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首页> 外文期刊>The American Journal of Tropical Medicine and Hygiene >The Effectiveness of Community Bed Net Use on Malaria Parasitemia among Children Less Than 5 Years Old in Liberia
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The Effectiveness of Community Bed Net Use on Malaria Parasitemia among Children Less Than 5 Years Old in Liberia

机译：社区床网对利比里亚5岁以下儿童疟疾寄生虫的有效性

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In 2013, the under-5 mortality rate in Liberia was 71 deaths per 1,000 live births, with malaria responsible for 22% of those deaths. One of the primary existing control tools, long-lasting insecticide-treated bed nets (LLINs), is thought to be dually effective, acting as a physical barrier but also decreasing the mosquito population in communities. However, there has been little investigation into the protective effects of community-wide bed net use above and beyond the individual level. Using data from the population-representative 2011 Liberia Malaria Indicator Survey, we estimated the association between proportion of a community using LLINs and malaria in children using multi-level logistic regression. To investigate the potential effect measure modification of the relationship by urbanicity, we included an interaction term and calculated stratum-specific prevalence odds ratios (PORs) for rural and urban communities. We calculated a POR of malaria for an absolute 10% increase in community bed net use of 1.13 (95% confidence interval [CI]: 0.91, 1.41) and 0.35 (95% CI: 0.13, 0.92) for rural and urban communities, respectively, indicating a strong, though imprecise, protective effect within urban communities only. Our results indicate that bed net use has an indirect protective effect in urban areas, above and beyond individual use. Little or no such effect of community-wide use is seen in rural areas, likely because of population density factors. Therefore, although all control efforts should be multifaceted, promotion of bed net use in urban areas in particular will likely be a highly effective tool for control.
机译：2013年，利比里亚的5岁以下的死亡率为每1000个活产的71人死亡，疟疾负责这些死亡的22％。主要现有的控制工具之一，持久的杀虫剂处理的床网（Llins）被认为是双重有效的，作为物理障碍，但也减少了社区中的蚊虫人口。然而，对以上和超出个人水平的社区宽床净使用的保护作用几乎没有调查。利用来自人口代表的数据2011年利比里亚疟疾指标调查，我们估计使用多级逻辑回归使用Llins和疟疾的社区比例之间的关联。为了调查潜在的效果来衡量城市关系的修改，我们包括农村和城市社区的互动项和计算的阶层特异性患病率（PORS）。我们计算了疟疾的疟疾POR，为农村和城市社区分别为1.13（95％置信区间[CI]：0.91,1.41）和0.35（95％CI：0.13,0.92）分别用于农村和城市社区的绝对疟疾净额10％ ，表明强大的，虽然不精确，但仅限于城市社区的保护效果。我们的结果表明，床净净使用在城市地区，以上及超出个人使用间接保护效果。在农村地区，可能因人口密度因素而言，在农村地区看到很少或没有这样的社区使用的效果。因此，虽然所有控制努力都应该多方面，但升级城市地区的净净使用可能是一个高效的控制工具。

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