Reduction in the Burden of Malarial Anemia in Benin: Confirmation of an Anti-Vector Approach at the National Level

Abstract

To assess the association between mosquito net use and the burden of malaria as proxied by severe anemia. We also attempt to discern the comparative validity of two proposed cut-offs (Hb <8 and Hb <7 g dL^-1) for defining severe anemia. We use data from the nationally-representative Benin Demographic and Health Surveys (BDHS) conducted in 2001 and 2006 to assess the use of mosquito nets and severe anemia in children 6-23 months of age. We find that use of mosquito nets among all children in Beninois households is associated with a >40% reduction in the adjusted odds of being severely anemic for both survey years. The results of this analysis are equivocal on the question of whether <7 or <8 g dL^-1 is the more valid cut-off point to define severe anemia in the context of malaria. There is a clear association between mosquito net use and reduced burden of severe anemia: not only is there a decrease in the national prevalence of severe anemia at the same time that an increase in mosquito net use was observed, but analyses of individual-level data also indicate a strong negative association between mosquito net use and severe anemia. These findings provide additional support for the continued promotion of mosquito nets as an important anti-vector strategy in the fight against malaria.