Dis­trib­ut­ing mos­quito nets to young chil­dren has been so effec­tive that the most vul­ner­a­ble group to malaria are now chil­dren from 5 to 19 years old. A new study shows a shift on the most vul­ner­a­ble to the dis­ease and calls for changed dis­tri­b­u­tion methods.

From the East African, writer Dagi Kimani details the survey.

The study, funded by the Well­come Trust and pub­lished in the free online jour­nal BMC Pub­lic Health says that the shift in vul­ner­a­bil­ity is due to the fact that younger chil­dren are more likely to have access to the few bed­nets already dis­trib­uted than their older sib­lings, who also are exposed to bites by mos­quito vec­tors when they are outdoors.

Data com­puted from 18 sub-Saharan Africa coun­tries, includ­ing those in the East African Com­mu­ni­ties, from 2005 to 2009 shows that this trend of shift­ing vul­ner­a­bil­ity is gen­er­ally the same across most malaria-endemic areas, the study says.

Accord­ing to Dr Abdis­alan Noor from the Kenyan Med­ical Research Insti­tute (Kemri)-Wellcome Trust Research Pro­gramme who was lead researcher, the find­ings are sig­nif­i­cant because they touch on a huge demo­graphic seg­ment that has not received as much atten­tion as it should from exist­ing malaria con­trol efforts.

“First, they (5–19 year olds) rep­re­sent a large frac­tion of the pop­u­la­tion in most devel­op­ing African com­mu­ni­ties,” said Dr Noor. “Sec­ond, while they may have devel­oped immu­nity against clin­i­cal dis­ease, they will not have devel­oped immu­nity to the malaria par­a­site and will there­fore con­tinue to con­tribute trans­mis­sion in the community.”

Accord­ing to Dr Noor and his col­leagues, the con­cen­tra­tion of pre­ven­tion activ­i­ties to the most vul­ner­a­ble — chil­dren under five and preg­nant moth­ers — in a bid to meet the tar­gets set by the Abuja Dec­la­ra­tion and Mil­len­nium Devel­op­ment Goals (MDGs) may have unwit­tingly left older chil­dren at risk.

This is despite the fact that they play a major role in the trans­mis­sion cycle of malaria.

An esti­mated 80 per cent of human-to-mosquito trans­mis­sion comes from those aged over five years, with young ado­les­cents and older chil­dren being the peak transmitters.

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