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EFFECT OF SUSTAINED INSECTICIDE-TREATED BED NET USE ON ALL-CAUSE CHILD MORTALITY IN AN AREA OF INTENSE PERENNIAL MALARIA TRANSMISSION IN WESTERN KENYA

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  • 1 Department of International Heath and Development, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana; Division of Parasitic Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; Liverpool School of Tropical Medicine, Liverpool, United Kingdom; Centre for Vector Biology and Control Research, Kenya Medical Research Institute, Kisumu, Kenya; Roll Back Malaria, World Health Organization, Geneva, Switzerland

We present results from a study conducted in western Kenya where all-cause child mortality was assessed among a population with high levels of sustained insecticide-treated bed net (ITN) use for up to six years. Although ITNs were associated with significant reductions in all-cause mortality among infants 1–11 months old, there was no difference in the rate of all-cause mortality among children 12–59 months old with ITNs for 2–4 years, compared historically with children from villages without ITNs, after controlling for seasonality and underlying child mortality across calendar years (adjusted hazard ratio [AHR] = 0.91, 95% confidence interval [CI] = 0.77–1.07). There was no increase in the proportion of child deaths at older ages (12–59 months old) of all child deaths within villages with ITNs for 5–6 years (48.1%) compared historically with villages without ITNs (47.9%), after controlling for seasonality (AHR = 1.03, P = 0.834). We find no evidence that sustained ITN use increased the risk of mortality in older children in this area of intense perennial malaria transmission.

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