Effect of sustained insecticide-treated bed net use on all-cause child mortality in an area of intense perennial malaria transmission in western Kenya.
We present results from a study conducted in western Kenya where all-cause child mortality was assessed among a population with high levels of sustained insecticide-treated bed net (ITN) use for up to six years. Although ITNs were associated with significant reductions in all-cause mortality among infants 1-11 months old, there was no difference in the rate of all-cause mortality among children 12-59 months old with ITNs for 2-4 years, compared historically with children from villages without ITNs, after controlling for seasonality and underlying child mortality across calendar years (adjusted hazard ratio [AHR] = 0.91, 95% confidence interval [CI] = 0.77-1.07). There was no increase in the proportion of child deaths at older ages (12-59 months old) of all child deaths within villages with ITNs for 5-6 years (48.1%) compared historically with villages without ITNs (47.9%), after controlling for seasonality (AHR = 1.03, P = 0.834). We find no evidence that sustained ITN use increased the risk of mortality in older children in this area of intense perennial malaria transmission.
Eisele
Thomas P
TP
Department of International Heath and Development, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana 70112, USA. teisele@tulane.edu
Lindblade
Kim A
KA
Wannemuehler
Kathleen A
KA
Gimnig
John E
JE
Odhiambo
Frank
F
Hawley
William A
WA
Ter Kuile
Feiko O
FO
Phillips-Howard
Penny
P
Rosen
Daniel H
DH
Nahlen
Bernard L
BL
Vulule
John M
JM
Slutsker
Laurence
L
D000818:Animals; D001512:Bedding and Linens; D002675:Child, Preschool; D005260:Female; D005843:Geography; D006801:Humans; D015994:Incidence; D007306:Insecticides; D007630:Kenya / Q000453:epidemiology; D008288:Malaria / Q000401:mortality / Q000517:prevention & control*; D008297:Male; D009032:Mosquito Control / Q000379:methods; D016016:Proportional Hazards Models
D007306:Insecticides