학술논문

A quasi-experimental study estimating the impact of long-lasting insecticidal nets with and without piperonyl butoxide on pregnancy outcomes
Document Type
article
Source
Malaria Journal. 21(1)
Subject
Microbiology
Biological Sciences
Biomedical and Clinical Sciences
Women's Health
Prevention
Conditions Affecting the Embryonic and Fetal Periods
Pregnancy
Pediatric
Vector-Borne Diseases
Infectious Diseases
Preterm
Low Birth Weight and Health of the Newborn
Perinatal Period - Conditions Originating in Perinatal Period
Rare Diseases
Maternal Health
Reproductive health and childbirth
Good Health and Well Being
Adult
Female
Humans
Insecticide-Treated Bednets
Insecticides
Interrupted Time Series Analysis
Malaria
Mosquito Vectors
Piperonyl Butoxide
Pregnancy Outcome
Retrospective Studies
Uganda
Young Adult
Plasmodium falciparum
Malaria in pregnancy
Long-lasting insecticidal net
Low birthweight
Stillbirth
Difference-in-differences
Interrupted time series
Piperonyl butoxide
Pyrethroid resistance
Medical Microbiology
Public Health and Health Services
Tropical Medicine
Medical microbiology
Public health
Language
Abstract
BackgroundLong-lasting insecticidal nets (LLINs) are the main vector control tool for pregnant women, but their efficacy may be compromised, in part, due to pyrethroid resistance. In 2017, the Ugandan Ministry of Health embedded a cluster randomized controlled trial into the national LLIN campaign, where a random subset of health subdistricts (HSDs) received LLINs treated with piperonyl butoxide (PBO), a chemical synergist known to partially restore pyrethroid sensitivity. Using data from a small, non-randomly selected subset of HSDs, this secondary analysis used quasi-experimental methods to quantify the overall impact of the LLIN campaign on pregnancy outcomes. In an exploratory analysis, differences between PBO and conventional (non-PBO) LLINs on pregnancy outcomes were assessed.MethodsBirth registry data (n = 39,085) were retrospectively collected from 21 health facilities across 12 HSDs, 29 months before and 9 months after the LLIN campaign (from 2015 to 2018). Of the 12 HSDs, six received conventional LLINs, five received PBO LLINs, and one received a mix of conventional and PBO LLINs. Interrupted time-series analyses (ITSAs) were used to estimate changes in monthly incidence of stillbirth and low birthweight (LBW;