Protective efficacy of holed and aging PBO-pyrethroid synergist-treated nets on malaria infection prevalence in north-western Tanzania.
Protective efficacy of holed and aging PBO-pyrethroid synergist-treated nets on malaria infection prevalence in north-western Tanzania.
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DOI：
10.1371/journal.pgph.0000453
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发表时间：
2022
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自2004年以来，已在撒哈拉以南非洲地区分发了20亿顶拟除虫菊酯长效杀虫蚊帐，用于预防疟疾。目前的疟疾控制战略依赖于假定的LLIN有效寿命为3年。PBO增效剂LLIN是一种新推荐的蚊帐，但关于它们在社区中的寿命和长期保护效果的信息有限。为了评估他们的手术生存，在坦桑尼亚西部对来自396户家庭的390只PBO LLIN(Olyset Plus)和367只标准拟除虫菊酯LLIN(Olyset Net)进行了36个月的跟踪调查。为了评估LLIN的状况与疟疾感染之间的关系，在分发后4、9、16、21、28和33个月的疟疾流行横断面调查中，对至少480个随机选择的家庭的蚊帐进行了评估。收集了关于蚊帐的存在和状况的信息，以及来自家庭的人口统计信息，以评估影响蚊帐耐久性的因素。3年后，仍有不到17%的蚊帐仍留在家庭中。在这两种类型的蚊帐中，织物状况与疟疾感染没有关联。不同类型的蚊帐在1-2年龄之间的差异最大，当时PBO网似乎与不到一年龄的网具有类似的保护作用，而标准网在老化后防护能力大大降低，无论织物状况如何。PBO LLIN组和标准LLIN组的中位功能生存期分别为1.6年(95%CI 1.38~1.87)和1.9年(95%CI 1.67~2.06)，差异无统计学意义。3年后，两种蚊帐的氯菊酯(拟除虫菊酯)含量都损失了55%，PBO LLIN中的PBO含量损失了97%。这些结果表明，这两种网络类型的功能存活期都少于推荐的3年。然而，即使随着蚊帐的老化，PBO蚊帐仍然比标准蚊帐更具保护性，无论其状况如何。
Two billion pyrethroid long-lasting insecticidal nets (LLINs) have been distributed since 2004 for malaria prevention in Sub-Saharan Africa. Current malaria control strategies rely on an assumed effective 3-year lifespan for LLINs. PBO synergist LLINs are a newly recommended class of net but there is limited information on their life span and long-term protective efficacy in communities. To assess their operational survival, a cohort of 390 PBO LLINs (Olyset Plus) and 367 standard pyrethroid LLIN (Olyset net) from 396 households were followed for 36 months in Western Tanzania. To assess the association between the condition of the LLIN and malaria infection, nets from at least 480 randomly selected households were assessed during malaria prevalence cross-sectional surveys at 4, 9, 16, 21, 28, and 33 months post-distribution. Information on the presence and condition of nets, and demographic information from the household, were collected to evaluate factors influencing net durability. After 3 years less than 17% of nets distributed still remained in the households. The fabric condition was not associated with malaria infection in either type of net. The difference between the net types was highest when nets were between 1–2 years old, when PBO nets appeared to be similarly protective as nets less than a year old, whereas standard nets were considerably less protective as they aged, regardless of fabric condition. There was no statistical difference in the estimated median functional survival time between net types with 1.6 years (95% CI 1.38–1.87) for PBO LLIN and 1.9 years (95% CI 1.67–2.06) for standard LLINs. After 3 years, there was a loss of 55% of permethrin (pyrethroid) content for both nets, and 97% of PBO content was lost in PBO LLIN. These results highlight that functional survival is less than the recommended 3 years for both net types. However, even as the nets age, the PBO nets remained more protective than standard nets, regardless of their condition.