Effect of insecticide-treated bed nets on visceral leishmaniasis incidence in Bangladesh. A retrospective cohort analysis
Effect of insecticide-treated bed nets on visceral leishmaniasis incidence in Bangladesh. A retrospective cohort analysis
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DOI：
10.1371/journal.pntd.0007724
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发表时间：
2019-09-01
影响因子：
3.8
通讯作者：
Banu, Qamar
中科院分区：
文献类型：
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作者：
Chowdhury, Rajib;Chowdhury, Vashkar;Banu, Qamar
内脏利什曼病（VL）是一种寄生虫病，在印度次大陆由白蛉种银足白蛉传播。有效的病媒控制是非常必要的，以减少病媒密度和地方性社区中人与病媒的接触，从而减少疾病传播。我们评估了长效杀虫剂处理的蚊帐（LLIN）和浸渍缓释杀虫剂片剂K-O TAB 1-2-3的蚊帐（联合杀虫剂处理的蚊帐或ITN）对孟加拉国一个高度流行的分区（upazila）VL发病率的影响。方法2004 - 2008年，美国亚特兰大CDC（2004年）和瑞士日内瓦WHO TDR（2006 & 2008年）资助的3个研究项目在Mymensigh区Fulbaria upazila地区发放LLIN或K-O TAB 1-2-3，用于家庭自浸蚊帐。我们将20个村庄的所有家庭（n = 8142）纳入“暴露队列”，这些家庭过去曾受益于其中一项干预措施（1295个捐赠的LLIN和11,918个浸渍K-O TAB 1-2-3的当地蚊帐）。我们招募了一个“非暴露队列”的村庄，同期发病率相似，谁没有收到这样的媒介控制干预措施（7 729人，来自9个村庄）。在这两个队列中，我们挨家挨户访问了所有家庭，并确定了干预前后3年内的任何VL病例。我们采用差异中的差异方法，评价了两个队列中VL的发生率（IR）作为主要终点。结果干预前共发现VL病例1011例，发病率为140.47/万人/年，其中干预区534例，对照区477例。干预区和对照区的IR分别为144.13/10，000 py（534/37050）和136.59/10，000 py（477/34923），干预前无显著差异（p = 0.3901）。干预后，共发现555例（IR 77.11/10，000 py），其中干预区178例（IR 48.04/10，000 py），对照区377例（107.95/10，000 py）。随访期间，干预区的IR显著低于对照区，率差=-59.91，p
Background Visceral leishmaniasis (VL) is a parasitic disease, transmitted by the sand fly species Phlebotomus argentipes in the Indian sub-continent. Effective vector control is highly desirable to reduce vector density and human and vector contact in the endemic communities with the aim to curtail disease transmission. We evaluated the effect of long lasting insecticide treated bed nets (LLIN) and bed nets impregnated with slow-release insecticide tablet K-O TAB 1-2-3 (jointly insecticide-treated nets or ITN) on VL incidence in a highly endemic sub-district (upazila) in Bangladesh. Methods Several distributions of LLIN or K-O TAB 1-2-3 for self-impregnation of bed nets at home took place in Fulbaria upazila, Mymensigh district from 2004 to 2008 under three research projects, respectively funded by CDC, Atlanta, USA (2004) and WHO-TDR, Geneva, Switzerland (2006 & 2008). We included all households (n = 8142) in the 20 villages that had benefited in the past from one of these interventions (1295 donated LLIN and 11,918 local bed nets impregnated with K-O TAB 1-2-3) in the "exposed cohort". We recruited a "non-exposed cohort" in villages with contemporaneously similar incidence rates who had not received such vector control interventions (7729 HHs from nine villages). In both cohorts, we visited all families house to house and ascertained any VL cases for the 3 year period before and after the intervention. We evaluated the incidence rate (IR) of VL in both cohorts as primary endpoint, applying the difference-in-differences method. Results The study identified 1011 VL cases (IR 140.47/10,000 per year [py]) before the intervention, of which 534 and 477 cases in the intervention and control areas respectively. The IR was 144.13/10,000 py (534/37050) and 136.59/10,000 py (477/34923) in the intervention and control areas respectively, with no significant difference (p = 0.3901) before the intervention. After the intervention, a total of 555 cases (IR 77.11/10,000 py) were identified of which 178 (IR 48.04/10,000 py) in the intervention and 377 (107.95/10,000 py) in the control area. The intervention area had a significant lower IR than the control area during follow up, rate difference = -59.91, p