pHI, the physical condition of 277 LLINs was estimated by the WHOPES method and then compared with two more thorough measurement methods: image analysis of digital photographs of each LLIN side; and for 10 nets, ruler measurements of the length, width, and location of each hole. Total hole counts and areas per net were estimated by each method, and detailed results of hole shapes and composite pictures of hole locations were generated using image analysis. RESULTS: , IQR 3-101; p < 0.0001). The WHOPES method classified fewer LLINs in 'good condition' compared to image analysis (42% vs 74%). The ruler method detected significantly more holes than image analysis did (p = 0.002) in 10 LLINs; however, total hole area was not significantly different (p = 0.16). Most holes were not circular but roughly 2-5 times longer in one direction. The lower quarter of LLIN sides was found to have the most holes. CONCLUSIONS: The WHOPES method overestimated total hole area, likely because holes are elongated rather than circular, suggesting further adjustments to the pHI formula may be warranted when considering LLIN replacement strategies.

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Eng, J., Mathanga, D., Landman, K., Mwandama, D., Minta, A., Shah, M., SUTCLIFFE, J., Chisaka, J., Lindblade, K., Steinhardt, L. (2017). Assessing bed net damage: comparisons of three measurement methods for estimating the size, shape, and distribution of holes on bed nets. https://doi.org/10.1186/s12936-017-2049-8

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Auteur(s)

Jodi L. Vanden Eng Don P. Mathanga Keren Z. Landman Dyson Mwandama Anna A. Minta Monica P. Shah J. F. SUTCLIFFE Joseph Chisaka Kim A. Lindblade Laura C. Steinhardt

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