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The importance of considering community-level effects when selecting insecticidal malaria vector products

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Killeen, Gerry ORCID: https://orcid.org/0000-0002-8583-8739, Okumu, Fredros O, N'Guessan, Raphael, Coosemans, Marc, Adeogun, Adedapo, Awolola, Sam, Etang, Josiane, Dabiré, Roch K and Corbel, Vincent (2011) 'The importance of considering community-level effects when selecting insecticidal malaria vector products'. Parasites & Vectors, Vol 4, e160.

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Abstract

Background

Insecticide treatment of nets, curtains or walls and ceilings of houses represent the primary means
for malaria prevention worldwide. Direct personal protection of individuals and households arises from deterrent and insecticidal activities which divert or kill mosquitoes before they can feed. However, at high coverage,
community-level reductions of mosquito density and survival prevent more transmission exposure than the personal protection acquired by using a net or living in a sprayed house.

Methods

A process-explicit simulation of malaria transmission was applied to results of 4 recent Phase II
experimental hut trials comparing a new mosaic long-lasting insecticidal net (LLIN) which combines deltamethrin
and piperonyl butoxide with another LLIN product by the same manufacturer relying on deltamethrin alone.

Results

Direct estimates of mean personal protection against insecticide-resistant vectors in Vietnam, Cameroon,
Burkina Faso and Benin revealed no clear advantage for combination LLINs over deltamethrin-only LLINs (P = 0.973) unless both types of nets were extensively washed (Relative mean entomologic inoculation rate (EIR) ± standard error of the mean (SEM) for users of combination nets compared to users of deltamethrin only nets = 0.853 ± 0.056,
P = 0.008). However, simulations of impact at high coverage (80% use) predicted consistently better impact for the combination net across all four sites (Relative mean EIR ± SEM in communities with combination nets, compared with those using deltamethrin only nets = 0.613 ± 0.076, P < 0.001), regardless of whether the nets were washed or not (P = 0.467). Nevertheless, the degree of advantage obtained with the combination varied substantially between sites and their associated resistant vector populations.

Conclusion

Process-explicit simulations of community-level protection, parameterized using locally-relevant experimental hut studies, should be explicitly considered when choosing vector control products for large-scale
epidemiological trials or public health programme procurement, particularly as growing insecticide resistance
necessitates the use of multiple active ingredients.

Item Type: Article
Additional Information: The electronic version of this article is the complete one and can be found online at: http://www.parasitesandvectors.com/content/4/1/160
Subjects: QX Parasitology > Insects. Other Parasites > QX 600 Insect control. Tick control
QX Parasitology > Insects. Other Parasites > QX 650 Insect vectors
WA Public Health > Preventive Medicine > WA 110 Prevention and control of communicable diseases. Transmission of infectious diseases
WA Public Health > WA 30 Socioeconomic factors in public health (General)
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 765 Prevention and control
Faculty: Department: Groups (2002 - 2012) > Vector Group
Digital Object Identifer (DOI): https://doi.org/10.1186/1756-3305-4-160
Depositing User: Users 183 not found.
Date Deposited: 15 Feb 2012 16:31
Last Modified: 16 Sep 2019 10:12
URI: https://archive.lstmed.ac.uk/id/eprint/2481

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