Effects of insecticide-treated net access and use on infant mortality in Malawi: A pooled analysis of demographic health surveys

Nkoka, O., Chuang, T.-W. and Chen, Y.-H. (2019) Effects of insecticide-treated net access and use on infant mortality in Malawi: A pooled analysis of demographic health surveys. Preventive Medicine, 127, 105790. (doi: 10.1016/j.ypmed.2019.105790) (PMID:31398410)

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Abstract

Malaria continues to be among the top causes of death in children and insecticide-treated nets (ITNs) are considered among the most effective malaria control methods. However, information on the association between universal ITN coverage and infant mortality is limited. A Cox proportional hazard model was applied to Malawi Demographic and Health Surveys to determine the association between ITN access and use and infant mortality between 2004 and 2015–2016. The overall infant mortality rate for the entire period was 47.9/1000 live births. Infants from the ITN-user households exhibited a lower risk of mortality [adjusted Hazard Ratio (aHR) = 0.61, 95% Confidence Interval (CI) = 0.44–0.85] than those from the ITN-nonuser households. Similarly, the infants from the high-access households exhibited a lower risk of death (aHR = 0.63, 95% CI = 0.46–0.86) than those from the no-access households. Infants from the ITN-user and high-access households exhibited a significantly lower risk of death (aHR = 0.57, 95% CI = 0.40–0.82) than those from the ITN-nonuser and no-access households. The relationship between ITN access and use and infant mortality was significant among female infants with a second or higher birth order and interval of ≥2 years. The findings of the present population-based study emphasized the importance of ITN access and use in providing optimal protection against malaria to infants in Malawi. Malaria control programs should ensure high ITN access and use in Malawi to reduce infant mortality.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Nkoka, Dr Owen
Authors: Nkoka, O., Chuang, T.-W., and Chen, Y.-H.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Robertson Centre
Journal Name:Preventive Medicine
Publisher:Elsevier
ISSN:0091-7435
ISSN (Online):1096-0260
Published Online:06 August 2019
Copyright Holders:Copyright © 2019 Elsevier
First Published:First published in Preventive Medicine 127:105790
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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