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Effect of expanded insecticide-treated bednet coverage on child survival in rural Kenya: a longitudinal study.

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Title: Effect of expanded insecticide-treated bednet coverage on child survival in rural Kenya: a longitudinal study.
Authors: Fegan GW (AUTHOR), Noor AM (AUTHOR), Akhwale WS (AUTHOR), Cousens S (AUTHOR), Snow RW (AUTHOR), Fegan, Greg W (AUTHOR), Noor, Abdisalan M (AUTHOR), Akhwale, Willis S (AUTHOR), Cousens, Simon (AUTHOR), Snow, Robert W (AUTHOR)
Source: Lancet. 9/22/2007, Vol. 370 Issue 9592, p1035-1039. 5p.
Abstract: Background: The potential of insecticide-treated bednets (ITNs) to contribute to child survival has been well documented in randomised controlled trials. ITN coverage has increased rapidly in Kenya from 7% in 2004 to 67% in 2006. We aimed to assess the extent to which this investment has led to improvements in child survival.Methods: A dynamic cohort of about 3500 children aged 1-59 months were enumerated three times at yearly intervals in 72 rural clusters located in four districts of Kenya. The effect of ITN use on mortality was assessed with Poisson regression to take account of potential effect-modifying and confounding covariates.Findings: 100 children died over 2 years. Overall mortality rates were much the same in the first and second years of the study (14.5 per 1000 person-years in the first year and 15.4 per 1000 person-years in the second). After adjustment for age, time period, and a number of other possible confounding variables, ITN use was associated with a 44% reduction in mortality (mortality rate ratio 0.56, 95% CI 0.33-0.96; p=0.04). This level of protection corresponds to about seven deaths averted for every 1000 ITNs distributed.Interpretation: A combined approach of social marketing followed by mass free distribution of ITNs translated into child survival effects that are comparable with those seen in previous randomised controlled trials. [ABSTRACT FROM AUTHOR]
Copyright of Lancet is the property of Lancet and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Effect of expanded insecticide-treated bednet coverage on child survival in rural Kenya: a longitudinal study.
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  Data: <searchLink fieldCode="AR" term="%22Fegan+GW%22">Fegan GW</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Noor+AM%22">Noor AM</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Akhwale+WS%22">Akhwale WS</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Cousens+S%22">Cousens S</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Snow+RW%22">Snow RW</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Fegan%2C+Greg+W%22">Fegan, Greg W</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Noor%2C+Abdisalan+M%22">Noor, Abdisalan M</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Akhwale%2C+Willis+S%22">Akhwale, Willis S</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Cousens%2C+Simon%22">Cousens, Simon</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Snow%2C+Robert+W%22">Snow, Robert W</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Lancet%22">Lancet</searchLink>. 9/22/2007, Vol. 370 Issue 9592, p1035-1039. 5p.
– Name: Abstract
  Label: Abstract
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  Data: <bold>Background: </bold>The potential of insecticide-treated bednets (ITNs) to contribute to child survival has been well documented in randomised controlled trials. ITN coverage has increased rapidly in Kenya from 7% in 2004 to 67% in 2006. We aimed to assess the extent to which this investment has led to improvements in child survival.<bold>Methods: </bold>A dynamic cohort of about 3500 children aged 1-59 months were enumerated three times at yearly intervals in 72 rural clusters located in four districts of Kenya. The effect of ITN use on mortality was assessed with Poisson regression to take account of potential effect-modifying and confounding covariates.<bold>Findings: </bold>100 children died over 2 years. Overall mortality rates were much the same in the first and second years of the study (14.5 per 1000 person-years in the first year and 15.4 per 1000 person-years in the second). After adjustment for age, time period, and a number of other possible confounding variables, ITN use was associated with a 44% reduction in mortality (mortality rate ratio 0.56, 95% CI 0.33-0.96; p=0.04). This level of protection corresponds to about seven deaths averted for every 1000 ITNs distributed.<bold>Interpretation: </bold>A combined approach of social marketing followed by mass free distribution of ITNs translated into child survival effects that are comparable with those seen in previous randomised controlled trials. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Lancet is the property of Lancet and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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              Text: 9/22/2007
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