Model-based investigations of different vector-related intervention strategies to eliminate visceral leishmaniasis on the Indian subcontinent.
Model-based investigations of different vector-related intervention strategies to eliminate visceral leishmaniasis on the Indian subcontinent.
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DOI：
10.1371/journal.pntd.0002810
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发表时间：
2014-04
影响因子：
3.8
通讯作者：
Eichner M
中科院分区：
文献类型：
--
作者：
Stauch A;Duerr HP;Picado A;Ostyn B;Sundar S;Rijal S;Boelaert M;Dujardin JC;Eichner M
消除传染病需要将传播降低到一定的门槛以下。东南亚消除内脏利什曼病倡议旨在通过病例管理和媒介控制相结合的方式，到2015年将流行地区的内脏利什曼病年发病率降低到每万名居民1例以下。利用之前开发的VL传播模型，我们研究了传播阈值取决于通过杀灭沙蝇(例如室内残留喷洒和长效杀虫蚊帐)或通过破坏繁殖地(例如环境管理)来降低沙蝇密度的措施。模型模拟表明，如果通过杀灭沙蝇将沙蝇密度降低67%，或者通过环境管理措施将繁殖地点的数量减少79%以上，就有可能消除白纹伊蚊。这些结果与最近在印度、尼泊尔和孟加拉国进行的两个群组随机对照试验的数据进行了比较，这些试验显示，室内残留喷洒后沙蝇密度减少了72%，使用长效驱虫蚊帐分别减少了44%和25%，环境管理后减少了42%。基于模型预测，我们确定了VL传播周期内的主要参数，这些参数决定了干预成功的前景。我们建议进行进一步的研究，以完善基于模型的预测，以消除VL。内脏利什曼病被怀疑是仅次于疟疾的世界第二大寄生虫杀手。在印度次大陆，这种媒介传播的疾病是由原生动物鞭毛虫多诺瓦尼利什曼原虫引起的，并由沙蝇Phlebotomus argentipe传播。区域消除方案建议将到2015年将年发病率降至万人一例以下作为目标线。利用之前开发的数学模型，我们调查了必须在多大程度上控制沙蝇种群才能实现消灭。将这些计算的阈值与最近在印度、尼泊尔和孟加拉国进行的两项试验的数据进行比较，以评估不同媒介控制措施的效果。结果表明，由于室内滞留喷雾的评价效果超过了阈值，因此消除是可行的。然而，新出现的杀虫剂抗药性可能会损害这一措施的有效性。观察到的长效驱虫蚊帐和环境管理的效果似乎不足以达到这两个阈值。以室内滞留喷洒为基础的病媒综合管理，结合长效杀虫蚊帐和更有效的环境管理，可以克服目前病媒控制方法的局限性，还应防止在局部灭绝后再次出现感染。
The elimination of infectious diseases requires reducing transmission below a certain threshold. The Visceral Leishmaniasis (VL) Elimination Initiative in Southeast Asia aims to reduce the annual VL incidence rate below 1 case per 10,000 inhabitants in endemic areas by 2015 via a combination of case management and vector control. Using a previously developed VL transmission model, we investigated transmission thresholds dependent on measures reducing the sand fly density either by killing sand flies (e.g., indoor residual spraying and long-lasting insecticidal nets) or by destroying breeding sites (e.g., environmental management). Model simulations suggest that elimination of VL is possible if the sand fly density can be reduced by 67% through killing sand flies, or if the number of breeding sites can be reduced by more than 79% through measures of environmental management. These results were compared to data from two recent cluster randomised controlled trials conducted in India, Nepal and Bangladesh showing a 72% reduction in sand fly density after indoor residual spraying, a 44% and 25% reduction through the use of long-lasting insecticidal nets and a 42% reduction after environmental management. Based on model predictions, we identified the parameters within the transmission cycle of VL that predominantly determine the prospects of intervention success. We suggest further research to refine model-based predictions into the elimination of VL. Visceral leishmaniasis is suspected to be the second largest parasitic killer in the world after malaria. On the Indian subcontinent, the vector-borne disease is caused by the protozoan flagellate Leishmania donovani and transmitted by the sand fly Phlebotomus argentipes. The regional elimination programme has suggested as a target line to reduce the annual incidence below 1 case in 10,000 by 2015. Using a previously developed mathematical model, we investigated to what extent the sand fly population must be controlled to achieve elimination. These calculated thresholds were compared to data from two recent trials conducted in India, Nepal and Bangladesh to evaluate the efficacy of different vector control measures. Our results indicate that elimination should be feasible because the evaluated effect of indoor residual spraying exceeds the threshold. However, emerging insecticide resistance may compromise the effectiveness of this measure. The observed effects of long lasting insecticidal nets and environmental management do not seem to be sufficient to reach either threshold. Integrated vector management based on indoor residual spraying combined with long lasting insecticidal nets and more effective environmental management may allow overcoming the limitations of the current vector control methods and should also prevent re-emergence of the infection after local extinction.
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影响因子：
3.8
作者：
Dinesh DS;Das ML;Picado A;Roy L;Rijal S;Singh SP;Das P;Boelaert M;Coosemans M
通讯作者：
Coosemans M
影响因子：
2.7
作者：
Guarga, JL;Lucientes, J;Castillo, JA
通讯作者：
Castillo, JA
影响因子：
3.3
作者：
Dinesh, Diwakar S.;Das, Pradeep;Coosemans, Marc
通讯作者：
Coosemans, Marc
影响因子：
3.3
作者：
Boelaert, M.;Meheus, F.;Sundar, S.
通讯作者：
Sundar, S.
影响因子：
2.7
作者：
Das, M. L.;Roy, L.;Boelaert, M.
通讯作者：
Boelaert, M.