Volume 84, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645



We examined the relationship between insecticide-treated mosquito nets (ITNs), malaria parasite infection, and severe anemia prevalence in children in Luangwa District, Zambia, an area with near-universal ITN coverage, at the end of the 2008 and 2010 malaria transmission seasons. Malaria parasite infection prevalence among children < 5 years old was 9.7% (95% confidence interval [CI] = 8.0–11.4%) over both survey years. Prevalence of severe anemia among children 6–59 months old was 6.9% (95% CI = 5.4–8.5%) over both survey years. Within this context of near-universal ITN coverage, we were unable to detect a significant association between malaria parasite or severe anemia prevalence and ITNs (possession and use). In addition to maintaining universal ITN coverage, it will be essential for the malaria control program to achieve high ITN use and laboratory diagnosis and treatment of all fevers among all age groups to further reduce the malaria burden in this area.


Article metrics loading...

The graphs shown below represent data from March 2017
Loading full text...

Full text loading...



  1. Lengeler C, , 2004. Insecticide-treated bed nets and curtains for preventing malaria. Cochrane Database Syst Rev CD000363. [Google Scholar]
  2. Eisele TP, Larsen D, Steketee RW, , 2010. Protective efficacy of interventions for preventing malaria mortality in children in Plasmodium falciparum endemic areas. Int J Epidemiol 39: i88i101.[Crossref] [Google Scholar]
  3. Roll Back Malaria, 2008. Global Malaria Action Plan: For a Malaria Free World. Geneva, Switzerland: Roll Back Malaria Partnership. [Google Scholar]
  4. Howard SC, Omumbo J, Nevill C, Some ES, Donnelly CA, Snow RW, , 2000. Evidence for a mass community effect of insecticide-treated bednets on the incidence of malaria on the Kenyan coast. Trans R Soc Trop Med Hyg 94: 357360.[Crossref] [Google Scholar]
  5. Hawley WA, Phillips-Howard PA, ter Kuile FO, Terlouw DJ, Vulule JM, Ombok M, Nahlen BL, Gimnig JE, Kariuki SK, Kolczak MS, Hightower AW, , 2003. Community-wide effects of permethrin-treated bed nets on child mortality and malaria morbidity in western Kenya. Am J Trop Med Hyg 68: 121127. [Google Scholar]
  6. Keating J, Miller JM, Bennett A, Moonga HB, Eisele TP, , 2009. Plasmodium falciparum parasite infection prevalence from a household survey in Zambia using microscopy and a rapid diagnostic test: implications for monitoring and evaluation. Acta Trop 112: 277282.[Crossref] [Google Scholar]
  7. Centers for Disease Control and Prevention, 2007. Diagnostic Procedures for Blood Specimens. Available at: http://www.dpd.cdc.gov/dpdx/HTML/DiagnosticProcedures.htm. Accessed April 19, 2007. [Google Scholar]
  8. Rutstein SO, Johnson K, , 2004. The DHS Wealth Index. DHS Comparative Reports No. 6. Calverton, MD: Macro International. [Google Scholar]
  9. Zambia Ministry of Health, 2008. Zambia National Malaria Indicator Survey 2008. Lusaka, Zambia: Zambia Ministry of Health. [Google Scholar]
  10. Zambia Ministry of Health, 2006. Zambia National Malaria Indicator Survey 2006. Lusaka, Zambia: Zambia Ministry of Health. [Google Scholar]
  11. Abdulla S, Schellenberg JR, Mukasa O, Lengeler C, , 2002. Usefulness of a dispensary-based case-control study for assessing morbidity impact of a treated net programme. Int J Epidemiol 31: 175180.[Crossref] [Google Scholar]
  12. Abdulla S, Gemperli A, Mukasa O, Schellenberg JRMA, Lengeler C, Vounatsou P, Smith T, , 2005. Spatial effects of the social marketing of insecticide-treated nets on malaria morbidity. Trop Med Int Health 10: 1118.[Crossref] [Google Scholar]
  13. Noor AM, Moloney G, Borle M, Fegan GW, Shewchuk T, Snow RW, , 2008. The use of mosquito nets and the prevalence of Plasmodium falciparum infection in rural South Central Somalia. PLoS ONE 3: e2081.[Crossref] [Google Scholar]
  14. Guyatt HL, Kinnear J, Burini M, Snow RW, , 2002. A comparative cost analysis of insecticide-treated nets and indoor residual spraying in highland Kenya. Health Policy Plan 17: 144153.[Crossref] [Google Scholar]
  15. Clarke SE, Bogh C, Brown RC, Pinder M, Walraven GE, Lindsay SW, , 2001. Do untreated bednets protect against malaria? Trans R Soc Trop Med Hyg 95: 457462.[Crossref] [Google Scholar]
  16. Mathanga DP, Campbell CH, Taylor TE, Barlow R, Wilson ML, , 2006. Socially marketed insecticide-treated nets effectively reduce Plasmodium infection and anaemia among children in urban Malawi. Trop Med Int Health 11: 13671374.[Crossref] [Google Scholar]
  17. Gimnig JE, Vulule JM, Lo TQ, Kamau L, Kolczak MS, Phillips-Howard PA, Mathenge EM, ter Kuile FO, Nahlen BL, Hightower AW, Hawley WA, , 2003. Impact of permethrin-treated bed nets on entomologic indices in an area of intense year-round malaria transmission. Am J Trop Med Hyg 68: 1622. [Google Scholar]

Data & Media loading...

  • Received : 20 May 2010
  • Accepted : 28 Sep 2010
  • Published online : 05 Jan 2011

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error