Miller John M, Korenromp Eline L, Nahlen Bernard L, W Steketee Richard
PATH Malaria Control and Evaluation Partnership in Africa (MACEPA), National Malaria Control Centre, Lusaka, Zambia.
JAMA. 2007 May 23;297(20):2241-50. doi: 10.1001/jama.297.20.2241.
African countries are scaling up malaria interventions, especially insecticide-treated nets (ITNs), for which ambitious coverage targets have been set.
To estimate how many ITNs are available in African households that are at risk of malaria and how many ITNs are needed to reach targets for use by children younger than 5 years and pregnant women.
Primary sources of data were the Multiple Indicator Cluster Surveys II, the Demographic and Health Surveys, or other nationally representative or large-scale household surveys that measured household possession and use of nets or ITNs among children younger than 5 years.
Data from 42 household surveys between 1999 and 2006 on net and ITN coverage (either household possession or use) and average numbers of nets and ITNs per household were compared with populations and households at risk. Data are included for 43 sub-Saharan African countries.
For the median survey year 2003, the population-weighted mean proportion of households possessing at least 1 ITN was 6.7% (range among countries, 0.1%-71.0%) and was 23.8% (range, 5.0%-91.2%) for any type of net. Based on an average of 0.13 ITNs per household, we estimated that 53.6 million nets, of which 16.7 million were ITNs, were available in households at risk of malaria. Between 130 million and 264 million ITNs are required in 2007 to reach the 80% coverage target for about 133 million children younger than 5 years and pregnant women living in 123 million households in risk areas; the exact number depends on usage patterns (best estimate, assuming 55% of owned ITNs are used by the target groups, 192 million ITNs).
To achieve the targeted ITN usage rates, numbers of ITNs available to African households must be dramatically increased.
非洲国家正在扩大疟疾干预措施，特别是经杀虫剂处理的蚊帐（ITN），并为此设定了宏伟的覆盖目标。
估计有疟疾风险的非洲家庭中现有多少顶经杀虫剂处理的蚊帐，以及需要多少顶经杀虫剂处理的蚊帐才能实现5岁以下儿童和孕妇的使用目标。
数据的主要来源是多指标类集调查II、人口与健康调查，或其他衡量5岁以下儿童家庭蚊帐或经杀虫剂处理的蚊帐拥有情况和使用情况的全国代表性或大规模家庭调查。
将1999年至2006年期间42项关于蚊帐和经杀虫剂处理的蚊帐覆盖情况（家庭拥有或使用）以及每户蚊帐和经杀虫剂处理的蚊帐平均数量的家庭调查数据与有风险的人口和家庭进行比较。数据涵盖43个撒哈拉以南非洲国家。
对于2003年这一调查中位数年份，拥有至少一顶经杀虫剂处理的蚊帐的家庭的人口加权平均比例为6.7%（各国范围为0.1%-71.0%），拥有任何类型蚊帐的家庭的这一比例为23.8%（范围为5.0%-91.2%）。根据每户平均有0.13顶经杀虫剂处理的蚊帐，我们估计有疟疾风险的家庭中有5360万顶蚊帐，其中1670万顶是经杀虫剂处理的蚊帐。2007年需要1.3亿至2.64亿顶经杀虫剂处理的蚊帐，才能实现约1.33亿5岁以下儿童和生活在1.23亿处于风险地区家庭中的孕妇的80%覆盖目标；确切数字取决于使用模式（最佳估计，假设目标群体使用55%的自有经杀虫剂处理的蚊帐，则为1.92亿顶经杀虫剂处理的蚊帐）。
为实现经杀虫剂处理的蚊帐的目标使用率，必须大幅增加非洲家庭可获得的经杀虫剂处理的蚊帐数量。
