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Impact of Insecticide-Treated Net Ownership on All-Cause Child Mortality in Malawi, 2006-2010.
Florey, Lia S; Bennett, Adam; Hershey, Christine L; Bhattarai, Achuyt; Nielsen, Carrie F; Ali, Doreen; Luhanga, Misheck; Taylor, Cameron; Eisele, Thomas P; Yé, Yazoume.
Afiliação
  • Florey LS; ICF, The DHS Program, Rockville, Maryland.
  • Bennett A; Malaria Elimination Initiative, University of California, San Francisco, California.
  • Hershey CL; President's Malaria Initiative, United States Agency for International Development, Arlington, Virginia.
  • Bhattarai A; President's Malaria Initiative, Malaria Branch, Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Nielsen CF; President's Malaria Initiative, Malaria Branch, Centers for Disease Control and Prevention, Atlanta, Georgia.
  • Ali D; National Malaria Control Programme, Ministry of Health, Lilongwe, Malawi.
  • Luhanga M; National Malaria Control Programme, Ministry of Health, Lilongwe, Malawi.
  • Taylor C; ICF, The DHS Program, Rockville, Maryland.
  • Eisele TP; Center for Applied Malaria Research and Evaluation, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana.
  • Yé Y; ICF, MEASURE Evaluation, Rockville, Maryland.
Am J Trop Med Hyg ; 97(3_Suppl): 65-75, 2017 Sep.
Article em En | MEDLINE | ID: mdl-28990922
ABSTRACT
Insecticide-treated nets (ITNs) have been shown to be highly effective at reducing malaria morbidity and mortality in children. However, there are limited studies that assess the association between increasing ITN coverage and child mortality over time, at the national level, and under programmatic conditions. Two analytic approaches were used to examine this association a retrospective cohort analysis of individual children and a district-level ecologic analysis. To evaluate the association between household ITN ownership and all-cause child mortality (ACCM) at the individual level, data from the 2010 Demographic and Health Survey (DHS) were modeled in a Cox proportional hazards framework while controlling for numerous environmental, household, and individual confounders through the use of exact matching. To evaluate population-level association between ITN ownership and ACCM between 2006 and 2010, program ITN distribution data and mortality data from the 2006 Multiple Indicator Cluster Survey and the 2010 DHS were aggregated at the district level and modeled using negative binomial regression. In the Cox model controlling for household, child and maternal health factors, children between 1 and 59 months in households owning an ITN had significantly lower mortality compared with those without an ITN (hazard ratio = 0.75, 95% confidence interval [CI] = 0.62-90). In the district-level model, higher ITN ownership was significantly associated with lower ACCM (incidence rate ratio = 0.77; 95% CI = 0.60-0.98). These findings suggest that increasing ITN ownership may have contributed to the decline in ACCM during 2006-2010 in Malawi and represent a novel use of district-level data from nationally representative surveys.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Propriedade / Mortalidade Infantil / Mortalidade da Criança / Mosquiteiros Tratados com Inseticida Tipo de estudo: Observational_studies / Prognostic_studies Limite: Adolescent / Adult / Child, preschool / Female / Humans / Infant / Male / Middle aged País/Região como assunto: Africa Idioma: En Ano de publicação: 2017 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Propriedade / Mortalidade Infantil / Mortalidade da Criança / Mosquiteiros Tratados com Inseticida Tipo de estudo: Observational_studies / Prognostic_studies Limite: Adolescent / Adult / Child, preschool / Female / Humans / Infant / Male / Middle aged País/Região como assunto: Africa Idioma: En Ano de publicação: 2017 Tipo de documento: Article