title: Marked increase in child survival after four years of intensive malaria control.
abstract: In malaria-endemic countries in Africa, a large proportion of child deaths are directly or indirectly attributable to infection with Plasmodium falciparum. Four years after high coverage, multiple malaria control interventions were introduced on Bioko Island, Equatorial Guinea, changes in infection with malarial parasites, anemia, and fever history in children were estimated and assessed in relation to changes in all-cause under-5 mortality. There were reductions in prevalence of infection (odds ratio [OR] = 0.31, 95% confidence interval [CI] = 0.2-0.46), anemia (OR = 0.11, 95% CI = 0.07-0.18), and reported fevers (OR = 0.41, 95% CI = 0.22-0.76) in children. Under-5 mortality fell from 152 per 1,000 births (95% CI = 122-186) to 55 per 1,000 (95% CI = 38-77; hazard ratio = 0.34 [95% CI = 0.23-0.49]). Effective malaria control measures can dramatically increase child survival and play a key role in achieving millennium development goals.
authors.affiliation: London School of Hygiene and Tropical Medicine, London, United Kingdom; Medical Care Development International, Silver Spring, Maryland. Immo.Kleinschmidt@lshtm.ac.uk
authors.forename: Immo
authors.initials: I
authors.lastname: Kleinschmidt
authors.forename: Christopher
authors.initials: C
authors.lastname: Schwabe
authors.forename: Luis
authors.initials: L
authors.lastname: Benavente
authors.forename: Miguel
authors.initials: M
authors.lastname: Torrez
authors.forename: Frances C
authors.initials: FC
authors.lastname: Ridl
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Segura
authors.forename: Paul
authors.initials: P
authors.lastname: Ehmer
authors.forename: Gloria Nseng
authors.initials: GN
authors.lastname: Nchama
mesh_terms: D000293:Adolescent; D000328:Adult; D000740:Anemia / Q000453:epidemiology / Q000469:parasitology / Q000517:prevention & control; D000962:Antimalarials / Q000627:therapeutic use; D001512:Bedding and Linens; D002648:Child; D002675:Child, Preschool; D016703:Equatorial Guinea / Q000453:epidemiology; D005260:Female; D006801:Humans; D007221:Industry / Q000191:economics; D007306:Insecticides; D016778:Malaria, Falciparum / Q000188:drug therapy / Q000401:mortality* / Q000517:prevention & control*; D009032:Mosquito Control / Q000191:economics / Q000379:methods; D010578:Petroleum / Q000191:economics; D011247:Pregnancy; D055815:Young Adult
chemical_list: D000962:Antimalarials; D007306:Insecticides; D010578:Petroleum