What Is Threatening the Effectiveness of Insecticide-Treated Bednets? A Case-Control Study of Environmental, Behavioral, and Physical Factors Associated with Prevention Failure.

ABSTRACT:

Background

Insecticide-treated nets are the cornerstone of global malaria control and have been shown to reduce malaria morbidity by 50-60%. However, some areas are experiencing a resurgence in malaria following successful control. We describe an efficacy decay framework to understand why high malaria burden persists even under high ITN coverage in a community in western Kenya.

Methods

We enrolled 442 children hospitalized with malaria and paired them with age, time, village and gender-matched controls. We completed comprehensive household and neighborhood assessments including entomological surveillance. The indicators are grouped into five domains in an efficacy decay framework: ITN ownership, compliance, physical integrity, vector susceptibility and facilitating factors.

SUBMITTER: Obala AA 

PROVIDER: S-EPMC4501815 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature