Design of a study to determine the impact of insecticide resistance on malaria vector control: a multi-country investigation.
Design of a study to determine the impact of insecticide resistance on malaria vector control: a multi-country investigation.
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DOI：
10.1186/s12936-015-0782-4
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发表时间：
2015-07-22
期刊：
影响因子：
3
通讯作者：
Donnelly MJ
中科院分区：
文献类型：
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作者：
Kleinschmidt I;Mnzava AP;Kafy HT;Mbogo C;Bashir AI;Bigoga J;Adechoubou A;Raghavendra K;Knox TB;Malik EM;Nkuni ZJ;Bayoh N;Ochomo E;Fondjo E;Kouambeng C;Awono-Ambene HP;Etang J;Akogbeto M;Bhatt R;Swain DK;Kinyari T;Njagi K;Muthami L;Subramaniam K;Bradley J;West P;Massougbodji A;Okê-Sopoh M;Hounto A;Elmardi K;Valecha N;Kamau L;Mathenge E;Donnelly MJ
最近几年通过大幅扩大以杀虫剂为基础的病媒控制来减少疟疾疾病负担方面的进展可能会因广泛出现的杀虫剂耐药性而逆转。杀虫剂抗性对驱虫蚊帐(ITN)和室内滞留喷洒(IRS)保护效果的影响尚不清楚。在苏丹、肯尼亚、印度、喀麦隆和贝宁进行了一项多国研究，以量化由于疟疾媒介对杀虫剂的敏感性降低而可能丧失的ITNS和IRS的流行病学效力。本文介绍了本研究的设计。在多个疟疾季节疟疾病媒控制覆盖率较高的大约300个不同地点(群组)，监测了儿童队列中活跃病例检测的疟疾发病率以及当地病媒的抗药性指标。每年对表型和基因抗性进行评估。在苏丹和印度这两个国家，随机分配的群组只接受信托基金的普遍覆盖，或将信托基金的普遍覆盖与国税局的高覆盖相结合。分别评估疟疾发病率与抗药性之间的关系，以及媒介生物控制方法的保护效果与抗药性的关系。在所有五个国家都建立了队列，并在所有集群中收集了表型耐药性数据。在苏丹、肯尼亚、喀麦隆和贝宁，数据收集工作将于2015年完成。在印度，数据收集工作将于2016年完成。本文讨论了研究设计和实施中面临的挑战、分析计划、优势和劣势，以及所选研究设计的可能替代方案。
Progress in reducing the malaria disease burden through the substantial scale up of insecticide-based vector control in recent years could be reversed by the widespread emergence of insecticide resistance. The impact of insecticide resistance on the protective effectiveness of insecticide-treated nets (ITN) and indoor residual spraying (IRS) is not known. A multi-country study was undertaken in Sudan, Kenya, India, Cameroon and Benin to quantify the potential loss of epidemiological effectiveness of ITNs and IRS due to decreased susceptibility of malaria vectors to insecticides. The design of the study is described in this paper. Malaria disease incidence rates by active case detection in cohorts of children, and indicators of insecticide resistance in local vectors were monitored in each of approximately 300 separate locations (clusters) with high coverage of malaria vector control over multiple malaria seasons. Phenotypic and genotypic resistance was assessed annually. In two countries, Sudan and India, clusters were randomly assigned to receive universal coverage of ITNs only, or universal coverage of ITNs combined with high coverage of IRS. Association between malaria incidence and insecticide resistance, and protective effectiveness of vector control methods and insecticide resistance were estimated, respectively. Cohorts have been set up in all five countries, and phenotypic resistance data have been collected in all clusters. In Sudan, Kenya, Cameroon and Benin data collection is due to be completed in 2015. In India data collection will be completed in 2016. The paper discusses challenges faced in the design and execution of the study, the analysis plan, the strengths and weaknesses, and the possible alternatives to the chosen study design.