Do insecticide‐treated curtains reduce all‐cause child mortality in Burkina Faso?

Abstract

SummaryT o evaluate whether insecticide-treated netting (ITN) reduces child mortality in different epidemiological settings, 4 large, randomized, controlled trials were conducted in Africa. Here we report the findings from the trial in Burkina Faso, in an area of hyperendemic and markedly seasonal malaria transmission. The trial involved 158 villages, with a total population of some yo,ooo, grouped into 16 geographical clusters. Ascertainment of mortality among children aged 6-59 months began in early 1993. In June/July 1994, 8 of the clusters, randomly selected, received permethrin-treated curtains. Follow-up of children and ascertainment of mortality continued until May 1996. A 15% reduction in all-cause mortality among children aged 6-59 months was observed over the r-year period following the installation of the curtains (95% c.i. -4% to 30%). In the first year, post-intervention mortality was substantially lower in the clusters receiving curtains compared with the control clusters (rate ratio = 0.74; ~5 % c.i. 0.57,o.yj) but in the second year, there was no difference between mortality in the two groups (rate ratio = 0.99). The overall twoyear impact of the intervention is consistent with the impacts observed in other trials which have demonstrated reductions in child mortality of from 17% to 33%. However, the year-by-year analysis raises some concerns about the long-term effect of ITN. Further follow-up of this population is warranted.

Long term mortality after community and facility based treatment of severe acute malnutrition: Analysis of data from Bangladesh, Kenya, Malawi and Niger

“…In industrialized countries, yearly national statistics are available and MMR calculation allows adjustment to the principal risk factors including age and socio-economic background. In Africa, precise estimations have been obtained in a limited number of prospective studies by conducting concurrent surveys of the unexposed population or when the study is conducted in an area with an ongoing demographic survey (Habluetzel et al, 1997;Binka et al, 1998;Lindblade et al, 2007;Ye et al, 2007). However, it is usually not possible to obtain this current data and the DHS survey is often the best option available (Mahapatra et al, 2007).…”

KINET: a social marketing programme of treated nets and net treatment for malaria control in Tanzania, with evaluation of child health and long-term survival

“…Other African projects are attempting to do this in Ghana and in Burkina Faso where the population formerly involved in the scientific trials (Bn\r~ et al, 1996;HABLUETZEL et al, 1997) is being followed-un for a further 3 vears in I 2 order to detect a p&sible delayed increase in mortality in the former intervention group compared to the former control group (F. Binka, personal communication; E.…”

9. Effect of insecticide-treated bed nets on haemoglobin values, prevalence and multiplicity of infection with Plasmodium falciparum in a randomized controlled trial in Tanzania

“…1994: PREMTI et al. 1995: BINKA , , 1 , et al, 1996HABLUETZEL et al, 1997), parasite prevalence (GRAVES et al, 1987;KARCH et al, 1993;JAEN-SON et al, 1994), parasite density (KARCH et al, 1993;PREMJI et al, 1995;HABLUETZEL et al, 1997), and acute morbidity and mortality (ALONSO et al, 1991;D'ALESSANDRO et al, 1995;BINKA et al, 1996;NEV-ILL et al, 1996;HABLUETZEL et al, 1997). Our study has confirmed the efficacy of the nets in controlling high parasite densities and anaemia in an area of very high perennial transmission.…”