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The effect of holes in long-lasting insecticidal nets on malaria in Malawi: results from a case–control study

Overview of attention for article published in Malaria Journal, October 2017
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Title
The effect of holes in long-lasting insecticidal nets on malaria in Malawi: results from a case–control study
Published in
Malaria Journal, October 2017
DOI 10.1186/s12936-017-2033-3
Pubmed ID
Authors

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

Abstract

Long-lasting insecticidal nets (LLINs) are a cornerstone of malaria prevention. Holes develop in LLINs over time and compromise their physical integrity, but how holes affect malaria transmission risk is not well known. After a nationwide mass LLIN distribution in July 2012, a study was conducted to assess the relationship between LLIN damage and malaria. From March to September 2013, febrile children ages 6-59 months who consistently slept under LLINs (every night for 2 weeks before illness onset) were enrolled in a case-control study at Machinga District Hospital outpatient department. Cases were positive for Plasmodium falciparum asexual parasites by microscopy while controls were negative. Digital photographs of participants' LLINs were analysed using an image-processing programme to measure holes. Total hole area was classified by quartiles and according to the World Health Organization's proportionate hole index (pHI) cut-offs [< 79 cm(2) (good), 80-789 cm(2) (damaged), and > 790 cm(2) (too torn)]. Number of holes by location and size, and total hole area, were compared between case and control LLINs using non-parametric analyses and logistic regression. Of 248 LLINs analysed, 97 (39%) were from cases. Overall, 86% of LLINs had at least one hole. The median number of holes of any size was 9 [interquartile range (IQR) 3, 22], and most holes were located in the lower halves of the nets [median 7 (IQR 2, 16)]. There were no differences in number or location of holes between LLINs used by cases and controls. The median total hole area was 10 cm(2) (IQR 2, 125) for control LLINs and 8 cm(2) (IQR 2, 47) for case LLINs (p = 0.10). Based on pHI, 109 (72%) control LLINs and 83 (86%) case LLINs were in "good" condition. Multivariable modeling showed no association between total hole area and malaria, controlling for child age, caregiver education, and iron versus thatched roof houses. LLIN holes were not associated with increased odds of malaria in this study. However, most of the LLINs were in relatively good condition 1 year after distribution. Future studies should examine associations between LLIN holes and malaria risk with more damaged nets.

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 61 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 61 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 12 20%
Researcher 11 18%
Student > Ph. D. Student 10 16%
Other 4 7%
Student > Bachelor 3 5%
Other 8 13%
Unknown 13 21%
Readers by discipline Count As %
Medicine and Dentistry 10 16%
Social Sciences 6 10%
Agricultural and Biological Sciences 5 8%
Nursing and Health Professions 4 7%
Biochemistry, Genetics and Molecular Biology 4 7%
Other 15 25%
Unknown 17 28%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 04 October 2017.
All research outputs
#19,305,317
of 24,580,204 outputs
Outputs from Malaria Journal
#5,042
of 5,786 outputs
Outputs of similar age
#238,610
of 327,618 outputs
Outputs of similar age from Malaria Journal
#112
of 121 outputs
Altmetric has tracked 24,580,204 research outputs across all sources so far. This one is in the 18th percentile – i.e., 18% of other outputs scored the same or lower than it.
So far Altmetric has tracked 5,786 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.9. This one is in the 9th percentile – i.e., 9% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 327,618 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 22nd percentile – i.e., 22% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 121 others from the same source and published within six weeks on either side of this one. This one is in the 2nd percentile – i.e., 2% of its contemporaries scored the same or lower than it.