Laboratory of Entomology, Wageningen University, Wageningen, the Netherlands.
Veterinary Public Health, Vector Control and Environment Unit, Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland.
PLoS Negl Trop Dis. 2021 Apr 30;15(4):e0009358. doi: 10.1371/journal.pntd.0009358. eCollection 2021 Apr.
Interventions to control the vectors of human diseases, notably malaria, leishmaniasis and dengue, have relied mainly on the action of chemical insecticides. However, concerns have been raised regarding the management of insecticides in vector-borne disease-endemic countries. Our study aimed to analyze how vector control insecticides are managed in selected countries to extract lessons learned. A qualitative analysis of the situation of vector control insecticides management was conducted in six countries. Multi-stakeholder meetings and key informer interviews were conducted on aspects covering the pesticide lifecycle. Findings were compared and synthesized to extract lessons learned. Centrally executed guidelines and standards on the management of insecticides offered direction and control in most malaria programs, but were largely lacking from decentralized dengue programs, where practices of procurement, application, safety, storage, and disposal were variable between districts. Decentralized programs were better at facilitating participation of stakeholders and local communities and securing financing from local budgets. However, little coordination existed between malaria, visceral leishmaniasis and dengue programs within countries. Entomological capacity was concentrated in malaria programs at central level, while dengue and visceral leishmaniasis programs were missing out on expertise. Monitoring systems for insecticide resistance in malaria vectors were rarely used for dengue or visceral leishmaniasis vectors. Strategies for insecticide resistance management, where present, did not extend across programs or sectors in most countries. Dengue programs in most countries continued to rely on space spraying which, considering the realities on the ground, call for revision of international guidelines. Vector control programs in the selected countries were confronted with critical shortcomings in the procurement, application, safety measures, storage, and disposal of vector control insecticides, with implications for the efficiency, effectiveness, and safety of vector control. Further international support is needed to assist countries in situation analysis, action planning and development of national guidelines on vector control insecticide management.
控制人类疾病（尤其是疟疾、利什曼病和登革热）的媒介的干预措施主要依赖于化学杀虫剂的作用。然而，人们对病媒传播疾病流行国家的杀虫剂管理提出了担忧。我们的研究旨在分析选定国家的病媒控制杀虫剂管理情况，以汲取经验教训。在六个国家进行了病媒控制杀虫剂管理情况的定性分析。就农药生命周期涵盖的各个方面举行了多方利益攸关方会议和关键知情者访谈。对调查结果进行了比较和综合，以汲取经验教训。在大多数疟疾规划中，中央执行的杀虫剂管理准则和标准为管理工作提供了方向和控制，但在分散的登革热规划中则缺乏这些准则和标准，在这些规划中，采购、应用、安全、储存和处置的做法在各地区之间存在差异。分散的规划更有利于促进利益攸关方和地方社区的参与，并从地方预算中获得资金。然而，各国内部疟疾、内脏利什曼病和登革热规划之间几乎没有协调。在中央一级，昆虫学能力集中在疟疾规划中，而登革热和内脏利什曼病规划则缺乏专业知识。疟疾媒介抗药性监测系统很少用于登革热或内脏利什曼病媒介。在大多数国家，即使有抗药性管理战略，也没有扩展到所有规划或部门。大多数国家的登革热规划继续依赖空间喷洒，考虑到实地情况，需要对国际准则进行修订。选定国家的病媒控制规划在病媒控制杀虫剂的采购、应用、安全措施、储存和处置方面面临严重不足，这对病媒控制的效率、效果和安全性产生了影响。需要进一步提供国际支持，以协助各国进行情况分析、行动计划制定和国家病媒控制杀虫剂管理准则的制定。
