Net Benefits A Multicountry Analysis of Observational Data Examining Associations between Insecticide-Treated Mosquito Nets and Health Outcomes 英文参考文献.docVIP
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Net Benefits A Multicountry Analysis of Observational Data Examining Associations between Insecticide-Treated Mosquito Nets and Health Outcomes 英文参考文献
NetBenefits:AMulticountryAnalysisofObservational
DataExaminingAssociationsbetweenInsecticide-
TreatedMosquitoNetsandHealthOutcomes
StephenS.Lim1*,NancyFullman1,AndrewStokes2,NirmalaRavishankar3,FelixMasiye4,ChristopherJ.L.
Murray1,EmmanuelaGakidou1
1Institute for Health Metrics and Evaluation, University of Washington, Seattle, Washington, United States of America, 2Population Studies Center, University of
Pennsylvania, Philadelphia, Pennsylvania, United States of America, 3Abt Associates Inc., Bethesda, Maryland, United States of America, 4Department of Economics,
UniversityofZambia,Lusaka,Zambia
Abstract
Background:Severalsub-SaharanAfricancountrieshaverapidlyscaledupthenumberofhouseholdsthatowninsecticide-
treatedmosquitonets(ITNs).AlthoughtheefficacyofITNsintrialshasbeenshown,evidenceontheirimpactunderroutine
conditions is limited to a few countries and the extent to which the scale-up of ITNs has improved population health
remainsuncertain.
MethodsandFindings:Weusedmatchedlogisticregressiontoassesstheindividual-levelassociationbetweenhousehold
ITNownershiporuseinchildrenunder5yearsofageandtheprevalenceofparasitemiaamongchildrenusingsixmalaria
indicatorsurveys(MIS)andonedemographicandhealthsurvey.WeusedCoxproportionalhazardsmodelstoassessthe
relationshipbetweenITNhouseholdownershipandchildmortalityusing29demographicandhealthsurveys.Thepooled
relativereductioninparasitemiaprevalencefromrandomeffectsmeta-analysisassociatedwithhouseholdownershipofat
leastoneITNwas20%(95%confidenceinterval[CI]3%–35%;I2=73.5%,p,0.01forI2value).SleepingunderanITNwas
associated with a pooled relative reduction in parasitemia prevalence in children of 24% (95% CI 1%–42%; I2 =79.5%,
p,0.001forI2value).OwnershipofatleastoneITNwasassociatedwithapooledrelativereductioninmortalitybetween1
monthand5yearsofageof23%(95%CI13–31%;I2=25.6%,p.0.05forI2value).
Conclusions: Our findings across a number of sub-Saharan African countries were highly consistent with results from
previous clinical trial
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