Malaria
Insecticide-treated bed nets and curtains for preventing malaria
Impact of insecticide treated bed nets on mortality
Authors:
C. Lengeler
Publisher:
Cochrane Library, 2006
Malaria is an important cause of illness and death in many parts of the world, especially in sub-Saharan Africa. Recently there has been a renewed emphasis on preventive measures at community and individual levels. Insecticide-treated nets (ITNs) are the most prominent malaria preventive measure for large-scale deployment in highly endemic areas. This document from the Cochrane Database of Systematic Reviews assess the impact of insecticide-treated bed nets or curtains on mortality, malarial illness (life-threatening and mild), malaria parasitaemia, anaemia, and spleen rates. The report documents a literature review or all relevant research which included individual and cluster randomized controlled trials of insecticide-treated bed nets or curtains compared to nets without insecticide or no nets.
The author concludes that ITNs are highly effective in reducing childhood mortality and morbidity from malaria. Widespread access to ITNs is currently being advocated, but universal deployment will require major financial, technical, and operational inputs. Five randomised controlled trials have provided strong evidence within the literature examined that the widespread use of ITNs can reduce overall mortality by about a fifth in Africa. For every 1,000 children protected, on average about 5.5 lives can be saved in children aged 1 to 59 months every year. In Africa, full ITN coverage could prevent 370,000 child deaths per year. Given the consistency of the impact results for different outcomes and different areas of the world, it is unlikely that many more trial data are required however the author highlights further areas which still need additional research. These include the impact of ITNs under large-scale programme conditions and further investigation of how impact varies with ITN coverage rate, and how effectiveness depends on a mass eradication of the mosquito population.
