A carregar...
Child mortality patterns in rural Tanzania: an observational study on the impact of malaria control interventions
Background Between 1997 and 2009, a number of key malaria control interventions were implemented in the Kilombero and Ulanga Districts in south central Tanzania to increase insecticide-treated nets (ITN) coverage and improve access to effective malaria treatment. In this study we estimated the contr...
Autores principales: | , , , , |
---|---|
Formato: | Online Artigo Texto |
Idioma: | English |
Publicado em: |
Oxford University Press
2014
|
Assuntos: | |
Acesso em linha: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3937976/ https://www.ncbi.nlm.nih.gov/pubmed/24355745 http://dx.doi.org/10.1093/ije/dyt231 |
_version_ | 1782305551385886720 |
---|---|
author | Alba, Sandra Nathan, Rose Schulze, Alexander Mshinda, Hassan Lengeler, Christian |
author_facet | Alba, Sandra Nathan, Rose Schulze, Alexander Mshinda, Hassan Lengeler, Christian |
author_sort | Alba, Sandra |
collection | PubMed |
description | Background Between 1997 and 2009, a number of key malaria control interventions were implemented in the Kilombero and Ulanga Districts in south central Tanzania to increase insecticide-treated nets (ITN) coverage and improve access to effective malaria treatment. In this study we estimated the contribution of these interventions to observed decreases in child mortality. Methods The local Health and Demographic Surveillance Site (HDSS) provided monthly estimates of child mortality rates (age 1 to 5 years) expressed as cases per 1000 person-years (c/1000py) between 1997 and 2009. We conducted a time series analysis of child mortality rates and explored the contribution of rainfall and household food security. We used Poisson regression with linear and segmented effects to explore the impact of malaria control interventions on mortality. Results Child mortality rates decreased by 42.5% from 14.6 c/1000py in 1997 to 8.4 c/1000py in 2009. Analyses revealed the complexity of child mortality patterns and a strong association with rainfall and food security. All malaria control interventions were associated with decreases in child mortality, accounting for the effect of rainfall and food security. Conclusions Reaching the fourth Millenium Development Goal will require the contribution of many health interventions, as well as more general improvements in socio-environmental and nutritional conditions. Distinguishing between the effects of these multiple factors is difficult and represents a major challenge in assessing the effect of routine interventions. However, this study suggests that credible estimates can be obtained when high-quality data on the most important factors are available over a sufficiently long time period. |
format | Online Article Text |
id | pubmed-3937976 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2014 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-39379762014-03-04 Child mortality patterns in rural Tanzania: an observational study on the impact of malaria control interventions Alba, Sandra Nathan, Rose Schulze, Alexander Mshinda, Hassan Lengeler, Christian Int J Epidemiol Mortality Background Between 1997 and 2009, a number of key malaria control interventions were implemented in the Kilombero and Ulanga Districts in south central Tanzania to increase insecticide-treated nets (ITN) coverage and improve access to effective malaria treatment. In this study we estimated the contribution of these interventions to observed decreases in child mortality. Methods The local Health and Demographic Surveillance Site (HDSS) provided monthly estimates of child mortality rates (age 1 to 5 years) expressed as cases per 1000 person-years (c/1000py) between 1997 and 2009. We conducted a time series analysis of child mortality rates and explored the contribution of rainfall and household food security. We used Poisson regression with linear and segmented effects to explore the impact of malaria control interventions on mortality. Results Child mortality rates decreased by 42.5% from 14.6 c/1000py in 1997 to 8.4 c/1000py in 2009. Analyses revealed the complexity of child mortality patterns and a strong association with rainfall and food security. All malaria control interventions were associated with decreases in child mortality, accounting for the effect of rainfall and food security. Conclusions Reaching the fourth Millenium Development Goal will require the contribution of many health interventions, as well as more general improvements in socio-environmental and nutritional conditions. Distinguishing between the effects of these multiple factors is difficult and represents a major challenge in assessing the effect of routine interventions. However, this study suggests that credible estimates can be obtained when high-quality data on the most important factors are available over a sufficiently long time period. Oxford University Press 2014-02 2013-12-19 /pmc/articles/PMC3937976/ /pubmed/24355745 http://dx.doi.org/10.1093/ije/dyt231 Text en Published by Oxford University Press on behalf of the International Epidemiological Association © The Author 2013. http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com |
spellingShingle | Mortality Alba, Sandra Nathan, Rose Schulze, Alexander Mshinda, Hassan Lengeler, Christian Child mortality patterns in rural Tanzania: an observational study on the impact of malaria control interventions |
title | Child mortality patterns in rural Tanzania: an observational study on the impact of malaria control interventions |
title_full | Child mortality patterns in rural Tanzania: an observational study on the impact of malaria control interventions |
title_fullStr | Child mortality patterns in rural Tanzania: an observational study on the impact of malaria control interventions |
title_full_unstemmed | Child mortality patterns in rural Tanzania: an observational study on the impact of malaria control interventions |
title_short | Child mortality patterns in rural Tanzania: an observational study on the impact of malaria control interventions |
title_sort | child mortality patterns in rural tanzania: an observational study on the impact of malaria control interventions |
topic | Mortality |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3937976/ https://www.ncbi.nlm.nih.gov/pubmed/24355745 http://dx.doi.org/10.1093/ije/dyt231 |
work_keys_str_mv | AT albasandra childmortalitypatternsinruraltanzaniaanobservationalstudyontheimpactofmalariacontrolinterventions AT nathanrose childmortalitypatternsinruraltanzaniaanobservationalstudyontheimpactofmalariacontrolinterventions AT schulzealexander childmortalitypatternsinruraltanzaniaanobservationalstudyontheimpactofmalariacontrolinterventions AT mshindahassan childmortalitypatternsinruraltanzaniaanobservationalstudyontheimpactofmalariacontrolinterventions AT lengelerchristian childmortalitypatternsinruraltanzaniaanobservationalstudyontheimpactofmalariacontrolinterventions |