Case-control study of mosquito nets against malaria in the Amazon region of Colombia.
The degree of effectiveness of mosquito nets against malaria in the Americas has remained uncertain. We carried out a case-control study of net use and mild malaria in the Amazonas state of Colombia. Two hundred ninety cases were enrolled via the Health Department services, and 977 community-based controls matched for age, sex, and place of residence. We found that a large proportion of the population (96% of controls) slept under nets. Nevertheless, we found a benefit of impregnated nets compared with no net use: adjusted odds ratio (OR) for mild malaria 0.44, 95% confidence interval (CI) 0.20-0.98. Nonimpregnated nets had a benefit that was only slightly smaller but not statistically significant (OR for mild malaria 0.54, 95% CI 0.25-1.18). Travel in the previous month had an odds ratio of 6.2 (95% CI 3.1-8.8) and a population attributable fraction of 13% compared with 11% for failure to use an impregnated net. We conclude that, in the Amazon region, promotion of mosquito net use and impregnation is justified, and that there is a need for measures to protect travelers from malaria.
Alexander
Neal
N
London School of Hygiene and Tropical Medicine, London, UK. neal.alexander@lshtm.ac.uk
Rodríguez
Mauricio
M
Pérez
Ligia
L
Caicedo
Juan Carlos
JC
Cruz
Jesús
J
Prieto
Guillermo
G
Arroyo
José Antonio
JA
Cotacio
Maria Cristina
MC
Suárez
Martha
M
DE LA Hoz
Fernando
F
Hall
Andrew J
AJ
D000293:Adolescent; D000328:Adult; D000818:Animals; D001512:Bedding and Linens; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003105:Colombia / Q000453:epidemiology; D003710:Demography; D005260:Female; D005843:Geography; D006801:Humans; D007223:Infant; D008288:Malaria / Q000453:epidemiology* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D009032:Mosquito Control / Q000379:methods*; D010961:Plasmodium; D013696:Temperature