Effect of Investment in Malaria Control on Child Mortality in Sub-Saharan Africa in 2002–2008Reportar como inadecuado

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Around 8.8 million children under-five die each year, mostly due to infectious diseases, including malaria that accounts for 16% of deaths in Africa, but the impact of international financing of malaria control on under-five mortality in sub-Saharan Africa has not been examined.

Methods and Findings

We combined multiple data sources and used panel data regression analysis to study the relationship among investment, service delivery-intervention coverage, and impact on child health by observing changes in 34 sub-Saharan African countries over 2002–2008. We used Lives Saved Tool to estimate the number of lives saved from coverage increase of insecticide-treated nets ITNs-indoor residual spraying IRS. As an indicator of outcome, we also used under-five mortality rate. Global Fund investments comprised more than 70% of the Official Development Assistance ODA for malaria control in 34 countries. Each $1 million ODA for malaria enabled distribution of 50,478 ITNs 95%CI: 37,774–63,182 in the disbursement year. 1,000 additional ITNs distributed saved 0.625 lives 95%CI: 0.369–0.881. Cumulatively Global Fund investments that increased ITN-IRS coverage in 2002–2008 prevented an estimated 240,000 deaths. Countries with higher malaria burden received less ODA disbursement per person-at-risk compared to lower-burden countries $3.90 vs. $7.05. Increased ITN-IRS coverage in high-burden countries led to 3,575 lives saved per 1 million children, as compared with 914 lives in lower-burden countries. Impact of ITN-IRS coverage on under-five mortality was significant among major child health interventions such as immunisation showing that 10% increase in households with ITN-IRS would reduce 1.5 95%CI: 0.3–2.8 child deaths per 1000 live births.


Along with other key child survival interventions, increased ITNs-IRS coverage has significantly contributed to child mortality reduction since 2002. ITN-IRS scale-up can be more efficiently prioritized to countries where malaria is a major cause of child deaths to save greater number of lives with available resources.

Autor: Yoko Akachi, Rifat Atun

Fuente: http://plos.srce.hr/


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