Larvicid za sprečavanje prenošenja malarije.
The Cochrane database of systematic reviews
Sažetak istraživanja
Pozadina Larvicidiranje se odnosi na redovnu primjenu hemijskih ili mikrobnih insekticida na vodena tijela ili posude za vodu kako bi se ubili vodeni nezreli oblici komaraca (larve i kukuljice).
Ciljevi Sažeti dokaze istraživanja koji procjenjuju da li larvicidiranje s kemijskim ili mikrobnim insekticidima sprječava prijenos malarije.
Metode pretraživanja Pretražili smo specijalizovani registar Cochrane grupe za zarazne bolesti; Cochrane Central Register of Controlled Trials (CENTRAL), objavljen u Cochrane biblioteci; MEDLINE; Embase; CAB Abstracts; Jorgovani; Međunarodna platforma za registar kliničkih ispitivanja Svjetske zdravstvene organizacije (WHO ICTRP); ClinicalTrials. gov; i ISRCTN registar do 6. juna 2019. Kriterijumi odabira Uključili smo klaster randomizirane kontrolirane studije (cRCT), prekinute vremenske serije (ITS), randomizirane unakrsne studije, nerandomizirane unakrsne studije i kontrolirane studije prije i poslije (CBA) koje su upoređivale larvicidiranje bez larvicida. Prikupljanje i analiza podataka Nezavisno smo procijenili ispitivanja za podobnost i rizik od pristrasnosti i izvukli podatke. Procijenili smo sigurnost dokaza koristeći GRADE pristup. Glavni rezultati Četiri studije (jedna cRCT, dva CBA i jedan nerandomizirani cross-over dizajn) ispunile su kriterije za uključivanje. Sva korišćena prizemna primena larvicida (ljudi koji ručno dostavljaju larvicide); jedna procijenjena hemikalija i tri procijenjena mikrobna agensa. Studije su sprovedene u Gambiji, Tanzaniji, Keniji i Šri Lanki. Provedene su tri studije u područjima gdje su vodena staništa komaraca bila manje ekstenzivna (1 km²; unakrsna studija iz Gambije). Za vodena staništa manja od 1 km², jedan cRCT je randomizirao osam sela u Šri Lanki kako bi procijenio hemijsko larvicidiranje korištenjem regulatora rasta insekata; i dvije CBA studije sprovedene u Keniji i Tanzaniji ocjenjivale su mikrobne larvicide. U cRCT-u, larvicidiranje u svim selima bilo je povezano sa nižom učestalošću malarije (omjer stope 0,24, 4649 učesnika, dokazi niske sigurnosti) i prevalencijom parazita (omjer rizika (RR) 0,26, 5897 učesnika, dokazi niske sigurnosti) u poređenju sa odsustvom larvicida. Dvije CBA studije su prijavile nižu prevalenciju malarije tokom perioda intervencije (prevalencija parazita RR 0,79, 95% interval pouzdanosti (CI) 0,71 do 0,89; 70,902 učesnika; dokazi niske sigurnosti). Kenijska studija je također prijavila smanjenje incidencije novih slučajeva malarije (RR 0,62, 95% CI 0,38 do 1,01; 720 učesnika; dokazi vrlo niske sigurnosti). Za vodena staništa od više od 1 km², nerandomizirano unakrsno ispitivanje korištenjem mikrobnih larvicida nije otkrilo učinak na pojavu malarije (RR 1,58, 95% CI 0,94 do 2,65; 4226 učesnika) ili prevalencije parazita (RR 19,5% CI, 19,5% CI, 19,5% CI, 9,5% CI, 1,5% CI, 0,94 do 2,65). 20; 3547 učesnika; oboje su bili dokazi vrlo niske sigurnosti. Ispitivanje u Gambiji je takođe prijavilo srednji nivo hemoglobina i nije bilo razlike u četiri poređenja (srednja razlika -0,13, 95% CI -0,40 do 0,13; 3586 učesnika). Nismo bili u mogućnosti da sumiramo ili objedinimo entomološke rezultate zbog neprijavljenih podataka i podataka koji nedostaju.
Zaključci autora Većina kontrolisanih studija o larvicidiranju rađena je sa mikrobnim agensima. Prizemni larvicid za neekstenzivna staništa larvi može imati utjecaj na prijenos malarije, a ne znamo postoji li učinak u velikim vodenim staništima. Nismo pronašli studije koje koriste tehnike primjene larvicida koje bi mogle pokriti velika vodena staništa, kao što je prskanje iz zraka pomoću zrakoplova.
Prikaži originalni naslov i sažetak na engleskom
Larviciding to prevent malaria transmission.
Background Larviciding refers to the regular application of chemical or microbial insecticides to water bodies or water containers to kill the aquatic immature forms of the mosquito (the larvae and pupae).
Objectives To summarize research evidence evaluating whether larviciding with chemical or microbial insecticides prevents malaria transmission. Search methods We searched the Cochrane Infectious Diseases Group Specialized Register; the Cochrane Central Register of Controlled Trials (CENTRAL), published in the Cochrane Library; MEDLINE; Embase; CAB Abstracts; LILACS; the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP); ClinicalTrials.gov; and the ISRCTN registry up to 6 June 2019. Selection criteria We included cluster-randomized controlled trials (cRCTs), interrupted time series (ITS), randomized cross-over studies, non-randomized cross-over studies, and controlled before-and-after studies (CBAs) that compared larviciding with no larviciding. Data collection and analysis We independently assessed trials for eligibility and risk of bias, and extracted data. We assessed the certainty of evidence using the GRADE approach. Main results Four studies (one cRCT, two CBAs, and one non-randomized cross-over design) met the inclusion criteria. All used ground application of larvicides (people hand-delivering larvicides); one evaluated chemical and three evaluated microbial agents. Studies were carried out in The Gambia, Tanzania, Kenya, and Sri Lanka. Three studies were conducted in areas where mosquito aquatic habitats were less extensive ( 1 km²; a cross-over study from The Gambia).For aquatic habitats of less than 1 km², one cRCT randomized eight villages in Sri Lanka to evaluate chemical larviciding using insect growth regulator; and two CBA studies undertaken in Kenya and Tanzania evaluated microbial larvicides. In the cRCT, larviciding across all villages was associated with lower malaria incidence (rate ratio 0.24, 4649 participants, low-certainty evidence) and parasite prevalence (risk ratio (RR) 0.26, 5897 participants, low-certainty evidence) compared to no larviciding. The two CBA studies reported lower malaria prevalence during the intervention period (parasite prevalence RR 0.79, 95% confidence interval (CI) 0.71 to 0.89; 70,902 participants; low-certainty evidence). The Kenyan study also reported a reduction in the incidence of new malaria cases (RR 0.62, 95% CI 0.38 to 1.01; 720 participants; very low-certainty evidence).For aquatic habitats of more than 1 km², the non-randomized cross-over trial using microbial larvicides did not detect an effect for malaria incidence (RR 1.58, 95% CI 0.94 to 2.65; 4226 participants), or parasite prevalence (RR 1.15, 95% CI 0.41 to 3.20; 3547 participants); both were very low-certainty evidence. The Gambia trial also reported the mean haemoglobin level, and there was no difference across the four comparisons (mean difference -0.13, 95% CI -0.40 to 0.13; 3586 participants).We were unable to summarize or pool entomological outcomes due to unreported and missing data. Authors' conclusions Most controlled studies on larviciding have been performed with microbial agents. Ground larviciding for non-extensive larval habitats may have an effect on malaria transmission, and we do not know if there is an effect in large-scale aquatic habitats. We found no studies using larviciding application techniques that could cover large aquatic habitats, such as aerial spraying using aircraft.
Izvorni podaci
- DOI
- 10.1002/14651858.cd012736.pub2
- PMID
- 31425624
- PMCID
- PMC6699674
- Provjereno
- 2026-07-26
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