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Bed nets protect whole communities from malaria if enough people use them

BMJ 2007; 335 doi: (Published 12 July 2007) Cite this as: BMJ 2007;335:68

Bed nets treated with insecticide protect people from malarial mosquitoes. They can also provide herd protection by killing some mosquitos and diverting others to feed on non-human mammals that are not hosts of the malarial parasite. Both mechanisms reduce the burden of malaria in a community, reduce transmission between humans, and prevent disease even in people with no access to a net. But at what level of coverage do these community wide effects offer the same protection as sleeping under a net? This question is especially important for pregnant women and children, those most likely to die from falciparum malaria.

Using mathematical modelling, researchers estimated recently that pregnant women and children would be well protected if 35-65% of the population slept under a net. These estimates support the growing consensus that wider distribution of nets might help control malaria better than the current strategy of targeting pregnant women and young children. At the least, this more equitable option should be explored further while targeted net distribution continues, say the researchers.


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