1College of Public Health, University of South Florida, Tampa, Florida.
2Nwoya District Local Government, Nwoya, Uganda.
Am J Trop Med Hyg. 2021 Jan 11;104(4):1394-1403. doi: 10.4269/ajtmh.20-1104.
Onchocerciasis, caused by infection with Onchocerca volvulus, has been targeted for elimination by 2030. Currently, onchocerciasis elimination programs rely primarily on mass distribution of ivermectin. However, ivermectin alone may not be sufficient to achieve elimination in some circumstances, and additional tools may be needed. Vector control has been used as a tool to control onchocerciasis, but vector control using insecticides is expensive and ecologically detrimental. Community-directed removal of the trailing vegetation black fly larval attachment sites (slash and clear) has been shown to dramatically reduce vector biting densities. Here, we report studies to optimize the slash and clear process. Conducting slash and clear interventions at Simulium damnosum sensu stricto breeding sites located within 2 km of afflicted communities resulted in a 95% reduction in vector biting. Extending slash and clear further than 2 km resulted in no further decrease. A single intervention conducted at the first half of the rainy season resulted in a 97% reduction in biting rate, whereas an intervention conducted at the end of the rainy season resulted in a 94% reduction. Vector numbers in any of the intervention villages did not fully recover by the start of the following rainy season. These results suggest that slash and clear may offer an inexpensive and effective way to augment ivermectin distribution in the effort to eliminate onchocerciasis in Africa.
盘尾丝虫病由感染盘尾丝虫引起，目标是到 2030 年消除该病。目前，盘尾丝虫病消除规划主要依赖大规模分发伊维菌素。然而，在某些情况下，单独使用伊维菌素可能不足以实现消除，可能需要其他工具。病媒控制一直被用作控制盘尾丝虫病的一种手段，但使用杀虫剂进行病媒控制既昂贵又对生态有害。已经证明，清除黑蝇幼虫附着点（砍伐和清理）的社区定向行动可显著降低病媒叮咬密度。在此，我们报告了优化砍伐和清理过程的研究。在距受影响社区 2 公里范围内的 Simulium damnosum sensu stricto 滋生地进行砍伐和清理干预，可使病媒叮咬率降低 95%。超出 2 公里的范围进行砍伐和清理不会进一步降低叮咬率。在雨季的前半段进行一次干预，可使叮咬率降低 97%，而在雨季结束时进行干预，则可使叮咬率降低 94%。在任何干预村庄，到下一个雨季开始时，病媒数量都没有完全恢复。这些结果表明，砍伐和清理可能是一种廉价且有效的方法，可以在非洲消除盘尾丝虫病的努力中增加伊维菌素的分发。
