Purchasing considerations.

OBJECTIVE: To assess the impact of a social marketing programme for distributing nets treated with insecticide on malarial parasitaemia and anaemia in very young children in an area of high malaria transmission. DESIGN: Community cross sectional study. Annual, cross sectional data were collected at the beginning of the social marketing campaign (1997) and the subsequent two years. Net ownership and other risk and confounding factors were assessed with a questionnaire. Blood samples were taken from the children to assess prevalence of parasitaemia and haemoglobin levels. SETTING: 18 villages in the Kilombero and Ulanga districts of southwestern Tanzania. PARTICIPANTS: A random sample of children aged under 2 years. MAIN OUTCOME MEASURES: The presence of any parasitaemia in the peripheral blood sample and the presence of anaemia (classified as a haemoglobin level of <80 g/l). RESULTS: Ownership of nets increased rapidly (treated or not treated nets: from 58% to 83%; treated nets: from 10% to 61%). The mean haemoglobin level rose from 80 g/l to 89 g/l in the study children in the successive surveys. Overall, the prevalence of anaemia in the study population decreased from 49% to 26% in the two years studied. Treated nets had a protective efficacy of 62% (95% confidence interval 38% to 77%) on the prevalence of parasitaemia and of 63% (27% to 82%) on anaemia. CONCLUSIONS: These results show that nets treated with insecticide have a substantial impact on morbidity when distributed in a public health setting.

Bedding and Linens↗

PubMed2000

Changes to infant sleep practices in Canterbury.

AIM: "Reducing the risk" is a public health primary initiative to minimise the incidence of Sudden Infant Death Syndrome (SIDS) in New Zealand. A number of SIDS risks relate to infant sleep practices. We describe current prevalences of these practices. METHODS: A cohort of Canterbury mothers delivering live infants during May 1997 (n = 411) were mailed a questionnaire in July surveying their infant's sleep practices. Survey results were compared to results derived from the Canterbury control infant component of the 1987-90 New Zealand Cot Death Study (NZCDS) (n = 174). Those mothers using either plastic or rubber mattress covers (n = 63) were issued a subsequent questionnaire pertaining to this mattress-wrapping practice. RESULTS: Completed questionnaires were returned by 274 (66.7%) mothers. Room sharing with mother was usual for 133 (48.5%) infants, no different from the 94 (54.0%) recorded in the NZCDS (chi 2 = 5.6, df = 2, p = 0.06). However, of those infants sharing a room with their mother, 101 (75.9%) slept in their own bed compared to 46 (48.9%) in the NZCDS (chi 2 = 57.0, df = 2, p < 0.01). Only 8 (2.9%) infants were regularly placed prone to sleep, considerably fewer than the 69 (39.7%) reported in the NZCDS (chi 2 = 100.1, df = 1, p < 0.01). Mattress-wrapping with plastic (14.6% vs. 4.0%; chi 2 = 12.8, df = 1, p < 0.01) and rubber (8.4% vs. 3.4%; chi 2 = 4.4, df = 1, p = 0.04) has significantly increased since the NZCDS. Results from the subsequent questionnaire, completed by 42 (66.7%) respondents, indicated that most, 25 (59.5%), wrapped their infant's mattress to stop soiling. Less than half, 18 (42.9%), wrapped the mattress for the "safety of their baby". CONCLUSION: The "non-prone sleeping" campaign has been successful in Canterbury. Most infants are now routinely placed non-prone for sleep. Of those infants sharing a room with their mothers, an increased proportion is sleeping in separate beds. The use of "drycot" under-blankets and sheepskins has diminished. While impermeable mattress-wrapping usage has significantly increased, over three-quarters of Canterbury mothers did not use plastic or rubber mattress-covers on their infant's beds.

Bedding and Linens↗