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利用昆虫接种率评估媒介控制对疟疾寄生虫传播和消除的影响。

Using the entomological inoculation rate to assess the impact of vector control on malaria parasite transmission and elimination.

机构信息

Division of International Epidemiology and Population Studies, Fogarty International Center, National Institutes of Health, Bethesda, MD, USA.

出版信息

Malar J. 2010 May 12;9:122. doi: 10.1186/1475-2875-9-122.

Abstract

BACKGROUND

Prior studies have shown that annual entomological inoculation rates (EIRs) must be reduced to less than one to substantially reduce the prevalence of malaria infection. In this study, EIR values were used to quantify the impact of insecticide-treated bed nets (ITNs), indoor residual spraying (IRS), and source reduction (SR) on malaria transmission. The analysis of EIR was extended through determining whether available vector control tools can ultimately eradicate malaria.

METHOD

The analysis is based primarily on a review of all controlled studies that used ITN, IRS, and/or SR and reported their effects on the EIR. To compare EIRs between studies, the percent difference in EIR between the intervention and control groups was calculated.

RESULTS

Eight vector control intervention studies that measured EIR were found: four ITN studies, one IRS study, one SR study, and two studies with separate ITN and IRS intervention groups. In both the Tanzania study and the Solomon Islands study, one community received ITNs and one received IRS. In the second year of the Tanzania study, EIR was 90% lower in the ITN community and 93% lower in the IRS community, relative to the community without intervention; the ITN and IRS effects were not significantly different. In contrast, in the Solomon Islands study, EIR was 94% lower in the ITN community and 56% lower in the IRS community. The one SR study, in Dar es Salaam, reported a lower EIR reduction (47%) than the ITN and IRS studies. All of these vector control interventions reduced EIR, but none reduced it to zero.

CONCLUSION

These studies indicate that current vector control methods alone cannot ultimately eradicate malaria because no intervention sustained an annual EIR less than one. While researchers develop new tools, integrated vector management may make the greatest impact on malaria transmission. There are many gaps in the entomological malaria literature and recommendations for future research are provided.

摘要

背景

先前的研究表明,要大幅降低疟疾感染率,每年的昆虫学接种率(EIR)必须降低到 1 以下。本研究使用 EIR 值来量化经杀虫剂处理的蚊帐(ITN)、室内滞留喷洒(IRS)和源头减少(SR)对疟疾传播的影响。通过确定现有的病媒控制工具是否最终可以消灭疟疾,对 EIR 进行了分析。

方法

该分析主要基于对所有使用 ITN、IRS 和/或 SR 并报告其对 EIR 影响的对照研究进行的审查。为了比较研究之间的 EIR,计算了干预组和对照组之间 EIR 的百分比差异。

结果

共发现 8 项衡量 EIR 的病媒控制干预研究:4 项 ITN 研究、1 项 IRS 研究、1 项 SR 研究以及 2 项分别进行 ITN 和 IRS 干预的研究。在坦桑尼亚研究和所罗门群岛研究中,一个社区接受了 ITN,另一个社区接受了 IRS。在坦桑尼亚研究的第二年,与未干预社区相比,ITN 社区的 EIR 降低了 90%,IRS 社区的 EIR 降低了 93%;ITN 和 IRS 的效果没有显著差异。相比之下,在所罗门群岛研究中,ITN 社区的 EIR 降低了 94%,IRS 社区的 EIR 降低了 56%。在达累斯萨拉姆进行的唯一一项 SR 研究报告称,EIR 的降低幅度(47%)低于 ITN 和 IRS 研究。所有这些病媒控制干预措施都降低了 EIR,但没有一项将其降低到零以下。

结论

这些研究表明,仅依靠当前的病媒控制方法无法最终消灭疟疾,因为没有任何干预措施能将每年的 EIR 维持在 1 以下。虽然研究人员正在开发新工具,但综合病媒管理可能对疟疾传播产生最大影响。在病媒传播疟疾文献中存在许多空白,并提出了未来研究的建议。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da21/2890672/c60c8141562f/1475-2875-9-122-1.jpg

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