Anti-larval measures for malaria control in The Gambia

拟议的研究重点是评估两种幼虫防治剂芽孢杆菌的能力。 Sphaericus(BS)和苏云金芽孢杆菌Bt.Israelensis(Bti)(VectoLex和Vectobac)，Valent Biosciences， 美国)以减少儿童的临床疟疾。有效的疟疾控制受到药物和杀虫剂的威胁 热带不同地区的抗药性和幼虫防治可能为有效防治提供一种新的选择。 幼虫控制在历史上是成功的，但在过去50年里在很大程度上被忽视了。 最近有希望的BS和Bti的新配方被证明能很好地控制主要的 疟疾在非洲的传播媒介。这些产品的使用比化学杀幼虫剂更好，因为它们有多种 联合使用时，似乎不会引起耐药性的演变。到目前为止，很少有试验 测量了使用BS和Bti杀幼虫的临床影响，这些影响因样本较少而受阻 集群内的大小和缺乏集群的复制，因此统计能力较低。更大规模的干预 迫切需要进行复制研究，以证明控制幼虫是一种 有效的疟疾控制工具，并使国际政策制定者能够在知情的情况下 幼虫控制的相对优点。因此，我们建议开展一项大型分组随机干预 在冈比亚进行了一项试验，以调查控制幼虫以减少儿童疟疾发病率的能力。这个 这项研究的结果将对量化使用B和Bti的重要性做出重大贡献 与疟疾作斗争。

The proposed research focuses on the assessment of the ability of 2 larval control agents, Bacillus sphaericus (Bs) and B. thuringiensis var. israelensis (Bti) (VectoLex¿ and Vectobac¿, Valent Biosciences, USA) to reduce clinical malaria in children. Effective malaria control is under threat from drug and insecticide resistance in different parts of the tropics, and larval control may offer a new alternative for effective control. Larval control has been historically successful, but has been largely neglected over the last 50 years. Promising new formulations of Bs and Bti have recently been shown to give excellent control of the major vectors of malaria in Africa. Use of these products is better than chemical larvicides since they have multiple actions and do not appear to elicit the evolution of resistance when used together. To date few trials have measured the clinical impact of larviciding with Bs and Bti and these have been hampered by small sample size within clusters and a lack of replication of clusters and hence, low statistical power. A larger intervention study with replication is urgently required to demonstrate the proof of concept that larval control is an effective malaria control tool and to allow informed decision making by international policy makers of the relative merits of larval control. We therefore propose to carry out a large cluster-randomised intervention trial in The Gambia to investigate the ability of larval control to reduce malaria morbidity in children. The results from this study will make a major contribution to quantifying the importance of the use of Bs and Bti in the fight against malaria.