Evidence for a mass community effect of insecticide-treated bednets on the incidence of malaria on the Kenyan coast
Evidence for a mass community effect of insecticide-treated bednets on the incidence of malaria on the Kenyan coast
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DOI：
10.1016/s0035-9203(00)90103-2
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发表时间：
2000-07-01
影响因子：
2.2
通讯作者：
Snow, RW
中科院分区：
文献类型：
--
作者：
Howard, SC;Omumbo, J;Snow, RW
事实证明，使用驱虫蚊帐可有效降低疟疾的死亡率和发病率。然而，有混合的证据表明，在社区范围内使用ITBN是否会产生“群体效应”，例如，那些不在蚊帐下睡觉的人会得到保护，免受ITBN在他们居住地区的广泛使用。我们分析了在肯尼亚基利菲收集的一组儿童出生后的数据，以调查儿童所在地的蚊帐使用程度如何影响患疟疾的风险。使用考克斯比例风险模型探索了该效应。对于那些不使用ITBN的人，我们发现每个儿童周围区域内ITBN使用率的增加与发展疟疾的风险降低有关，从而提供了支持大规模社区效应的证据。这种影响的大小和意义被认为是减少非重叠区域的距离增加远离孩子的家。在距离每个儿童最多1.5公里的地区，效果显著。
The use of insecticide-treated bednets (ITBNs) has been shown to be effective in reducing mortality and morbidity from malaria. However, there is mixed evidence as to whether or not community-wide use of ITBNs engenders a 'mass effect', such that those not sleeping under bednets are offered protection from widespread ITBN use in the area in which they live. We have analysed data collected in Kilifi, Kenya, from a cohort of children followed from birth to investigate how the degree of net usage in the locality of a child affects the risk of developing malaria. This effect was explored using a Cox proportional hazards model. For those not using ITBNs, we found that an increasing level of ITBN usage within the area surrounding each child was associated with a decreasing risk of developing malaria, thus providing evidence in support of a mass community effect. The size and significance of this effect were found to decrease as non-overlapping areas of increasing distance away from a child's home were considered. The effect was significant for areas at distances of up to 1.5 km away from each child.