How much does malaria vector control quality matter: the epidemiological impact of holed nets and inadequate indoor residual spraying.
How much does malaria vector control quality matter: the epidemiological impact of holed nets and inadequate indoor residual spraying.
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DOI：
10.1371/journal.pone.0019205
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发表时间：
2011-04-29
期刊：
影响因子：
3.7
通讯作者：
Kleinschmidt I
中科院分区：
文献类型：
--
作者：
Rehman AM;Coleman M;Schwabe C;Baltazar G;Matias A;Gomes IR;Yellott L;Aragon C;Nchama GN;Mzilahowa T;Rowland M;Kleinschmidt I
驱虫蚊帐和室内滞留喷洒是非洲疟疾病媒控制的两大支柱，但这两种干预措施都受到质量和覆盖面问题的困扰。从三个控制方案的数据被用来调查的影响：1）物理恶化的驱虫蚊帐，2）IRS喷洒覆盖面不足，对各自的保护效果。2009年和2010年在比奥科岛、赤道几内亚大陆和马拉维进行了疟疾指标调查，以监测儿童恶性疟原虫感染情况、蚊帐使用情况、蚊帐状况和房屋喷洒状况。根据其状况对蚊帐进行分类。感染和干预措施的质量和覆盖面之间的关联进行了调查。在赤道几内亚和马拉维，睡在完整的驱虫蚊帐下的儿童感染恶性疟原虫的几率降低（比值比（OR）：0.65，95%CI：0.55-0.77和OR：0.81，95%CI：0.56-1.18），但随着蚊帐条件的日益恶化，保护作用也越来越小。有证据表明，每类蚊帐的感染率呈线性上升趋势。在赤道几内亚，与生活在室内滞留喷洒覆盖率低的地区（<20%）的人相比，当邻里喷洒覆盖率高（≥80%）时，室内滞留喷洒对喷洒过和未喷洒过室内滞留喷洒的人都提供了保护，而不管他们居住的房屋是否喷洒过（调整后的OR = 0.54，95% CI 0.33-0.89）。 经杀虫剂处理过的蚊帐只提供个人保护，对非使用者不提供保护。虽然在马拉维也看到了类似的影响，但证据比赤道几内亚弱得多。普遍覆盖战略应考虑采取政策，修理和更换有洞的蚊帐，并促进蚊帐所有者对蚊帐的护理。IRS计划应确保高喷洒覆盖率，因为覆盖率不足几乎没有保护。
Insecticide treated nets (ITN) and indoor residual spraying (IRS) are the two pillars of malaria vector control in Africa, but both interventions are beset by quality and coverage concerns. Data from three control programs were used to investigate the impact of: 1) the physical deterioration of ITNs, and 2) inadequate IRS spray coverage, on their respective protective effectiveness. Malaria indicator surveys were carried out in 2009 and 2010 in Bioko Island, mainland Equatorial Guinea and Malawi to monitor infection with P.falciparum in children, mosquito net use, net condition and spray status of houses. Nets were classified by their condition. The association between infection and quality and coverage of interventions was investigated. There was reduced odds of infection with P.falciparum in children sleeping under ITNs that were intact (Odds ratio (OR): 0.65, 95% CI: 0.55–0.77 and OR: 0.81, 95% CI: 0.56–1.18 in Equatorial Guinea and in Malawi respectively), but the protective effect became less with increasingly worse condition of the net. There was evidence for a linear trend in infection per category increase in deterioration of nets. In Equatorial Guinea IRS offered protection to those in sprayed and unsprayed houses alike when neighbourhood spray coverage was high (≥80%) compared to those living in areas of low IRS coverage (<20%), regardless of whether the house they lived in was sprayed or not (adjusted OR = 0.54, 95% CI 0.33–0.89). ITNs provided only personal protection, offering no protection to non users. Although similar effects were seen in Malawi, the evidence was much weaker than in Equatorial Guinea. Universal coverage strategies should consider policies for repair and replacement of holed nets and promote the care of nets by their owners. IRS programs should ensure high spray coverage since inadequate coverage gives little or no protection at all.
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发表时间：
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影响因子：
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