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一项关于用于坦桑尼亚疟疾媒介控制的溴氟酰胺室内滞留喷洒杀虫剂VECTRON T500的非劣效性整群随机评估。

A noninferiority cluster randomised evaluation of a broflanilide indoor residual spraying insecticide, VECTRON T500, for malaria vector control in Tanzania.

作者信息

Mbewe Njelembo J, Tungu Patrick K, Messenger Louisa A, Bradley John, Mangesho Peter E, Shirima Boniface, Moshi Oliver, Shayo Magreth F, Seif Mohammed, Portwood Natalie M, Snetselaar Janneke, Azizi Salum, Magogo Frank, Mabenga Peter, Sudi Wema, Mlay George, Kirby Matthew J, Mosha Franklin W, Kisinza William, Matowo Johnson, Small Graham, Rowland Mark W

机构信息

Department of Disease Control, London School of Hygiene and Tropical Medicine, London, WC1E7HT, UK.

Department of Parasitology, Kilimanjaro Christian Medical University College, Moshi, Tanzania.

出版信息

Sci Rep. 2025 Apr 29;15(1):15013. doi: 10.1038/s41598-025-99809-9.

Abstract

Effective malaria vector control is being undermined by the rapid spread of insecticide resistance. VECTRON T500, a new indoor residual spraying (IRS) product containing the active ingredient broflanilide as a 50% wettable powder (WP), was previously shown to be efficacious in experimental hut trials. A two-arm non-inferiority cluster randomized controlled community trial was conducted in Muheza District, Tanga Region, Tanzania. VECTRON T500 was compared to the IRS product Fludora Fusion (clothianidin 50% + deltamethrin 6.25% WP-SB). Sixteen village clusters were pair-matched on baseline vector densities and allocated to reference and intervention arms. Monthly CDC light trapping sampled mosquitoes to estimate vector density, indoor biting, sporozoite and entomological inoculation rate (EIR). The non-inferiority margin of mosquito density was defined as a density ratio of 1.5. Susceptibility to IRS active ingredients was assessed in one of the local vectors, Anopheles gambiae sensu lato (s.l.), using WHO/CDC bottle bioassays. The residual efficacy of both IRS products was monitored for 12 months using susceptible and pyrethroid resistant An. gambiae sensu stricto (s.s.) mosquitoes. This study is registered with ClinicalTrials.gov (NCT05150808). A total of 916 and 844 houses were sprayed with Fludora Fusion and VECTRON T500, respectively, with equitable spray coverage. An. gambiae s.l. was resistant to deltamethrin but susceptible to clothianidin and broflanilide. The density ratio adjusted for baseline Anopheline mosquito density was 0.77 (95% CI: 0.45-1.29). The baseline adjusted sporozoite rate and EIR differences between the two trial arms were 0.84% and 15.61%, respectively. The residual efficacy was > 80% mortality for VECTRON T500 and Fludora Fusion, on both mud and concrete walls, 12 months post spraying. VECTRON T500 was non-inferior to Fludora Fusion in terms of its ability to reduce vector density, sporozoite rate and EIR, providing an additional vector control tool with a new mode of action for malaria prevention and insecticide resistance management.

摘要

杀虫剂抗性的迅速传播正在破坏有效的疟疾媒介控制。VECTRON T500是一种新型室内滞留喷洒(IRS)产品,其活性成分是溴氟酰胺,为50%可湿性粉剂(WP),此前在实验小屋试验中已证明其有效。在坦桑尼亚坦噶地区的穆赫扎区进行了一项双臂非劣效性整群随机对照社区试验。将VECTRON T500与IRS产品Fludora Fusion(50%噻虫胺+6.25%溴氰菊酯WP-SB)进行比较。16个村庄群组根据基线媒介密度进行配对,并分配到对照组和干预组。每月使用疾控中心诱蚊灯诱捕蚊子,以估计媒介密度、室内叮咬、子孢子和昆虫学接种率(EIR)。蚊子密度的非劣效性界限定义为密度比为1.5。使用世卫组织/疾控中心瓶式生物测定法,在当地一种媒介冈比亚按蚊复合组(Anopheles gambiae sensu lato,s.l.)中评估对IRS活性成分的敏感性。使用易感和对拟除虫菊酯耐药的冈比亚按蚊指名亚种(Anopheles gambiae sensu stricto,s.s.)蚊子,对两种IRS产品的残留效力进行了12个月的监测。本研究已在ClinicalTrials.gov注册(NCT05150808)。分别用Fludora Fusion和VECTRON T500喷洒了916间和844间房屋,喷洒覆盖均匀。冈比亚按蚊复合组对溴氰菊酯耐药,但对噻虫胺和溴氟酰胺敏感。根据基线按蚊密度调整后的密度比为0.77(95%CI:0.45-1.29)。两个试验组之间基线调整后的子孢子率和EIR差异分别为0.84%和15.61%。喷洒后12个月,在泥墙和混凝土墙上,VECTRON T500和Fludora Fusion的残留效力死亡率均>80%。在降低媒介密度、子孢子率和EIR方面,VECTRON T500不劣于Fludora Fusion,为疟疾预防和杀虫剂抗性管理提供了一种具有新作用方式的额外媒介控制工具。

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