Abstract
BackgroundLong-lasting insecticidal net screens (LLIS) fitted to domestic windows and doors in combination with targeted treatment (TT) of the most productive Aedes aegypti breeding sites were evaluated for their impact on dengue vector indices in a cluster-randomised trial in Mexico between 2011 and 2013.MethodsSequentially over 2 years, LLIS and TT were deployed in 10 treatment clusters (100 houses/cluster) and followed up over 24 months. Cross-sectional surveys quantified infestations of adult mosquitoes, immature stages at baseline (pre-intervention) and in four post-intervention samples at 6-monthly intervals. Identical surveys were carried out in 10 control clusters that received no treatment.ResultsLLIS clusters had significantly lower infestations compared to control clusters at 5 and 12 months after installation, as measured by adult (male and female) and pupal-based vector indices. After addition of TT to the intervention houses in intervention clusters, indices remained significantly lower in the treated clusters until 18 (immature and adult stage indices) and 24 months (adult indices only) post-intervention.ConclusionsThese safe, simple affordable vector control tools were well-accepted by study participants and are potentially suitable in many regions at risk from dengue worldwide.
Highlights
The dengue vector Aedes aegypti is a highly anthropophilic, endophilic and endophagic mosquito and has successfully exploited human-made ecosystems more than any other vector
At five months postintervention with Long-lasting insecticidal net screens (LLIS), significantly fewer treated houses were infested with Ae. aegypti adult females (OR1⁄40.38, 95% CI 0.21– 0.69), blood-fed females (OR1⁄40.36, 95% CI 0.21–0.60) and males (OR1⁄40.39, 95% CI 0.19–0.77)
Analyses of infestation density showed a similar trend with a significant reduction in mean Ae. aegypti abundance in houses with LLIS: adult females at 5 (IRR1⁄40.37, 95% CI 0.27–0.49) and 12 (IRR1⁄40.40, 95% CI 0.23–0.70) months post-intervention; males at 5 (IRR1⁄40.39, 95% CI 0.28–0.54) and 12 (IRR1⁄40.49, 95% CI 0.33–0.72) months; blood-fed females at 5 (IRR1⁄40.32, 95% CI 0.23–0.45) but not at 12 (IRR1⁄40.49, 95% CI 0.23–1.05) months (Figure 3)
Summary
The dengue vector Aedes aegypti is a highly anthropophilic, endophilic and endophagic mosquito and has successfully exploited human-made ecosystems more than any other vector. Traditional Ae. aegypti interventions that are based on insecticide application such as indoor or outdoor space-spraying (or fogging) and larviciding, effective in some settings, have shown limitations in terms of spatial and temporal coverage, residual power, sustainability and effectiveness in many contexts.[1] There is a pressing need from vector control programmes worldwide, for better dengue vector control tools that can achieve sustained reduction of dengue virus transmission by impacting the adult vector populations and/or interrupting their interaction with humans.[2] Ecosystem management interventions such as the deployment of insecticide treated materials (ITMs) as window/indoor net curtains in houses, and the targeted treatment (TT) of productive breeding-sites have shown potential for integrated. Long-lasting insecticidal net screens (LLIS) fitted to domestic windows and doors in combination with targeted treatment (TT) of the most productive Aedes aegypti breeding sites were evaluated for their impact on dengue vector indices in a cluster-randomised trial in Mexico between 2011 and 2013
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