Owalla Tonny Jimmy, Okurut Emmanuel, Ssaka Kenneth, Apungia Gonsaga, Cemeri Barbara, Akileng Andrew, Ojakol Basil, Paine Mark J I, Ismail Hanafy M, Egwang Thomas G
Med Biotech Laboratories, Kampala P.O. Box 9364, Uganda.
Department of Global Health, University of Washington, Seattle, WA 98105, USA.
Trop Med Infect Dis. 2024 Dec 24;10(1):4. doi: 10.3390/tropicalmed10010004.
Indoor residual spraying (IRS) and the use of insecticide-treated bednets for malaria vector control have contributed substantially to a reduction in malaria disease burden. However, these control tools have important shortcomings including being donor-dependent, expensive, and often failing because of insufficient uptake. We assessed the safety and efficacy of a user-friendly, locally tailored malaria vector control approach dubbed "Hut Decoration for Malaria Control" (HD4MC) based on the incorporation of a WHO-approved insecticide, Actellic 300 CS, into a customary hut decoration practice in rural Uganda where millions of the most vulnerable and malaria-prone populations live in mud-walled huts. Three hundred sixty households were randomly assigned to either the HD4MC (120 households), IRS (120 households) or control group without any wall treatment (120 households). Entomological indices were assessed using pyrethrum spray catching, CDC light traps and human landing catches. The Actellic 300 CS toxicity on acetylcholinesterase activity among applicators of HD4MC was evaluated using the Test-mate (Model 400) erythrocyte acetylcholinesterase (AChE) test V.2, whereas toxicity in household occupants was monitored clinically. The Actellic 300 CS level in house dust was analyzed using reversed-phase high-performance liquid chromatography (RP-HPLC). Entomological indices were compared between the three study arms at 1.5, 3 and 6 months post-intervention. HD4MC- and IRS-treated huts had a significantly reduced malaria vector density and feeding rate compared to control huts. There was no significant reduction in acetylcholinesterase activity at 1.5 and 24 h post exposure. Actellic 300 CS exposure did not result in any serious adverse events among the household occupants. In conclusion, HD4MC was safe and had comparable efficacy to canonical IRS.
室内滞留喷洒（IRS）以及使用经杀虫剂处理的蚊帐来控制疟疾传播媒介，在大幅减轻疟疾疾病负担方面发挥了重要作用。然而，这些控制手段存在一些重要缺陷，包括依赖捐助、成本高昂，而且常常由于使用率不足而效果不佳。我们评估了一种名为“疟疾防控屋舍装饰”（HD4MC）的便于使用、因地制宜的疟疾传播媒介控制方法的安全性和有效性。该方法是将世界卫生组织批准的杀虫剂阿克泰300 CS（Actellic 300 CS）融入乌干达农村地区的一种传统屋舍装饰做法中，那里数百万最脆弱且易感染疟疾的人群居住在泥墙屋舍里。360户家庭被随机分为三组，分别接受HD4MC处理（120户）、IRS处理（120户）或不进行任何墙面处理的对照组（120户）。使用除虫菊酯喷雾捕捉法、疾控中心（CDC）诱蚊灯和人饵诱捕法评估昆虫学指标。使用Test-mate（400型）红细胞乙酰胆碱酯酶（AChE）测试V.2评估HD4MC施用人员中阿克泰300 CS对乙酰胆碱酯酶活性的毒性，而对住户的毒性则进行临床监测。使用反相高效液相色谱法（RP-HPLC）分析屋尘中的阿克泰300 CS含量。在干预后1.5、3和6个月，比较三个研究组之间的昆虫学指标。与对照屋相比，经HD4MC和IRS处理的屋舍中疟疾传播媒介的密度和叮咬率显著降低。暴露后1.5小时和24小时，乙酰胆碱酯酶活性没有显著降低。阿克泰300 CS暴露未在住户中导致任何严重不良事件。总之，HD4MC安全且与传统的IRS效果相当。
