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Am J Trop Med Hyg. 2014 Nov;91(5):950-8. doi: 10.4269/ajtmh.14-0318. Epub 2014 Sep 8.

Community coverage with insecticide-treated mosquito nets and observed associations with all-cause child mortality and malaria parasite infections.

Author information

1
Department of Public Health, Food Studies and Nutrition, Syracuse University, Syracuse, New York; Department of Global Health Systems and Development, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, California; Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; Global Health Group, University of California, San Francisco, California dalarsen@syr.edu.
2
Department of Public Health, Food Studies and Nutrition, Syracuse University, Syracuse, New York; Department of Global Health Systems and Development, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, California; Center for Applied Malaria Research and Evaluation, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; Global Health Group, University of California, San Francisco, California.

Abstract

Randomized trials and mathematical modeling suggest that insecticide-treated mosquito nets (ITNs) provide community-level protection to both those using ITNs and those without individual access. Using nationally representative household survey datasets from 17 African countries, we examined whether community ITN coverage is associated with malaria infections in children < 5 years old and all-cause child mortality (ACCM) among children < 5 years old in households with one or more ITNs versus without any type of mosquito net (treated or untreated). Increasing ITN coverage (> 50%) was protective against malaria infections and ACCM for children in households with an ITN, although this protection was not conferred to children in households without ITNs in these data. Children in households with ITNs were protected against malaria infections and ACCM with ITN coverage > 30%, but this protection was not significant with ITN coverage < 30%. Results suggest that ITNs are more effective with higher ITN coverage.

PMID:
25200267
PMCID:
PMC4228892
DOI:
10.4269/ajtmh.14-0318
[Indexed for MEDLINE]
Free PMC Article

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