Insecticide treated eave nets and window screens for malaria control

用于控制疟疾的经杀虫剂处理的屋檐网和纱窗

• 批准号: MR/T003677/1
• 负责人: John Bradley
• 金额: $ 27.25万
• 依托单位: London School of Hygiene & Tropical Medicine
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2020
• 资助国家: 英国
• 起止时间: 2020 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FT003677%2F1
• 关键词: Insecticide; treated; eave; nets; window

Long lasting insecticidal nets (LLIN) are a key component of malaria control and are responsible for saving many lives; but they have several drawbacks. About half of people living in malaria endemic areas do not have access to LLINs. Some of this deficit is due to insufficient delivery of nets, but a major factor is LLINS becoming rapidly damaged, resulting in a lifespan less than their intended 3-years. Additionally, there is typically an unequal distribution of nets to certain groups within households. For example, while the youngest children and their mothers are likely to sleep under nets, school age children often have very low access to nets. And even those who do have access to nets are only protected when they are sleeping. We propose a new tool - purpose made insecticide-treated eave nets (ITENs) with insecticide treated window screens (ITWS) for full house screening. ITENs are purpose made netting rolls that are applied to the house under the overhang of the roof and across windows within 30 minutes by local teams using hammer and nails. These interventions have at least three potential advantages over LLINs: they protect everybody in the household; they protect them at all times when they are in the household; and the are potentially much more durable than LLINs, giving up to 5 years' protection and making them highly cost effective (up to $1.75 per year per household less than LLINs). ITENs fixed across the eaves of household structures and ITWS on the windows block access to and kill Anopheles mosquitoes at their main access points into houses. Mosquitoes are attracted to houses, try to enter through the eaves or windows, and will come up against insecticides in the interventions, turning the house into a "lure and kill", that not only protect people in the house but also everyone in the community. Preliminary household randomised evaluation of ITENs and ITWS among 80 households in Western Kenya in 2012-14 showed 75% fewer vector mosquitoes in the houses using ITENs, ITWS and LLINs when compared to households using LLINs only. ITENs and ITWS are already available and scalable and can be fitted to any type of house.ITENs and ITWS have advantages over LLINs for the application of insecticides. LLINS are touched daily and washed regularly, limiting the range of chemicals which can be applied. ITENs and ITWS are compatible with a wider range of insecticides. This will be greatly advantageous because insecticides used for malaria control are becoming less effective in Africa due to the growing resistance of mosquitoes - and particularly because resistance is a local phenomenon: chemicals that work in one place may be ineffective in another so it is vital to have a wide choice of insecticides. In addition, ITENs and ITWS can be made from denser, more durable material. This not only makes them more physically durable but allows a greater quantity of insecticide to be impregnated, killing more mosquitoes, even resistant ones, and making the effect last longer. We propose in due course to undertake a large-scale cluster randomised trial with epidemiological endpoints in Tanzania. However, before this is possible it is necessary to investigate which particular combination of insecticides, is appropriate to the local conditions. We also wish to undertake a study to assess how feasible it is to fit ITENs and ITWS to local houses and how acceptable local communities find them. We are therefore applying for a development grant for a 2 small preliminary studies: one in experimental huts, which will be conducted to compare the household and community protective efficacy of 2 ITEN and ITWS products with different insecticides in local conditions to see which is better to take forward to a large scale trial; and a second in which 200 local houses are fitted with ITENs and ITWS and followed up after 1 year to assess ease and cost of fitting, longevity and community acceptability.

持久的杀虫网（LLIN）是疟疾控制的关键组成部分，并负责挽救许多生命。但是他们有几个缺点。居住在疟疾地区的大约一半的人无法进入llins。这种赤字中的一些是由于网络输送不足所致，但一个主要因素是LLIN迅速受损，其寿命少于其预期的3年。此外，通常在家庭中某些群体的网络分配不平等。例如，虽然最小的孩子及其母亲可能会在蚊帐下睡觉，但学龄儿童往往可以使用网。即使那些确实可以使用网的人也只有在睡觉时也受到保护。我们提出了一种新工具 - 用杀虫剂处理的窗帘（ITEN）进行了杀虫剂处理的屋顶网（ITEN），以进行全室内筛选。 Itens是用锤子和指甲的本地团队在30分钟内横跨屋顶和窗户下方的房屋的目的网卷。这些干预措施至少具有三个潜在的优势：它们保护家庭中的每个人；他们始终在家庭中保护他们；而且它们的耐用性比LLIN耐用得多，可提供长达5年的保护，并使其具有高度的成本效益（每年最多每年1.75美元的少于LLINS）。 Itens固定在Windows块上的家庭结构和ITW的屋檐上，并在其主要接入点进入房屋的主要接入点，并杀死了Anopheles蚊子。蚊子被房屋吸引，试图通过屋檐或窗户进入，并会在干预措施中遇到杀虫剂，将房屋变成“诱饵和杀死”，不仅保护房屋中的人们，而且保护社区中的每个人。 2012 - 14年，肯尼亚西部80个家庭中的ITEN和ITW的初步家庭随机评估显示，与仅使用LLIN的家庭相比，使用ITENS，ITWS和LLIN的房屋中的媒介蚊子少了75％。 ITEN和ITWS已经可用且可扩展，并且可以安装到任何类型的房屋中。它和ITW具有比LLIN的优势用于应用杀虫剂。每天接触LLIN并定期洗涤，限制了可以应用的化学物质范围。 ITENS和ITW与更广泛的杀虫剂兼容。这将非常有利，因为用于疟疾控制的杀虫剂在非洲的效果较低，因为蚊子的抵抗力越来越大 - 尤其是因为耐药性是一种局部现象：在另一个地方起作用的化学物质在另一个地方可能无效，因此对于多种昆虫糖苷选择至关重要。此外，ITENS和ITW可以用更密集，更耐用的材料制成。这不仅使它们在身体上更耐用，而且还可以浸渍更多的杀虫剂，杀死更多的蚊子，甚至耐药性，并使效果持续更长的时间。我们建议在适当的时候进行一项大规模的聚类随机试验，并在坦桑尼亚进行流行病学终点。但是，在此之前，有必要研究哪种特定的杀虫剂组合适合当地条件。我们还希望进行一项研究，以评估与当地房屋相适应和ITW的可行性以及当地社区如何找到它们的可行性。因此，我们正在为2项小型初步研究申请开发赠款：一项在实验小屋中，将对2种ITEN和ITWS产品的家庭和社区保护效率进行比较，并在当地条件下与不同的杀虫剂进行比较，以查看哪些更好地进行大规模试验；第二秒，有200个本地房屋配有ITENS和ITWS，并在1年后进行了跟进，以评估适合，寿命和社区可接受性的便捷性和成本。

项目成果

Insecticide-treated eave nets and window screens for malaria control in Chalinze district, Tanzania: a study protocol for a household randomised control trial.

• DOI: 10.1186/s13063-022-06408-4
• 发表时间: 2022-07-19
• 期刊: Trials
• 影响因子: 2.5