BACKGROUND: Mosquito control interventions are widely used to reduce mosquito-borne diseases. It is unclear what combination of interventions are most effective in reducing human disease. A novel intervention study for Buruli ulcer targeting mosquito vectors was proposed for a Buruli ulcer-endemic area of Victoria, Australia. The local community expressed a preference for avoiding widespread residual spraying of pyrethroids. To inform the design of a future cluster randomised control study (cRCT) for Buruli ulcer prevention in Victoria, we conducted a systematic literature review.
AIMS: The aim was to describe cRCT designs which investigated interventions other than non-targeted insecticide for reducing mosquito-borne disease transmission, and comment on the strengths and weaknesses of these study designs.
METHODS: Five medical research databases were searched for eligible literature from the earliest available sources up to 5 July 2019 (Medline, Embase, Web of Science, EBM Reviews, CAB Direct). Reference lists of identified studies were hand searched. Eligible studies were cRCTs using targeted chemical or biological mosquito control interventions, or mosquito breeding source reduction, with the occurrence of mosquito-borne disease as an outcome.
RESULTS: Eight eligible cRCTs, conducted between 1994-2013 were identified in a variety of settings in the Americas and Asia. Interventions to reduce dengue transmission were mass adult trapping and source reduction. Interventions to reduce malaria transmission were largescale larvicide administration and (topical and spatial) repellent use. Three studies showed the intervention was associated with statistically significant reductions in the disease of interest and entomological indicators. High community engagement with the intervention were common to all three. In two studies, large buffer zones reduced contamination between study arms. Heterogeneity was reduced through increasing study cluster numbers, cluster matching and randomisation.
CONCLUSION: High community engagement is vital for a cRCT reducing mosquito-borne disease with a mosquito control intervention. These findings support a mosquito breeding source reduction intervention for Aedes control in a future study of Buruli ulcer prevention if local communities are supportive and very engaged. Regular administration of larvicide to sites unsuited to source reduction may supplement the intervention.
En este trabajo, nuestro objetivo es evaluar la efectividad de las intervenciones basadas en la comunidad (CBI) para la prevención y tratamiento de la malaria. Se realizó una revisión sistemática y se identificaron 42 estudios para su inclusión. Veinticinco de los estudios incluidos evaluaron el impacto de la distribución basada en la comunidad de mosquiteros tratados con insecticida (MTI), la pulverización residual (IRS), o sábanas impregnadas; 14 estudios evaluaron el tratamiento preventivo intermitente (TPI) entregado en ámbitos comunitarios; dos estudios se centraron en la educación basada en la comunidad para la prevención de la malaria; y un estudio evaluó la gestión ambiental a través de la limpieza de desagües. Nuestro análisis sugiere que, en general, la entrega basada en la comunidad de las intervenciones para prevenir y controlar la malaria se tradujo en un aumento significativo en la propiedad de MTI (RR: 2,16 IC del 95%: 1,86, 2,52) y el uso (RR: 1,77; IC del 95% : 1,48, 2,11). Sin embargo, el uso de mosquiteros tratados con insecticidas se limitaba a dos tercios de la población a quién pertenecían. Estrategias basadas en la comunidad también condujeron a una disminución significativa en la parasitemia (RR: 0,56 IC del 95%: 0,42 a 0,74), la prevalencia de la malaria (RR: 0,46 IC del 95%: 0,29, 0,73), la incidencia del paludismo (RR: 0.70, 95 % CI: 0,54, 0,90), y la prevalencia de anemia (RR: 0,79 IC del 95%: 0,64, 0,97). Encontramos un impacto no significativo en la esplenomegalia, los resultados del parto (bajo peso al nacer, prematuridad, muerte fetal / aborto espontáneo), medidas antropométricas (retraso del crecimiento, emaciación y bajo peso) y la mortalidad (por todas las causas y específica por malaria). El análisis de subgrupos sugirió que la distribución comunitaria de mosquiteros tratados con insecticidas, sábanas impregnadas y el IRS, y IPT son estrategias efectivas. Síntesis cualitativa sugiere que la alta cobertura podría lograrse a un costo más bajo con la integración de la CBI con campañas de atención y vacunación prenatales existentes. Entrega basada en la comunidad de las intervenciones para prevenir y controlar la malaria son estrategias efectivas para mejorar la cobertura y el acceso y reducir la carga de la malaria, sin embargo, los esfuerzos deberían también ser concertado para evitar el exceso de diagnóstico y resistencia a los medicamentos.
Mosquito control interventions are widely used to reduce mosquito-borne diseases. It is unclear what combination of interventions are most effective in reducing human disease. A novel intervention study for Buruli ulcer targeting mosquito vectors was proposed for a Buruli ulcer-endemic area of Victoria, Australia. The local community expressed a preference for avoiding widespread residual spraying of pyrethroids. To inform the design of a future cluster randomised control study (cRCT) for Buruli ulcer prevention in Victoria, we conducted a systematic literature review.
AIMS:
The aim was to describe cRCT designs which investigated interventions other than non-targeted insecticide for reducing mosquito-borne disease transmission, and comment on the strengths and weaknesses of these study designs.
METHODS:
Five medical research databases were searched for eligible literature from the earliest available sources up to 5 July 2019 (Medline, Embase, Web of Science, EBM Reviews, CAB Direct). Reference lists of identified studies were hand searched. Eligible studies were cRCTs using targeted chemical or biological mosquito control interventions, or mosquito breeding source reduction, with the occurrence of mosquito-borne disease as an outcome.
RESULTS:
Eight eligible cRCTs, conducted between 1994-2013 were identified in a variety of settings in the Americas and Asia. Interventions to reduce dengue transmission were mass adult trapping and source reduction. Interventions to reduce malaria transmission were largescale larvicide administration and (topical and spatial) repellent use. Three studies showed the intervention was associated with statistically significant reductions in the disease of interest and entomological indicators. High community engagement with the intervention were common to all three. In two studies, large buffer zones reduced contamination between study arms. Heterogeneity was reduced through increasing study cluster numbers, cluster matching and randomisation.
CONCLUSION:
High community engagement is vital for a cRCT reducing mosquito-borne disease with a mosquito control intervention. These findings support a mosquito breeding source reduction intervention for Aedes control in a future study of Buruli ulcer prevention if local communities are supportive and very engaged. Regular administration of larvicide to sites unsuited to source reduction may supplement the intervention.
