title: Can Long-lasting Insecticide-treated Bednets with Holes Protect Children from Malaria?
abstract: Although long-lasting insecticide-treated bednets (LLINs) have been widely used for malaria control, little is known about how the condition of LLINs affects the risk of malaria infection. The objective of this cross-sectional study was to examine the association between the use of LLINs with holes and caregiver-reported malaria diagnosed in children under five years of age (U5). Data were collected in Boboye health district, Niger, in 2010. Surveyors conducted interviews and bednet inspections in 1,034 households. If a household had a U5 child, the surveyor asked the caregiver whether the child had experienced a fever episode in the past two weeks that entailed standard treatment for uncomplicated malaria at a healthcare facility. The authors analyzed the association between the use of LLINs with holes and caregiver-reported malaria episodes in U5 children using logistic regression, adjusted for possible confounders. Of the 1,165 children included in the analysis, approximately half (53.3%) used an intact LLIN while far fewer (10.6%) used a LLIN with holes. Compared to children using an intact LLIN, children using a LLIN with holes were significantly more likely to have a caregiver-reported malaria episode (8.7% vs. 17.1%; odds ratio: 2.23; 95% confidence interval: 1.24-4.01). In this study site, LLINs with holes were less protective than intact LLINs.
authors.affiliation: Department of Parasitology and Immunopathoetiology, Graduate School of Medicine, University of the Ryukyus , Uehara 207, Nishihara-cho, Okinawa 903-0215, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Nonaka
authors.affiliation: National Malaria Control Programme , Niamey, Niger.
authors.forename: Abani
authors.initials: A
authors.lastname: Maazou
authors.affiliation: Malaria Control Project, Japan International Cooperation Agency , Dosso, Niger.
authors.forename: Shigeo
authors.initials: S
authors.lastname: Yamagata
authors.affiliation: Health Planning and Information Unit, Regional Department of the Public Health , Dosso, Niger.
authors.forename: Issofou
authors.initials: I
authors.lastname: Oumarou
authors.affiliation: Malaria Control Project, Japan International Cooperation Agency , Dosso, Niger.
authors.forename: Takako
authors.initials: T
authors.lastname: Uchida
authors.affiliation: Epidemiological Surveillance, Health District of Boboye , Dosso, Niger.
authors.forename: Honoré
authors.initials: H
authors.lastname: Jg Yacouba
authors.affiliation: Department of Parasitology and Immunopathoetiology, Graduate School of Medicine, University of the Ryukyus , Uehara 207, Nishihara-cho, Okinawa 903-0215, Japan.
authors.forename: Nami
authors.initials: N
authors.lastname: Toma
authors.affiliation: Transdisciplinary Research Organization for Subtropics and Island Studies, University of the Ryukyus , Senbaru 1, Nishihara-cho, Okinawa 903-0213, Japan.
authors.forename: Rie
authors.initials: R
authors.lastname: Takeuchi
authors.affiliation: School of Health Sciences, University of the Ryukyus , Uehara 207, Nishihara-cho, Okinawa 903-0215, Japan ; Department of International Medical Cooperation, National Center for Global Health and Medicine , 1-21-1 Toyama Shinjuku-ku, Tokyo 162-8655, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Kobayashi
authors.affiliation: Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine , 1-21-1 Toyama Shinjuku-ku, Tokyo 162-8655, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Mizoue
keywords: Niger; insecticide-treated bednets; malaria; mosquito control