Walker K
American Association for the Advancement of Science Fellow, US Environmental Protection Agency, Washington DC, USA.
Med Vet Entomol. 2000 Dec;14(4):345-54. doi: 10.1046/j.1365-2915.2000.00262.x.
In anti-malaria operations the use of DDT for indoor residual spraying has declined substantially over the past 30years, but this insecticide is still considered valuable for malaria control, mainly because of its low cost relative to alternative insecticides. Despite the development of resistance to DDT in some populations of malaria vector Anopheles mosquitoes (Diptera: Culicidae), DDT remains generally effective when used for house-spraying against most species of Anopheles, due to excitorepellency as well as insecticidal effects. A 1990 cost comparison by the World Health Organization (WHO) found DDT to be considerably less expensive than other insecticides, which cost 2 to 23 times more on the basis of cost per house per 6 months of control. To determine whether such a cost advantage still prevails for DDT, this paper compares recent price quotes from manufacturers and WHO suppliers for DDT and appropriate formulations of nine other insecticides (two carbamates, two organophosphates and five pyrethroids) commonly used for residual house-spraying in malaria control programmes. Based on these 'global' price quotes, detailed calculations show that DDT is still the least expensive insecticide on a cost per house basis, although the price appears to be rising as DDT production declines. At the same time, the prices of pyrethroids are declining, making some only slightly more expensive than DDT at low application dosages. Other costs, including operations (labour), transportation and human safety may also increase the price advantages of DDT and some pyrethroids vs. organophosphates and carbamates, although possible environmental impacts from DDT remain a concern. However, a global cost comparison may not realistically reflect local costs or effective application dosages at the country level. Recent data on insecticide prices paid by the health ministries of individual countries showed that prices of particular insecticides can vary substantially in the open market. Therefore, the most cost-effective insecticide in any given country or region must be determined on a case-by-case basis. Regional coordination of procurement of public health insecticides could improve access to affordable products.
在抗疟疾行动中，过去30年来用于室内滞留喷洒的滴滴涕使用量大幅下降，但这种杀虫剂仍被认为对疟疾控制具有重要价值，主要是因为相对于其他杀虫剂而言其成本较低。尽管在一些疟疾病媒按蚊种群（双翅目：蚊科）中已出现对滴滴涕的抗性，但由于其驱避兴奋作用以及杀虫效果，滴滴涕用于房屋喷洒防治大多数按蚊种类时总体上仍然有效。世界卫生组织（世卫组织）1990年进行的成本比较发现，滴滴涕的成本远低于其他杀虫剂，按每间房屋每6个月防治成本计算，其他杀虫剂的成本是滴滴涕的2至23倍。为确定滴滴涕是否仍具有这种成本优势，本文比较了制造商和世卫组织供应商提供的滴滴涕以及其他九种常用于疟疾防治项目房屋滞留喷洒的杀虫剂（两种氨基甲酸酯类、两种有机磷类和五种拟除虫菊酯类）合适制剂的近期报价。基于这些“全球”报价进行的详细计算表明，按每间房屋计算，滴滴涕仍是最便宜的杀虫剂，尽管随着滴滴涕产量下降其价格似乎在上涨。与此同时，拟除虫菊酯类的价格在下降，在低施用剂量下，有些拟除虫菊酯类仅比滴滴涕略贵。包括作业（劳动力）、运输和人员安全在内的其他成本，也可能增加滴滴涕和某些拟除虫菊酯类相对于有机磷类和氨基甲酸酯类的价格优势，尽管滴滴涕可能产生的环境影响仍然令人担忧。然而，全球成本比较可能无法实际反映国家层面的当地成本或有效施用剂量。各国卫生部支付的杀虫剂价格近期数据表明，特定杀虫剂在公开市场上的价格可能有很大差异。因此，任何特定国家或地区最具成本效益的杀虫剂必须逐案确定。公共卫生杀虫剂采购的区域协调可改善获得价格可承受产品的机会。
