Child mortality in a West African population protected with insecticide-treated curtains for a period of up to 6 years

Objectives To determine the impact of insecticide-treated curtains (ITC) on all-cause child mortality (6–59 months) over a period of six years. To determine whether initial reductions in child mortality following the implementation of ITC are sustained over the longer term or whether “delayed” mortality occurs. Methods A rural population of ca 100 000 living in an area with high, seasonal Plasmodium falciparum transmission was studied in Burkina Faso. Annual censuses were conducted from 1993 to 2000 to measure child mortality. ITC to cover doors, windows, and eaves were provided to half the population in 1994 with the remainder receiving ITC in 1996. Curtains were re-treated or, if necessary, replaced annually. Findings Over six years of implementation of ITC, no evidence of the shift in child mortality from younger to older children was observed. Estimates of the reduction in child mortality associated with ITC ranged from 19% to 24%. Conclusions In our population there was no evidence to suggest that initial reduction in child mortality associated with the introduction of insecticide-treated materials was subsequently compromised by a shift in child mortality to older-aged children. Estimates of the impact of ITC on child mortality in this population range from 19% to 24%. Keywords Malaria/epidemiology/mortality; Bedding and linens/utilization/statistics; Child, Preschool; Infant mortality; Plasmodium falciparum/immunology; Malaria, Falciparum/prevention and control/transmission; Anopheles; Mosquito control; Permethrin; Remission induction; Age factors; Regression analysis; Incidence; Survival rate; Randomized controlled trials; Burkina Faso/epidemiology (source: MeSH, NLM). Mots clés Paludisme/épidémiologie/mortalité; Literie et linge/utilisation/statistique; Enfant âge pré-scolaire; Mortalité nourrisson; Plasmodium falciparum/immunologie; Paludisme plasmodium falciparum/prévention et contrôle/transmission; Anophèles; Lutte contre moustique; Perméthrine; Traitement induction rémission; Facteur âge; Analyse régression; Incidence; Taux survie; Essai clinique randomisé; Burkina Faso/épidémiologie (source: MeSH, INSERM). Palabras clave Paludismo/epidemiología/mortalidad; Ropa de cama y ropa blanca/utilización/estadística; Infante; Mortalidad infantil; Plasmodium falciparum/inmunología; Paludismo falciparum/prevención y control/ transmisión; Anopheles; Control de mosquitos; Permetrina; Inducción de remisión; Factores de edad; Análisis de regresión; Incidencia; Tasa de supervivencia; Ensayos controlados aleatorios; Burkina Faso/epidemiología (fuente: DeCS, BIREME). Bulletin of the World Health Organization 2004;82:85-91.