Habluetzel A, Diallo DA, Esposito F, Lamizana L, Pagnoni F, Lengeler C, et al.Do insecticide-impregnated curtains reduce all-cause child mortality in Burkina Faso?. Tropical Medicine and International Health 1997;2(9):855–62.

Cluster randomized

All houses in intervention cluster

Curtains v. no curtains

94% of curtains installed at 2 years

"Village meetings were held to explain the use of the curtains. The curtains were impregnated and installed by the communities themselves with assistance from fieldworkers of the Centre National de Lutte contre le Paludisme (CNLP). Each village was visited daily by a supervisor who checked the dilution of the permethrin and the progress of the installation."

15% reduction in all-cause child mortality

"In the first intervention year, the proportion of houses with correctly installed, treated curtains (93"L)was determined from forms filled in by the fieldworkers for each compound during the re-treatment in November/ December 1994. A survey conducted in August 1995 revealedequallyhighcoverage(94%)inthesecondyear of intervention. "

Moyou-Somo R, Lehman LG, Awahmukalah S, Ayuk Enyong P. Deltamethrin impregnated bednets for the control of urban malaria in Kumba Town, South-West Province of Cameroon. Journal of Tropical Medicine and Hygiene 1995;98(5):319–24.

Individual randomized

Selected households

Treated bed nets v. no bed nets

<20% (according to Lengeler)

High in selected group (see column L), but because it was an individual randomized trial, overall coverage could not be high

"Care was taken to please the nets over all beds in each selected house and the people were instructed on how to tuck the nets when sleeping"

"Overall malaria prevalence rates in the test and control groups were 29.0% (n=439) and 41.0% (n=321) respectively."; "Overall spleen rates were 18.5% (n=313) and 30.4% (n=415) in the test and control group"; (study lasted one year)

Kroeger A, Mancheno M, Alarcon J, Pesse K. Insecticide-impregnated bed nets for malaria control: varying experiences from Ecuador, Colombia, and Peru concerning acceptability and effectiveness. American Journal of Tropical Medicine and Hygiene 1995;53(4): 313–23.

Yes, from Josh

Vs. untreated nets

Cluster randomized

Those who chose to buy - program was promotion of buying nets plus free treatment

Promotion of purchase of bednets plus treatment of nets v. less intensive promotion plus generic health education

96% with untreated nets, no info about treated nets

Only usage available

"The health promotors organized meetings, particularly with the mothers in the communities."

71% reduction in malaria incidence in the year

58.5% with treated nets (perhaps others with untreated nets)

Kroeger A, Mancheno M, Alarcon J, Pesse K. Insecticide-im- pregnated bed nets for malaria control: varying experiences from Ecuador, Colombia, and Peru concerning acceptability and effectiveness. American Journal of Tropical Medicine and Hygiene 1995;53(4): 313–23.

Vs. untreated nets

Cluster randomized

Those who chose to buy - program was promotion of buying nets plus free treatment

Promotion of purchase of bednets plus treatment of nets v. less intensive promotion plus generic health education

96-97% with untreated nets, no info about treated nets

Only usage available

"The health promotors organized meetings, particularly with the mothers in the communities."

20-22% (not stat sig) reduction in malaria incidence in the year

68.3-79.7% with treated nets (perhaps others with untreated nets)

D’Alessandro U, Olaleye B, McGuire W, Langerock P, Bennett S, Aikins MK, et al. Mortality and morbidity from malaria in Gambian children after introduction of an impregnated bednet programme. Lancet 1995;345(8948):479–83.

Thomson MC, Adiamah JH, Connor SJ, Jawara M, Bennett S, D’Alessandro U, et al. Entomological evaluation of the Gambia’s National Impregnated Bednet Programme. Annals of Tropical Medicine and Parasitology 1995;89(3):229–41.

Thomson MC, Connor SJ, Quinones ML, Jawara M, Todd J, Greenwood BM. Movement of Anopheles gambiae s.l. malaria vectors between villages in The Gambia. Medical and Veterinary Entomology 1995;9(4):413–9.

(1) and (2) only

Vs. untreated nets

Cluster randomized

All existing nets were eligible for treatment in treatment clusters

Treating of existing bed nets v. leaving nets untreated, also "the program has also tried to encourage those not using bednets to buy them and have them treated"

untreated: 46.4-78.6% of beds covered (varies by area)

treated: 46.4-78.6% of beds covered (varies by area)

Nothing mentioned

25% reduction in mortality in children 1-9 in first year (study lasted one year)

70% for children 1-4%

Lindsay SW, Snow RW, Broomfield GL, Janneh MS, Wirtz RA, Greenwood BM. Impact of permethrin-treated bednets on malaria transmission by the Anopheles gambiae complex in The Gambia. Medical and Veterinary Entomology 1989;3(4):263–71.

Snow RW, Rowan KM, Greenwood BM. A trial of permethrin-treated bed nets in the prevention of malaria in Gambian children. Transactions of the Royal Society of Tropical Medicine and Hygiene 1987; 81(4):563–7.

Vs. untreated nets

Individual randomized

Study treated nets that were used by children 1-9

Treated nets v. untreated nets (double-blind)

98% (presumably mostly untreated)

All nets of children in the intervention group were treated

Nothing mentioned

23 '"new" febrile episodes with malaria parasitaemia' in 205 children in intervention group v. 34 episodes in 184 children in plecebo group (stat sig); 18.2% of intervention children aquired enlarged spleens v. 16.% in placebo group; 2 deaths in treatment v. 6 in control (not stat sig)

80.1-83.3% in treatment group; 92.5-95.7% in plecebo group

Snow RW, Rowan KM, Lindsay SW, Greenwood BM. A trial of bed nets (mosquito nets) as a malaria control strategy in a rural area of The Gambia, West Africa. Transactions of the Royal Society of Tropical Medicine and Hygiene 1988;82(2):212–5.

Cluster randomized

Everyone ("Bed nets were issued to all residents in the villages receiving nets after an initial clinical survey")

Untreated nets v. no nets

Only usage available

"Public meetings were held to demonstrate the correct use of nets and the main points were reiterated at the time of each net issue. Mothers of the children in the study cohort were reminded weekly how to use the net. Nets which became torn or damaged were repaired or replaced. A survey was conducted every 4 weeks during the rainy season to determine whether the bed nets had been tucked in and the entry flaps placed correctly."

No effect: "There was no significant difference in the incidence of clinical attacks of malaria or in any other malariometric measurement between the 2 groups."

"Bed nets were reported as being tucked in and their flaps placed correctly in 92.4% and 90.2% of interviews, respectively. However, only 50% of interviews from one village, Tally Ya, showed that children had their nets tucked in. Field staff checked the inside of nets during these interviews to identify any mosquitoes....27% of children had nets which contained at least one mosquito...During the night of observation 35.8% of subjects left their beds either to check on a disturbance in teh compound or, usually, to urinate."

Binka FN, Kubaje A, Adjuik M, Williams LA, Lengeler C, Maude GH, et al. Impact of permethrin impregnated bednets on child mortality in Kassena-Nankana district, Ghana: a randomized controlled trial. Tropical Medicine & International Health 1996;1(2):147–54.

Cluster randomized

Almost everyone in treatment cluster: "nets were provided for all women, children and, in most compounds, men...An additional 7000 nets were provided to men and other in-migrants during the re-impregnation"

Treated bed nets v. no bed nets

4% (doesn't specify if these were treated: "Only 4 % of compounds in the study area owned a bednet at the start of the trial. How- ever, there were no local taboos against sleeping under a net.")

(3.5 nets per compound, 12 ppl/compound)

"There was also a demonstration of the use of bednets both indoors and outdoors"

17% reduction in all-cause mortality; no difference in 5-9 year old mortality; no statistically-significant difference in malaria-specific mortality; effect isn't reported on yearly basis, though a chart shows quarterly mortality data -- Sheet2 shows data read off this chart and shows no difference in effects in the two years of the study

"In the first year of follow-up, 97% of bednets in 243 randomly selected compounds visited between 1900 and 2100 hours from July to December 1993 and 65% of bednets in 138 compounds visited between January and June 1994 had been used on the day of visit. In the second year of follow-up, 680 and 946 compounds were visited in the morning from 0430 to 0730 h between July and December 1994 and January and June 1995 respectively. The compliance in the use of the bednets was lower than in the first year but the trend was similar, with 72% of the bed- nets having been used that night between July and December 1994 and 50% of the nets used that night between January and June 1995."

97% Jul-Dec; 65% Jan-Jun; 72% Jul-Dec year 2; 50% Jan-Jun year 2

Zaim M, Ghavami MB, Nazari M, Edrissian G, Nateghpour M. Cyfluthrin (EW 050)-impregnated bednets in malaria control programme in Ghassreghand (Baluchistan, Iran). Journal of the American Mosquito Control Association 1998;14(4):421–30.

No (could not get access)

Vs. untreated nets

Cluster randomized

The study treated existing nets

Treated nets v. untreated nets

No effect: "The use of impregnated mosquito nets (used primarily outside) had no significant effect on the incidence of malaria. No difference was detected in the parasite density of patients with positive slides. No significant effect was observed in the parous rate, human blood index, and sporozoite rate of anopheline vectors."

Henry M-C, Assi SB, Rogier C, Dossou-Yovo J, Chandre F, Guillet P, et al. The challenge of malaria control in an area of pyrethroid resistance in Cote d’Ivoire. Efficacy of lambdacyhalothrin treated nets on malaria infection and disease. Am J Trop Med Hyg 2005; Vol. 73, issue 5:859–64.

Cluster randomized

Everyone ("The implementation of ITNs in 1999 led to the coverage in 4 villages of more than 80% of beds with nets")

Treated bed nets v. no bed nets

80% of beds ("Average coverage rate with ITNs was regularly checked and ranged from 76.7% to 84.0% in different villages.")

0.8 clinical malaria attacks per child per year instead of 1.8 (56% protective efficacy)

Mbogo CN, Baya NM, Ofulla AV, Githure JI, Snow RW. The impact of permethrin-impregnated bednets on malaria vectors of the Kenyan coast. Medical and Veterinary Entomology 1996;10(3):251–9.

Nevill CG, Some ES, Mung’ala VO, Mutemi W, New L, Marsh K, et al. Insecticide-treated bednets reduce mortality and severe morbidity from malaria among children on the Kenyan coast. Tropical Medicine & International Health 1996;1(2):139–46.

Snow RW, Molyneux CS, Njeru EK, Omumbo J, Nevill CG, Munui E, et al. The effects of malaria control on nutritional status in infancy. Acta Tropica 1997;65(1):1–10.

Cluster randomized

Everyone ("Bednets were distributed to each intervention household and issues according to the 'bed' registers of each house...bednets were issued to 17742 (96%) of the 18 478 beds registered during the census."

Treated bed nets v. no bed nets

"Distribution was accompanied by pre-tested demonstrations of correct hanging and care of nets by trained field staff. Education in bednet use was continued the following day by government public health technicians who reviewed net hanging and held discussion meetings with small groups of mothers. Posters and school-based bednet plays and interactive learning sessions continued to be used throughout the trial (Marsh et al. in press). Local bednet committees were formed through the existing primary health care system to identify, resolve or report subsequent bednet issues, losses and difficulties within their communities."

33% reduction in mortality for 1-4 year olds; not reported on an annual basis

"Approximately 220 randomly selected intervention children were sampled every 6 weeks during the first year and twice during the second year of the trial to assess bednet use by direct observation using early morning (0430-0700 h) visits. During the dry, hot season (January-March) 65% of intervention children were found to be using the net correctly and during the wet, cooler months of highest malaria transmission observed bednet use was 77% among the target childhood population."

65% Jan-Mar; 77% otherwise

Hawley WA, Phillips-Howard PA, ter Kuile FO, Terlouw DJ, Vulule JM, Ombok M, et al. Community-wide effects of permethrin-treated bed nets on child mortality and malaria morbidity in western Kenya. American Journal of Tropical Medicine and Hygiene 2003;68 Suppl (4):121–7.

Phillips-Howard PA, Nahlen BL, Kolczak MS, Hightower AW, ter Kuile FO, Alaii JA, et al. Efficacy of permethrin-treated bed nets in the prevention of mortality in young children in an area of high perennial malaria transmission in western Kenya. American Journal of Tropical Medicine and Hygiene 2003;68 Suppl(4):23–9.

ter Kuile FO, Terlouw DJ, Kariuki SK, Phillips-Howard PA, Mirel LB, Hawley WA, et al. Impact of permethrin-treated bed nets on malaria, anemia, and growth in infants in an area of intense perennial malaria transmission in western Kenya. American Journal of Tropical Medicine and Hygiene 2003;68 Suppl(4):68–77.

ter Kuile FO, Terlouw DJ, Phillips-Howard PA, Hawley WA, Fried- man JF, Kolczak MS, et al. Impact of permethrin-treated bed nets on malaria and all-cause morbidity in young children in an area of intense perennial malaria transmission in western Kenya: cross-sectional survey. American Journal of Tropical Medicine and Hygiene 2003;68 Suppl(4):100–7.

Cluster randomized

Everyone ("distributed to over all sleeping spaces in the intervention population")

Treated bed nets v. no bed nets

High (94.% of infants sleeping under nets; distributed for all sleeping spaces)

"After distribution, study staff went door-to-door to ensure that nets were hung properly."

16% reduction in child mortality; "We also observed a significant reduc- tion in ITN efficacy in the second year in our passive morbidity surveillance in Asembo, as described elsewhere, but this was not confirmed in our individual-based mortality analysis. Although the village-based analysis and the initial multivariate survival analysis (adjusted for covariates) also indicated a reduced efficacy in the second year, further stratified analysis that took into account whether bed nets had been re-treated according to study protocol or not (every six months), suggested that almost all of the reduced efficacy in the second study year could be explained by late re-treatment of nets."; "mid-upper-arm circumference and weight-for-age Z-scores were better in children from intervention villages. The weight gain benefit was only apparent in infancy. Inaddition, a significant difference in length- for-age Z-scores was apparent (mean difference in Z-score 0.36). Although this difference was statistically significant (P<0.01), it could not be concluded with certainty that this was associated with the introduction of ITNs because of an existing difference, albeit smaller and not statistically significant, in length-for-age Z-scores pre-intervention (mean difference in Z-score = 0.17; P<0.08). Of interest is that unlike weight gain, the beneficial effect on linear growth was maintained in the second year of life."

"an adherence rate (persons directly observed to be sleeping under ITNs) of 66% in children less than five years old."; "Periodic spot checks during this period showed that few (<3%) nets were sold or moved outside the study area, although adherence to net use, measured as the proportion of study participants directly seen to be sleeping under nets during early morning observational surveys, was usually approximately 70%."

Sexton JD, Ruebush TK 2nd, Brandling-Bennett AD, Breman JG, Roberts JM, Odera JS, et al. Permethrin-impregnated curtains and bed-nets prevent malaria in western Kenya. Annals of Tropical Medicine and Parasitology 1990;43(1):11–8.

Individual randomized

Not clear how many nets each household in the bed-net group received

Treated bed nets v. treated curtains v. nothing

"When the nets/curtains were distributed , the recipient families were instructed in their use and maintenance. They were asked to use the nets at all times while sleeping or to draw the curtains over the window/doors in the evening…Three months later, the families were interviewed again to determine their opinions and practices in using the nets and curtains. During these visits, all nets and curtains were examined for cleanliness and damage."

"Infections per person-weeks at risk were ower for the curtain users and the bed-net users (2.35 cases and 2.77 cases per 100 person weeks, repectively) than for the control group (5.42 cases per 100 person weeks risk, P<0.05)…The bed-net group reported significantly fewer total episodes of fever (2.52 episodes/100 weeks) than the control group (4.07 episodes/100 weeks). Otherwise, no signficant differences were found between the 3 groups in total number of episodes of fever, chills, or fever plus chills over a 15 week period."

85% reported consistent bed-net use, but visits found 70-73% use; "In the last month of the study, 2 unannounced nighttime visits were made to the houses with bed-nets to assess compliance in their use."

Rabarison P, Ramambanirina L, Rajaonarivelo E, Rakotoarivony I, Andrianaivolambo L, Jambou R, et al. Study of the impact of deltamethrin impregnated curtains on malaria morbidity in Ankazobe of the Madagascar highlands [Etude de l’impact de l’utilisation des rideaux imprégnés de deltaméthrine sur la morbidité palustre à Ankazobe, sur les hautes terres de Madagascar]. Medecine Tropicale 1995;55 Suppl(4):105–8.

Yes, from Josh (in French)

Vs. untreated curtains

Individual randomized

Everyone (some received treated curtains and some received untreated curtains)

Treated curtains v. untreated curtains

Difference in morbidity stat sig in 2 out of 3 seasons. Diff increased as time passed since installation; "In 1993, reducing man-vector contact is very marked, 65% lower in group I than in the OR and is less pronounced during the second year with only 40% difference. In effect, if the biting rate of Anopheles remained stable in the first group, it fell sharply in houses with unimpregnated curtains. In group I, the effect of curtains already evident in 1993, continued in 1994 with a number of bites per man per night low and stable, equal to 1.7 of January to June"

Kroeger A, Gonzalez M, Ordonez-Gonzalez J. Insecticide-treated materials for malaria control in Latin America: to use or not to use?. Transactions of the Royal Society of Tropical Medicine and Hygiene 1999; 93(6):565–70.

Cluster randomized

Those who chose to buy - program was promotion of buying nets plus free treatment

Promotion of purchase of bednets plus treatment of nets v. less intensive promotion plus generic health education

"In the baseline survey, 34.2% of households had 1 or more unimpregnated bednets and 25.3% of individuals actually used a net. The use of bednets was higher for infants (45.8%) and children aged 1-4 years (31.8%) than for older children and adultes (less than 25%)."

Only usage available

Education/promotion

Results presented by coverage rate group. Incidence of malaria reduced by 68% in villages with 31-70% coverage (stat sig); 31.5% in villages with 16-30% coverage (stat sig); and 0% in villages with <16% coverage. Study lasted one year.

"After the first educational intervention and the promotion of bednet use in the 6 intervention communities (1831 persons) approzimately 75% used a bednet; after the 1st impregnation campaign in 1995, 51% of individuals used an impregnated mosquito net."

Rowland M, Bouma M, Ducornez D, Durrani N, Rozendaal J, Schapira A, et al. Pyrethroid-impregnated bed nets for personal protection against malaria for Afghan refugees. Transactions of the Royal Society of Tropical Medicine and Hygiene 1996;90(4):357–61.

Individual randomized

Individually randomized families and probably everyone in the family was covered

Treated bed nets v. no bed nets

10% of families and it appears that everyone in the family was covered: "we wanted them to conduct an unbiased survey of the villagers' existing personal protection practices and sleeping arrangements so that the number of nets needed could be accurately calculated", "families in whcih the majority used their nets regularly"

"At mass meetings of the intevention group males, insecticide dipping procedures and net erection methods were demonstrated...Two months after bed net distribution, the teams revisited the trial families to give further encouragement."

"The protective efficacy of [nets] was 42% against p. vivax and 61% against P. falciparum."

73% of the families who received nets claimed to use them every night

Kroeger A, Mancheno M, Alarcon J, Pesse K. Insecticide-impregnated bed nets for malaria control: varying experiences from Ecuador, Colombia, and Peru concerning acceptability and effectiveness. American Journal of Tropical Medicine and Hygiene 1995;53(4): 313–23.

Vs. untreated nets

Cluster randomized

Those who chose to buy - program was promotion of buying nets plus free treatment

Promotion of purchase of bednets plus treatment of nets v. less intensive promotion plus generic health education

95% with untreated nets, no info on treated nets

Only usage available

"The health promotors organized meetings, particularly with the mothers in the communities."

33-40% reduction in malaria incidence

60.8% using treated nets (perhaps others with untreated nets)

Kroeger A, Mancheno M, Alarcon J, Pesse K. Insecticide-impregnated bed nets for malaria control: varying experiences from Ecuador, Colombia, and Peru concerning acceptability and effectiveness. American Journal of Tropical Medicine and Hygiene 1995;53(4): 313–23.

Vs. untreated nets

Cluster randomized

Those who chose to buy - program was promotion of buying nets plus free treatment

Promotion of purchase of bednets plus treatment of nets v. less intensive promotion plus generic health education

63% with untreated nets

Only usage available

"The health promotors organized meetings, particularly with the mothers in the communities."

Both first and second years: no stat sig difference in malaria incidence (possible increase in second year)

66.4% using treated nets (perhaps others with untreated nets)

Magbity EB, Marbiah NT, Maude G, Curtis CF, Bradley DJ, Greenwood BM, et al. Effects of community-wide use of lambda-cyhalothrin-impregnated bednets on malaria vectors in rural Sierra Leone. Medical and Veterinary Entomology 1997;11(1):79–86.

Marbiah NT. Control of disease due to perennially transmitted malaria in children in a rural area of Sierra Leone [PhD thesis]. London: University of London, 1995.

Marbiah NT, Petersen E, David K, Magbity E, Lines J, Bradley DJ. A controlled trial of lambda-cyhalothrin-impregnated bed nets and/or dapsone/pyrimethamine for malaria control in Sierra Leone. American Journal of Tropical Medicine and Hygiene 1998;58(1):1–6.

(1) and (3) only

Cluster randomized

Treated bed nets v. no nets (randomly selected children also received malaria prophylaxis, results here for nets-only group)

very low ("Before this study, bednets were very scarce.")

High ("In the villages randomised to receive nets, all beds have received nets." Petersen et al. 1993)

49% reduction in clinical malaria episodes; study was one year long

Fraser-Hurt N, Felger I, Edoh D, Steiger S, Mashaka M, Masanja H, et al. Effect of insecticide-treated bed nets on haemoglobin values, prevalence and multiplicity of infection with Plasmodium falciparum in a randomized controlled trial in Tanzania. Transactions of the Royal Society of Tropical Medicine and Hygiene 1999;93 Suppl 1:47–51.

Individual randomized

Individually randomized children (age 5 to 24 months)

Treated bed nets v. no bed nets

Not currently using a bednet was an inclusion criteria, but 14 of 60 control children were found "using a torn net of home-made netting"; no information on study area net coverage

Complete coverage among treatment children in individual randomized trial

"Initial net installation was done by the parent and checked by project staff who also checked net use by surprise visits between 05:00 and 08:00."

"There was a significant increase in mean heamoglobin values [93.4 g/L in treatment v. 88.2 g/L in control] and a significant decrease of 16.4% in microscopically determined P. falciparum prevalence in children in the ITN group six months after the start of the trial….However, no significant difference was observed in parasite density or multipicity of infection among infected children...This study shows that ITNs reduce the risk of amaemia in highly exposed young children." (study lasted 6 months)

"The homes of children in both groups were visited to assess bed net use, which was reported in 97% of 229 early morning home visits to children in the ITN group. The child was observed sleeping inside or outside the ITN on 82% and 1% of these occasions, respectively. On 17% of visits, direct observation of sleeping behaviour was not possible. In the control group, 14 children were each found using a torn net of home-made netting but, as the protection provided was negligble, ther were not withdrawn from the study."

Kamol-Ratanakul P, Prasittisuk C. The effectiveness of permethrin- impregnated bed nets against malaria for migrant workers in eastern Thailand. American Journal of Tropical Medicine and Hygiene 1992; 47(3):305–9.

Vs. untreated nets

Individual randomized

Individually randomized migrant workers

Treated nets v. untreated nets (double-blind)

All participants received nets, but likely a small % of wider community

"Community leaders, key employers (who authorized the organization of the worker), the sanitarian and midwives at the local health center, school teachers, and malaria village volunteers collaborators were informed of the purpose of the study and askd for their coorperation. They helped us communicate with the study subjects, encourages workers to use their nets properly, and impregnated nets and distributed them to the study subjects. IN additiona, we specifically trained a volunteers who supervised and encouraged workers to use their nets properly."

"During the 35 weeks of observation…the reduction in risk per subject due to treted nets was 0.06" (24% in control group got malaria v. 18% in the treatment group, i.e. a 25% decrease); "A total of 1.95 working days per worker were lost because of malaria in teh impregnated-net group compared with 3.33 days per worker in the untreated-net group."

"Subject compliance was monitored by unannounced inspections on the use of the net during home visits made at night…The compliance level among these workers was approximately 70-80% in both groups."

Luxemburger C, Perea WA, Delmas G, Pruja C, Pecoul B, Moren A. Permethrin-impregnated bed nets for the prevention of malaria in schoolchildren on the Thai-Burmese border. Transactions of the Royal Society of Tropical Medicine and Hygiene 1994;88(2):155–9.

Vs. untreated nets

Individual randomized

Individually randomized school children (age 4 to 15)

Treated bed nets v. untreated net (double-blind)

"Although irregularly and improperly used, at least one mosquito net was present in 70% of the surveyed houses…The proportion og households in the village that possessed impregnated nets was about 22%."

All participants received nets, but no data on % of community

"Advice was given on the use of new nets; in particular, mothers were asked not to wash them"

"reduced the number of parasitaemic Plasmodium falciparum infections by 38% [86 infections v. 124 in the control group; "Similar proportions of episodes were symptomatic" (81% v. 71% in control)] and the number of symptomatic episodes by 42%...The number of positive bood films in the 2 groups did not change significantly during the study. A reduction in spleen rate … could not be related to the overall use of nets." (six-month follow up);

"Overall, 1986 noctural home visits (95% of the expected visits) were performed. Children were found under their nets at 93% of visits in both groups."