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Volume 4, Pages 978-988
Review Article

Assessing the Health Effects of Long-Term Exposure to Insecticide-Treated Mosquito Nets in the Control of Malaria in Endemic Regions

1Neurosciences Research, Cahers Inc., 8787 Shenandoah Park Drive, Suite 122, Conroe, Houston, TX 77385, USA
2Department of Maternal and Child Health, School of Public Health, University of Alabama at Birmingham (UAB), Birmingham, AL, USA
33Department of Microbiology, Abia State University, Uture, Abia State, Nigeria
4Clalit Health Services and Division of Community Health, Department of Family Medicine, Ben Gurion University, Beer-Sheva, Israel
5The Quality of Life Research Center, Teglgårdstræde 4-8, DK-1452 Copenhagen K, Denmark and The Scandinavian Foundation for Holistic Medicine, Sandvika, Norway
6National Institute of Child Health and Human Development, Office of the Medical Director, Division for Mental Retardation, Ministry of Social Affairs, Jerusalem and Zusman Child Development Center, Division of Pediatrics and Community Health, Ben Gurion University, Beer-Sheva, Israel

Received 21 August 2004; Revised 22 October 2004; Accepted 23 October 2004

Academic Editor: Hatim A. Omar

Copyright © 2004 Ebere C. Anyanwu et al.


Malaria is a protozoan disease caused in humans by the genus Plasmodium of which four species are known: P. falciparum, P. vivax, P. ovale, and P. malariae. It is transmitted through the bite of infected female mosquitoes of the genus Anopheles. Malaria is endemic in tropical and subtropical regions of the world. It is characterized by extreme exhaustion associated with paroxysms of high fever, sweating, shaking chills, and anemia. Approximately 40% of the world's population, mostly those living in the poorest nations, are at risk. Much of the deaths due to malaria occur in Africa, mostly among children. The search for prevention and control interventions that are effective and sustainable remains an abiding challenge for national governments and international health agencies. To this end, the World Health Organization and several nongovernmental organizations are investing in the use of insecticide-treated mosquito nets (ITMNs) as a viable option. Trials of ITMNs in the 1980s and 1990s showed that they reduce deaths in young children by an average of 20% and multilateral agencies, spearheaded by Roll Back Malaria (RBM), seek to have 60% of the populations at risk sleeping under ITMNs by 2005. All pesticides are toxic by nature and present risks of adverse effects that depend on toxicity of the chemical and the degree of exposure. While there is agreement that ITMNs can be effective in reducing malaria morbidity and mortality under field trials, a number of factors relating to their sustainability and contribution to health improvement in less-developed countries have yet to be determined. In particular, the adverse effects associated with their long-term use and misuse has yet to be fully evaluated. Although this paper examines potential neurotoxic and neurobehavioral effects of long-term use of ITMNs and discusses priority public health actions for protecting the health of users, it forms the basis for further research.