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The impact of insecticide treated curtains on dengue virus transmission: A cluster randomized trial in Iquitos, Peru

Lenhart, Audrey, Morrison, Amy C, Paz-Solden, Valerie A, Forshay, Brett M, Cordova-Lopez, Jhonny J., Astete, Helvio, Elder, John P, Sihuincha, Moises, Gotlieb, Esther E, Halsey, Eric S, Kochel, Tadeusz J., Scott, Thomas W, Alexander, Nei and McCall, Philip ORCID: https://orcid.org/0000-0002-0007-3985 (2020) 'The impact of insecticide treated curtains on dengue virus transmission: A cluster randomized trial in Iquitos, Peru'. PLoS Neglected Tropical Diseases, Vol 14, Issue 4, e0008097.

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Abstract

Dengue is one of the most important vector-borne diseases, resulting in an estimated hundreds of millions of infections annually throughout the tropics. Control of dengue is heavily dependent upon control of its primary mosquito vector, Aedes aegypti. Innovative interventions that are effective at targeting the adult stage of the mosquito are needed to increase the options for effective control. The use of insecticide-treated curtains (ITCs) has previously been shown to significantly reduce the abundance of Ae. aegypti in and around homes, but the impact of ITCs on dengue virus (DENV) transmission has not been rigorously quantified. A parallel arm cluster-randomized controlled trial was conducted in Iquitos, Peru to quantify the impact of ITCs on DENV seroconversion as measured through plaque-reduction neutralization tests. Seroconversion data showed that individuals living in the clusters that received ITCs were at greater risk to seroconverting to DENV, with an average seroconversion rate of 50.6 per 100 person-years (PY) (CI: 29.9–71.9), while those in the control arm had an average seroconversion rate of 37.4 per 100 PY (CI: 15.2–51.7). ITCs lost their insecticidal efficacy within 6 months of deployment, necessitating re-treatment with insecticide. Entomological indicators did not show statistically significant differences between ITC and non-ITC clusters. It’s unclear how the lack of protective efficacy reported here is attributable to simple failure of the intervention to protect against Ae. aegypti bites, or the presence of a faulty intervention during much of the follow-up period. The higher risk of dengue seroconversion that was detected in the ITC clusters may have arisen due to a false sense of security that inadvertently led to less routine protective behaviors on the part of households that received the ITCs. Our study provides important lessons learned for conducting Randomized Cluster Trials for vector control interventions against Aedes-transmitted virus infections.

Item Type: Article
Subjects: QX Parasitology > Insects. Other Parasites > QX 525 Aedes
WA Public Health > Preventive Medicine > WA 240 Disinfection. Disinfestation. Pesticides (including diseases caused by)
WA Public Health > Health Problems of Special Population Groups > WA 395 Health in developing countries
WC Communicable Diseases > Virus Diseases > Infectious Mononucleosis. Arbovirus Infections > WC 528 Dengue
Faculty: Department: Biological Sciences > Vector Biology Department
Digital Object Identifer (DOI): https://doi.org/10.1371/journal.pntd.0008097
Depositing User: Mel Finley
Date Deposited: 16 Apr 2020 09:22
Last Modified: 17 Aug 2022 08:58
URI: https://archive.lstmed.ac.uk/id/eprint/14196

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