title: Impact on malaria morbidity of a programme supplying insecticide treated nets in children aged under 2 years in Tanzania: community cross sectional study.
abstract: OBJECTIVE
  To assess the impact of a social marketing programme for distributing nets treated with insecticide on malarial parasitaemia and anaemia in very young children in an area of high malaria transmission.
  
  
  METHODS
  Community cross sectional study. Annual, cross sectional data were collected at the beginning of the social marketing campaign (1997) and the subsequent two years. Net ownership and other risk and confounding factors were assessed with a questionnaire. Blood samples were taken from the children to assess prevalence of parasitaemia and haemoglobin levels.
  
  
  METHODS
  18 villages in the Kilombero and Ulanga districts of southwestern Tanzania.
  
  
  METHODS
  A random sample of children aged under 2 years.
  
  
  METHODS
  The presence of any parasitaemia in the peripheral blood sample and the presence of anaemia (classified as a haemoglobin level of <80 g/l).
  
  
  RESULTS
  Ownership of nets increased rapidly (treated or not treated nets: from 58% to 83%; treated nets: from 10% to 61%). The mean haemoglobin level rose from 80 g/l to 89 g/l in the study children in the successive surveys. Overall, the prevalence of anaemia in the study population decreased from 49% to 26% in the two years studied. Treated nets had a protective efficacy of 62% (95% confidence interval 38% to 77%) on the prevalence of parasitaemia and of 63% (27% to 82%) on anaemia.
  
  
  CONCLUSIONS
  These results show that nets treated with insecticide have a substantial impact on morbidity when distributed in a public health setting.
authors.affiliation: Ifakara Health Research and Development Centre, PO Box 53, Ifakara, Tanzania.
authors.forename: S
authors.initials: S
authors.lastname: Abdulla
authors.forename: J A
authors.initials: JA
authors.lastname: Schellenberg
authors.forename: R
authors.initials: R
authors.lastname: Nathan
authors.forename: O
authors.initials: O
authors.lastname: Mukasa
authors.forename: T
authors.initials: T
authors.lastname: Marchant
authors.forename: T
authors.initials: T
authors.lastname: Smith
authors.forename: M
authors.initials: M
authors.lastname: Tanner
authors.forename: C
authors.initials: C
authors.lastname: Lengeler
mesh_terms: D001512:Bedding and Linens / Q000600:supply & distribution*; D003430:Cross-Sectional Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007306:Insecticides; D008288:Malaria / Q000517:prevention & control*; D009017:Morbidity; D015980:Public Health Practice; D012044:Regression Analysis; D013636:Tanzania
chemical_list: D007306:Insecticides