Investigating the public health impact of the spread of pyrethroid resistance in malaria vectors

据估计，自2000年以来已预防的6.63亿疟疾病例中，68%是由于使用了长效杀虫剂处理过的蚊帐。近年来，蚊子对拟除虫菊酯类杀虫剂的抗药性出现了令人担忧的增加；目前唯一可用于蚊帐的杀虫剂。目前尚不清楚抗药性的地理范围和程度的扩大是由于蚊帐的大量分布，还是由于其他选择压力（如农业中使用杀虫剂）而演变而来。抗药性对公共卫生的影响也不清楚，尽管人们担心它的传播会危及疟疾的控制，因为未来十年可能使用的所有新开发的蚊帐都含有拟除虫菊酯。利用拟除虫菊酯抗性蚊子传播的历史记录和疟疾流行病学数据，将对疟疾流行、蚊帐使用和杀虫剂抗性水平之间的关系进行统计检验。然后将通过使用疾病传播动力学的数学模型进一步分析这些数据，以调查观察到的抗杀虫剂蚊子传播的增加是否可以解释疟疾的时间趋势和蚊子控制规划的有效性。

It is estimated that 68% of the 663 million cases of malaria that have been prevented since the year 2000 are attributable to the use of long-lasting insecticide treated bednets. In recent years, there has been a worrying increase in mosquito resistance to pyrethroid insecticides; the only insecticide currently available for use on bednets. It is currently unknown whether the extended geographic range and magnitude of resistance is due to the mass distribution of bednets or whether it has evolved due to other selection pressures, such as insecticide use in agriculture. The public health impact of resistance is also unclear, though it is feared its spread puts malaria control in jeopardy as all newly-developed bednets likely to be used in the next decade will contain pyrethroids.Using historical records of the spread of pyrethroid resistant mosquitoes and epidemiological data on malaria prevalence, the relationship between malaria prevalence, bednet use and the level of insecticide resistance will be statistically examined. This data will then be further analysed through the use of mathematical models of disease transmission dynamics to investigate whether the observed increase in the spread of insecticide resistant mosquitoes can explain temporal trends in malaria and the effectiveness of mosquito control programmes.