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

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) prop...

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Bibliographic Details
Published in:Malaria journal 2017-10, Vol.16 (1), p.405-405, Article 405
Main Authors: Vanden Eng, Jodi L, Mathanga, Don P, Landman, Keren, Mwandama, Dyson, Minta, Anna A, Shah, Monica, Sutcliffe, James, Chisaka, Joseph, Lindblade, Kim A, Steinhardt, Laura
Format: Article
Language:English
Subjects:
Analysis
Bed net
Hole index
Human diseases
Image analysis
Image processing
Insecticides
Malaria
Measurement
Methodology
Methods
Nets
Organizations
Pesticides
Physical durability
Software
Vector control
Vector-borne diseases
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Summary: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. 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. The WHOPES method and image analysis resulted in similar estimates of total hole counts, each with a median of 10 (inter-quartile range (IQR) 4-24 and 4-23, respectively; p = 0.004); however, estimated hole areas were significantly larger using the WHOPES method (median 162 cm , IQR 28-793) than image analysis (median 13 cm , IQR 3-101; p 
ISSN:1475-2875
1475-2875
DOI:10.1186/s12936-017-2049-8