Eisele TP, Larsen D, Steketee RW. Protective efficacy of interventions for preventing malaria mortality in children in Plasmodium falciparum endemic areas. Int J Epidemiol. 2010 Apr; 39 (Suppl 1): i88-i101.
- Malaria in sub-Saharan Africa was estimated to have caused over 800,000 deaths in 2000. (1)
- ITNs and IRS are recommended strategies for preventing malaria in children with their impact on all-cause child mortality (AACM) well demonstrated (2-6), but impact on reducing deaths due to malaria in children has not been well quantified.
Insecticide-treated Mosquito Nets (ITNs) on Malaria-attributable Mortality
- 55% (95% CI: 49-60%) reduction in malaria-attributable mortality among children 1-59 months in Plasmodium falciparum endemic settings. [Moderate Data Quality – based on meta-analyses]:
- 18% (RR=0.82; 95% CI: 0.75-0.90) protective efficacy (PE) of ITNs for reducing ACCM
- 51% (RR=0.49; 95% CI: 0.44-0.54) PE of ITNs for reducing uncomplicated malaria
- 17% (RR=0.83; 95% CI: 0.64-0.88) PE of ITNs for reducing malaria parasite infection prevalence in children
Indoor-residual Spraying (IRS) on Malaria-attributable Mortality
- Based on the fact that IRS impact on malaria morbidity has been shown to be similar to that of ITNs, it is assumed the impact of IRS I equal to that of ITNs on reducing malaria-attributable mortality in children.
Intermittent Preventive Therapy in Pregnant Women (IPTp) and ITNs in Pregnancy on Low Birth Weight (LBW) among First or Second Pregnancies
- IPTp is the administration of two or more treatment doses of an effective antimalarial drug (in this case sulphadoxine-pyrimethamine (SP) given at defined intervals during pregnancy of at least 1 month, regardless of parasitic infection at time of treatment.
- 35% (95% CI: 23-45%) reduction in the prevalence of low birth weight (LBW) in the first or second pregnancy in areas of stable P. falciparum transmission with either IPTp or ITNs.
- High quality of data (5 high-quality randomized controlled trials – 3 for IPTp and 2 for ITNs)
- These data support the continued scale-up of these malaria prevention interventions in endemic settings.
References from Eisele Paper Cited Here
- Rowe AK, Samantha YR, Robert WS, et al. The burden of malaria mortality among African children in the year 2000. Int J Epidemiol. 2006; 35:691–704.
- Lengeler C. Insecticide-treated bed nets and curtains for preventing malaria. Cochrane Database Syst Rev. 2004;:CD000363.
- Bradley D. Morbidity and mortality at Pare-Taveta, Kenya and Tanzania, 1954-66: the effects of a period of malaria control. In: Feachem R, Jamison D, editors. Disease and Mortality in sub-Saharan Africa. New York: University Oxford Press; 1991. pp. 248–63.
- Molineaux L, Gramiccia G. The Garki Project: Research on the Epidemiology and Control of Malaria in the Sudan Savanna of West Africa. Geneva: World Health Organization; 1980.
- Pringle G. Malaria in the Pare area of Tanzania. 3. The course of malaria transmission since the suspension of an experimental programme of residual insecticide spraying. Trans R Soc Trop Med Hyg. 1967;61:69–79.
- Payne D, Grab B, Fontaine RE, Hempel JH. Impact of control measures on malaria transmission and general mortality. Bull World Health Organ. 1976;54:369–77.