Malaria, which is transmitted to humans by mosquitoes,
is common among pregnant women in sub-Saharan Africa
and is a major contributing factor to low birth weights
and infant deaths in that region.
UNC-CHAPEL HILL—Giving insecticide-treated
bed nets, at a cost of only about $6 each,
to nearly 18,000 mothers at prenatal clinics
in the Democratic Republic of Congo prevented
hundreds of malaria-related infant deaths,
a new study finds.
"This is an extremely cost-effective intervention,"
says Sylvia Becker-Dreps, assistant professor
of family medicine in the University of North
lead author of the study.
"In fact, it approaches the cost effectiveness
of measles vaccination and is far more
cost effective than prevention measures
that are routine in the U.S."
When costs for transporting and distributing
the nets and educating people how to use
them are factored in, it cost just over
$411 for every infant death prevented,
In addition, the intervention prevented
an estimated 587 low birth weight deliveries,
which in turn reduced long-term disability.
The study stems from a project Becker-Dreps
worked on while pursuing her Master
of Public Health degree in the UNC Gillings
Andrea Biddle, associate professor in
the Gillings Schools, mentored
Becker-Dreps and was a coauthor of the study.
Study coauthor Frieda Behets, associate
professor of epidemiology at
the Gillings School, helped 28 clinics
in Kinshasa, the capital and largest city
in the Democratic Republic of Congo,
implement a program to prevent
mother-to-child transmission of HIV.
As part of that program, nearly
18,000 pregnant women were given
long-lasting, insecticide-treated bed nets for free.
Malaria, which is transmitted to humans
by mosquitoes, is common among
pregnant women in sub-Saharan Africa and
is a major contributing factor
to low birth weights and infant deaths in that region.
"The goal of this study," Becker-Dreps
explains, "was to find out the costs and
impact of giving bed nets to pregnant women
in prenatal clinics before their babies
were born. The pregnant women could then
use the bed nets during their pregnancies
to reduce preterm deliveries and then
use it to protect their young infants after birth."
Questionnaires administered to the mothers
found that 84 percent reported sleeping
under the bed net every day or almost
every day, six months after delivery.
Interviewers who visited a sample of
the mothers reported that 70 percent
had their bed nets hanging in the
correct position in their homes.
Becker-Dreps and colleagues combined
this data with actual infant mortality and
low birth weight data from clinics in the region
and then performed statistical analyses
that enabled them to produce
They concluded that bed net distribution
is a cost-effective addition to prenatal
services in the region.
Researchers from the School of
Public Health and the Salvation Army,
both in Kinshasa, contributed to the study,
which was published in the September
issue of the American Journal of Tropical
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