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Insecticide-treated nets and malaria prevalence, Papua New Guinea, 2008-2014

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Hetzel, Manuel W, Pulford, Justin ORCID: https://orcid.org/0000-0003-4756-8480, Ura, Yangta, Jamea-Maiasa, Sharon, Tandrapah, Anthony, Tarongka, Nandao, Lorry, Lina, Robinson, Leanne J, Lilley, Ken, Makita, Leo, Siba, Peter M and Mueller, Ivo (2017) 'Insecticide-treated nets and malaria prevalence, Papua New Guinea, 2008-2014'. Bulletin of the World Health Organization, Vol 95, Issue 10, 695-705b.

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Abstract

Objective
To investigate changes in malaria prevalence in Papua New Guinea after the distribution of long-lasting Insecticide-treated nets, starting in 2004, and the introduction of artemisinin-based combination therapy in 2011.

Methods
Two malaria surveys were conducted in 2010–2011 and 2013–2014. They included 77 and 92 randomly selected villages, respectively. In each village, all members of 30 randomly selected households gave blood samples and were assessed for malaria infection by light microscopy. In addition, data were obtained from a malaria survey performed in 2008–2009.

Results
The prevalence of malaria below 1600 m in altitude decreased from 11.1% (95% confidence interval, CI: 8.5–14.3) in 2008–2009 to 5.1% (95% CI 3.6–7.4) in 2010–2011 and 0.9% (95% CI 0.6–1.5) in 2013–2014. Prevalence decreased with altitude. Plasmodium falciparum was more common than P. vivax overall, but not everywhere, and initially the prevalence of P. vivax infection decreased more slowly
than P. falciparum infection. Malaria infections were clustered in households. In contrast to findings in 2008–2009, no significant association between net use and prevalence was found in the later two surveys. The prevalence of both fever and splenomegaly also decreased but their association with malaria infection became stronger.

Conclusion
Large-scale insecticide-treated net distribution was associated with an unprecedented decline in malaria prevalence throughout Papua New Guinea, including epidemic-prone highland areas. The decline was accompanied by broader health benefits, such as decreased morbidity. Better clinical management of nonmalarial fever and research into residual malaria transmission are required.

Item Type: Article
Subjects: QX Parasitology > Insects. Other Parasites > QX 510 Mosquitoes
QX Parasitology > Insects. Other Parasites > QX 600 Insect control. Tick control
WA Public Health > Preventive Medicine > WA 240 Disinfection. Disinfestation. Pesticides (including diseases caused by)
WA Public Health > WA 30 Socioeconomic factors in public health (General)
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > WC 20 Research (General)
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 680 Tropical diseases (General)
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria
Faculty: Department: Clinical Sciences & International Health > International Public Health Department
Digital Object Identifer (DOI): https://doi.org/10.2471/BLT.16.189902
Depositing User: Stacy Murtagh
Date Deposited: 15 Sep 2017 13:42
Last Modified: 01 Jun 2018 13:51
URI: https://archive.lstmed.ac.uk/id/eprint/7595

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