Anti-larval measures for malaria control in The Gambia

本研究主要对芽孢杆菌、枯草芽孢杆菌 sphaericus（Bs）和B.苏云Israelensis（Bti）（VectoLex和Vectobac，Valent Biosciences， 美国），以减少儿童临床疟疾。有效的疟疾控制受到药物和杀虫剂的威胁 在热带不同地区的抗性，幼虫控制可能提供一个新的替代有效的控制。 幼虫控制在历史上是成功的，但在过去的50年里在很大程度上被忽视了。 最近已经显示出有希望的Bs和Bti的新制剂对主要的 非洲疟疾的传播媒介。使用这些产品比化学杀幼虫剂更好，因为它们具有多种 作用，并且当一起使用时似乎不会引起抗性的演变。迄今为止， 测量了用Bs和Bti杀幼虫的临床影响，但由于样本量小， 集群内的大小和集群的复制缺乏，因此，统计能力低。更大的干预 迫切需要进行复制研究，以证明幼虫控制是一种 有效的疟疾控制工具，并使国际决策者能够作出知情的决策， 幼虫控制的相对优点。因此，我们建议进行大规模的随机分组干预。 在冈比亚进行的一项试验，旨在调查幼虫控制降低儿童疟疾发病率的能力。的 这项研究的结果将对量化使用Bs和Bti的重要性做出重大贡献， 与疟疾的斗争。

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.