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The fact that the use of mosquito nets can protect users from malaria deaths, especially children, is not news.But what happens once the child grows up and stops sleeping under the net?We know that without nets, children gain partial immunity, which protects them from severe malaria.Therefore, it is hypothesized that once children grow up, protecting children from exposure to pathogens increases their mortality rate.A new study sheds light on the problem.
Children in sub-Saharan Africa, in particular, are most vulnerable to malaria.In 2019, the percentage of total malaria deaths among children under 5 was 76%, an improvement from 86% in 2000.At the same time, the use of insecticide-treated mosquito nets (ITNs) for this age group increased from 3% to 52%.
Sleeping under a mosquito net can prevent mosquito bites.When used properly, mosquito nets can reduce malaria cases by 50%.They are recommended for anyone in malaria-endemic areas, especially children and pregnant women, the latter because bed nets can improve pregnancy outcomes.
Over time, people living in malaria-endemic areas gained “essentially complete protection from severe illness and death” but from mild and asymptomatic infections.Despite important advances in our understanding of how malaria immunity works, many questions remain.
In the 1990s, it was suggested that bed nets might “reduce immunity” and simply shift death from malaria to old age, possibly “costing more lives than it saves”.In addition, the findings suggest that the nets reduce antibodies that are important for acquiring immunity to malaria.It still seems unclear whether later weather or less/less exposure to malaria pathogens has the same effect on acquiring immunity (such as in the study in Malawi).
Early research has shown that the net result of ITN is positive.However, these studies cover a maximum of 7.5 years (Burkina Faso, Ghana and Kenya).This was also true some 20 years later, when a recently published study in Tanzania showed that from 1998 to 2003, more than 6000 children born between January 1998 and August 2000 were observed using mosquito nets.Child survival rates were recorded during this period as well as in 2019.
In this longitudinal study, parents were asked if their children slept under a mosquito net the previous night.The children were then grouped into those who slept more than 50% under a mosquito net versus those who slept under a mosquito net less than 50% at the early visit, and those who always slept under a mosquito net versus those who never slept.
The data collected once again confirmed that mosquito nets can reduce the mortality rate of children under the age of five.In addition, those participants who survived their fifth birthday also had lower mortality rates when sleeping under a mosquito net.Most prominent were the benefits of the nets, comparing participants who reported always sleeping under the nets as children to those who never slept.
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