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The incidence of malaria has decreased recently in parts of Africa, coinciding with the widespread use of long-lasting insecticide-treated nets (LLINs) and artemisinin-based combination therapy (ACT). This reduction was also observed in Dielmo, our study area, and it was associated with the use of ACT as the first-line treatment against malaria beginning in 2006 and the implementation of LLINs in 2008. However, an unexplained slight increase in malaria incidence was observed in October and November of 2013. The aim of this study was to identify individual and environmental risk factors for malaria using a case-control study approach. Thirty cases and sixty controls were investigated. The use of LLINs was protective against malaria (adjusted odds ratio [AOR] = 0.10; 95% confidence interval [95% CI] = 0.02–0.45; P = 0.003). The risk of malaria transmission was high among villagers who watched television outside the house or the bedroom during the night (AOR = 8.83; 95% CI = 1.39–56.22; P = 0.021). The use of LLINs should be reinforced by the use of individual protection measures to avoid malaria transmission outside of the home.
Financial support: This publication was made possible through support provided by the Institut de Recherche pour le Développement-Direction des Programmes de Recherche et de la Formation au Sud (IRD-DPF). A.N.W. was partially supported by the African Doctoral Dissertation Research Fellowship (ADDRF) offered by the African Population and Health Research Center (APHRC) in partnership with the International Development Research Centre (IDRC).
Authors' addresses: Amélé N. Wotodjo, Nafissatou Diagne, and Cheikh Sokhna, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Campus UCAD-IRD, Dakar, Sénégal, E-mails: Ameleemail@example.com, Nafissatou.firstname.lastname@example.org, and Cheikh.Sokhna@ird.fr. Jean Gaudart, Aix-Marseille Université, UMR912 SESSTIM (INSERM-IRD-AMU), Marseille, France, E-mail: email@example.com. Vincent Richard, Institut Pasteur de Dakar, Unité d'Epidémiologie, Dakar, Sénégal, E-mail: firstname.lastname@example.org. Didier Raoult, Institut Hospitalo Universitaire Mediterranee-Infection, Aix-Marseille Université, Unité de Recherche sur les Maladies Infectieuses et Tropicales Emergentes, Marseille, France, E-mail: email@example.com.