Estimating the Association between Types of Bed Net Usage and Malaria Incidence in a Cohort of Children in Kintampo, Ghana (2024)

Undergraduate: Zhijie Duan

Faculty Advisor: Michael Emch
Department: Biostatistics, Epidemiology

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Previous research utilizing phase III trial data of RTS,S/AS01, the world's first malaria vaccine approved by WHO, has demonstrated that the combined use of the RTS,S/AS01 vaccine and bed nets was more effective in preventing malaria during the study’s extension phase than using the RTS,S/AS01 vaccine alone. This study aims to evaluate whether the type of bed net usage, either perfect or imperfect, was associated with a reduction in malaria incidence compared to not using bed nets at all during the trial, in scenarios where RTS,S/AS01 was absent._x000D_
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We utilized data from a cohort of children enrolled in the control group of the phase III trial of the RTS,S/AS01 vaccine in Kintampo, Ghana. We started with a univariate analysis without adjusting for confounding effects and then conducted a multivariate analysis that adjusted for potential confounders. For both analyses, we employed a mixed-effects Poisson regression models._x000D_
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Our univariate and multivariate analyses did not reveal a significant impact of bed net usage on malaria incidence in either model. Future studies could benefit from data with more consistent measurements of bed net usage in an controlled environment. Our analysis suggests that targeted interventions in Ghana should prioritize resources and support for younger children and households with lower socioeconomic status, as well as for children living in areas with higher estimated background malaria transmission intensity. This will allow us to enhance the overall effectiveness of existing interventions and reduce the burden of this disease among the most vulnerable populations.