title: Case-control study of mosquito nets against malaria in the Amazon region of Colombia.
abstract: 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.
authors: London School of Hygiene and Tropical Medicine, London, UK. neal.alexander@lshtm.ac.uk
authors: Neal
authors: N
authors: Alexander
authors: Mauricio
authors: M
authors: Rodríguez
authors: Ligia
authors: L
authors: Pérez
authors: Juan Carlos
authors: JC
authors: Caicedo
authors: Jesús
authors: J
authors: Cruz
authors: Guillermo
authors: G
authors: Prieto
authors: José Antonio
authors: JA
authors: Arroyo
authors: Maria Cristina
authors: MC
authors: Cotacio
authors: Martha
authors: M
authors: Suárez
authors: Fernando
authors: F
authors: DE LA Hoz
authors: Andrew J
authors: AJ
authors: Hall
mesh_terms: 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