Community-wide effects of permethrin-treated bed nets on child mortality and malaria morbidity in western Kenya
Community-wide effects of permethrin-treated bed nets on child mortality and malaria morbidity in western Kenya
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DOI：
10.4269/ajtmh.2003.68.121
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发表时间：
2003-04-01
影响因子：
3.3
通讯作者：
Hightower, AW
中科院分区：
文献类型：
--
作者：
Hawley, WA;Phillips-Howard, PA;Hightower, AW
空间分析杀虫剂（氯菊酯）处理过的蚊帐（驱虫蚊帐）对附近的家庭，无论是有和没有驱虫蚊帐的影响进行了大规模的背景下，组随机，控制死亡率试验在Asembo，肯尼亚西部。结果表明，驱虫蚊帐对位于驱虫蚊帐化合物300米范围内缺乏驱虫蚊帐的化合物的儿童死亡率、中度贫血、高密度寄生虫血症和血红蛋白水平具有保护作用。这种社区对附近没有蚊帐的大院的影响，与在有驱虫蚊帐的村庄内观察到的影响大致相同。这意味着，在疟疾传播密集、驱虫蚊帐覆盖率高的地区，驱虫蚊帐的主要效果是通过对整个地区蚊子数量的影响，而不是像通常认为的那样，通过简单地设置物理屏障保护个人免受叮咬。社区效应的强度取决于附近化合物与处理过的蚊帐的比例。为了最大限度地扩大驱虫蚊帐对公共卫生的影响，驱虫蚊帐的高覆盖率至关重要。
Spatial analyses of the effect of insecticide (permethrin) -treated bed nets (ITNs) on nearby households both with and without ITNs was performed in the context of a large-scale, group-randomized, controlled mortality trial in Asembo, western Kenya. Results illustrate a protective effect of ITNs on compounds lacking ITNs located within 300 meters of compounds with ITNs for child mortality, moderate anemia, high-density parasitemia, and hemoglobin levels. This community effect on nearby compounds without nets is approximately as strong as the effect observed within villages with ITNs. This implies that in areas with intense malaria transmission with high ITN coverage, the primary effect of insecticide-treated nets is via area-wide effects on the mosquito population and not, as commonly supposed, by simple imposition of a physical barrier protecting individuals from biting. The strength of the community effect depended upon the proportion of nearby compounds with treated nets. To maximize their public health impact, high coverage with treated nets is essential.