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Sleeping under an insecticide-treated bed net improves survival among young children in areas with high malaria transmission (NEJM JW Infect Dis Oct 3 2007; [e-pub] and Lancet 2007; 370:1035) — but might this practice delay acquisition of immunity to malaria, thereby shifting deaths to older ages? Investigators analyzed data from a 22-year prospective cohort study in Tanzania to estimate the association between early-childhood use of treated nets and long-term survival.
The original 5-year study (initiated in 1998) enrolled 6706 children, among whom about 25% always slept under a treated net, 50% sometimes did, and 25% never did. In 2019, researchers verified the vital status of 5983 participants and compared survival trajectories according …