Uni-Logo
Sektionen
Sie sind hier: Startseite Forschung und Projekte Aktuelle Publikationen Efficacy, Safety and Cost of Insecticide Treated Wall Lining, Insecticide Treated Bed Nets and Indoor Wall Wash with Lime for Visceral Leishmaniasis Vector Control in the Indian Sub-continent: A Multi-country Cluster Randomized Controlled Trial
Artikelaktionen

Efficacy, Safety and Cost of Insecticide Treated Wall Lining, Insecticide Treated Bed Nets and Indoor Wall Wash with Lime for Visceral Leishmaniasis Vector Control in the Indian Sub-continent: A Multi-country Cluster Randomized Controlled Trial

Background
We investigated the efficacy, safety and cost of lime wash of household walls plus treatment
of sand fly breeding places with bleach (i.e. environmental management or EM), insecticide
impregnated durable wall lining (DWL), and bed net impregnation with slow release insecticide
(ITN) for sand fly control in the Indian sub-continent.


Methods
This multi-country cluster randomized controlled trial had 24 clusters in each three sites with
eight clusters per high, medium or low sand fly density stratum. Every cluster included 45–
50 households. Five households from each cluster were randomly selected for entomological
measurements including sand fly density and mortality at one, three, nine and twelve
months post intervention. Household interviews were conducted for socioeconomic information
and intervention acceptability assessment. Cost for each intervention was calculated.
There was a control group without intervention.

Findings
Sand fly mortality [mean and 95%CI] ranged from 84% (81%-87%) at one month to 74%
(71%-78%) at 12 months for DWL, 75% (71%-79%) at one month to 49% (43%-55%) at
twelve months for ITN, and 44% (34%-53%) at one month to 22% (14%-29%) at twelve
months for EM. Adjusted intervention effect on sand fly density measured by incidence rate
ratio ranged from 0.28 (0.23–0.34) at one month to 0.62 (0.51–0.75) at 12 months for DWL;
0.72 (0.62–0.85) at one month to 1.02 (0.86–1.22) at 12 months for ITN; and 0.89 (0.76–
1.03) at one months to 1.49 (1.26–1.74) at 12 months for EM. Household acceptance of EM
was 74% compared to 94% for both DWL and ITN. Operational cost per household in USD
was about 5, 8, and 2 for EM, DWL and ITN, respectively. Minimal adverse reactions were
reported for EM and ITN while 36% of households with DWL reported transient itching.


Interpretation
DWL is the most effective, durable and acceptable control method followed by ITN. The Visceral
Leishmaniasis (VL) Elimination Program in the Indian sub-continent should consider
DWL and ITN for sand fly control in addition to IRS.

Benutzerspezifische Werkzeuge