昆虫杀虫剂床网与巴布亚新几内亚的丝虫病传播。
Insecticidal bed nets and filariasis transmission in Papua New Guinea.
机构信息
Papua New Guinea Institute of Medical Research, Goroka and Madang, Papua New Guinea.
出版信息
N Engl J Med. 2013 Aug 22;369(8):745-53. doi: 10.1056/NEJMoa1207594.
BACKGROUND
Global efforts to eliminate lymphatic filariasis are based on the annual mass administration of antifilarial drugs to reduce the microfilaria reservoir available to the mosquito vector. Insecticide-treated bed nets are being widely used in areas in which filariasis and malaria are coendemic.
METHODS
We studied five villages in which five annual mass administrations of antifilarial drugs, which were completed in 1998, reduced the transmission of Wuchereria bancrofti, one of the nematodes that cause lymphatic filariasis. A total of 21,899 anopheles mosquitoes were collected for 26 months before and 11 to 36 months after bed nets treated with long-lasting insecticide were distributed in 2009. We evaluated the status of filarial infection and the presence of W. bancrofti DNA in anopheline mosquitoes before and after the introduction of insecticide-treated bed nets. We then used a model of population dynamics to estimate the probabilities of transmission cessation.
RESULTS
Village-specific rates of bites from anopheline mosquitoes ranged from 6.4 to 61.3 bites per person per day before the bed-net distribution and from 1.1 to 9.4 bites for 11 months after distribution (P<0.001). During the same period, the rate of detection of W. bancrofti in anopheline mosquitoes decreased from 1.8% to 0.4% (P=0.005), and the rate of detection of filarial DNA decreased from 19.4% to 14.9% (P=0.13). The annual transmission potential was 5 to 325 infective larvae inoculated per person per year before the bed-net distribution and 0 after the distribution. Among all five villages with a prevalence of microfilariae of 2 to 38%, the probability of transmission cessation increased from less than 1.0% before the bed-net distribution to a range of 4.9 to 95% in the 11 months after distribution.
CONCLUSIONS
Vector control with insecticide-treated bed nets is a valuable tool for W. bancrofti elimination in areas in which anopheline mosquitoes transmit the parasite. (Funded by the U.S. Public Health Service and the National Institutes of Health.).
背景
全球消灭淋巴丝虫病的努力是基于每年大规模使用抗丝虫药物来减少蚊子传播媒介可用的微丝蚴库。在丝虫病和疟疾并存的地区，正在广泛使用经杀虫剂处理过的蚊帐。
方法
我们研究了五个村庄，这些村庄在 1998 年完成了五次年度大规模抗丝虫药物治疗，从而降低了班氏吴策线虫（引起淋巴丝虫病的线虫之一）的传播。在 2009 年分发长效杀虫剂处理过的蚊帐之前和之后的 26 个月内，共收集了 21899 只疟蚊。我们评估了引入经杀虫剂处理的蚊帐前后疟蚊感染丝虫的状况和存在班氏吴策线虫 DNA 的情况。然后，我们使用种群动态模型来估计传播停止的概率。
结果
在分发蚊帐之前，每个村庄的疟蚊叮咬率为每人每天 6.4 至 61.3 次，分发后 11 个月为 1.1 至 9.4 次（P<0.001）。在此期间，疟蚊中检测到班氏吴策线虫的比例从 1.8%降至 0.4%（P=0.005），检测到丝虫 DNA 的比例从 19.4%降至 14.9%（P=0.13）。在分发蚊帐之前，每年的传播潜力为每人每年接种 5 至 325 条感染性幼虫，分发后则为 0。在所有五个微丝蚴患病率为 2 至 38%的村庄中，在分发蚊帐之前传播停止的概率小于 1.0%，而在分发后 11 个月内的范围为 4.9%至 95%。
结论
使用经杀虫剂处理的蚊帐进行病媒控制是在疟蚊传播寄生虫的地区消除班氏吴策线虫的有效工具。（由美国公共卫生服务和美国国立卫生研究院资助）。
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