Malaria control intervention coverage increased nationwide in Malawi during 2000–2010. Trends in intervention
coverage were assessed against trends in malaria parasite prevalence, severe anemia (hemoglobin < 8 g/dL),
and all-cause mortality in children under 5 years of age (ACCM) using nationally representative household surveys.
Associations between insecticide-treated net (ITN) ownership, malaria morbidity, and ACCM were also assessed.
Household ITN ownership increased from 27.4% (95% confidence interval [CI] = 25.9–29.0) in 2004 to 56.8% (95% CI =
55.6–58.1) in 2010. Similarly intermittent preventive treatment during pregnancy coverage increased from 28.2%
(95% CI = 26.7–29.8) in 2000 to 55.0% (95% CI = 53.4–56.6) in 2010. Malaria parasite prevalence decreased significantly
from 60.5% (95% CI = 53.0–68.0) in 2001 to 20.4% (95% CI = 15.7–25.1) in 2009 in children aged 6–35 months. Severe
anemia prevalence decreased from 20.4% (95% CI: 17.3–24.0) in 2004 to 13.1% (95% CI = 11.0–15.4) in 2010 in children
aged 6–23 months. ACCM decreased 41%, from 188.6 deaths per 1,000 live births (95% CI = 179.1–198.0) during
1996–2000, to 112.1 deaths per 1,000 live births (95% CI = 105.8–118.5) during 2006–2010. When controlling for other
covariates in random effects logistic regression models, household ITN ownership was protective against malaria parasitemia
in children (odds ratio [OR] = 0.81, 95% CI = 0.72–0.92) and severe anemia (OR = 0.82, 95% CI = 0.72–0.94). After
considering the magnitude of changes in malaria intervention coverage and nonmalaria factors, and given the contribution
of malaria to all-cause mortality in malaria-endemic countries, the substantial increase in malaria control interventions
likely improved child survival in Malawi during 2000–2010.