Nutritional Advice El Mondo
Objectives:
Insecticide-treated bed nets (ITNs) are recommended for use by 3.4 billion people at risk of malaria world-wide. Policy makers rely on measurements of ITN use to optimize malaria prevention efforts. Self-reports are the most common means of assessing ITN use, but self-reports may be biased in a way that reduces their reliability as a proxy for ITN adherence.
The aim of this review article is to compare self-reported and two methods which are more objective measures of ITN use to explore whether self-reports overestimate actual ITN adherence.
Study design:
This review article included 16 articles, published between 1989 and 2014. All 16 studies employed a cross-sectional design to assess ITN use and therefore are of “low quality” according to the GRADE system for grading evidence.
Results and conclusions:
The investigators found that self-reported insecticide-treated bed nets use was 8 percentage points [95% CI = 3 to 13, I2 = 92.2%] higher than objectively measured insecticide-treated bed nets use, representing a 13.6% overestimation relative to the proportion measured as adherent to insecticide-treated bed nets use by objective measures.
The investigators found wide variations in the discrepancies between self-reports and objective measures were unable to be explained using stratified analyses of variables including location, year of publication, seasonality and others.
The investigators concluded self-reports overestimate insecticide-treated bed nets adherence relative to objectively measured insecticide-treated bed nets use by 13.6% and do so in an unpredictable manner that raises questions about the reliability of using self-reported ITN use alone as a surveillance tool and a guide for making policy decisions.
Original title:
Quantifying bias in measuring insecticide-treated bednet use: meta-analysis of self-reported vs objectively measured adherence by Krezanoski PJ, Bangsberg DR and Tsai AC.
Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5878861/
Additional information of El Mondo:
Find more information/studies on food fortification/malnutrition and study design/meta-analysis/significant right here.