INSECTICIDE-IMPREGNATED BED NETS FOR MALARIA CONTROL - VARYING EXPERIENCES FROM ECUADOR, COLOMBIA, AND PERU CONCERNING ACCEPTABILITY AND EFFECTIVENESS
INSECTICIDE-IMPREGNATED BED NETS FOR MALARIA CONTROL - VARYING EXPERIENCES FROM ECUADOR, COLOMBIA, AND PERU CONCERNING ACCEPTABILITY AND EFFECTIVENESS
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DOI：
10.4269/ajtmh.1995.53.313
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发表时间：
1995-10-01
影响因子：
3.3
通讯作者：
PESSE, K
中科院分区：
文献类型：
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作者：
KROEGER, A;MANCHENO, M;PESSE, K
1991年至1994年期间，在厄瓜多尔、秘鲁和哥伦比亚的五个疟疾流行区，分别实施了一项为期九个月的使用氯菊酯和氟氯氰菊酯浸渍蚊帐的干预方案。通过家庭调查、血液取样、深入的纵向研究和昆虫学分析对该方案进行了评估。根据疟疾发病率、规模和蚊帐覆盖率，将84个社区（包括约35 000人）配对，然后随机分配到干预组和对照组。结果表明，人们对这项措施的接受程度与他们对立即保护昆虫的看法有关。蚊帐的有效性，衡量干预社区与对照社区相比疟疾发病率的降低，显示研究地区之间和内部存在很大差异。当只看干预组和对照组之间的干预后差异时，保护效力在0%和70%之间变化。当考虑到临床疟疾发作四个月的发病率时，平均保护率为40.8%，当考虑到两周的疟疾发病率时，平均保护率为28.3%。蚊帐方案取得成功的重要因素是昆虫对拟除虫菊酯的敏感性、浸渍蚊帐的高覆盖率、高疟疾发病率、良好的社区参与、人们上床睡觉时蚊子密度高以及恶性疟原虫比例高。在一个地区，在对照社区喷洒滴滴涕，蚊帐浸渍的效果略好于喷洒。
Between 1991 and 1994, an intervention program with permethrin- and lambdacyhalothrin-impregnated bed nets was carried out over a period of nine months in each of five endemic, malarious areas of Ecuador, Peru, and Colombia. This program was evaluated through household surveys, blood sampling, in-depth longitudinal studies, and entomologic analysis. Eighty-four communities (including approximately 35,000 individuals) were paired according to malaria incidence, size, and coverage with bed nets and then randomly allocated to intervention and control groups. The results showed that peoples' acceptance of the measure was related to their perception of an immediate protective effect against insects. The effectiveness of the bed nets, measured as a reduction of malaria incidence in intervention communities as against control communities, showed large variations between and within the study areas. The protective efficacy varied between 0% and 70% when looking only at the postintervention differences between intervention and control groups. The average protection was 40.8% when considering a four-month incidence of clinical malaria attacks and 28.3% when considering a two-week malaria incidence. Important factors for the success of the bed net program were insect susceptibility to pyrethroids, high coverage with impregnated bed nets, high malaria incidence, good community participation, high mosquito densities when people go to bed, and a high proportion of Plasmodium falciparum. In one area, where DDT spraying in the control communities was executed, the effectiveness of bed net impregnation was slightly better than that of spraying.