Mosquito Net Use in Early Childhood and Survival to Adulthood in Tanzania.
N Engl J Med
; 386(5): 428-436, 2022 02 03.
Article
em En
| MEDLINE
| ID: mdl-35108469
ABSTRACT
BACKGROUND:
It has been hypothesized that in high-transmission settings, malaria control in early childhood (<5 years of age) might delay the acquisition of functional immunity and shift child deaths from younger to older ages.METHODS:
We used data from a 22-year prospective cohort study in rural southern Tanzania to estimate the association between early-life use of treated nets and survival to adulthood. All the children born between January 1, 1998, and August 30, 2000, in the study area were invited to enroll in a longitudinal study from 1998 through 2003. Adult survival outcomes were verified in 2019 through community outreach and mobile telephones. We used Cox proportional-hazards models to estimate the association between the use of treated nets in early childhood and survival to adulthood, adjusting for potential confounders.RESULTS:
A total of 6706 children were enrolled. In 2019, we verified information on the vital status of 5983 participants (89%). According to reports of early-life community outreach visits, approximately one quarter of children never slept under a treated net, one half slept under a treated net some of the time, and the remaining quarter always slept under a treated net. Participants who were reported to have used treated nets at half the early-life visits or more had a hazard ratio for death of 0.57 (95% confidence interval [CI], 0.45 to 0.72) as compared with those who were reported to have used treated nets at less than half the visits. The corresponding hazard ratio between 5 years of age and adulthood was 0.93 (95% CI, 0.58 to 1.49).CONCLUSIONS:
In this long-term study of early-life malaria control in a high-transmission setting, the survival benefit from early-life use of treated nets persisted to adulthood. (Funded by the Eckenstein-Geigy Professorship and others.).
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Contexto em Saúde:
2_ODS3
/
3_ND
/
4_TD
/
7_ODS3_muertes_prevenibles_nacidos_ninos
Problema de saúde:
2_enfermedades_transmissibles
/
2_muertes_prevenibles
/
3_malaria
/
3_neglected_diseases
/
4_malaria
/
7_environmental_health
/
7_infections
Assunto principal:
Mosquiteiros
/
Inseticidas
/
Malária
Tipo de estudo:
Etiology_studies
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Female
/
Humans
/
Infant
/
Male
País/Região como assunto:
Africa
Idioma:
En
Revista:
N Engl J Med
Ano de publicação:
2022
Tipo de documento:
Article