Crystal Hart 06/24/13 Bio 1615 Mon Impact of Permethrin-Treated Bed Nets on Malaria, Anemia, and Growth in Infants

in an Area of Intense Perennial Malaria Transmission in Western Kenya Introduction Malaria can be a deadly disease and in some parts of the world it's almost impossible to avoid contracting it. Malaria is transmitted to people when bitten by infected mosquitoes. Studies have been done before to test the impact bed nets have on malaria transmission, but this study has a more specific focus. This study aims to look at the effects of using insecticide-treated bed nets (ITNs) on pregnant women, infants, and children under five years of age.(Ter Kuile et.al., 2003) This study was done in western Kenya because it has intense and perennial malaria transmission (Ter Kuile et.al., 2003). Pregnant women and small children are at greatest risk of having adverse effects from contraction of the disease. This study follows a number of pregnant women and their children from 1992 to 1999.The researchers wanted to observe the effects of ITNs on women throughout their pregnancy and on their infants until age two in an area with high transmission rates. The researchers thought that the use of ITNs would lower transmission rates and thus lead to improved health for the children. They also wanted to evaluate if the ITNs would have any adverse effects such as lowering the immune systems ability to fight the disease once contracted. Materials and Methods The villages in the area of study were randomly divided into two groups. One group was the control group and the other was the intervention group. Those who chose to participate were studied from June 1992 until March 1999. From June 1992 through December 1996 the participants were studied before the intervention period began. Data was collected as to when the first transmission occurred and how well the children grew. The intervention period was from January 1997 through March 1999. The demographics of each participant were noted as part of the study. Those in the intervention group were

given ITNs that were retreated twice a year. Data was collected at the time of birth and every two weeks there after until the end of the study or the child turned two or the child died. At the time of birth the birth attendant would record all the data such as weight and gestational age. Blood samples were also taken to determine if transmission had already occurred through the mother. The child was visited every two weeks and every four weeks a blood sample was taken. Blood smear tests were also preformed. Results The ITNs helped prolong the time until an infant had their first infection. Before the study the first infection occurred at about 3.1 months. During the intervention period the first infection occurred at 10.7 months for those using ITNs (Ter Kuile et.al., 2003). The use of ITNs also decreased the number of daily attacks thereby delaying the time until first transmission. The results indicate that the use of ITNs in the intervention villages had a positive effects for the control villages and that was a little unexpected. There was a decrease in the number of malaria transmissions for the whole area, not just the intervention villages. Discussion The ITNs were very successful in decreasing the rate of transmission and thereby improving the overall health of the children. There was a decrease in malaria and anemia. The ITNs delayed the first infection from 4.5 months in the control groups to 10.7 months in the intervention group. There were a few limitations in the study, but none that affected the results enough to change the conclusions that were reached. The length of the study was a little short. Many of the children did not reach their second birthday before the study ended. Another limitation of the study is that not all of the participants completed the study. Some of the participants moved and some of them died. Overall the hypothesis was proven correct since the INTs delayed the rate of first transmission, the children were healthier, and there did not seem to be any adverse effects from using the INTs.

Bibliography: Ter Kuile, F.O., Terlouw, D.J., Kariuki, S.K., Phillips-Howard, P.A., Mirel, L.B., Hawley, W.A., Friedman, J.F., Shi, Y.P., Kolczak, M.S., Lal, A.A., Vulule, J.M., Nahlen, B.L., Impact of Permethrin-Treated Bed Nets on Malaria, Anemia, and Growth in Infants in an Area of Intense Perennial Malaria Transmission in Western Kenya. The American Society of Tropical Medicine and Hygiene.pp68-77.2003