Fabric integrity, net type and risk index predicts attrition of insecticide-treated nets: evidence from a community durability trial of piperonyl butoxide (PBO) nets in Tanzania

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dc.contributor.authorMvungi, Nolvin
dc.contributor.authorOlukayode, Odufuwa
dc.contributor.authorRuzige, Philipo
dc.contributor.authorMuganga, Joseph
dc.contributor.authorMmasi, Dorin
dc.contributor.authorMachange, Jane
dc.contributor.authorKamande, Dismas
dc.contributor.authorMadumla,Edith
dc.contributor.authorMoore, Jason
dc.contributor.authorMwema, Mwema
dc.contributor.authorMoore, Sarah
dc.contributor.authorMbuba, Emmanuel
dc.date.accessioned2025-12-23T06:39:15Z
dc.date.issued2025-11-26
dc.description2: Zero Hunger 3: Good Health and Well-being 11: Sustainable Cities and Communities
dc.description.abstractThe fabric integrity of insecticide-treated nets (ITNs) deteriorates over time during household use, often leading households to discard or stop using damaged nets. This study quantified the extent to which net loss from households is attributable to declining fabric integrity, accounting for variation in user behaviour and environmental conditions. Methods This secondary analysis used data from an ITN durability trial in Bagamoyo, Tanzania. A total of 2,514 ITNs (three pyrethroid-PBO and one pyrethroid-only) distributed among 1,509 households were included because they had the outcome of interest (attrition). Fabric integrity was classified as good, damaged, or too-torn according to WHO ITN guidelines and assessed at 12-month intervals. The association between fabric integrity and net attrition over the subsequent 12 months was evaluated using an adjusted logistic regression model, accounting for net type, household risk index, household size, and age of the household head as fixed effects, with household as a random effect. Results Attrition increased over time, from 20% at one year to 53% at two years, and 83% at three years post-distribution, and it was associated with net type, household risk index, household size, and age of the household head. Damaged ITNs at one year were more likely to be lost by year two. Compared to nets in good condition, damaged nets had higher odds of attrition (OR: 1.73, 95% CI: 1.06-2.82), and too-torn nets were at greater risk (OR: 9.82, 95% CI: 5.87-16.4). Similar patterns were observed between years two and three (damaged: OR =1.55, 95% CI: 0.83-2.90; too- torn: OR=11.7, 95% CI: 6.16-22.3).ACCEPTED MANUSCRIPTARTICLE IN PRESS ARTICLE IN PRESSConclusion Fabric integrity was the main driver of rapid ITN attrition and the strongest predictor of loss. Damaged nets were approximately twice as likely to be discarded after one year and at least ten times more likely to be lost in years two and three. These findings highlight the importance of promoting proper net care practices and procuring durable nets that withstand harsh household conditions, ensuring sustained population coverage.
dc.identifier.urihttps://doi.org/10.1186/s1293
dc.identifier.urihttps://dspace.nm-aist.ac.tz/handle/123456789/3530
dc.language.isoen
dc.publisherMalaria Journal
dc.subjectInsecticide-treated nets: ITN: fabric integrity: attrition: piperonyl butoxide: household risk index: Tanzania
dc.titleFabric integrity, net type and risk index predicts attrition of insecticide-treated nets: evidence from a community durability trial of piperonyl butoxide (PBO) nets in Tanzania
dc.typeArticle

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