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ITNs: other and dk brands classification [message #22736]

Wed, 28 April 2021 07:45

Thiago Melo
Messages: 5
Registered: April 2021

Member

Hello,

We are having some trouble matching published results for use of mosquito nets by children. More specifically:

Indicator: Number of de facto children under age 5 who reported sleeping under an ITN the night before the survey (hv103 = 1 & hml16 in 0:4 & hml12 in 1:2)
Surveys: Cameroon, 2018 and Nigeria, 2018
Dataset: PR
Problem: when we cross tabulate hml7 and hml12, we can see that most people who slept under "other brand" (code 96) and "don't know brand" (code 98) are also classified as someone who slept under "only treated (itn) nets".

Question: how are they being classified as ITNs?

Thank you in advance

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Re: ITNs: other and dk brands classification [message #22759 is a reply to message #22736]

Mon, 03 May 2021 08:52

Bridgette-DHS
Messages: 2801
Registered: February 2013

Senior Member

Following is a response from DHS Lead Malaria Research Analyst, Cameron Taylor:

Thank you for your question. As part of the household questionnaire, we ask questions about the brand of net, where the household obtained the net, if the net was used etc. During the interview there are households that do not know the brand of their net and/or the interviewer was not able to determine the brand based on the net tag. However, if the household states that they obtained the net as part of a mass distribution campaign or from a health care facility we are confident that the net is some type of ITN (though we don't know the exact brand). See variables hml22 and hml23. As part of the recoding process we recategorize the net as an ITN even though we don't know the exact brand.

Hopefully this clears up confusion in the dataset.

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Re: ITNs: other and dk brands classification [message #22769 is a reply to message #22759]

Tue, 04 May 2021 14:11

Thiago Melo
Messages: 5
Registered: April 2021

Member

Thank you very much for the answer. It does help a lot.

Two further questions:

1) Was this applied for all countries?
For Senegal 2018, it appears that even those obtained in campaigns were classified as untreated according to hml12.

2) Do you classify then as ITNs according to the more recent definition (long lasting insecticidal nets) or according to the older definition of ITNs (that include soaking, etc.)?
Take Senegal 2017 as an example. If the net was obtained in a campaign or health facility, should it be classified as treated in hml12 automatically, or should we take into account when it was received (prior to 12 months) in order to consider it as treated?

Thank you in advance.

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Re: ITNs: other and dk brands classification [message #22803 is a reply to message #22769]

Thu, 13 May 2021 07:01

Bridgette-DHS
Messages: 2801
Registered: February 2013

Senior Member

Following is another response from DHS Lead Malaria Research Analyst, Cameron Taylor:

Yes the reclassification/recoding of nets that were obtained as part of a mass distribution campaign as ITNs is a new change that occurred around 2018-ish. In total this isn't a large portion of the nets. Senegal 2018 might not have instituted this recoding change before it was released.

To answer your second question, the timing of when the household obtained the net doesn't dictate if it is a treated net or not. The 12 months you are citing is about retreatment of nets using chemical packets. Prior to 2018 the definition of an ITN was the following: An insecticide-treated net (ITN) is a factory-treated net that does not require any further treatment (LLIN) or a net that has been soaked with insecticide within the past 12 months.

As part of questionnaire changes in DHS8 we dropped questions on retreatment of mosquito nets because bednets that require annual retreatment and the products used for retreatment are no longer distributed, so the distinction between ITNs and LLINs is no longer meaningful. https://blog.dhsprogram.com/dhs-7-malaria-indicators/
Now we just base the definition of an ITN on a factory-treated net that does not require any further treatment. This is based on brand. You can see the brand of ITNs in the questionnaires at the back of the final report. We also include a footnote about the definition of an ITN in both the tables and in the figures in the final report.

You can read more information about the ITN indicator definitions on page 11 https://www.malariasurveys.org/documents/Household%20Survey% 20Indicators%20for%20Malaria%20Control_FINAL.pdf

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