Assessing the impact of the addition of pyriproxyfen on the durability of permethrin-treated bed nets in Burkina Faso: a compound-randomized controlled trial
Assessing the impact of the addition of pyriproxyfen on the durability of permethrin-treated bed nets in Burkina Faso: a compound-randomized controlled trial
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DOI：
10.1186/s12936-019-3018-1
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发表时间：
2019-12-02
期刊：
影响因子：
3
通讯作者：
Sagnon, N'Fale
中科院分区：
文献类型：
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作者：
Toe, Kobie H.;Mechan, Frank;Sagnon, N'Fale
用拟除虫菊酯处理的长效驱虫蚊帐是撒哈拉以南非洲疟疾控制的基础。然而，病媒对拟除虫菊酯的抗药性不断上升，推动了替代蚊帐配方的开发。在布基纳法索农村地区，对含有拟除虫菊酯、二氯苯醚菊酯和昆虫保幼激素模拟物吡丙醚（PPF）的新型组合的聚乙烯蚊帐与标准二氯苯醚菊酯长效杀虫剂的耐久性进行了评估。方法在两个村进行复合随机对照试验。在一个村庄，分发了326顶PPF-氯菊酯蚊帐（Olyset Duo）和327顶标准长效驱虫蚊帐（Olyset），以评估生物功效。在第二个村庄，分发了170顶PPF-氯菊酯蚊帐和376个长效驱虫蚊帐，以评估存活率。每隔6个月对蚊帐进行为期3年的随访。通过将对氯菊酯敏感和具有抗性的冈比亚按蚊品系暴露于标准的世界卫生组织（世卫组织）锥形和隧道试验，评估了生物功效，并在抗性品系中测量了对生育力的影响。使用高效液相色谱法测定了茚三酮含量。LLIN存活率通过问卷记录，并通过使用比例孔指数（pHI）比较物理完整性进行评估。结果PPF-氯菊酯净在前18个月符合WHO生物功效标准（死亡率>= 80%或击倒率>= 95%），而标准LLIN为6个月。在所有时间点，PPF-氯菊酯蚊帐的平均蚊子死亡率比标准LLIN高8.6%（CI 2.6-14.6%）。生育率降低后，PPF-氯菊酯净暴露在1个月后分布，但不是更晚。两种蚊帐的氯菊酯含量保持在20克/千克+/- 25%的目标范围内，共检测了242/248顶蚊帐。在36个月内，PPF-二氯苯菊酯蚊帐的吡丙醚含量下降了54%，从10.4克/千克（CI 10.2-10.6）降至4.7克/千克（CI 3.5-6.0，p < 0.001）。净存活率很低，36个月后，只有13%的PPF-氯菊酯蚊帐和12%的长效驱虫蚊帐仍然存在于原来的家庭中。两种补片类型之间的织物完整性或存活率没有差异。结论在本研究中，PPF-氯菊酯蚊帐Olyset Duo的性能达到或超过WHO推荐的标准LLIN（Olyset），但两种蚊帐类型均未达到WHO 3年生物有效性标准。
Background Long-lasting insecticidal nets (LLINs) treated with pyrethroids are the foundation of malaria control in sub-Saharan Africa. Rising pyrethroid resistance in vectors, however, has driven the development of alternative net formulations. Here the durability of polyethylene nets with a novel combination of a pyrethroid, permethrin, and the insect juvenile hormone mimic, pyriproxyfen (PPF), compared to a standard permethrin LLIN, was assessed in rural Burkina Faso. Methods A compound-randomized controlled trial was completed in two villages. In one village 326 of the PPF-permethrin nets (Olyset Duo) and 327 standard LLINs (Olyset) were distributed to assess bioefficacy. In a second village, 170 PPF-permethrin nets and 376 LLINs were distributed to assess survivorship. Nets were followed at 6-monthly intervals for 3 years. Bioefficacy was assessed by exposing permethrin-susceptible and resistant Anopheles gambiae sensu lato mosquito strains to standard World Health Organization (WHO) cone and tunnel tests with impacts on fertility measured in the resistant strain. Insecticide content was measured using high-performance liquid chromatography. LLIN survivorship was recorded with a questionnaire and assessed by comparing the physical integrity using the proportionate hole index (pHI). Results The PPF-permethrin net met WHO bioefficacy criteria (>= 80% mortality or >= 95% knockdown) for the first 18 months, compared to 6 months for the standard LLIN. Mean mosquito mortality for PPF-permethrin nets, across all time points, was 8.6% (CI 2.6-14.6%) higher than the standard LLIN. Fertility rates were reduced after PPF-permethrin net exposure at 1-month post distribution, but not later. Permethrin content of both types of nets remained within the target range of 20 g/kg +/- 25% for 242/248 nets tested. The pyriproxyfen content of PPF-permethrin nets declined by 54%, from 10.4 g/kg (CI 10.2-10.6) to 4.7 g/kg (CI 3.5-6.0, p < 0.001) over 36 months. Net survivorship was poor, with only 13% of PPF-permethrin nets and 12% of LLINs still present in the original household after 36 months. There was no difference in the fabric integrity or survivorship between the two net types. Conclusion The PPF-permethrin net, Olyset Duo, met or exceeded the performance of the WHO-recommended standard LLIN (Olyset) in the current study but both net types failed the 3-year WHO bioefficacy criteria.