9/12/09

Low-cost bed nets prove priceless

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

Carolina School of Medicine and

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,

Becker-Dreps says.

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

School of Global Public Health.

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

their estimates.

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

Medicine and Hygiene.

UNC-Chapel Hill news: http://uncnews.unc.edu

Link here


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