The use of insecticide-treated nets for reducing malaria morbidity among children aged 6-59 months, in an area of high malaria transmission in central Côte d'Ivoire
2010
Koudou B.G. | Ghattas H. | Esse C. | Nsanzabana C. | Rohner F. | Utzinger J. | Faragher B.E. | Tschannen A.B. | Koudou, B.G., Vector Group, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, United Kingdom, Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01 BP 1303, Abidjan 01, Côte d'Ivoire, Brazil, UFR Sciences de Nature, Université d'Abobo-Adjamé, 02 BP 801, Abidjan 02, Côte d'Ivoire, Brazil | Ghattas, H., MRC International Nutrition Group, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom, Department of Nutrition and Food Sciences, American University of Beirut, P.O. Box 11-0236, Beirut 1107 2020, Lebanon | Essé, C., Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01 BP 1303, Abidjan 01, Côte d'Ivoire, Brazil, Institut d'Ethno Sociologie, Université de Cocody-Abidjan, 01 BP V34, Abidjan 01, Côte d'Ivoire, Brazil | Nsanzabana, C., Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01 BP 1303, Abidjan 01, Côte d'Ivoire, Brazil, Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland, University of Basel, P.O. Box, CH-4003 Basel, Switzerland | Rohner, F., Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01 BP 1303, Abidjan 01, Côte d'Ivoire, Brazil, Institute of Food, Nutrition, and Health, Swiss Federal Institute of Technology Zurich, CH-8092 Zurich, Switzerland | Utzinger, J., Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box, CH-4002 Basel, Switzerland, University of Basel, P.O. Box, CH-4003 Basel, Switzerland | Faragher, B.E., Clinical Group, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, United Kingdom | Tschannen, A.B., Centre Suisse de Recherches Scientifiques en Côte d'Ivoire, 01 BP 1303, Abidjan 01, Côte d'Ivoire, Brazil | Koudou, B. G.; Vector Group, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool L3 5QA, United Kingdom; email: [email protected] | University: American University of Beirut; Faculty: Faculty of Agricultural and Food Sciences; Department: Nutrition and Food Sciences; | Nutrition and Food Sciences | [email protected] | Faculty of Agricultural and Food Sciences | Koudou, BG | Ghattas, H | Esse, C | Nsanzabana, C | Rohner, F | Utzinger, J | Faragher, BE | Tschannen, AB | Koudou, BG (reprint author), Univ Liverpool, Liverpool Sch Trop Med, Vector Grp, Pembroke Pl, Liverpool L3 5QA, Merseyside, England. | American University of Beirut
Background: Long-lasting insecticidal nets (LLINs) are an important tool for controlling malaria. Much attention has been devoted to determine both the effect of LLINs on the reduction of Plasmodium infection rate and on clinically-confirmed malaria cases in sub-Saharan Africa. We carried out an epidemiological study to investigate whether LLINs impact on Plasmodium prevalence rate and the proportion of clinically-confirmed malaria cases, in five villages in the district of Toumodi, central Côte d'Ivoire. Methods: From April 2007 to November 2008, a community-based malaria control programme was implemented in the study villages, which involved large-scale distribution of LLINs, and training and sensitization activities within the community. We determined the effect of this programme on Plasmodium prevalence rate, clinically-confirmed malaria cases and proportion of high parasitaemia rates in children aged 6-59 months through a series of cross-sectional surveys starting in April 2007 and repeated once every 6 months. Results: We observed a significant decrease in the mean P. falciparum prevalence rate from April 2007 to April 2008 (p = 0.029). An opposite trend was observed from November 2007 to November 2008 when P. falciparum prevalence rate increased significantly (p = 0.003). Highly significant decreases in the proportions of clinical malaria cases were observed between April 2007 and April 2008 (p 0.001), and between November 2007 and November 2008 (p = 0.001). Conclusions: Large-scale distribution of LLINs, accompanied by training and sensitization activities, significantly reduced Plasmodium prevalence rates among young children in the first year of the project, whereas overall clinical malaria rates dropped over the entire 18-month project period. A decrease in community motivation to sleep under bed nets, perhaps along with changing patterns of malaria transmission, might explain the observed increase in the Plasmodium prevalence rate between November 2007 and November 2008. © 2010 Koudou et al; licensee BioMed Central Ltd.
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