Global Status of DDT and Its Alternatives for Use in Vector Control to Prevent Disease

Objective: I review the status of dichlorodiphcnyltrichloroethane (DDT), used for disease vector control, along with current evidence on its benefits and risks in relation to the available alternatives. Data Sources and Extraction: Contemporary data on DDT use were largely obtained from questionnaires and reports. I also conducted a Scopus search to retrieve published articles. Data Synthesis: DDT has been recommended as part of the arsenal of insecticides available for indoor residual spraying until suitable alternatives are available. Approximately 14 countries use DDT for disease control, and several countries are preparing to reintroduce DDT. Ihe effectiveness of DDT depends on local settings and merits close consideration in relation to the alternatives. Concerns about the continued use of DDT are fueled by recent reports of high levels of human exposure sure associated with indoor spraying amid accumulating e signs that more malaria vectors are becoming resistance is spreading to new countries. A comprehensive cos L'cent reports of high levels of human expoidence on chronic health effects. There are the toxic action of DDT, and that resis assessment of DDT versus its alternatives that takes side effects into account is missing. Effective chemical methods are available as immediate alternatives to DDT, but the choice of insecticide class is limited, and in certain areas the development of resistance is undermining the efficacy of insecticidal tools. New insecticides are not expected in the short term. Nonchemical methods are potentially important, but their effectiveness at program level needs urgent study. Conclusions: To reduce reliance on DDT, support is needed for integrated and multipartner strategies of vector control and for the continued development of new technologies. Integrated vector management provides a framework for developing and implementing effective technologies and strategies as sustainable alternatives to reliance on DDT.