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WHAT'S NEW THIS THURSDAY: BEDNETS OR SPRAY?

Thursday, 7th of March 2013

 

• BEDNETS OR SPRAY?

“Overall the findings suggest that the combined use of IRS and ITNs provides greater protection against malaria than the use of IRS or ITNs alone. In addition, in medium malaria transmission areas, these results suggest that there may be a synergistic effect of using ITNs and IRS together.”

Abstract below; full text is at http://www.malariajournal.com/content/pdf/1475-2875-12-62.pdf

Abstract

 

Background

Malaria control programmes currently face the challenge of maintaining, as well as

accelerating, the progress made against malaria with fewer resources and uncertain funding.

There is a critical need to determine what combination of malaria interventions confers the

greatest protection against malaria morbidity and child mortality under routine conditions.

 

Methods

This study assesses intervention effectiveness experienced by children under the age of five

exposed to both insecticide-treated nets (ITNs) and indoor residual spraying (IRS), as

compared to each intervention alone, based on nationally representative survey data collected

from 17 countries in sub-Saharan Africa.

 

Results

Living in households with both ITNs and IRS was associated with a significant risk reduction

against parasitaemia in medium and high transmission areas, 53% (95% CI 37% to 67%) and

31% (95% CI 11% to 47%) respectively. For medium transmission areas, an additional 36%

(95% CI 7% to 53%) protection was garnered by having both interventions compared with

exposure to only ITNs or only IRS. Having both ITNs and IRS was not significantly more

protective against parasitaemia than either intervention alone in low and high malaria

transmission areas. In rural and urban areas, exposure to both interventions provided

significant protection against parasitaemia, 57% (95% CI 48% to 65%) and 39% (95% CI

10% to 61%) respectively; however, this effect was not significantly greater than having a

singular intervention. Statistically, risk for all-cause child mortality was not significantly

reduced by having both ITNs and IRS, and no additional protectiveness was detected for

having dual intervention coverage over a singular intervention.

 

Conclusions

These findings suggest that greater reductions in malaria morbidity and health gains for

children may be achieved with ITNs and IRS combined beyond the protection offered by IRS

or ITNs alone.