Heidelberg Institute of Global Health, Research to Practice Group, Heidelberg University, Heidelberg, Germany.
Instituto de Investigaciones, Centro Universitario de Zacapa, Universidad de San Carlos de Guatemala, Zacapa, Guatemala.
PLoS Negl Trop Dis. 2022 Mar 2;16(3):e0010196. doi: 10.1371/journal.pntd.0010196. eCollection 2022 Mar.
Visceral leishmaniasis (VL) has been targeted for elimination from Southeast Asia (SEA). The disease has been endemic in SEA, and in other parts of the world involving both humans and animals. One of the key strategies for combating VL is controlling for the vector sandfly. There are a few vector control strategies that are currently in practice. We sought to assess the efficacy and community effectiveness of insecticide treated nets (ITNs) in controlling the burden of sandfly and the occurrence of VL among humans. We conducted a systematic review following a study protocol and the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) criteria. 6331 initial hits were retrieved from Google Scholar, Lilacs, PubMed, Science Direct, WHOlis, WHOiris and PAHOiris. 25 met the full inclusion criteria. Findings show that the insecticide impregnated bednets and the commercially treated long lasting insecticidal nets (LLINs) are effective in controlling sandflies, with mortalities as high as 75% lasting over a year; although their role in controlling VL in the community was not extensively studied, since effectiveness was usually measured with sandflies densities. Findings also show that insecticide impregnated bednets are low cost and well accepted in the community, however, early erosion of insecticides from nets could occur. Some studies also showed that killing of sandflies may not translate into reduction of VL, therefore sandfly knock down and killing data needs to be interpreted with caution. Conclusions of this review are (1) combining insecticide impregnated bednets, as targeted interventions, with another vector control measure, particularly indoor residual spraying, and in conjunction with case detection, could be the way forward to controlling VL in resource limited settings. (2) Given the current low incidence of VL in SEA, it can be difficult to further research the community effectiveness of those control measures in reducing VL.
内脏利什曼病 (VL) 已被定为要从东南亚 (SEA) 消除的疾病。这种疾病在 SEA 以及世界其他涉及人类和动物的地区都有地方性流行。防治该病的关键策略之一是控制媒介沙蝇。目前有几种媒介控制策略正在实施。我们旨在评估经杀虫剂处理的蚊帐 (ITN) 在控制沙蝇负担和人类中利什曼病发生方面的效果和社区效果。我们按照研究方案和系统评价和荟萃分析的首选报告项目 (PRISMA) 标准进行了系统评价。从 Google Scholar、Lilacs、PubMed、Science Direct、WHOlis、WHOiris 和 PAHOiris 检索到 6331 个初始命中。25 项符合全部纳入标准。研究结果表明，经杀虫剂浸渍的床罩和商业处理的长效杀虫蚊帐 (LLIN) 可有效控制沙蝇，死亡率高达 75%，持续时间超过一年；尽管它们在社区中控制 VL 的作用尚未得到广泛研究，因为有效性通常是通过沙蝇密度来衡量的。研究结果还表明，经杀虫剂浸渍的床罩成本低且在社区中被广泛接受，但是，杀虫剂可能会从网中迅速流失。一些研究还表明，杀死沙蝇可能不会转化为 VL 的减少，因此需要谨慎解释沙蝇击倒和杀死数据。本综述的结论是：(1) 将经杀虫剂浸渍的床罩作为有针对性的干预措施，与另一种媒介控制措施（特别是室内滞留喷洒）相结合，并与病例发现相结合，可能是在资源有限的环境中控制 VL 的方法。(2) 鉴于目前 SEA 内脏利什曼病的发病率较低，因此很难进一步研究这些控制措施在降低 VL 方面的社区效果。
