Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, UK.
Liverpool School of Tropical Medicine, Liverpool, UK.
Malar J. 2017 Oct 13;16(1):412. doi: 10.1186/s12936-017-2059-6.
Large-scale use of insecticide-treated nets and indoor residual spraying have contributed to a significant decrease in malaria transmission worldwide. Further reduction and progress towards elimination, however, require complementary control measures which can address the remaining gaps in protection from mosquito bites. Following the development of novel pyrethroids with high knockdown effects on malaria vectors, programmatic use of spatial repellents has been suggested as one potential strategy to fill the gaps. This report explores social and contextual factors that may influence the relevance, uptake and sustainable use of a spatial repellent in two remote villages in Mondulkiri province, Cambodia, with endemic malaria transmission. The repellent consisted of polyethylene emanators, held in an open plastic frame and impregnated with 10% metofluthrin.
In a baseline survey, 90.9% of households in Ou Chra (n = 30/33) and 96.6% in Pu Cha (n = 57/59) were interviewed. Behavioural data were collected for all household occupants (n = 448). In both villages, there were times and places in which people remained exposed to mosquito bites. Prior to the installation of the repellent, 50.6 and 59.5% of respondents noted that bites occurred "very often" inside the house and in the outdoor area surrounding the house, respectively. Indoor biting was reported to occur more frequently in the evening, followed by at night, while outdoor biting occurred more frequently in the early morning. In a follow-up survey, spatial repellents were well received in both villages, although 63.2% of respondents would not replace bed nets with repellents. Most participants (96.6%) were willing to use the product again; the mean willingness to pay was US$ 0.3 per unit. A preference for local procurement methods emerged.
Widespread use of spatial repellents would not fill all protective gaps, but, if their entomological efficacy can be ascertained, outdoor application has the potential to enhance vector control strategies in Cambodia. Successful implementation would require subsidisation and integration with the existing national malaria control strategy. It is hoped that this study, while contributing to a better understanding of the social contexts of residual malaria transmission, will generate further interest in the evaluation of spatial repellents for malaria control.
大规模使用经杀虫剂处理的蚊帐和室内滞留喷洒已有助于在全球范围内显著降低疟疾传播。然而，要进一步减少并朝着消除疟疾的目标取得进展，则需要采取补充控制措施，以解决防蚊叮咬方面尚存的差距。在开发出对疟疾传播媒介具有高击倒效果的新型拟除虫菊酯之后，有建议将空间驱避剂的计划使用作为填补空白的一种潜在策略。本报告探讨了在柬埔寨蒙多基里省两个存在地方性疟疾传播的偏远村庄中，可能影响空间驱避剂相关性、采用率和可持续使用的社会和背景因素。该驱避剂由聚乙烯散发器组成，装在一个敞开的塑料框架中，并浸渍有 10%的氯菊酯。
在基线调查中，乌恰村（n=30/33）和普恰村（n=57/59）各有 90.9%和 96.6%的家庭接受了访谈。对所有住户（n=448）都收集了行为数据。在这两个村庄，人们在某些时间和地点仍然会受到蚊子叮咬。在安装驱避剂之前，分别有 50.6%和 59.5%的受访者表示，家里和房屋周围的户外区域经常受到蚊子叮咬。屋内叮咬被报告更多发生在傍晚，其次是夜间，而户外叮咬则更多发生在清晨。在后续调查中，空间驱避剂在两个村庄都受到了欢迎，尽管 63.2%的受访者不会用驱避剂代替蚊帐。大多数参与者（96.6%）愿意再次使用该产品；平均支付意愿为每单位 0.3 美元。出现了对本地采购方法的偏好。
广泛使用空间驱避剂并不能填补所有的防护空白，但如果能确定其昆虫学效果，户外应用有可能增强柬埔寨的病媒控制策略。成功实施需要补贴并与现有的国家疟疾控制战略相结合。希望本研究在有助于更好地了解残留疟疾传播的社会背景的同时，能进一步引起人们对空间驱避剂用于疟疾控制的评估的兴趣。
