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Soap,
Nets Aid Developing Nations' Health
Soap and insecticide-treated nets
to cover beds are effective, low-tech solutions to deadly infections
that plague children in developing countries, two studies released
found.
In one study, promoting hand-washing
and giving free soap to families in impoverished settlements in
Karachi, Pakistan, significantly reduced cases of infectious diarrhea
in children.
In another study, treated bed nets
given to families in western Kenya led to dramatic reductions
in malaria-carrying mosquitoes and infant deaths over a period
of about six years.
"What many people look at as just
overwhelming problems of poverty" can be tackled by addressing
one aspect of behavior and don't require trying to solve the more
complex underlying causes of impoverishment, said Dr. Stephen
Luby of the federal Centers for Disease Control and Prevention.
That doesn't mean that the underlying
causes shouldn't be addressed, but rather that making a dent may
not be as daunting as some people have thought, said Luby, lead
author of the hand-washing study.
The studies appear in the Wednesday
Journal of the American Medical Association, an issue on global
health.
A journal essay says that many
developing countries face a double burden of infectious disease
and rising rates of heart disease, cancer, diabetes and other
chronic diseases. In India, for example, infections such as diarrhea,
malaria and pneumonia kill 2.5 million children each year, but
the country also has the world's highest number of diabetics,
according to the report by Derek Yak at the World Health Organization
and colleagues.
A JAMA editorial says the bed net
and soap studies are encouraging evidence of successful interventions
but that more research is needed to evaluate the long-term effects.
In the soap study, 600 households
received regular supplies of soap for about a year. Field workers
also made weekly home visits to encourage regular hand-washing.
Children younger than 15 years
had a 53 percent lower incidence of diarrhea than youngsters living
in households that didn't receive the soap or hand-washing advice.
Severely malnourished children under age 5 had 42 percent fewer
days of diarrhea than children in households without the intervention.
The bed net study involved 130,000
residents of 221 Kenyan villages from 1997 to 2002. About half
were given nets in the study's initial phase; the remainder received
nets later on. Nets were periodically retreated and replaced as
needed.
More than 20 percent of deaths
in children under 5 in the region are attributed to malaria, which
is transmitted by mosquitoes.
Less than half as many malaria
cases occurred in infants whose families had the nets in the first
phase than in infants in families without nets. In the first phase,
there also were significantly fewer infant deaths from all causes
in the bed net group. Death rates fell in the no-net group in
the second phase after they received nets.
An earlier analysis determined
that the program's first phase, which cost $725,700, was cost-effective
given the lives saved and reduced disease burden.
CDC researcher Kim Lindblade, the
lead author, said a cost-effectiveness analysis has not been done
for the study's second phase.
The results show the benefits "are
likely to endure if programs continue to actively supply nets
and insecticide," Lindblade said.
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On the Net:
JAMA: http://jama.ama-assn.org
Reference
Source 102
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