Insecticide-treated net effectiveness at preventing Plasmodium falciparum infection varies by age and season

Malaria Journal

Research

Terrie E. Taylor¹  Andrea G. Buchwald²  John D. Sorkin²  Lauren M. Cohee²  Miriam K. Laufer²  Jenny A. Walldorf²  Kondwani Nkanaunena³  Don P. Mathanga³  Nelson Chimbiya³  Andrew Ngwira³  Andy Bauleni³  Jenna E. Coalson⁴ 

[1] Department of Osteopathic Medicine, Michigan State University, West Fee Hall, 909 Fee Road, Room B305, 48824, East Lansing, MI, USA;Institute for Global Health, University of Maryland School of Medicine, 685W, Baltimore St. HSF-1 Room 480, 21201, Baltimore, MD, USA;University of Malawi College of Medicine, Private Bag 360, Chichiri, Blantyre, Malawi;University of Michigan School of Public Health, 1415 Washington Heights, 48109, Ann Arbor, MI, USA;

关键词: Insecticide-treated nets;    Plasmodium falciparum;    Universal distribution campaign;    School-aged children;    Malawi;   

DOI  :  10.1186/s12936-017-1686-2

 received in 2016-11-11, accepted in 2017-01-07,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundAfter increasing coverage of malaria interventions, malaria prevalence remains high in Malawi. Previous studies focus on the impact of malaria interventions among children under 5 years old. However, in Malawi, the prevalence of infection is highest in school-aged children (SAC), ages 5 to 15 years. This study examined the interaction between age group and insecticide-treated net (ITN) use for preventing individual and community-level infection in Malawi.MethodsSix cross-sectional surveys were conducted in the rainy and dry seasons in southern Malawi from 2012 to 2014. Data were collected on household ITN usage and demographics. Blood samples for detection of Plasmodium falciparum infection were obtained from all household members present and over 6 months of age. Generalized linear mixed models were used to account for clustering at the household and community level.ResultsThere were 17,538 observations from six surveys. The association between ITN use and infection varied by season in SAC, but not in other age groups. The adjusted odds ratio (OR) for infection comparing ITN users to non-users among SAC in the rainy season and dry season was 0.78 (95% CI 0.56, 1.10) and 0.51 (0.35, 0.74), respectively. The effect of ITN use did not differ between children under five and adults. Among all non-SACs the OR for infection was 0.78 (0.64, 0.95) in those who used ITNs compared to those that did not. Community net use did not protect against infection.ConclusionsProtection against infection with ITN use varies by age group and season. Individual estimates of protection are moderate and a community-level effect was not detected. Additional interventions to decrease malaria prevalence are needed in Malawi.

【 授权许可】

CC BY   
© The Author(s) 2017