Impact of fly control on childhood diarrhoea in Pakistan: community-randomised trial
Impact of fly control on childhood diarrhoea in Pakistan: community-randomised trial
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DOI：
10.1016/s0140-6736(98)03366-2
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发表时间：
1999-01-02
期刊：
影响因子：
168.9
通讯作者：
Akhtar, T
中科院分区：
文献类型：
--
作者：
Chavasse, DC;Shler, RP;Akhtar, T
背景每年有数百万儿童死于腹泻疾病；适合发展中国家的预防战略至关重要。尽管有强有力的间接证据表明苍蝇是腹泻疾病的媒介，但还没有关于控制苍蝇对发展中国家腹泻发病率影响的令人信服的研究报告。我们对喷洒杀虫剂对腹泻发病率的影响进行了随机研究。A组和B组分别于1995年和1996年通过施药控制蝇类。1997年，在A组村庄测试诱蝇装置的效果。通过母亲每周探视一名卫生人员期间的报告，监测5岁以下儿童的腹泻情况。苍蝇密度是用悬挂在哨兵房内的粘性苍蝇纸监测的，在1995年和1996年的苍蝇季节(3-6月)，喷洒杀虫剂几乎消除了受处理村庄的苍蝇数量。1995年和1996年，喷药村的腹泻发病率均低于未喷药村(6.3vs7.1)和1996年(4.4vs6.5)，发病率下降23%(95%可信区间11-33，p=0.007)。在除苍蝇季节以外的其他时间，没有证据表明喷药和未喷药的村庄之间腹泻发病率存在差异。1997年的苍蝇密度数据表明诱饵诱捕器在这种情况下无效。解释苍蝇控制对腹泻发病率的影响与世卫组织目前建议列入发展中国家腹泻病控制方案的干预措施的影响相似或更大。这一重要发现需要在发展中国家的其他环境中得到证实。需要开发和推广阻断苍蝇传播疾病的技术和做法。
Background Several million children are killed each year by diarrhoeal diseases; preventive strategies appropriate for developing countries are vital. Despite strong circumstantial evidence that flies are vectors of diarrhoeal diseases, no convincing studies of the impact of fly control on diarrhoea incidence in developing countries have been reported. We undertook a randomised study of the effect of insecticide spraying on diarrhoea incidence.Methods Six study villages were randomly assigned to two groups. Flies were controlled through insecticide application in group A in 1995 and in group B in 1996. In 1997 the effectiveness of baited fly traps was tested in group A villages. Diarrhoea episodes were monitored in children under 5 years through mothers' reports during weekly visits by a health visitor. Fly density was monitored by use of sticky fly-papers hung in sentinel compounds.Findings During the fly seasons (March-June) of both 1995 and 1996, insecticide application practically eliminated the fly population in the treated villages. The incidence of diarrhoea was lower in the sprayed villages than in the unsprayed villages in both 1995 (mean episodes per child-year 6.3 vs 7.1) and 1996 (4.4 vs 6.5); the reduction in incidence was 23% (95% CI 11-33, p=0.007). At times other than the fly season there was no evidence of a difference in diarrhoea morbidity between sprayed and unsprayed villages. Fly density data for 1997 indicate the ineffectiveness of baited traps in this setting.Interpretation Fly control can have an impact on diarrhoea incidence similar to, or greater than, that of the interventions currently recommended by WHO for inclusion in diarrhoeal disease control programmes in developing countries. This important finding needs confirmation in other settings in developing countries. Technologies and practices that interrupt disease transmission by flies need to be developed and promoted.