# Training of machine learning algorithms for the classification of accelerometer-measured bednet use and related behaviors associated with malaria risk

> **NIH NIH R21** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2024 · $301,881

## Abstract

PROJECT SUMMARY/ABSTRACT
Malaria affects three billion people worldwide. Despite remarkable reductions in malaria incidence over the last
15 years, recent evidence shows that our traditional control tools are weakening. Long-lasting insecticide-treated
bednets (LLINs) are the most widely used tool for malaria prevention and have contributed significantly to de-
creases in malaria incidence, but recent studies suggest that LLINs are either less effective than before or people
are not using them as reported. A rigorous assessment of the timing and circumstances of LLIN use could be
vitally important to regain the initiative in malaria control, but we lack a reliable measure of LLIN use. Current
measurement tools, like self-reported use, are subjective and unable to account for temporal variations in use. I
previously invented an electronic monitor of LLIN use to address these limitations. In my NIAID-funded K23 work
we use these tools to measure LLIN use related to malaria exposure. Most recently, I have pioneered a vastly
improved approach using machine learning algorithms and accelerometer-based sensors to measure LLIN use.
The central rationale for this project is that by leveraging this novel accelerometer LLIN use monitor we can be
more ambitious with our goals for measuring malaria risk related to LLINs. When combined with a carefully
trained machine learning algorithm, I believe that we can accurately classify a far wider range of behaviors than
merely when an LLIN is used. In this study, we will additionally 1) measure if there is someone under the LLIN,
2) determine how many people are under the LLIN, 3) identify interruptions in LLIN use (such as entering or
exiting an LLIN), and 4) characterize who is under the LLIN (e.g. adult versus child). Longitudinal surveillance of
exactly this type of data is crucial to disentangle the role of LLINs in malaria prevention. The immediate goal of
this R21 proposal is to train a comprehensive platform for highly accurate remote monitoring of LLIN use and
other behaviors related to malaria risk. Our approach thus gathers data from the community, trains a machine
learning algorithm and then tests the real-life accuracy of that system. We will pursue our research goal by with
these three aims: 1) gather real-life data about how LLINs are hung and used in the community, 2) train the
machine learning algorithms based off pre-defined protocols informed by actual practice and 3) test the accuracy
of the machine learning algorithms in real-life settings. This high-risk, high-reward proposal represents an inno-
vative approach to answer a pressing question that limits our understanding of how LLINs prevent malaria: when
and how are LLINs used in practice? The long term goal for this novel surveillance platform is to develop a tool
for measuring LLIN use and related behaviors to point the way towards identifying better interventions for malaria
prevention. The single accelerometer and generality in the training...

## Key facts

- **NIH application ID:** 10899664
- **Project number:** 5R21AI178393-02
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Paul Joseph Krezanoski
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $301,881
- **Award type:** 5
- **Project period:** 2023-08-04 → 2026-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10899664

## Citation

> US National Institutes of Health, RePORTER application 10899664, Training of machine learning algorithms for the classification of accelerometer-measured bednet use and related behaviors associated with malaria risk (5R21AI178393-02). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10899664. Licensed CC0.

---

*[NIH grants dataset](/datasets/nih-grants) · CC0 1.0*
