Men spread a malaria bed net in Mbarara, Uganda. (Courtesy - Paul Krezanoski)
FILE - Researchers in Uganda demonstrate the design of the SmartNet technology. SmartNets use conductive fabric to detect when they are folded up or in use. (Photo courtesy of Paul Krezanoski)

Malaria kills more than 400,000 people every year, but malaria prevention expert Dr. Paul Krezanoski says insecticide-treated bed nets can help reduce that number.

Estimates from 2000 to 2015 show the mortality rate from malaria dropping by about half, Krezanoski said, adding that "about 60% of that improvement might be due to the use of bed nets."

However, the World Health Organization reports that efforts to stop the spread of malaria have stalled since 2015, causing some researchers to suggest that bed nets might not be as effective as they used to be.

Krezanoski questioned whether people were using their bed nets as recommended. He worked with the Consortium for Affordable Medical Technologies in Uganda to develop the SmartNet, which uses strips of conductive fabric to detect when it's in use. He asked families in Uganda to use it as they would a normal bed net.

"You would think that if people are being monitored … that they would use their bed net in a pristine way — you know, almost in a way of anticipating what the researchers might want, but, in fact, that's not what happened and what that tells me is that there's probably a whole lot more variation in bed net use than we realize," Krezanoski said.

That finding helps explain some of the setbacks in the fight against malaria, said Kate Zinszer, an infectious disease epidemiologist at the University of Montreal.

"I think it's quite innovative," she said. "I think it's really important to understand, given the investment in bed nets, if they're actually being used. … So I think this is a really important advancement."

Ultimately, Krezanoski hopes to show a correlation between how long young children use bed nets and their risk of getting malaria. 

"I think that will help the international malaria community define exactly how much investment we need to give to bed nets as a whole and also in terms of human behaviors around bed nets, and help us figure out the best ways to reduce malaria going into the future," he said. 

According to the World Health Organization, 21 countries have the potential to eliminate malaria by 2020, and proper use of bed nets could be part of the strategy.