National Institute of Malariology, Parasitology and Entomology, Hanoi, Vietnam.
PLoS One. 2009 Oct 7;4(10):e7369. doi: 10.1371/journal.pone.0007369.
In Vietnam, malaria remains a problem in some remote areas located along its international borders and in the central highlands, partly due to the bionomics of the local vector, mainly found in forested areas and less vulnerable to standard control measures. Long Lasting Insecticidal Hammocks (LLIH), a tailored and user-friendly tool for forest workers, may further contribute in reducing the malaria burden. Their effectiveness was tested in a large community-based intervention trial carried out in Ninh Thuan province in Central Vietnam.
Thirty villages (population 18,646) were assembled in 20 clusters (1,000 individuals per cluster) that were randomly allocated to either the intervention or control group (no LLIH) after stratification according to the pre-intervention P. falciparum antibody prevalence (<30%; > or =30%). LLIH were distributed to the intervention group in December 2004. For the following 2 years, the incidence of clinical malaria and the prevalence of infection were determined by passive case detection at community level and by bi-annual malariometric surveys. A 2-fold larger effect on malaria incidence in the intervention as compared to the control group was observed. Similarly, malaria prevalence decreased more substantially in the intervention (1.6-fold greater reduction) than in the control group. Both for incidence and prevalence, a stronger and earlier effect of the intervention was observed in the high endemicity stratum. The number of malaria cases and infections averted by the intervention overall was estimated at 10.5 per 1,000 persons and 5.6/100 individuals, respectively, for the last half of 2006. In the high endemicity stratum, the impact was much higher, i.e. 29/1000 malaria cases and 15.7 infections/100 individuals averted.
LLIH reduced malaria incidence and prevalence in this remote and forested area of Central Vietnam. As the targets of the newly-launched Global Malaria Action Plan include the 75% reduction of the global malaria cases by 2015 and eventually the elimination/eradication of malaria in the long term, LLIH may represent an additional tool for reaching such objectives, particularly in high endemicity areas where standard control tools have a modest impact, such as in remote and forested areas of Southeast Asia and possibly South America.
ClinicalTrials.gov NCT00853281.
在越南，一些偏远地区和中部高地的疟疾仍然是一个问题，部分原因是当地媒介的生物学特性，这些媒介主要存在于森林地区，对标准控制措施的抵抗力较低。长效驱虫蚊帐（LLIH）是一种为森林工作者量身定制的、易于使用的工具，可能有助于进一步减轻疟疾负担。它们的有效性在越南中北部宁顺省进行的一项大型社区干预试验中得到了检验。
三十个村庄（人口 18646 人）被分为 20 个集群（每个集群 1000 人），根据干预前疟原虫抗体流行率（<30%；≥30%）进行分层后，随机分配到干预组或对照组（无 LLIH）。2004 年 12 月向干预组发放 LLIH。在接下来的 2 年中，通过社区层面的被动病例检测和每两年一次的疟疾测量调查来确定临床疟疾的发病率和感染率。干预组的疟疾发病率比对照组高出两倍。同样，干预组的疟疾流行率下降幅度也明显大于对照组。在高流行地区，干预的效果更强，更早。总的来说，干预措施避免了 10.5 例/1000 人和 5.6/100 人感染疟疾，这分别是 2006 年下半年的估计数。在高流行地区，影响要高得多，即避免了 29 例/1000 例疟疾和 15.7 例/100 人感染疟疾。
长效驱虫蚊帐在越南中部这个偏远的森林地区降低了疟疾的发病率和流行率。由于新启动的全球疟疾行动计划的目标包括到 2015 年将全球疟疾病例减少 75%，并最终从长远来看消除疟疾，长效驱虫蚊帐可能成为实现这些目标的另一个工具，特别是在标准控制工具影响较小的高流行地区，如东南亚和可能的南美洲的偏远和森林地区。
ClinicalTrials.gov NCT00853281。
