Effect of indoor residual spraying on sandfly abundance and incidence of visceral leishmaniasis in India, 2016-22: an interrupted time-series analysis and modelling study.

IF 36.4 1区 医学 Q1 INFECTIOUS DISEASES Lancet Infectious Diseases Pub Date : 2024-11-01 Epub Date: 2024-08-09 DOI:10.1016/S1473-3099(24)00420-1
Luc E Coffeng, Sake J de Vlas, Rudra Pratap Singh, Ananthu James, Joy Bindroo, Niteen K Sharma, Asgar Ali, Chandramani Singh, Sadhana Sharma, Michael Coleman
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引用次数: 0

Abstract

Background: Efforts to eliminate visceral leishmaniasis in India mainly consist of early detection and treatment of cases and indoor residual spraying with insecticides to kill the phlebotomine sandfly Phlebotomus argentipes that transmits the causative Leishmania protozoa. In this modelling study, we aimed to estimate the effect of indoor residual spraying (IRS) on vector abundance and transmission of visceral leishmaniasis in India.

Methods: In this time-series analysis and modelling study, we assessed the effect of IRS on vector abundance by using indoor vector-abundance data (from 2016 to 2022) and IRS quality-assurance data (from 2017-20) from 50 villages in eight endemic blocks in India where IRS was implemented programmatically. To assess a potential dose-response relation between insecticide concentrations and changes in sandfly abundance, we examined the correlation between site-level insecticide concentrations and the site-level data for monthly sandfly abundances. We used mathematical modelling to link vector data to visceral leishmaniasis case numbers from the national Kala-Azar Management Information System registry (2013-21), and to predict the effect of IRS on numbers of averted cases and deaths.

Findings: IRS was estimated to reduce indoor sandfly abundance by 27% (95% CI 20-34). Concentrations of insecticides on walls were significantly-but weakly-associated with the degree of reduction in vector abundance, with a reduction of -0·0023 (95% CI -0·0040 to -0·0007) sandflies per mg/m2 insecticide (p=0·0057). Reported case numbers of visceral leishmaniasis were well explained by trends in vector abundance. Village-wide IRS in response to a newly detected case of visceral leishmaniasis was predicted to reduce disease incidence by 6-40% depending on the presumed reduction in vector abundance modelled.

Interpretation: Indoor residual spraying has substantially reduced sandfly abundance in India, which has contributed to reductions in visceral leishmaniasis and related deaths. To prevent the re-emergence of visceral leishmaniasis as a public health problem, surveillance of transmission and sandfly abundance is warranted.

Funding: Bill & Melinda Gates Foundation.

Translation: For the Hindi translation of the abstract see Supplementary Materials section.

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2016-22 年室内滞留喷洒对印度沙蝇数量和内脏利什曼病发病率的影响:间断时间序列分析和模型研究。
背景:在印度,消除内脏利什曼病的工作主要包括早期发现和治疗病例,以及在室内喷洒杀虫剂杀灭传播致病利什曼原虫的沙蝇。在这项模拟研究中,我们旨在估算室内滞留喷洒(IRS)对印度内脏利什曼病病媒数量和传播的影响:在这项时间序列分析和建模研究中,我们利用印度八个流行区 50 个村庄的室内病媒丰度数据(2016 年至 2022 年)和 IRS 质量保证数据(2017 年至 20 年),评估了 IRS 对病媒丰度的影响。为了评估杀虫剂浓度与沙蝇丰度变化之间的潜在剂量反应关系,我们研究了地点级杀虫剂浓度与地点级月度沙蝇丰度数据之间的相关性。我们使用数学模型将病媒数据与国家卡拉-阿扎尔管理信息系统登记(2013-21 年)中的内脏利什曼病病例数联系起来,并预测 IRS 对避免病例数和死亡数的影响:据估计,IRS可将室内沙蝇的数量减少27%(95% CI 20-34)。墙壁上的杀虫剂浓度与病媒数量的减少程度有明显但微弱的关系,每毫克/平方米杀虫剂可减少-0-0023(95% CI -0-0040至-0-0007)只沙蝇(p=0-0057)。报告的内脏利什曼病病例数很好地解释了病媒丰度的变化趋势。针对新发现的内脏利什曼病病例,在全村范围内进行室内滞留喷洒,预计可将疾病发病率降低 6-40%,这取决于所模拟的病媒丰度的假定降幅:室内滞留喷洒大大降低了印度沙蝇的数量,从而减少了内脏利什曼病和相关死亡病例。为防止内脏利什曼病再次成为公共卫生问题,有必要对传播和沙蝇数量进行监测:比尔及梅琳达-盖茨基金会:摘要的印地语译文见补充材料部分。
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来源期刊
Lancet Infectious Diseases
Lancet Infectious Diseases 医学-传染病学
CiteScore
60.90
自引率
0.70%
发文量
1064
审稿时长
6-12 weeks
期刊介绍: The Lancet Infectious Diseases was launched in August, 2001, and is a lively monthly journal of original research, review, opinion, and news covering international issues relevant to clinical infectious diseases specialists worldwide.The infectious diseases journal aims to be a world-leading publication, featuring original research that advocates change or sheds light on clinical practices related to infectious diseases. The journal prioritizes articles with the potential to impact clinical practice or influence perspectives. Content covers a wide range of topics, including anti-infective therapy and immunization, bacterial, viral, fungal, and parasitic infections, emerging infectious diseases, HIV/AIDS, malaria, tuberculosis, mycobacterial infections, infection control, infectious diseases epidemiology, neglected tropical diseases, and travel medicine. Informative reviews on any subject linked to infectious diseases and human health are also welcomed.
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