Role of flies and provision of latrines in trachoma control: cluster-randomised controlled trial
Role of flies and provision of latrines in trachoma control: cluster-randomised controlled trial
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DOI：
10.1016/s0140-6736(04)15891-1
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发表时间：
2004-04-03
期刊：
影响因子：
168.9
通讯作者：
Bailey, RL
中科院分区：
文献类型：
--
作者：
Emerson, PM;Lindsay, SW;Bailey, RL
寻眼蝇作为可能的沙眼传播媒介受到了广泛关注，但这一点尚未得到证实。我们的目的是评估的作用，眼睛寻求苍蝇作为媒介的沙眼和测试提供简单的坑式厕所，没有额外的健康教育，作为一个可持续的方法，苍蝇control.Methods在一个社区为基础的，集群随机对照试验，我们招募了七组三个村庄，并随机将他们分配到定期喷洒杀虫剂或提供坑式厕所的干预组（不进行额外的健康教育），或不进行干预的对照组。我们的主要结果是蝇眼接触和活动性沙眼的患病率。每两周监测一次儿童蝇眼接触的频率。在基线和6个月后，对整个社区进行沙眼临床体征筛查。结果在招募的7080人中，有6087人（86%）在随访时接受了筛查。活动性沙眼的基线社区患病率为6%。与对照组相比，喷洒杀虫剂可使从儿童眼中捕获的家蝇数量减少88%（95% CI 64-100; p < 0.0001），提供厕所可使其减少30%（7-52; p = 0.04）。对年龄标准化的沙眼患病率进行的聚类分析（n = 14）表明，喷洒与沙眼患病率平均降低56%有关（19-93; p = 0.01）和30%有厕所（-81至22; p = 0.210）解释用杀虫剂控制苍蝇可以有效地减少捕获的苍蝇数量从儿童的眼睛，并与显着降低沙眼患病率与对照组相比。这一发现与苍蝇是沙眼的重要传播媒介相一致。由于厕所提供没有健康教育与一个显着减少蝇眼接触的M sorbens，研究其效果时，结合其他沙眼控制措施是必要的。
Background Eye-seeking flies have received much attention as possible trachoma vectors, but this remains unproved. We aimed to assess the role of eye-seeking flies as vectors of trachoma and to test provision of simple pit latrines, without additional health education, as a sustainable method of fly control.Methods In a community-based, cluster-randomised controlled trial, we recruited seven sets of three village clusters and randomly assigned them to either an intervention group that received regular insecticide spraying or provision of pit latrines (without additional health education) to each household, or to a control group with no intervention. Our primary outcomes were fly-eye contact and prevalence of active trachoma. Frequency of child fly-eye contact was monitored fortnightly. Whole communities were screened for clinical signs of trachoma at baseline and after 6 months. Analysis was per protocol.Findings Of 7080 people recruited, 6087 (86%) were screened at follow-up. Baseline community prevalence of active trachoma was 6%. The number of Musca sorbens flies caught from children's eyes was reduced by 88% (95% CI 64-100; p < 0.0001) by insecticide spraying and by 30% (7-52; p = 0.04) by latrine provision by comparison with controls. Analysis of age-standardised trachoma prevalence rates at the cluster level (n = 14) showed that spraying was associated with a mean reduction in trachoma prevalence of 56% (19-93; p = 0.01) and 30% with latrines (-81 to 22; p = 0.210) by comparison with the mean rate change in the controls.Interpretation Fly control with insecticide is effective at reducing the number of flies caught from children's eyes and is associated with substantially lower trachoma prevalence compared with controls. Such a finding is consistent with flies being important vectors of trachoma. Since latrine provision without health education was associated with a significant reduction in fly-eye contact by M sorbens, studies of their effect when combined with other trachoma control measures are warranted.