Quantifying Bias in Measuring Insecticide-Treated Bednet use: Meta-analysis of Self-Reported vs Objectively Measured Adherence

Paul J. Krezanoski, Zuckerberg San Francisco General Hospital
David R. Bangsberg, OHSU-PSU School of Public Health
Alexander C. Tsai, Center for Global Health, Massachusetts General Hospital, Boston, Massachusetts, USA

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Insecticide-treated bednets (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. This meta-analysis compared self-reported and two methods which are more objective measures of ITN use to explore whether self-reports overestimate actual ITN adherence.