Coverage and system efficiencies of insecticide-treated nets in Africa from 2000 to 2017

Elife. 2015 Dec 29:4:e09672. doi: 10.7554/eLife.09672.

Abstract

Insecticide-treated nets (ITNs) for malaria control are widespread but coverage remains inadequate. We developed a Bayesian model using data from 102 national surveys, triangulated against delivery data and distribution reports, to generate year-by-year estimates of four ITN coverage indicators. We explored the impact of two potential 'inefficiencies': uneven net distribution among households and rapid rates of net loss from households. We estimated that, in 2013, 21% (17%-26%) of ITNs were over-allocated and this has worsened over time as overall net provision has increased. We estimated that rates of ITN loss from households are more rapid than previously thought, with 50% lost after 23 (20-28) months. We predict that the current estimate of 920 million additional ITNs required to achieve universal coverage would in reality yield a lower level of coverage (77% population access). By improving efficiency, however, the 920 million ITNs could yield population access as high as 95%.

Keywords: Bayesian compatment model; ITN; LLIN; Malaria; epidemiology; global health; human.

MeSH terms

  • Africa
  • Disease Transmission, Infectious / prevention & control*
  • Health Services Research*
  • Insecticide-Treated Bednets / statistics & numerical data*
  • Malaria / epidemiology
  • Malaria / prevention & control*
  • Mosquito Control / methods*