Insecticide-treated nets are the most effective measure for malaria prevention

Objectives:
Malaria causes significant morbidity and mortality worldwide. There are several preventive measures that are currently employed, including insecticide-treated nets (ITNs, including long-lasting insecticidal nets and insecticidal-treated bed nets), indoor residual spraying (IRS), prophylactic drugs (PD) and untreated nets (UN). However, it is unclear which measure is the most effective for malaria prevention. Therefore, this review article has been conducted.

Which preventive measures are the most effective for malaria prevention?

Study design:
This review article included 30 studies from 1998-2016.

Results and conclusions:
The investigators found that the GPM framework led to a final ranking of effectiveness of measures in the following order from best to worst: prophylactic drugs (PD), insecticide-treated nets (ITNs, including long-lasting insecticidal nets and insecticidal-treated bed nets), indoor residual spraying (IRS) and untreated nets (UN), in comparison with no intervention (NI).

The investigators found, however, only ITN [RR = 0.49, 95% CI = 0.32-0.74] showed precision while other methods [PD: RR = 0.24, 95% CI = 0.004-15.43], IRS: RR = 0.55, 95% CI = 0.20-1.56] and UN: RR = 0.73, 95% CI = 0.28-1.90] demonstrating considerable uncertainty associated with their point estimates.

The investigators concluded current evidence is strong for the protective effect of insecticide-treated nets (including long-lasting insecticidal nets and insecticidal-treated bed nets), interventions in malaria prevention. Even though insecticide-treated nets are found to be the only preventive measure with statistical support for their effectiveness, the role of other malaria control measures may be important adjuncts in the global drive to eliminate malaria.

Original title:
Comparative effectiveness of malaria prevention measures: a systematic review and network meta-analysis by Wangdi K, Furuya-Kanamori L, […], Clements ACA.

Link:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5869791/

Additional information of El Mondo:
Find more information/studies on food fortification/malnutrition and study design/meta-analysis/significant right here.