Combining indoor residual spraying and insecticide-treated nets for malaria control in Africa: a review of possible outcomes and an outline of suggestions for the future

Malaria Journal

Review

Fredros O Okumu¹  Sarah J Moore¹ 

[1] Ifakara Health Institute, Biomedical and Environmental Sciences Thematic Group, P.O Box 53, Ifakara, Tanzania;London School of Hygiene and Tropical Medicine, Department of Infectious and Tropical Diseases, Disease Control and Vector Biology Unit, Keppel Street, WC1E 7HT, London, UK;

关键词: Malaria;    Malaria Control;    Indoor Residual Spray;    Malaria Vector;    Insecticide Resistance;   

DOI  :  10.1186/1475-2875-10-208

 received in 2011-04-28, accepted in 2011-07-28,  发布年份 2011

来源: Springer

【 摘 要 】

Insecticide-treated nets (ITNs) and indoor residual spraying (IRS) are currently the preferred methods of malaria vector control. In many cases, these methods are used together in the same households, especially to suppress transmission in holoendemic and hyperendemic scenarios. Though widespread, there has been limited evidence suggesting that such co-application confers greater protective benefits than either ITNs or IRS when used alone. Since both methods are insecticide-based and intradomicilliary, this article hypothesises that outcomes of their combination would depend on effects of the candidate active ingredients on mosquitoes that enter or those that attempt to enter houses. It is suggested here that enhanced household level protection can be achieved if the ITNs and IRS have divergent yet complementary properties, e.g. highly deterrent IRS compounds coupled with highly toxic ITNs. To ensure that the problem of insecticide resistance is avoided, the ITNs and IRS products should preferably be of different insecticide classes, e.g. pyrethroid-based nets combined with organophosphate or carbamate based IRS. The overall community benefits would however depend also on other factors such as proportion of people covered by the interventions and the behaviour of vector species. This article concludes by emphasizing the need for basic and operational research, including mathematical modelling to evaluate IRS/ITN combinations in comparison to IRS alone or ITNs alone.

【 授权许可】

CC BY   
© Okumu and Moore; licensee BioMed Central Ltd. 2011