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当前疟疾防治中病媒控制面临的挑战。

Current vector control challenges in the fight against malaria.

作者信息

Benelli Giovanni, Beier John C

机构信息

Department of Agriculture, Food and Environment, University of Pisa, via del Borghetto 80, 56124 Pisa, Italy.

Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States.

出版信息

Acta Trop. 2017 Oct;174:91-96. doi: 10.1016/j.actatropica.2017.06.028. Epub 2017 Jul 3.

Abstract

The effective and eco-friendly control of Anopheles vectors plays a key role in any malaria management program. Integrated Vector Management (IVM) suggests making use of the full range of vector control tools available. The strategies for IVM require novel technologies to control outdoor transmission of malaria. Despite the wide number of promising control tools tested against mosquitoes, current strategies for malaria vector control used in most African countries are not sufficient to achieve successful malaria control. The majority of National Malaria Control Programs in Africa still rely on indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs). These methods reduce malaria incidence but generally have little impact on malaria prevalence. In addition to outdoor transmission, growing levels of insecticide resistance in targeted vectors threaten the efficacy of LLINs and IRS. Larvicidal treatments can be useful, but are not recommended for rural areas. The research needed to improve the quality and delivery of mosquito vector control should focus on (i) optimization of processes and methods for vector control delivery; (ii) monitoring of vector populations and biting activity with reliable techniques; (iii) the development of effective and eco-friendly tools to reduce the burden or locally eliminate malaria and other mosquito-borne diseases; (iv) the careful evaluation of field suitability and efficacy of new mosquito control tools to prove their epidemiological impact; (v) the continuous monitoring of environmental changes which potentially affect malaria vector populations; (vi) the cooperation among different disciplines, with main emphasis on parasitology, tropical medicine, ecology, entomology, and ecotoxicology. A better understanding of behavioral ecology of malaria vectors is required. Key ecological obstacles that limit the effectiveness of vector control include the variation in mosquito behavior, development of insecticide resistance, presence of behavioral avoidance, high vector biodiversity, competitive and food web interactions, lack of insights on mosquito dispersal and mating behavior, and the impact of environmental changes on mosquito ecological traits. Overall, the trans-disciplinary cooperation among parasitologists and entomologists is crucial to ensure proper evaluation of the epidemiological impact triggered by novel mosquito vector control strategies.

摘要

在任何疟疾管理项目中,有效且环保地控制按蚊媒介都起着关键作用。综合媒介管理(IVM)建议利用现有的全方位媒介控制工具。IVM策略需要新技术来控制疟疾的户外传播。尽管针对蚊子测试了大量有前景的控制工具,但大多数非洲国家目前使用的疟疾媒介控制策略仍不足以实现成功的疟疾控制。非洲大多数国家疟疾控制项目仍依赖室内滞留喷洒(IRS)和长效驱虫蚊帐(LLINs)。这些方法降低了疟疾发病率,但通常对疟疾流行率影响不大。除了户外传播,目标媒介中不断增加的杀虫剂抗性水平也威胁着LLINs和IRS的效果。杀幼虫处理可能有用,但不建议在农村地区使用。改善蚊虫媒介控制质量和实施效果所需的研究应聚焦于:(i)优化媒介控制实施的流程和方法;(ii)用可靠技术监测媒介种群和叮咬活动;(iii)开发有效且环保的工具以减轻或在当地消除疟疾及其他蚊媒疾病;(iv)仔细评估新蚊虫控制工具的现场适用性和效果以证明其流行病学影响;(v)持续监测可能影响疟疾媒介种群的环境变化;(vi)不同学科之间的合作,主要侧重于寄生虫学、热带医学、生态学、昆虫学和生态毒理学。需要更好地了解疟疾媒介的行为生态学。限制媒介控制效果的关键生态障碍包括蚊子行为的变化、杀虫剂抗性的发展、行为回避的存在、高媒介生物多样性、竞争和食物网相互作用、对蚊子扩散和交配行为缺乏了解,以及环境变化对蚊子生态特征的影响。总体而言,寄生虫学家和昆虫学家之间的跨学科合作对于确保正确评估新型蚊虫媒介控制策略引发的流行病学影响至关重要。

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