[The impact of impregnated mosquito nets on prevalence and morbidity related to malaria in sub-Saharan africa].

Insecticide treated bed nets (permethrin, deltamethrin and lambda cyalothrin) were used for malaria control in The Gambia, Burkina Faso and Tanzania where Anopheles gambiae (and An.funestus in Burkina Faso) is the main vector. Treated mosquito nets are efficient when used on a large scale and not on an individual level. Such a large scale use, acting on longevity and infectivity of vectors, always induced a decrease of malaria transmission by more than 90%. Treated bed nets had no significant effect on the overall parasite rate, showing that malaria transmission was not stopped. But it was usually found that there was a significantly smaller number of children with parasitemia higher than a critical threshold, a sensitive parameter of malaria morbidity. Indeed, in the three situations studied, malaria morbidity (fever + high parasitemia greater than critical level in the concerned area) has generally shown a similar drop of 60%. These data demonstrate that treated bed nets are useful to reduce transmission and morbidity. Advised as a new way for reduction of nuisance, treated bed nets were always welcomed by the populations and this method may be considered as a complementary weapon in public health.