A household randomized, controlled trial of the efficacy of 0.03% transfluthrin coils alone and in combination with long-lasting insecticidal nets on the incidence of Plasmodium falciparum and Plasmodium vivax malaria in Western Yunnan Province, China

Malaria Journal

Research

Sarah J Moore¹  Ilona Carneiro²  Nigel Hill²  Hong Ning Zhou³  Piyu Wang⁴  Xiaofang Guo⁴ 

[1] Environmental Health and Ecological Sciences Thematic Group, Ifakara Health Institute, Bagamoyo Research and Training Centre, Bagamoyo, Tanzania;Swiss Tropical and Public Health Institute, Socinstr. 57, 4051, Basel, Switzerland;University of Basel, Petersplatz 1, 4003, Basel, Switzerland;London School of Hygiene and Tropical Medicine, Keppel St, WC1E 7HT, London, UK;London School of Hygiene and Tropical Medicine, Keppel St, WC1E 7HT, London, UK;Yunnan Institute of Parasitic Diseases, 6 Xiyuan Road, Simao, Puer, Yunnan, People’s Republic of China;Yunnan Institute of Parasitic Diseases, 6 Xiyuan Road, Simao, Puer, Yunnan, People’s Republic of China;

关键词: Malaria;    Malaria Case;    Malaria Infection;    Rapid Diagnostic Test;    Malaria Vector;   

DOI  :  10.1186/1475-2875-13-208

 received in 2014-02-05, accepted in 2014-05-27,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundMosquito coils are the most commonly used household insecticidal product in the world with sales exceeding 50 billion coils, used by two billion people worldwide annually. Despite strong evidence that coils prevent mosquito bites a systematic review concluded that there is no evidence that burning mosquito coils prevents malaria acquisition. Therefore, the current trial was designed to measure and compare prevention of malaria infection by mosquito coils or long-lasting insecticidal net (LLIN) or a combination of the two in Yunnan, China in the Greater Mekong sub-region.MethodsA four-arm single blind household-randomized design was chosen as coils emanate insecticide throughout the household. Households enrolled at baseline were randomly allocated by the lottery method to one of the four intervention arms: (i) nothing, (ii) 0.03% transfluthrin coils alone, (iii) deltamethrin long-lasting insecticide treated nets, (LLINs) alone or (iv) a combination of transfluthrin coils and deltamethrin LLINs. All household members were recruited to the study, with only those households excluded with pregnant or breastfeeding mothers, members with chest complaints or allergies or members that regularly slept away from home. The main outcome of interest was Plasmodium falciparum malaria prevalence detected by rapid diagnostic tests (RDTs) during six repeated monthly cross-sectional surveys. The secondary outcome of interest was the effect on Plasmodium vivax prevalence detected in the same way.ResultsA total of 2,052 households were recruited into the study, comprising 7,341 individuals The odds ratios of testing positive by RDT with P. falciparum or P. vivax were >75% lower for all intervention arms compared with the control arm. Coils alone provided 77% protection (95% CI: 50%-89%), LLINs provided 91% protection (95% CI: 72%-97%) and the combination of coils and LLINs provided 94% protection (95% CI: 77%-99%) against P. falciparum compared with the control arm. There was no statistically significant difference between the protective efficacies of the different interventions.ConclusionsThis is the first robust clinical evaluation of transfluthrin mosquito coils as a means to reduce malaria and the high degree of infection prevented would indicate they represent a potentially highly effective tool, which could be integrated into larger vector control programmes.Trial registrationClinicalTrials.gov Identifier:NCT00442442, March 2007.

【 授权许可】

Unknown   
© Hill et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.