PMID- 29017537 OWN - NLM STAT- MEDLINE DCOM- 20180514 LR - 20181202 IS - 1475-2875 (Electronic) IS - 1475-2875 (Linking) VI - 16 IP - 1 DP - 2017 Oct 10 TI - Assessing bed net damage: comparisons of three measurement methods for estimating the size, shape, and distribution of holes on bed nets. PG - 405 LID - 10.1186/s12936-017-2049-8 [doi] LID - 405 AB - 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: 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(2), IQR 28-793) than image analysis (median 13 cm(2), 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. FAU - Vanden Eng, Jodi L AU - Vanden Eng JL AD - Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA. jev8@cdc.gov. FAU - Mathanga, Don P AU - Mathanga DP AD - Malaria Alert Centre, University of Malawi College of Medicine, Blantyre, Malawi. FAU - Landman, Keren AU - Landman K AD - Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA. FAU - Mwandama, Dyson AU - Mwandama D AD - Malaria Alert Centre, University of Malawi College of Medicine, Blantyre, Malawi. FAU - Minta, Anna A AU - Minta AA AD - Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA. AD - Epidemic Intelligence Service, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA. FAU - Shah, Monica AU - Shah M AD - Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA. FAU - Sutcliffe, James AU - Sutcliffe J AD - Entomology Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA. FAU - Chisaka, Joseph AU - Chisaka J AD - Malaria Alert Centre, University of Malawi College of Medicine, Blantyre, Malawi. FAU - Lindblade, Kim A AU - Lindblade KA AD - Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA. FAU - Steinhardt, Laura AU - Steinhardt L AD - Malaria Branch, Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA, 30329, USA. LA - eng GR - U01 CK000135/CK/NCEZID CDC HHS/United States PT - Comparative Study PT - Journal Article DEP - 20171010 PL - England TA - Malar J JT - Malaria journal JID - 101139802 SB - IM MH - Case-Control Studies MH - Insecticide-Treated Bednets/*statistics & numerical data MH - Malawi MH - Mosquito Control/*methods PMC - PMC5635507 OTO - NOTNLM OT - Bed net OT - Hole index OT - Image analysis OT - Malaria OT - Physical durability OT - Vector control EDAT- 2017/10/12 06:00 MHDA- 2018/05/15 06:00 PMCR- 2017/10/10 CRDT- 2017/10/12 06:00 PHST- 2017/06/21 00:00 [received] PHST- 2017/09/30 00:00 [accepted] PHST- 2017/10/12 06:00 [entrez] PHST- 2017/10/12 06:00 [pubmed] PHST- 2018/05/15 06:00 [medline] PHST- 2017/10/10 00:00 [pmc-release] AID - 10.1186/s12936-017-2049-8 [pii] AID - 2049 [pii] AID - 10.1186/s12936-017-2049-8 [doi] PST - epublish SO - Malar J. 2017 Oct 10;16(1):405. doi: 10.1186/s12936-017-2049-8.