Two studies challenge current policies on the distribution of insecticide-treated bednets, which can drastically reduce the risk of malaria infection.

Current international guidelines recommend providing subsidised bednets for the most vulnerable groups - young children and pregnant women. But researchers at the Ifakara Health Research and Development Centre in Tanzania, led by Dr Gerry Killeen, have now used mathematical models of mosquito behaviour and mortality to show that protecting 35-65 per cent of older children and adults with treated nets would substantially enhance the protection of the more vulnerable groups, too. Most human-to-mosquito transmission originates from adults and older children, who constitute the bulk of the population and are more attractive to mosquitoes.

Meanwhile, researchers in Kenya have looked at the impact of distributing free bednets. Successful and equitable distribution of nets, even among young children, is not straightforward: by the end of 2004, only 7 per cent of children in rural Kenya were reported to be sleeping under the nets and only 3 per cent among the poorest sectors of these communities. Even when the price of a treated net is heavily subsidised, parents may have to choose between school fees and food or a net.

A 2006 initiative by the Kenyan Government provided 3.4 million treated nets free to as many young children as possible in a two-week period. Dr Abdisalan Mohamed Noor and Professor Bob Snow (Kenya Medical Research Institute-Wellcome Trust Research Programme, Nairobi) have evaluated the initiative and found it to have been an overwhelming success. Coverage rose to two-thirds of all children sleeping under a treated net, with no difference between children from rich or poor homes. The researchers call for international agencies to refocus their aims on the distribution of free nets.

• These studies were funded in part by the Wellcome Trust.

See also

• Press release: Kenyan malaria success strengthens call for free insecticide-treated nets for all (17 August 2007)

External links

• Killeen GF et al. Preventing childhood malaria in Africa by protecting adults from mosquitoes with insecticide-treated nets. PLoS Med 2007;4(7):e229.
• Noor AM et al. Increasing coverage and decreasing inequity in insecticide-treated bed net use among rural Kenyan children. PLoS Med 2007;4(8):e255.