Institute of Public Health, University of Heidelberg, Heidelberg, Germany.
Institute of Public Health, University of Heidelberg, Heidelberg, Germany; Special Programme for Research and Training in Tropical Diseases, World Health Organization, Geneva, Switzerland.
Lancet Infect Dis. 2018 May;18(5):e147-e158. doi: 10.1016/S1473-3099(17)30422-X. Epub 2017 Oct 23.
In light of the recent Zika virus outbreak, vector control has received renewed interest. However, which interventions are efficacious and community effective and how to best deliver them remains unclear. Following PRISMA guidelines, we did a systematic review to assess evidence for applied vector control interventions providing protection against Chagas disease, dengue, leishmaniasis, and lymphatic filariasis at the household level. We searched for published literature and grey literature between Jan 1, 1980, and Nov 30, 2015, and updated our search on April 2, 2017, using databases including the Cochrane, Embase, LILACS, PubMed, Web of Science, and WHOLIS. The Cochrane Collaboration's tool for assessing risk of bias was used. Inclusion criteria included studies reporting vector control interventions in and around a house or dwelling; and use of insecticides as sprays on netting or screens, and any method to control larval breeding in water containers in and around the home. 1416 articles were assessed and 32 articles included. The most effective interventions affecting vector indices for multiple diseases were found to be intradomiciliary residual spraying, insecticide-treated materials (especially insecticide-treated nets or curtains), and treatment of larval habitats with biological and chemical methods. Waste management and clean-up campaigns reduce vector populations, although to a lesser extent than other interventions and not consistently. Modifications to the structure of homes (eg, wall plastering) had no impact on the control of vectors. Protection of the house and its surroundings might affect the transmission of several diseases. The most effective interventions should be prioritised when vector control programmes are designed; however, the quality of delivery (ie, coverage and reapplication) of interventions is a crucial factor to ensure their effectiveness. Additional randomised trials that assess the measures of human disease and eventually target several diseases with a combination of interventions that protect the household and its inhabitants against multiple vectors, are needed to inform global policy in this area.
鉴于最近寨卡病毒的爆发,病媒控制重新受到关注。然而,哪些干预措施是有效的、对社区有效的,以及如何最好地实施这些措施仍不清楚。我们按照 PRISMA 指南,对在家庭层面提供针对查加斯病、登革热、利什曼病和淋巴丝虫病的保护的应用病媒控制干预措施的证据进行了系统评价。我们在 1980 年 1 月 1 日至 2015 年 11 月 30 日期间搜索了已发表的文献和灰色文献,并于 2017 年 4 月 2 日更新了搜索,使用的数据库包括 Cochrane、Embase、LILACS、PubMed、Web of Science 和 WHOLIS。我们使用 Cochrane 协作风险偏倚评估工具进行评估。纳入标准包括报告在房屋或住所内及周围进行病媒控制干预的研究;以及在网或筛上喷洒杀虫剂和在家中及周围控制幼虫滋生的任何方法。评估了 1416 篇文章,纳入了 32 篇文章。发现对多种疾病的病媒指数最有效的干预措施是室内滞留喷洒、经杀虫剂处理的材料(特别是经杀虫剂处理的蚊帐或窗帘)以及用生物和化学方法处理幼虫栖息地。废物管理和清理运动减少了病媒种群,但程度低于其他干预措施,且效果不一致。对房屋结构的修改(例如,墙壁抹灰)对控制病媒没有影响。保护房屋及其周围环境可能会影响几种疾病的传播。在设计病媒控制计划时,应优先考虑最有效的干预措施;然而,干预措施的提供质量(即覆盖率和再应用)是确保其有效性的关键因素。需要开展更多的随机试验,评估人类疾病的措施,并最终用组合干预措施来针对几种疾病,这种组合干预措施可以保护家庭及其居民免受多种病媒的侵害,为该领域的全球政策提供信息。