Demissie Dereje Bayisa, Fetensa Getahun, Desta Tilahun, Tiyare Firew Tiruneh
Department of Nursing and Midwifery, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town 7602, South Africa.
Department of Medical Surgical Nursing, School of Nursing, Saint Paul's Hospital Millennium Medical College, Addis Ababa P.O. Box 1271, Ethiopia.
Int J Environ Res Public Health. 2025 Jun 30;22(7):1045. doi: 10.3390/ijerph22071045.
: Long-lasting insecticidal nets (LLINs) have significantly reduced the malaria burden in recent decades, and this malaria prevalence reduction has been achieved through the upgrading of pyrethroid long-lasting insecticidal nets. However, this reduction has stalled due to many factors, including rapidly developing pyrethroid resistance. The protocol was registered in PROSPERO, and we used Cochrane methodology to assess bias and evidence quality. Three reviewers extracted data from individual studies, and a meta-analysis was performed using Excel and STATA version 17, expressing the data as a risk ratio. : A study involving 21,916 households from 11 randomized controlled trials showed that the chlorfenapyr treatment group had a 10% reduction in malaria infection risk, with a pooled overall prevalence of 25.96 per 100 children in the chlorfenapyr group and 32.38 per 100 children in the piperonyl butoxide group, compared to 41.60 per 100 children in the control (pyrethroid-only) group. This meta-analysis determined that the entomological outcomes of effectiveness and efficacy showed that these treatments effectively reduced vector density per household per night and mean inoculation rates, with a 23% reduction in chlorfenapyr, a 7% reduction in pyrethroid-only treatments, and a 12% reduction in piperonyl-butoxide-treated groups. This study shows that chlorfenapyr (CFP) and pyriproxyfen (PPF) LLINs are highly effective and more efficacious in reducing malaria infection, case incidence, and anemia among children, as well as in reducing mean indoor vector density, mean entomological inoculation rate, and sporozoite rate, compared to pyriproxyfen (PPF) LLINs in Africa. : This study found that chlorfenapyr (CFP) LLINs are highly effective and more efficacious in reducing malaria infection, case incidence, and anemia among children in Africa. Therefore, policymakers and health planners should place strong emphasis on addressing the effectiveness, efficacy, and resistance management of LLINs as part of their current public health agenda to eliminate malaria.
长效驱虫蚊帐（LLINs）在近几十年显著减轻了疟疾负担，而这种疟疾流行率的降低是通过升级拟除虫菊酯长效驱虫蚊帐实现的。然而，由于多种因素，包括拟除虫菊酯抗性的迅速发展，这种降低已经停滞。该方案已在国际前瞻性系统评价注册库（PROSPERO）中注册，我们采用Cochrane方法来评估偏倚和证据质量。三位评审员从个体研究中提取数据，并使用Excel和STATA 17版本进行荟萃分析，将数据表示为风险比。一项涉及来自11项随机对照试验的21916户家庭的研究表明，氯虫苯甲酰胺治疗组的疟疾感染风险降低了10%，氯虫苯甲酰胺组每100名儿童的总体患病率为25.96，胡椒基丁醚组为每100名儿童32.38，而对照组（仅使用拟除虫菊酯）为每100名儿童41.60。这项荟萃分析确定，有效性和功效的昆虫学结果表明，这些治疗有效地降低了每户每晚的病媒密度和平均接种率，氯虫苯甲酰胺降低了23%，仅使用拟除虫菊酯的治疗降低了7%，胡椒基丁醚治疗组降低了12%。这项研究表明，与非洲的吡丙醚（PPF）长效驱虫蚊帐相比，氯虫苯甲酰胺（CFP）和吡丙醚（PPF）长效驱虫蚊帐在降低儿童疟疾感染、病例发病率和贫血方面非常有效且更具功效，同时在降低室内平均病媒密度、平均昆虫学接种率和子孢子率方面也是如此。这项研究发现，氯虫苯甲酰胺（CFP）长效驱虫蚊帐在降低非洲儿童疟疾感染、病例发病率和贫血方面非常有效且更具功效。因此，政策制定者和卫生规划者应高度重视解决长效驱虫蚊帐有效性、功效和抗药性管理问题，将其作为当前消除疟疾公共卫生议程的一部分。
