Hamid Nurulhusna Ab, Alexander Neal, Suer Remco, Ahmed Nazni Wasi, Mudin Rose Nani, Omar Topek, Dapari Rahmat, Che Mat Din Shahrom Nor Azian, Rahman Roslinda Abdul, Jaraee Ropiah, Baur Frederic, Schmitt Frederic, Hamon Nick, Richardson Jason H, Langlois-Jacques Carole, Rabilloud Muriel, Saadatian-Elahi Mitra
Medical Entomology Unit, Institute for Medical Research, WHO Collaborating Centre, Institute for Medical Research, Ministry of Health Malaysia, Jalan Pahang, 50588Kuala Lumpur, Malaysia.
MRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT, United Kingdom.
Bull Entomol Res. 2020 Dec;110(6):700-707. doi: 10.1017/S0007485320000188. Epub 2020 May 15.
Currently, dengue control relies largely on reactive vector control programmes. Proactive vector-control using a rational, well-balanced integrated vector management approach may prove more successful for dengue control. As part of the development of a cluster randomized controlled epidemiological trial, a study was conducted in Johor Bahru, Malaysia. The study included one control site (three buildings) and three intervention sites which were treated as follows: targeted outdoor residual spraying only (TORS site, two buildings); deployment of autodissemination devices only (ADD site, four buildings); and the previous two treatments combined (TORS + ADD site, three buildings). The primary entomological measurement was per cent of positive ovitraps-ovitrap index (OI). The effect of each intervention on OI was analyzed by a modified ordinary least squares regression model. Relative to the control site, the TORS and ADD sites showed a reduction in the Aedes OI (-6.5%, P = 0.04 and -8.3%, P = 0.10, respectively). Analysis by species showed that, relative to control, the Ae. aegypti OI was lower in ADD (-8.9%, P = 0.03) and in TORS (-10.4%, P = 0.02). No such effect was evident in the TORS + ADD site. The present study provides insights into the methods to be used for the main trial. The combination of multiple insecticides with different modes of action in one package is innovative, although we could not demonstrate the additive effect of TORS + ADD. Further work is required to strengthen our understanding of how these interventions impact dengue vector populations and dengue transmission.
目前，登革热防控主要依赖于反应性病媒控制项目。采用合理、平衡的综合病媒管理方法进行主动病媒控制，对于登革热防控可能会更成功。作为一项整群随机对照流行病学试验开展的一部分，在马来西亚新山进行了一项研究。该研究包括一个对照地点（三座建筑）和三个干预地点，干预方式如下：仅进行有针对性的室外滞留喷洒（TORS地点，两座建筑）；仅部署自动散播装置（ADD地点，四座建筑）；以及将前两种处理方式结合（TORS + ADD地点，三座建筑）。主要的昆虫学测量指标是阳性诱蚊产卵器的百分比——诱蚊产卵器指数（OI）。通过改良的普通最小二乘回归模型分析每种干预措施对OI的影响。相对于对照地点，TORS和ADD地点的埃及伊蚊OI有所降低（分别为-6.5%，P = 0.04和-8.3%，P = 0.10）。按蚊种分析表明，相对于对照，ADD地点（-8.9%，P = 0.03）和TORS地点（-10.4%，P = 0.02）的埃及伊蚊OI较低。在TORS + ADD地点没有明显的这种效果。本研究为主要试验所用方法提供了见解。将多种具有不同作用方式的杀虫剂组合在一个方案中具有创新性，尽管我们未能证明TORS + ADD的叠加效应。需要进一步开展工作，以加强我们对这些干预措施如何影响登革热病媒种群和登革热传播的理解。
