THE EFFECTS OF MALARIA CONTROL ON NUTRITIONAL-STATUS IN INFANCY

Both malaria and undernutrition are major causes of paediatric mortali ty and morbidity in sub-Saharan Africa. The introduction of insecticid e-treated bed nets (ITBN) during a randomized controlled trial on the Kenyan coast significantly reduced severe, life-threatening malaria an d all-cause childhood mortality. This paper describes the effects of t he intervention upon the nutritional status of infants aged between 1 and 11 months of age. Seven hundred and eighty seven infants who slept under ITBN and 692 contemporaneous control infants, were seen during one of three cross-sectional surveys conducted during a one year perio d. Standardized weight-for-age and mid-upper arm circumference measure s were significantly higher among infants who used ITBN compared with control infants. Whether these improvements in markers of nutritional status were a direct result of concomitant reductions in clinical mala ria episodes remains uncertain. Never-the-less evidence suggests that even moderate increases in weight-for-age scores can significantly red uce the probability of mortality in childhood and ITBN may provide add itional gains to child survival,beyond their impressive effects upon m alaria-specific events. (C) 1997 Elsevier Science B.V.