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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%.

Original publication

DOI

10.7554/eLife.09672

Type

Journal article

Journal

Elife

Publication Date

29/12/2015

Volume

4

Keywords

Bayesian compatment model, ITN, LLIN, Malaria, epidemiology, global health, human, Africa, Disease Transmission, Infectious, Health Services Research, Insecticide-Treated Bednets, Malaria, Mosquito Control