Effect of village-wide use of long-lasting insecticidal nets on visceral Leishmaniasis vectors in India and Nepal: a cluster randomized trial

Visceral leishmaniasis (VL) control in the Indian subcontinent is currently based on case detection and treatment, and on vector control using indoor residual spraying (IRS). The use of long-lasting insecticidal nets (LN) has been postulated as an alternative or complement to IRS. Here we tested the...

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Veröffentlicht in:PLoS neglected tropical diseases 2010-01, Vol.4 (1), p.e587
Hauptverfasser: Picado, Albert, Das, Murari L, Kumar, Vijay, Kesari, Shreekant, Dinesh, Diwakar S, Roy, Lalita, Rijal, Suman, Das, Pradeep, Rowland, Mark, Sundar, Shyam, Coosemans, Marc, Boelaert, Marleen, Davies, Clive R
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container_title PLoS neglected tropical diseases
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creator Picado, Albert
Das, Murari L
Kumar, Vijay
Kesari, Shreekant
Dinesh, Diwakar S
Roy, Lalita
Rijal, Suman
Das, Pradeep
Rowland, Mark
Sundar, Shyam
Coosemans, Marc
Boelaert, Marleen
Davies, Clive R
description Visceral leishmaniasis (VL) control in the Indian subcontinent is currently based on case detection and treatment, and on vector control using indoor residual spraying (IRS). The use of long-lasting insecticidal nets (LN) has been postulated as an alternative or complement to IRS. Here we tested the impact of comprehensive distribution of LN on the density of Phlebotomus argentipes in VL-endemic villages. A cluster-randomized controlled trial with household P. argentipes density as outcome was designed. Twelve clusters from an ongoing LN clinical trial--three intervention and three control clusters in both India and Nepal--were selected on the basis of accessibility and VL incidence. Ten houses per cluster selected on the basis of high pre-intervention P. argentipes density were monitored monthly for 12 months after distribution of LN using CDC light traps (LT) and mouth aspiration methods. Ten cattle sheds per cluster were also monitored by aspiration. A random effect linear regression model showed that the cluster-wide distribution of LNs significantly reduced the P. argentipes density/house by 24.9% (95% CI 1.80%-42.5%) as measured by means of LTs. The ongoing clinical trial, designed to measure the impact of LNs on VL incidence, will confirm whether LNs should be adopted as a control strategy in the regional VL elimination programs. The entomological evidence described here provides some evidence that LNs could be usefully deployed as part of the VL control program. ClinicalTrials.gov CT-2005-015374.
doi_str_mv 10.1371/journal.pntd.0000587
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The use of long-lasting insecticidal nets (LN) has been postulated as an alternative or complement to IRS. Here we tested the impact of comprehensive distribution of LN on the density of Phlebotomus argentipes in VL-endemic villages. A cluster-randomized controlled trial with household P. argentipes density as outcome was designed. Twelve clusters from an ongoing LN clinical trial--three intervention and three control clusters in both India and Nepal--were selected on the basis of accessibility and VL incidence. Ten houses per cluster selected on the basis of high pre-intervention P. argentipes density were monitored monthly for 12 months after distribution of LN using CDC light traps (LT) and mouth aspiration methods. Ten cattle sheds per cluster were also monitored by aspiration. A random effect linear regression model showed that the cluster-wide distribution of LNs significantly reduced the P. argentipes density/house by 24.9% (95% CI 1.80%-42.5%) as measured by means of LTs. The ongoing clinical trial, designed to measure the impact of LNs on VL incidence, will confirm whether LNs should be adopted as a control strategy in the regional VL elimination programs. The entomological evidence described here provides some evidence that LNs could be usefully deployed as part of the VL control program. 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This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Picado A, Das ML, Kumar V, Kesari S, Dinesh DS, et al. (2010) Effect of Village-wide Use of Long-Lasting Insecticidal Nets on Visceral Leishmaniasis Vectors in India and Nepal: A Cluster Randomized Trial. 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The ongoing clinical trial, designed to measure the impact of LNs on VL incidence, will confirm whether LNs should be adopted as a control strategy in the regional VL elimination programs. The entomological evidence described here provides some evidence that LNs could be usefully deployed as part of the VL control program. 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subjects Animals
Bedding and Linens
Cattle
Clinical trials
Households
India
Infectious Diseases/Epidemiology and Control of Infectious Diseases
Infectious Diseases/Neglected Tropical Diseases
Insect Control - methods
Insect Vectors - drug effects
Insect Vectors - growth & development
Insecticides
Insecticides - chemistry
Insecticides - pharmacology
Leishmaniasis, Visceral - prevention & control
Nepal
Parasitic diseases
Phlebotomus - drug effects
Phlebotomus - growth & development
Population density
Public health
Sand & gravel
Studies
Tropical diseases
title Effect of village-wide use of long-lasting insecticidal nets on visceral Leishmaniasis vectors in India and Nepal: a cluster randomized trial
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