title: Cohort trial reveals community impact of insecticide-treated nets on malariometric indices in urban Ghana.
abstract: The efficacy of insecticide-treated nets (ITNs) in prevention of malaria and anaemia has been shown in rural settings, but their impact in urban settings is unknown. We carried out an ITN intervention in two communities in urban Accra, Ghana, where local malaria transmission is known to occur. There was evidence for a mass or community effect, despite ITN use by fewer than 35% of households. Children living within 300 m of a household with an ITN had higher haemoglobin concentrations (0.5g/dl higher, P=0.011) and less anaemia (odds ratio 2.21, 95% CI 1.08-4.52, P=0.031 at month 6), than children living more than 300 m away from a household with an ITN, although malaria parasitaemias were similar. With urban populations growing rapidly across Africa, this study shows that ITNs will be an effective tool to assist African countries to achieve their Millennium Development Goals in urban settings. [Registered trial number ISRCTN42261314; http://www.controlled-trials.com/ISRCTN42261314].
authors.affiliation: Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, UK.
authors.forename: Eveline
authors.initials: E
authors.lastname: Klinkenberg
authors.forename: Kwabena A
authors.initials: KA
authors.lastname: Onwona-Agyeman
authors.forename: P J
authors.initials: PJ
authors.lastname: McCall
authors.forename: Michael D
authors.initials: MD
authors.lastname: Wilson
authors.forename: Imelda
authors.initials: I
authors.lastname: Bates
authors.forename: Francine H
authors.initials: FH
authors.lastname: Verhoeff
authors.forename: Guy
authors.initials: G
authors.lastname: Barnish
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Donnelly
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000740:Anemia / Q000453:epidemiology / Q000517:prevention & control*; D002648:Child; D015331:Cohort Studies; D005191:Family Characteristics; D005260:Female; D005869:Ghana / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007306:Insecticides; D008288:Malaria / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D008297:Male; D008875:Middle Aged; D057147:Mosquito Nets / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D015397:Program Evaluation; D014504:Urban Health; D055815:Young Adult
chemical_list: D007306:Insecticides