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Antimalarial bednet protection of children disappears when shared by three or more people in a high transmission setting of western Kenya

Published online by Cambridge University Press:  10 September 2018

Noriko Tamari Open the ORCID record for Noriko Tamari [Opens in a new window] ,
Noboru Minakawa ,
George O. Sonye ,
Beatrice Awuor ,
James O. Kongere ,
Stephen Munga  and
Peter S. Larson
Noriko Tamari*
Affiliation:
Graduate School of Tropical Medicine and Global Health, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, Nagasaki, 852-8523, Japan Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, Nagasaki, 852-8523, Japan
Noboru Minakawa
Affiliation:
Institute of Tropical Medicine, Nagasaki University, 1-12-4 Sakamoto, Nagasaki, Nagasaki, 852-8523, Japan
George O. Sonye
Affiliation:
Ability to Solve by Knowledge Project, Mbita, Homa Bay, Kenya
Beatrice Awuor
Affiliation:
Ability to Solve by Knowledge Project, Mbita, Homa Bay, Kenya
James O. Kongere
Affiliation:
Centre for Research in Tropical Medicine and Community Development, Nairobi, Kenya
Stephen Munga
Affiliation:
Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
Peter S. Larson
Affiliation:
NUITM-KEMRI Project, Institute of Tropical Medicine, Nagasaki University, Nairobi, Kenya Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
*
Author for correspondence: Noriko Tamari, E-mail: norikotamari@gmail.com
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Abstract

A sizeable proportion of households is forced to share single long-lasting insecticide treated net (LLIN). However, the relationship between increasing numbers of people sharing a net and the risk for Plasmodium infection is unclear. This study revealed whether risk for Plasmodium falciparum infection is associated with the number of people sharing a LLIN in a holoendemic area of Kenya. Children ⩽5 years of age were tested for P. falciparum infection using polymerase chain reaction. Of 558 children surveyed, 293 (52.5%) tested positive for parasitaemia. Four hundred and fifty-eight (82.1%) reported sleeping under a LLIN. Of those, the number of people sharing a net with the sampled child ranged from 1 to 5 (median = 2). Children using a net alone or with one other person were at lower risk than non-users (OR = 0.29, 95% CI 0.10–0.82 and OR = 0.47, 95% CI 0.22–0.97, respectively). On the other hand, there was no significant difference between non-users and children sharing a net with two (OR = 0.88, 95% CI 0.44–1.77) or more other persons (OR = 0.75, 95% CI 0.32–1.72). LLINs are effective in protecting against Plasmodium infection in children when used alone or with one other person compared with not using them. Public health professionals should inform caretakers of the risks of too many people sharing a net.

Keywords

Bed netsbednet sharingchildrenKenyalong-lasting insecticide treated netsmalariaPlasmodiumuniversal coverage
Type
Research Article
Information
Parasitology , Volume 146 , Issue 3 , March 2019 , pp. 363 - 371
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Copyright
Copyright © Cambridge University Press 2018 

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