Jalouk L, Al Ahmed M, Gradoni L, Maroli M
Leishmaniasis Control Centre, Aleppo Health Directorate, Syrian Ministry of Health, Aleppo, Syria.
Trans R Soc Trop Med Hyg. 2007 Apr;101(4):360-7. doi: 10.1016/j.trstmh.2006.07.011. Epub 2006 Nov 13.
The increasing incidence of anthroponotic cutaneous leishmaniasis (ACL) in Syria, coupled with the inefficacy of residual insecticide spraying to control the disease, have led to the further evaluation of the preventive efficacy of insecticide-treated bednets (ITNs) through large-scale field studies. Two trials were performed in the historical ACL-endemic areas of the Aleppo Governorate. In 1997-1999, a matched-cluster randomized trial was conducted in five intervention (ITNs) and five control (untreated bednets) villages, which involved a population of 10354 in 1321 households. In 2001-2003, a second study was performed in four villages (a population of 9325 in 858 households), which allowed the evaluation of the impact of the interruption of ITN intervention on ACL incidence rates. Both studies not only confirmed the high efficacy of ITNs in preventing ACL during 1 year post-intervention [about 85% (95% CL 76-98%) in the 1997-1999 trial], but also suggested that the interruption of this control measure might restore the pre-intervention disease incidence within 1-2 years. These findings underline the need for a sustainable and durable implementation of ITN-based control of the disease.
叙利亚人兽共患皮肤利什曼病（ACL）发病率不断上升，加上残留杀虫剂喷洒对控制该病无效，促使人们通过大规模现场研究进一步评估经杀虫剂处理的蚊帐（ITN）的预防效果。在阿勒颇省历史上的ACL流行地区进行了两项试验。1997 - 1999年，在五个干预（ITN）村和五个对照（未处理蚊帐）村进行了配对整群随机试验，涉及1321户家庭的10354人。2001 - 2003年，在四个村庄（858户家庭的9325人）进行了第二项研究，以评估中断ITN干预对ACL发病率的影响。两项研究不仅证实了ITN在干预后1年内预防ACL的高效性[在1997 - 1999年试验中约为85%（95%CI 76 - 98%）]，还表明中断这种控制措施可能在1 - 2年内使疾病发病率恢复到干预前水平。这些发现强调了以ITN为基础的疾病控制措施需要可持续和持久地实施。
