Area effects of bednet use in a malaria-endemic are in Papua New Guinea

Hii, JLK; Smith, T; Vounatsou, P; Alexander, NDE; Mai, A; Ibam, E; Alpers, MP; (2001) Area effects of bednet use in a malaria-endemic are in Papua New Guinea. Transactions of the Royal Society of Tropical Medicine and Hygiene, 95 (1). pp. 7-13. ISSN 0035-9203 DOI:

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Relationships between area coverage with insecticide-free bednets and prevalence of Plasmodium falciparum were investigated in 7 community-based surveys over a 33-month period in 1990-93 in 6 villages in the Wosera area of Papua New Guinea. Spatial patterns in circumsporozoite rates for P. falciparum, P. vivax isomorphs K210 and K247, and P. malariae, and the proportions of mosquito blood meals positive for specific human, goat, cat, dog and pig antigens were determined using ELISAs. P. falciparum prevalence in humans was better explained by bednet coverage in the immediate vicinity than by personal protection alone. Circumsporozoite rates for both P. falciparum and P. vivax were also inversely related to coverage with bednets. There was some increase in zoophagy in areas with high coverage, but relatively little effect on the human blood index or on overall mosquito densities. In this setting, protracted use of untreated bednets apparently reduces sporozoite rates, and the associated effects on prevalence are greater than can be accounted for by personal protection. Even at high bednet coverage most anophelines feed on human hosts, so the decreased sporozoite rates are likely to be largely due to reduction of mosquito survival. This finding highlights the importance of local vector ecology for outcomes of bednet programmes and suggests that area effects of untreated bednets should be reassessed in other settings.

Item Type: Article
Keywords: Adolescent, Adult, Age Distribution, Animal, Anopheles, parasitology, Apicomplexa, Bedding and Linens, Child, Child, Preschool, Enzyme-Linked Immunosorbent Assay, Human, Infant, Infant, Newborn, Insect Vectors, Logistic Models, Malaria, Falciparum, epidemiology, prevention & control, Mosquito Control, methods, Papua New Guinea, epidemiology, Prevalence, Support, Non-U.S. Gov't, Support, U.S. Gov't, Non-P.H.S.
Faculty and Department: Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Tropical Epidemiology Group
PubMed ID: 11280071
Web of Science ID: 167561600002


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