Department of Medical Entomology, Research Institute for Tropical Medicine, Filinvest City Alabang, Muntinlupa City, Philippines.
Department of Virology, Research Institute for Tropical Medicine, Filinvest City Alabang, Muntinlupa City, Philippines.
Trials. 2019 May 14;20(1):269. doi: 10.1186/s13063-019-3376-6.
Mosquito-borne viruses are imposing an ever increasing health burden worldwide. In addition to the recent Zika and chikungunya virus epidemics, dengue viruses have become the fastest growing problem with a 40-fold increase in the number of reported cases over the past five decades. Current mosquito control techniques involving larval source reduction, larviciding, and space spray of adulticides are costly, laborious, and of debatable efficacy. There remains an urgent need for the development of intervention methods that can be reasonably implemented in the context of modern day urbanisation. Auto-dissemination (AD) of insecticide by adult mosquitoes offers a potentially practical and useful tool in an integrated vector control programme. Recently, an immediately employable AD device, the In2Care® mosquito trap, has been commercialised and shows promise as an effective tool. However, there remains a lack of demonstration of epidemiological efficacy.
METHODS/DESIGN: This trial aims to assess the extent to which implementation of In2Care® mosquito traps can reduce vector Aedes (Stegomyia) spp. adult mosquito densities and dengue virus transmission as measured by sequential sero-conversion rates in children 6-16 years of age in a dengue endemic location: Lipa City, Philippines. To achieve this, we will carry out a parallel, two-armed cluster randomised trial evaluating AD efficacy for reducing the incidence of dengue over a 2-year period with 4 consecutive months of vector control during peak dengue transmission each year.
For decades, it has been commonly accepted that an integrated approach to mosquito control is required. The World Health Organization (WHO) Global Strategic Framework for Integrated Vector Management recommends a range of interventions, in combination, to increase control impact to reduce transmission. This efficacy trial of the first commercial product using the AD approach will be informative in assessing the general utility of AD in reducing not only adult vector densities but, more importantly, reducing the incidence of dengue. The AD technique may complement source reduction and larviciding campaigns by more efficiently targeting the most productive containers and those beyond human reach. If successful, this mosquito control strategy could prove an invaluable tool in the fight against urban mosquito vectors and a reduction in the burden of associated disease.
ISRCTN44272773 . Registered on 31 January 2019.
蚊媒病毒在全球范围内造成的健康负担日益加重。除了最近的寨卡和基孔肯雅热病毒流行外，登革热病毒已成为增长最快的问题，在过去五十年中，报告的病例数增加了 40 倍。目前涉及幼虫来源减少、幼虫杀灭和空间喷洒杀虫剂的蚊子控制技术成本高、费力且效果存在争议。因此，迫切需要开发可以在现代城市化背景下合理实施的干预方法。成蚊自动传播（AD）为综合病媒控制计划提供了一种潜在实用且有用的工具。最近，一种可立即使用的 AD 设备，In2Care®蚊虫诱捕器已商业化，并显示出作为有效工具的潜力。然而，在流行病学效果方面仍缺乏证明。
方法/设计：本试验旨在评估在菲律宾登革热流行地区利帕市，实施 In2Care®蚊虫诱捕器可以在多大程度上降低病媒埃及伊蚊（Stegomyia）成蚊密度和登革病毒传播，方法是测量 6-16 岁儿童的连续血清转化率。为了实现这一目标，我们将开展一项平行的、双臂的集群随机试验，评估 AD 对降低登革热发病率的效果，为期 2 年，每年在登革热传播高峰期进行为期 4 个月的连续病媒控制。
几十年来，人们普遍认为需要采取综合的蚊子控制方法。世界卫生组织（WHO）全球病媒综合管理战略框架建议结合使用一系列干预措施，以提高控制效果，减少传播。这项使用 AD 方法的首个商业产品的功效试验将为评估 AD 方法在降低成蚊密度方面的普遍实用性提供信息，更重要的是，降低登革热的发病率。AD 技术可以通过更有效地针对最具生产力的容器和人类无法触及的容器，补充源减少和幼虫杀灭运动。如果成功，这种蚊子控制策略可能成为对抗城市蚊子媒介和减轻相关疾病负担的宝贵工具。
ISRCTN44272773。于 2019 年 1 月 31 日注册。
