Rowland M, Durrani N, Kenward M, Mohammed N, Urahman H, Hewitt S
HealthNet International, University Town, Peshawar, Pakistan.
Lancet. 2001 Jun 9;357(9271):1837-41. doi: 10.1016/S0140-6736(00)04955-2.
The standard method of malaria control in south Asia, indoor spraying of houses with residual insecticide, is becoming prohibitively expensive to implement and new approaches are needed. Since the region's vector mosquitoes feed predominantly on domestic animals and only secondarily on human beings, to apply insecticide to surfaces of cattle instead might be more costeffective. We aimed to investigate whether domestic livestock treated with deltamethrin (applied by a sponging method) would prove toxic to mosquitoes and therefore aid in malaria control.
Six Afghan refugee settlements in Pakistan were randomly assigned to one of two groups. In one group livestock were treated with deltamethrin during the malaria transmission seasons of 1995 and 1997, whereas in the other group livestock were treated during the 1996 season. Malaria was monitored by passive case detection at village clinics and by cross-sectional surveillance. Mosquitoes were also monitored.
According to clinic records the incidence of malaria caused by Plasmodium falciparum decreased by 56% (95% CI 14-78%) and P vivax by 31% (5-50%) in livestock-treated villages. Cross-sectional surveys showed comparable decreases in parasite prevalence. The density and life expectancy of Anopheles stephensi and A culicifacies populations were reduced in treated villages. The efficacy of livestock treatment was similar to that of indoor spraying but campaign costs were 80% less. When applied in a highly endemic settlement, the incidence of falciparum malaria decreased from 280 episodes per 1000 person-years to nine episodes per 1000 person-years.
Insecticide treatment of livestock is a cost-effective and promising alternative for south Asia and other regions where primary vectors are zoophilic.
在南亚，使用残留杀虫剂对房屋进行室内喷洒是控制疟疾的标准方法，但实施成本正变得高得令人望而却步，因此需要新的方法。由于该地区的病媒蚊子主要以家畜为食，其次才是人类，因此将杀虫剂应用于牛的体表可能更具成本效益。我们旨在调查用溴氰菊酯（通过擦拭法施用）处理家畜是否对蚊子有毒，从而有助于控制疟疾。
巴基斯坦的六个阿富汗难民定居点被随机分为两组。一组在1995年和1997年的疟疾传播季节对家畜进行溴氰菊酯处理，而另一组在1996年季节对家畜进行处理。通过在乡村诊所的被动病例检测和横断面监测来监测疟疾。同时也对蚊子进行监测。
根据诊所记录，在对家畜进行处理的村庄中，由恶性疟原虫引起的疟疾发病率下降了56%（95%置信区间14%-78%），间日疟原虫引起的疟疾发病率下降了31%（5%-50%）。横断面调查显示寄生虫流行率也有类似程度的下降。在处理过的村庄中，斯氏按蚊和库氏按蚊种群的密度和预期寿命降低。家畜处理的效果与室内喷洒相似，但活动成本降低了80%。在一个高度流行的定居点应用时，恶性疟原虫疟疾的发病率从每1000人年280例降至每1000人年9例。
对家畜进行杀虫剂处理对于南亚和其他主要病媒嗜动物的地区来说是一种具有成本效益且前景广阔的替代方法。
