Vythilingam I, Wan-Yusoff W S
Parasitology Department, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur.
Trop Biomed. 2017 Dec 1;34(4):746-758.
Dengue is a major public health problem across more than 123 countries. Vector control has been the hallmark of the dengue control programme in many countries in Southeast Asia since there are no anti-dengue drugs available, and the most recent dengue vaccine is partly efficacious. House-to-house larval surveys, source reduction, larviciding, fogging, ULV which have been carried out since the inception of the dengue control programme in the 1970s are no longer practicable and need to be augmented by more targeted but less ambitious outbreak responses that focus on a few tools that might justify expense of deployment. However, according to recent reports these tools have not really been evaluated for their effectiveness in dengue control. Novel techniques such the release of genetically modified mosquitoes (RIDL) and the use of the bacterium Wolbachia to control the populations of the Ae. aegypti are still under trial. In this review proactive methods to detect epidemics have been suggested. Tools based on adult mosquitoes is an important strategy for dengue vector surveillance and control. The outbreak response may be more efficient when timely vector control measures are implemented after the immediate detection of an infected mosquito.
登革热是123多个国家面临的主要公共卫生问题。由于没有抗登革热药物，且最新的登革热疫苗效果有限，在东南亚许多国家，病媒控制一直是登革热控制计划的标志。自20世纪70年代登革热控制计划启动以来开展的挨家挨户的幼虫调查、源头减少、杀幼虫、喷雾消毒、超低容量喷雾等措施已不再可行，需要通过更有针对性但规模较小的疫情应对措施加以补充，这些措施侧重于少数可能证明部署成本合理的工具。然而，根据最近的报告，这些工具在登革热控制中的有效性尚未得到真正评估。诸如释放转基因蚊子（RIDL）和利用沃尔巴克氏菌控制埃及伊蚊种群等新技术仍在试验中。在这篇综述中，有人提出了检测疫情的积极方法。基于成蚊的工具是登革热病媒监测和控制的重要策略。在立即检测到感染蚊子后及时实施病媒控制措施，疫情应对可能会更有效。
