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As the efficacy of LLINs depends in part on their physical integrity, this metric was quantified for Olyset\u00ae Nets post mass-distribution, in addition to net use, care and handling practices and other risk factors associated with net physical integrity.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>Nets were collected during a cross-sectional net evaluation, nine months after the Magude project commenced, which was 2 years after the nets were distributed by the National Malaria Control Programme (NMCP). The physical integrity of the nets was assessed by counting and sizing the holes at different positions on each net. A structured questionnaire was administered to assess how the selected net was used and treated (care, wash and repair). Net bio-efficacy was assessed following the standard World Health Organization (WHO) cone bioassay procedures.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Out of the 170 Olyset\u00ae Nets included in the analysis, 63.5% had been used the night before. The main reason for not using a net was the notion that there were no mosquitoes present. The average number of people using each net was 1.79. Two thirds of the nets had only been washed once or twice since distribution. Most nets (80.9%) were holed and 18% were torn, but none of the risk factors were significantly associated with net integrity, except for presence of mice in the household. Less than half of the participants noticed holes in holed nets, and of those only 38.6% attempted to repair those. None of the six nets that were tested for bio-efficacy passed the WHO threshold of 80% mosquito mortality.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Overall the majority of Olyset\u00ae Nets were in serviceable condition two years post-distribution, but their insecticidal effect may have been lost. This study\u2014together with previous evidence on suboptimal access to and use of LLINs in Magude district\u2014highlights that LLINs as an intervention could have been optimized during the Magude project to achieve maximum intervention impact.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12936-024-04910-5","type":"journal-article","created":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T03:02:02Z","timestamp":1711508522000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["An evaluation of LLIN physical integrity and population attitudes towards net use, care and handling during the Magude project in southern Mozambique"],"prefix":"10.1186","volume":"23","author":[{"given":"Celso","family":"Alafo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lucia Fernandez","family":"Montoya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helena","family":"Mart\u00ed-Soler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mara","family":"M\u00e1quina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arlindo","family":"Malheia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charfudin","family":"Sacoor","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Paula","family":"Ab\u00edlio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dulcisaria","family":"Marrenjo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nelson","family":"Cuamba","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beatriz","family":"Galatas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pedro","family":"Aide","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francisco","family":"Sa\u00fate","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Krijn P.","family":"Paaijmans","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2024,3,27]]},"reference":[{"key":"4910_CR1","volume-title":"World malaria report 2022","author":"WHO","year":"2022","unstructured":"WHO. 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Study participants (\u2265\u200915 years old) were informed about the purpose of the study in the local language (Shangana or Portuguese) using a written script that contained information on the study objectives, study risks and benefits, highlighting their right to withdraw from the study at any time during the study. Participants were enrolled when written informed consent was provided. The LLIN that was collected in each household was replaced by a new WHO-approved LLIN. All human data were de-identified to protect individual identity.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors have read the journal\u2019s policy and have the following competing interests: Abt Associates Inc. provided support in the form of salaries for author NC, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"87"}}