Comparing insecticide-treated bed net use to Plasmodium falciparum infection among schoolchildren living near Lake Victoria, KenyaReportar como inadecuado

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Malaria Journal

, 14:515

First Online: 22 December 2015Received: 03 April 2015Accepted: 02 December 2015


BackgroundUnder trial conditions insecticide-treated nets have been shown to provide significant clinical and mortality protection under a range of malaria transmission intensity conditions. There are, however, few operational impact data, notably in very intense transmission conditions. This study, reports on malaria infection among Kenyan schoolchildren living in areas of intense malaria transmission and their reported use of insecticide-treated bed nets.

Methods5188 children in 54 schools were randomly sampled from seven counties surrounding Lake Victoria between May and June 2014. A questionnaire was administered to schoolchildren in classes 2–6 on the use of a long-lasting, insecticide-treated net LLIN the night before the survey and provided a single blood sample for a rapid diagnostic test for malaria infection. Analysis of the impact of insecticide-treated net use on malaria prevalence was undertaken using a multivariable, mixed effects, logistic regression at 95 % confidence interval CI, taking into account hierarchical nature of the data and results adjusted for school clusters.

ResultsThe overall prevalence of malaria infection was 48.7 %, two-thirds 67.9 % of the children reported using LLIN, 91.3 % of the children reported that their households own at least one LLIN and the household LLIN coverage was 2.5 persons per one LLIN. The prevalence of infection showed variation across the counties, with prevalence being highest in Busia 66.9 % and Homabay 51.8 % counties, and lowest in Migori County 29.6 %. Generally, malaria parasite prevalence differed between age groups and gender with the highest prevalence occurring in children below 7 years 50.6 % and males 52.2 %. Adjusting for county and school, there was a significant reduction in odds of malaria infection among the schoolchildren who reported LLIN use the previous night by 14 % aOR 0.86, 95 % CI 0.74–0.98, P < 0.027.

ConclusionMalaria transmission continues to be high around Lake Victoria. Despite evidence of increasing pyrethroid resistance and the likely overall efficacy of LLIN distributed several years prior to the survey, LLIN continue to provide protection against infection among school-aged children.

KeywordsPlasmodium falciparum Malaria Long-lasting insecticide-treated net LLIN School surveys Electronic supplementary materialThe online version of this article doi:10.1186-s12936-015-1031-6 contains supplementary material, which is available to authorized users.

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Autor: Collins Okoyo - Charles Mwandawiro - Jimmy Kihara - Elses Simiyu - Caroline W. Gitonga - Abdisalan M. Noor - Sammy M. Nj


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