长效杀虫剂处理套件（ICON® Maxx）在家庭使用三年多的聚酯蚊帐中的效果：坦桑尼亚的世卫组织 III 期试验。

Effectiveness of a long-lasting insecticide treatment kit (ICON® Maxx) for polyester nets over three years of household use: a WHO phase III trial in Tanzania.

机构信息

Amani Medical Research Centre, National Institute for Medical Research, Muheza, Tanzania.

Pan-African Malaria Vector Research Consortium (PAMVERC), PO Box 81, Muheza, Tanga, Tanzania.

出版信息

Malar J. 2021 Aug 19;20(1):345. doi: 10.1186/s12936-021-03871-3.

DOI:10.1186/s12936-021-03871-3

PMID:34412651

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8375204/

Abstract

BACKGROUND

ICON® Maxx (Syngenta) is an insecticide treatment kit of pyrethroid and binding agent for long-lasting treatment of mosquito nets. Interim recommendation for use on nets was granted by the World Health Organization (WHO) after successful evaluation in experimental huts following multiple washes. A full WHO recommendation is contingent upon demonstration of continued bio-efficacy after 3 years of use.

METHODS

A household-randomized prospective study design was used to assess ICON Maxx-treated nets over 3 years in north-eastern Tanzania. Conventional treated nets (with lambda-cyhalothrin, but without binder) served as a positive control. At 6-monthly intervals, cross-sectional household surveys monitored net use and physical integrity, while cone and tunnel tests assessed insecticidal efficacy. Pyrethroid content was determined after 12 and 36 months. A parallel cohort of nets was monitored annually for evidence of net deterioration and attrition.

RESULTS

After 12 months' use, 97% of ICON Maxx-treated nets but only 67% of CTN passed the WHO efficacy threshold for insecticidal durability (> 80% mortality in cone or tunnel or 90% feeding inhibition in tunnel). After 24- and 36-months use, 67% and 26% of ICON Maxx treated nets met the cone criteria, respectively, and over 90% met the combined cone and tunnel criteria. Lambda-cyhalothrin content after 36 months was 17% (15.8 ± 4.3 mg/m) of initial content. ICON Maxx nets were used year-round and washed approximately 4 times per year. In cross-sectional survey after 36 months the average number of holes was 20 and hole index was 740 cm per net. Cohort nets had fewer holes and smaller hole index than cross-sectional nets. However, only 15% (40/264) of cohort nets were not lost to follow-up or not worn out after 36 months.

CONCLUSIONS

Because more than 80% of nets met the WHO efficacy criteria after 36 months use, ICON Maxx was granted WHO full recommendation. Cross-sectional and cohort surveys were complementary and gave a fuller understanding of net durability. To improve net usage and retention, stronger incentives and health messaging should be introduced in WHO LLIN longitudinal trials. Untreated polyester nets may be made long-lastingly insecticidal in Africa through simple household treatment using ICON Maxx pyrethroid-binder kits.

摘要

背景

ICON® Maxx（先正达）是一种杀虫剂处理套件，由拟除虫菊酯和结合剂组成，用于长时间处理蚊帐。在经过多次洗涤后，在实验小屋中成功评估后，世界卫生组织（WHO）临时推荐使用该产品。在经过 3 年的使用后，持续显示出生物功效，才能获得 WHO 的全面推荐。

方法

在坦桑尼亚东北部，采用家庭随机前瞻性研究设计，评估 ICON Maxx 处理过的蚊帐 3 年。常规处理过的蚊帐（含氯氟氰菊酯，但不含结合剂）作为阳性对照。每 6 个月进行一次横断面家庭调查，监测蚊帐的使用和物理完整性，同时进行锥体和隧道测试评估杀虫效果。在 12 个月和 36 个月后测定拟除虫菊酯含量。对一组平行的蚊帐进行了每年一次的监测，以观察蚊帐的恶化和损耗情况。

结果

使用 12 个月后，97%的 ICON Maxx 处理过的蚊帐通过了 WHO 对杀虫耐久性的疗效阈值（锥体或隧道中的死亡率>80%或隧道中的 90%摄食抑制），而只有 67%的 CTN 处理过的蚊帐通过了该阈值。使用 24 个月和 36 个月后，分别有 67%和 26%的 ICON Maxx 处理过的蚊帐符合锥体标准，超过 90%的蚊帐符合锥体和隧道联合标准。使用 36 个月后，氯氟氰菊酯的含量为初始含量的 17%（15.8±4.3mg/m）。ICON Maxx 蚊帐全年使用，每年大约洗涤 4 次。在 36 个月后的横断面调查中，平均每个蚊帐有 20 个孔，孔指数为 740cm/个。队列蚊帐的孔数和孔指数均小于横断面蚊帐。然而，只有 15%（40/264）的队列蚊帐在 36 个月后没有失访或没有磨损。

结论

由于 36 个月后超过 80%的蚊帐符合 WHO 的疗效标准，ICON Maxx 获得了 WHO 的全面推荐。横断面和队列调查是互补的，可以更全面地了解蚊帐的耐久性。为了提高蚊帐的使用和保留率，在 WHO 长效蚊帐纵向试验中，应引入更强的激励措施和健康宣传。未经处理的聚酯蚊帐通过使用 ICON Maxx 拟除虫菊酯结合剂套件进行简单的家庭处理，在非洲可能会变得持久杀虫。