Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia 30301, USA.
Am J Trop Med Hyg. 2011 Dec;85(6):1080-6. doi: 10.4269/ajtmh.2011.10-0684.
Both insecticide-treated bed nets (ITNs) and indoor residual spraying (IRS) reduce malaria in high malaria transmission areas. The combined effect of these interventions is unknown. We conducted a non-randomized prospective cohort study to determine protective efficacy of IRS with ITNs (ITN + IRS) compared with ITNs alone (ITN only) in preventing Plasmodium falciparum parasitemia. At baseline, participants provided blood samples for malaria smears, were presumptively treated for malaria, and received ITNs. Blood smears were made monthly and at sick visits. In total, 1,804 participants were enrolled. Incidence of P. falciparum parasitemia in the ITN + IRS and ITN only groups was 18 and 44 infections per 100 persons-years at risk, respectively (unadjusted rate ratio = 0.41; 95% confidence interval [CI] = 0.31-0.56). Adjusted protective efficacy of ITN + IRS compared with ITN only was 62% (95% CI = 0.50-0.72). The combination of IRS and ITN might be a feasible strategy to further reduce malaria transmission in areas of persistent perennial malaria transmission.
经杀虫剂处理的蚊帐（ITN）和室内滞留喷洒（IRS）均可降低疟疾在高疟疾传播地区的发病率。这些干预措施联合作用的效果尚不清楚。我们开展了一项非随机前瞻性队列研究，旨在确定 IRS 联合 ITN（ITN+IRS）与仅使用 ITN（ITN 组）预防恶性疟原虫感染的保护效果。在基线时，参与者提供疟疾涂片血样，进行疟疾疑似治疗，并获得 ITN。每月进行血涂片检查和就诊时进行检查。共有 1804 名参与者入组。ITN+IRS 和 ITN 组的恶性疟原虫感染发生率分别为每 100 人年 18 和 44 例（未校正率比=0.41；95%置信区间[CI]：0.31-0.56）。与 ITN 组相比，ITN+IRS 的调整后保护效果为 62%（95%CI：0.50-0.72）。IRS 与 ITN 联合应用可能是在持续常年疟疾传播地区进一步降低疟疾传播的可行策略。
