The online version of this article (doi:10.1186/1475-2875-11-327) contains supplementary material, which is available to authorized users.
Lucy C Okell, Lucy Smith Paintain contributed equally to this work.
The authors declare that they have no competing interests.
JL, LSP, JW and KH devised the study design and objectives. LO developed the model. LO, LSP, JL, JW and KH contributed to parameterization, analysis and interpretation. LSP and LO wrote the first draft of the manuscript. All authors read, commented on and approved the final manuscript.
The current target of universal access to long-lasting, insecticide-treated nets (LLIN) is 80% coverage to reduce malaria deaths by 75% by 2015. So far, campaigns have been the main channel for large-scale delivery of LLINs, however the World Health Organization has recommended that equal priority should be given to delivery via routine antenatal care (ANC) and immunization systems (EPI) to target pregnant women and children from birth. These various channels of LLIN delivery are targeted to children of different ages. Since risk of mortality varies with child age and LLIN effectiveness declines with net age, it was hypothesized that the age at which a child receives a new LLIN, and therefore the delivery channel, is important in optimizing the health impact of a net.
A simple dynamic mathematical model was developed of delivery and impact of LLINs among children under five years of age and their household members, incorporating data on age-specific malaria death rates, net use by household structure, and net efficacy over time.
The presented analysis finds that supplementing a universal mass campaign with extra ANC delivery would achieve a 1.4 times higher mortality reduction than campaign delivery alone, reflecting that children born in the years between campaigns would otherwise have access to old nets or no nets at an age of high risk. The relative advantage of supplementary ANC delivery is still present though smaller if malaria transmission levels are lower or if there is a strong mass effect achieved by mass campaigns.
These results indicate that LLIN delivery policies must take into account the age of greatest malaria risk. Emphasis should be placed on supporting routine delivery of LLINs to young children as well as campaigns.
Additional file 1: Supplementary information on parameter assumptions and data sources.(DOCX 178 KB)12936_2012_2524_MOESM1_ESM.docx
Authors’ original file for figure 112936_2012_2524_MOESM2_ESM.pdf
Authors’ original file for figure 212936_2012_2524_MOESM3_ESM.pdf
Authors’ original file for figure 312936_2012_2524_MOESM4_ESM.pdf
Authors’ original file for figure 412936_2012_2524_MOESM5_ESM.pdf
Authors’ original file for figure 512936_2012_2524_MOESM6_ESM.pdf
Lengeler C: Insecticide-treated bed nets and curtains for preventing malaria. Cochrane Database Syst Rev. 2004, 2: CD000363- PubMed
RBM: Global strategic plan: Roll back malaria 2005–2015. 2005, Geneva: Roll Back Malaria Partnership
Webster J, Lines J, Smith L: Protecting all pregnant women and children under five years living in malaria endemic areas in Africa with insecticide treated mosquito nets. 2005, Geneva: Roll Back Malaria
WHO: World Malaria Report 2011. 2011, Geneva: World Health Organisation
WHO: World Malaria Report 2009. 2009, Geneva: World Health Organisation
Wolkon A, Eng J, Terlouw D: Nine-month post campaign community-based cross-sectional ITN coverage survey. 2006, Atlanta: CDC
Eisele TP, Keating J, Littrell M, Larsen D, Macintyre K: Assessment of insecticide-treated bednet use among children and pregnant women across 15 countries using standardized national surveys. Am J Trop Med Hyg. 2009, 80: 209-214. PubMed
WHO: World Malaria Report 2011. Book World Malaria Report 2011. 2011, City: World Health Organisation
Carneiro I, Roca-Feltrer A, Griffin JT, Smith L, Tanner M, Schellenberg JA, Greenwood B, Schellenberg D: Age-patterns of malaria vary with severity, transmission intensity and seasonality in sub-Saharan Africa: a systematic review and pooled analysis. PLoS One. 2010, 5: e8988- PubMedCentralCrossRefPubMed
Rowe AK, Steketee RW: Predictions of the impact of malaria control efforts on all-cause child mortality in sub-Saharan Africa. Am J Trop Med Hyg. 2007, 77: 48-55. PubMed
Measure-DHS. Demographic and Health Surveys. http://www.measuredhs.com/,
National Bureau of Statistics (Tanzania), ORC Macro: Tanzania Demographic and Health Survey 2004–05. 2005, Tanzania: National Bureau of Statistics and ORC Macro, Dar es Salaam
Hanson K, Marchant T, Nathan R, Mponda H, Jones C, Bruce J, Mshinda H, Schellenberg JA: Household ownership and use of insecticide treated nets among target groups after implementation of a national voucher programme in the United Republic of Tanzania: plausibility study using three annual cross sectional household surveys. BMJ. 2009, 339: b2434- PubMedCentralCrossRefPubMed
Hawley WA, Phillips-Howard PA, ter Kuile FO, Terlouw DJ, Vulule JM, Ombok M, Nahlen BL, Gimnig JE, Kariuki SK, Kolczak MS, Hightower AW: Community-wide effects of permethrin-treated bed nets on child mortality and malaria morbidity in western Kenya. Am J Trop Med Hyg. 2003, 68: 121-127. PubMed
Baume CA, Marin MC: Intra-household mosquito net use in Ethiopia, Ghana, Mali, Nigeria, Senegal, and Zambia: are nets being used? Who in the household uses them?. Am J Trop Med Hyg. 2007, 77: 963-971. PubMed
Skarbinski J, Massaga JJ, Rowe AK, Kachur SP: Distribution of free untreated bednets bundled with insecticide via an integrated child health campaign in Lindi Region, Tanzania: lessons for future campaigns. Am J Trop Med Hyg. 2007, 76: 1100-1106. PubMed
Grabowsky M, Nobiya T, Ahun M, Donna R, Lengor M, Zimmerman D, Ladd H, Hoekstra E, Bello A, Baffoe-Wilmot A, Amofah G: Distributing insecticide-treated bednets during measles vaccination: a low-cost means of achieving high and equitable coverage. Bull World Health Organ. 2005, 83: 195-201. PubMedCentralPubMed
Willey BA, Smith Paintain L, Mangham L, Car J, Armstrong Schellenberg J: Strategies for scaling up delivery of insecticide-treated nets for malaria control: a systematic review. Bull World Health Organ. 2012, in press
Kilian A, Wijayanandana N, Ssekitoleeko J: Review of delivery strategies for insecticide treated mosquito nets – are we ready for the next phase of malaria control efforts?. Tropikanet Journal. 2010, 1:
RBM Vector Control Working Group (VCWG) Continuous Distribution Workstream: Consensus Statement on Continuous Distribution Systems for Insecticide Treated Nets. 2011, Geneva: World Health Organization
Lindblade KA, Eisele TP, Gimnig JE, Alaii JA, Odhiambo F, ter Kuile FO, Hawley WA, Wannemuehler KA, Phillips-Howard PA, Rosen DH: Sustainability of reductions in malaria transmission and infant mortality in western Kenya with use of insecticide-treated bednets: 4 to 6 years of follow-up. JAMA. 2004, 291: 2571-2580. CrossRefPubMed
Griffin JT, Hollingsworth TD, Okell LC, Churcher TS, White M, Hinsley W, Bousema T, Drakeley CJ, Ferguson NM, Basanez MG, Ghani AC: Reducing Plasmodium falciparum malaria transmission in Africa: a model-based evaluation of intervention strategies. PLoS Med. 2010, 7: e1000324- PubMedCentralCrossRefPubMed
- From intervention to impact: modelling the potential mortality impact achievable by different long-lasting, insecticide-treated net delivery strategies
Lucy C Okell
Lucy Smith Paintain
- BioMed Central
Neu im Fachgebiet Innere Medizin
Meistgelesene Bücher aus der Inneren Medizin
e.Med Kampagnen-Visual, Mail Icon II