Pub Date : 2024-11-01DOI: 10.1016/S2542-5196(24)00250-X
Hugh B Roland PhD , Jacob Kohlhoff , Kari Lanphier , Aissa Yazzie MS , Esther G Kennedy PhD , Sneha Hoysala MPH , Christopher Whitehead , Monica Lynn Sircar MA , Matthew O Gribble PhD
Limited reporting of Indigenous-led planetary health education programmes has constrained efforts to expand planetary health education, in Indigenous communities and beyond, despite urgent need. Although incorporation of Indigenous knowledge and cultures cannot be standardised, showcasing successful programmes could reveal good practices and aid replicability. In this Personal View, we highlight how shellfish toxin education programmes, designed and organised by the Sitka Tribe of Alaska, reduce local environmental health risks and support youth in pathways towards careers in planetary health. We describe how programmes build awareness and understanding of the local environment, environmental and health risks, and context-appropriate adaptation strategies by centring Tlingit culture and using hands-on activities that integrate Tlingit culture with western science. Lesson plans and resources created by Sitka Tribe of Alaska staff for these programmes are available in the US National Institute for Environmental Health Sciences Partnerships for Environmental Public Health resources web database.
{"title":"Tribally led planetary health education in southeast Alaska","authors":"Hugh B Roland PhD , Jacob Kohlhoff , Kari Lanphier , Aissa Yazzie MS , Esther G Kennedy PhD , Sneha Hoysala MPH , Christopher Whitehead , Monica Lynn Sircar MA , Matthew O Gribble PhD","doi":"10.1016/S2542-5196(24)00250-X","DOIUrl":"10.1016/S2542-5196(24)00250-X","url":null,"abstract":"<div><div>Limited reporting of Indigenous-led planetary health education programmes has constrained efforts to expand planetary health education, in Indigenous communities and beyond, despite urgent need. Although incorporation of Indigenous knowledge and cultures cannot be standardised, showcasing successful programmes could reveal good practices and aid replicability. In this Personal View, we highlight how shellfish toxin education programmes, designed and organised by the Sitka Tribe of Alaska, reduce local environmental health risks and support youth in pathways towards careers in planetary health. We describe how programmes build awareness and understanding of the local environment, environmental and health risks, and context-appropriate adaptation strategies by centring Tlingit culture and using hands-on activities that integrate Tlingit culture with western science. Lesson plans and resources created by Sitka Tribe of Alaska staff for these programmes are available in the US National Institute for Environmental Health Sciences Partnerships for Environmental Public Health resources web database.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"8 11","pages":"Pages e951-e957"},"PeriodicalIF":24.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/S2542-5196(24)00283-3
Cahal McQuillan
{"title":"Planetary Health Research Digest","authors":"Cahal McQuillan","doi":"10.1016/S2542-5196(24)00283-3","DOIUrl":"10.1016/S2542-5196(24)00283-3","url":null,"abstract":"","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"8 11","pages":"Page e878"},"PeriodicalIF":24.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/S2542-5196(24)00241-9
Jessica F Davies FANZA MSc , Forbes McGain MBBS PhD , Evelyn Sloan DPT , Prof Jill Francis PhD , Stephanie Best PhD
Hospitals use many single-use devices that produce more waste and greenhouse gas emissions than reusable devices; operating theatres alone are responsible for up to a third of hospital waste. We explored barriers and enablers to replacing disposable devices with reusable alternatives in operating theatres by use of interviews, the Theoretical Domains Framework, and theory-informed behaviour change techniques. 19 stakeholders were interviewed at a large tertiary hospital in Melbourne, Australia, and 53 barriers and 44 experience-based or intuition-based enablers were identified. 30 strategies were identified across six topics: external purchasing (two strategies); internal purchasing (seven strategies); incentivisation and standardised environmental decision making (three strategies); successful practical introduction of reusable devices (five strategies); identification of goals and facilitation of leadership (two strategies); and a community of practice and knowledge building (11 strategies). We present these 30 implementation strategies, from the individual to the policy level, which consist of evidence-based behaviour change techniques aimed at addressing the identified barriers to replacing single-use devices with reusable alternatives.
{"title":"A qualitative exploration of barriers, enablers, and implementation strategies to replace disposable medical devices with reusable alternatives","authors":"Jessica F Davies FANZA MSc , Forbes McGain MBBS PhD , Evelyn Sloan DPT , Prof Jill Francis PhD , Stephanie Best PhD","doi":"10.1016/S2542-5196(24)00241-9","DOIUrl":"10.1016/S2542-5196(24)00241-9","url":null,"abstract":"<div><div>Hospitals use many single-use devices that produce more waste and greenhouse gas emissions than reusable devices; operating theatres alone are responsible for up to a third of hospital waste. We explored barriers and enablers to replacing disposable devices with reusable alternatives in operating theatres by use of interviews, the Theoretical Domains Framework, and theory-informed behaviour change techniques. 19 stakeholders were interviewed at a large tertiary hospital in Melbourne, Australia, and 53 barriers and 44 experience-based or intuition-based enablers were identified. 30 strategies were identified across six topics: external purchasing (two strategies); internal purchasing (seven strategies); incentivisation and standardised environmental decision making (three strategies); successful practical introduction of reusable devices (five strategies); identification of goals and facilitation of leadership (two strategies); and a community of practice and knowledge building (11 strategies). We present these 30 implementation strategies, from the individual to the policy level, which consist of evidence-based behaviour change techniques aimed at addressing the identified barriers to replacing single-use devices with reusable alternatives.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"8 11","pages":"Pages e937-e945"},"PeriodicalIF":24.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/S2542-5196(24)00235-3
John Jamir Benzon R Aruta , Romiane Grace V Gonzales , Gaye Justinia R Delos Santos , Eliza Faye B Lumanog , Alexandra S Chew , Aenghel Marie D Bonoan , Ginger Erin Swa
{"title":"Climate injustice: lessons from the Philippines' jeepney modernisation programme","authors":"John Jamir Benzon R Aruta , Romiane Grace V Gonzales , Gaye Justinia R Delos Santos , Eliza Faye B Lumanog , Alexandra S Chew , Aenghel Marie D Bonoan , Ginger Erin Swa","doi":"10.1016/S2542-5196(24)00235-3","DOIUrl":"10.1016/S2542-5196(24)00235-3","url":null,"abstract":"","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"8 11","pages":"Pages e875-e876"},"PeriodicalIF":24.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142376157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/S2542-5196(24)00229-8
R Eric Lewandowski PhD , Susan D Clayton PhD , Lukas Olbrich MSc , Joseph W Sakshaug PhD , Britt Wray PhD , Sarah E O Schwartz PhD , Jura Augustinavicius PhD , Peter D Howe PhD , McKenna Parnes PhD , Sacha Wright BSc , Caitlyn Carpenter , Arkadiusz Wiśniowski PhD , Diego Perez Ruiz PhD , Lise Van Susteren MD
<div><h3>Background</h3><div>Climate change has adverse effects on youth mental health and wellbeing, but limited large-scale data exist globally or in the USA. Understanding the patterns and consequences of climate-related distress among US youth can inform necessary responses at the individual, community, and policy level.</div></div><div><h3>Methods</h3><div>A cross-sectional descriptive online survey was done of US youth aged 16–25 years from all 50 states and Washington, DC, between July 20 and Nov 7, 2023, via the Cint digital survey marketplace. The survey assessed: climate-related emotions and thoughts, including indicators of mental health; relational aspects of climate-related emotions; beliefs about who or what has responsibility for causing and responding to climate change; desired and planned actions in response to climate change; and emotions and thoughts about the US Government response to climate change. Respondents were asked whether they had been affected by various severe weather events linked to climate change and for their political party identification. Sample percentages were weighted according to 2022 US census age, sex, and race estimates. To test the effects of political party identification and self-reported exposure to severe weather events on climate-related thoughts and beliefs we used linear and logistic regression models, which included terms for political party identification, the number of self-reported severe weather event types in respondents' area of residence in the past year, and demographic control variables.</div></div><div><h3>Findings</h3><div>We evaluated survey responses from 15 793 individuals (weighted proportions: 80·5% aged 18–25 years and 19·5% aged 16–17 years; 48·8% female and 51·2% male). Overall, 85·0% of respondents endorsed being at least moderately worried, and 57·9% very or extremely worried, about climate change and its impacts on people and the planet. 42·8% indicated an impact of climate change on self-reported mental health, and 38·3% indicated that their feelings about climate change negatively affect their daily life. Respondents reported negative thoughts about the future due to climate change and actions planned in response, including being likely to vote for political candidates who support aggressive climate policy (72·8%). In regression models, self-reported exposure to more types of severe weather events was significantly associated with stronger endorsement of climate-related distress and desire and plans for action. Political party identification as Democrat or as Independent or Other (<em>vs</em> Republican) was also significantly associated with stronger endorsement of distress and desire and plans for action, although a majority of self-identified Republicans reported at least moderate distress. For all survey outcomes assessed in the models, the effect of experiencing more types of severe weather events did not significantly differ by political party identification.</div>
{"title":"Climate emotions, thoughts, and plans among US adolescents and young adults: a cross-sectional descriptive survey and analysis by political party identification and self-reported exposure to severe weather events","authors":"R Eric Lewandowski PhD , Susan D Clayton PhD , Lukas Olbrich MSc , Joseph W Sakshaug PhD , Britt Wray PhD , Sarah E O Schwartz PhD , Jura Augustinavicius PhD , Peter D Howe PhD , McKenna Parnes PhD , Sacha Wright BSc , Caitlyn Carpenter , Arkadiusz Wiśniowski PhD , Diego Perez Ruiz PhD , Lise Van Susteren MD","doi":"10.1016/S2542-5196(24)00229-8","DOIUrl":"10.1016/S2542-5196(24)00229-8","url":null,"abstract":"<div><h3>Background</h3><div>Climate change has adverse effects on youth mental health and wellbeing, but limited large-scale data exist globally or in the USA. Understanding the patterns and consequences of climate-related distress among US youth can inform necessary responses at the individual, community, and policy level.</div></div><div><h3>Methods</h3><div>A cross-sectional descriptive online survey was done of US youth aged 16–25 years from all 50 states and Washington, DC, between July 20 and Nov 7, 2023, via the Cint digital survey marketplace. The survey assessed: climate-related emotions and thoughts, including indicators of mental health; relational aspects of climate-related emotions; beliefs about who or what has responsibility for causing and responding to climate change; desired and planned actions in response to climate change; and emotions and thoughts about the US Government response to climate change. Respondents were asked whether they had been affected by various severe weather events linked to climate change and for their political party identification. Sample percentages were weighted according to 2022 US census age, sex, and race estimates. To test the effects of political party identification and self-reported exposure to severe weather events on climate-related thoughts and beliefs we used linear and logistic regression models, which included terms for political party identification, the number of self-reported severe weather event types in respondents' area of residence in the past year, and demographic control variables.</div></div><div><h3>Findings</h3><div>We evaluated survey responses from 15 793 individuals (weighted proportions: 80·5% aged 18–25 years and 19·5% aged 16–17 years; 48·8% female and 51·2% male). Overall, 85·0% of respondents endorsed being at least moderately worried, and 57·9% very or extremely worried, about climate change and its impacts on people and the planet. 42·8% indicated an impact of climate change on self-reported mental health, and 38·3% indicated that their feelings about climate change negatively affect their daily life. Respondents reported negative thoughts about the future due to climate change and actions planned in response, including being likely to vote for political candidates who support aggressive climate policy (72·8%). In regression models, self-reported exposure to more types of severe weather events was significantly associated with stronger endorsement of climate-related distress and desire and plans for action. Political party identification as Democrat or as Independent or Other (<em>vs</em> Republican) was also significantly associated with stronger endorsement of distress and desire and plans for action, although a majority of self-identified Republicans reported at least moderate distress. For all survey outcomes assessed in the models, the effect of experiencing more types of severe weather events did not significantly differ by political party identification.</div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"8 11","pages":"Pages e879-e893"},"PeriodicalIF":24.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Should climate and health researchers accept funding from industries that profit from climate-damaging consumption? In this Personal View, we aim to ignite discussions on this key topic and to introduce a guideline to possibly help climate and health researchers grappling with this complex question. Drawing from existing tools focused on other public health issues and the conclusions of the 2023 Lancet Series on commercial determinants of health, we propose a guideline comprising six parts: meeting public health and climate goals; building credibility and trust; avoiding undue dependence on particular sources of funding; not inflating without good reason the public image of industry; embedding processes to ensure transparency and independence; and protecting the freedom to publish. We invite other climate and public health scientists to report their own experiences and provide feedback on this guideline.
{"title":"Public good or climate washing? A guideline for climate and health researchers considering funding from carbon-intensive industries","authors":"Connie Hoe PhD , Aditi Bunker DrScHum , Cristina Arnés-Sanz MPharm , Prof Joacim Rocklöv PhD , Kirsty Wild PhD , Wallis Turner Holmes LLB , Prof Alistair Woodward PhD","doi":"10.1016/S2542-5196(24)00231-6","DOIUrl":"10.1016/S2542-5196(24)00231-6","url":null,"abstract":"<div><div>Should climate and health researchers accept funding from industries that profit from climate-damaging consumption? In this Personal View, we aim to ignite discussions on this key topic and to introduce a guideline to possibly help climate and health researchers grappling with this complex question. Drawing from existing tools focused on other public health issues and the conclusions of the 2023 <em>Lancet</em> Series on commercial determinants of health, we propose a guideline comprising six parts: meeting public health and climate goals; building credibility and trust; avoiding undue dependence on particular sources of funding; not inflating without good reason the public image of industry; embedding processes to ensure transparency and independence; and protecting the freedom to publish. We invite other climate and public health scientists to report their own experiences and provide feedback on this guideline.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"8 11","pages":"Pages e946-e950"},"PeriodicalIF":24.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/S2542-5196(24)00244-4
Prof Stephen P Luby MD , Jenna E Forsyth PhD , Prof Zafar Fatmi MBBS , Mahbubur Rahman MBBS , Jesmin Sultana MPH , Prof Erica L Plambeck PhD , Prof N Grant Miller PhD , Prof Eran Bendavid MD , Prof Peter J Winch MD , Prof Howard Hu MD , Prof Bruce Lanphear MD , Prof Philip J Landrigan MD
Lead, an element toxic to countless biological processes, occurs naturally in the earth's lithosphere and is geologically sequestered from the biosphere at the earth's surface. When humans remove lead from the lithosphere and distribute it throughout the economy, its toxic effects impact throughout the web of life. Lead mining and manufacturing is a small industry that generates enormous harms. Lead impairs the growth, development, and reproduction of microbes, insects, plants, and animals. The annual human costs of lead exposure include 5·5 million premature adult deaths from cardiovascular disease and US$1·4 trillion in losses to the global economy from lead impairing children's cognitive development. Although the lead industry touts lead as the most recycled metal, most recycling occurs within countries that are incapable of enforcing environmental regulations. Millions of metric tonnes of lead are dispersed into the environment each year, disproportionately in low-income and middle-income countries. Substitutes for lead in the economy are available and we should act in the best interests of the planet and human health by eliminating lead from the global economy by 2035.
{"title":"Removing lead from the global economy","authors":"Prof Stephen P Luby MD , Jenna E Forsyth PhD , Prof Zafar Fatmi MBBS , Mahbubur Rahman MBBS , Jesmin Sultana MPH , Prof Erica L Plambeck PhD , Prof N Grant Miller PhD , Prof Eran Bendavid MD , Prof Peter J Winch MD , Prof Howard Hu MD , Prof Bruce Lanphear MD , Prof Philip J Landrigan MD","doi":"10.1016/S2542-5196(24)00244-4","DOIUrl":"10.1016/S2542-5196(24)00244-4","url":null,"abstract":"<div><div>Lead, an element toxic to countless biological processes, occurs naturally in the earth's lithosphere and is geologically sequestered from the biosphere at the earth's surface. When humans remove lead from the lithosphere and distribute it throughout the economy, its toxic effects impact throughout the web of life. Lead mining and manufacturing is a small industry that generates enormous harms. Lead impairs the growth, development, and reproduction of microbes, insects, plants, and animals. The annual human costs of lead exposure include 5·5 million premature adult deaths from cardiovascular disease and US$1·4 trillion in losses to the global economy from lead impairing children's cognitive development. Although the lead industry touts lead as the most recycled metal, most recycling occurs within countries that are incapable of enforcing environmental regulations. Millions of metric tonnes of lead are dispersed into the environment each year, disproportionately in low-income and middle-income countries. Substitutes for lead in the economy are available and we should act in the best interests of the planet and human health by eliminating lead from the global economy by 2035.</div></div>","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"8 11","pages":"Pages e966-e972"},"PeriodicalIF":24.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142593329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-01DOI: 10.1016/S2542-5196(24)00232-8
Arthur Sovi PhD , Constantin J Adoha MSc , Boulais Yovogan MSc , Chad L Cross PhD , Dominic P Dee MSc , Alphonse Keller Konkon PhD , Aboubakar Sidick MSc , Manfred Accrombessi PhD , Minassou Juvenal Ahouandjinou MSc , Razaki Ossè PhD , Edouard Dangbénon MSc , Linda Towakinou BSc , Clément Agbangla PhD , Germain Gil Padonou MSc , Thomas S Churcher PhD , Corine Ngufor PhD , Jackie Cook PhD , Natacha Protopopoff PhD , Martin C Akogbéto , Prof Louisa A Messenger PhD
<div><h3>Background</h3><div>Insecticide resistance among malaria vector species now occurs in 84 malaria-endemic countries and territories worldwide. Novel vector-control interventions, including long-lasting insecticidal nets (LLINs) that incorporate new active ingredients with distinct modes of action, are urgently needed to delay the evolution and spread of resistance and to alleviate reversals in malaria-control gains. We aimed to assess the longitudinal effect of two dual-active-ingredient LLINs on insecticide resistance during a cluster-randomised, controlled trial in Benin.</div></div><div><h3>Methods</h3><div>This 3-year, three-arm, cluster-randomised, controlled trial was conducted between Oct 17, 2019, and Oct 24, 2022, in three districts in southern Benin, to compare the effects of LLINs containing chlorfenapyr–pyrethroid or pyriproxyfen–pyrethroid with LLINs containing pyrethroid only. In 19 292 mosquitoes (<em>Anopheles gambiae</em> sensu lato) collected over 36 months—3 months of baseline followed by 3 years post-intervention—we measured longitudinal phenotypic insecticide resistance profiles using bioassays and genotypic resistance profiles using quantitative, real-time, reverse transcriptase PCR of metabolic resistance genes in two clusters per trial group. The trial was registered with <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>, <span><span>NCT03931473</span><svg><path></path></svg></span>.</div></div><div><h3>Findings</h3><div>In all three trial groups, a significant effect of LLINs on insecticide resistance selection was evident, with the median lethal dose (LD<sub>50</sub>) of α-cypermethrin approximately halving between baseline and 12 months post-LLIN distribution (pyrethroid-only LLIN cluster 21: LD<em><sub>50</sub></em> 78·78 μg/ml [95% CI 65·75–94·48] <em>vs</em> 35·93 [29·41–43.86] and cluster 31: 79·26 [65·40–96·44] <em>vs</em> 38·71 [30·88–48·53]; chlorfenapyr–pyrethroid LLIN cluster 43: 104·30 [82·97–133·58] <em>vs</em> 43·99 [35·30–54·86]; and pyriproxyfen–pyrethroid LLIN cluster 36: 63·76 [52·14–77·75] <em>vs</em> 37·96 [30·88–46·69] and cluster 53: 77·67 [57·63–104·56] <em>vs</em> 39·72 [29·26–53·97]). Over the subsequent 2 years, the LD<em><sub>50</sub></em> of α-cypermethrin increased past baseline values in all three trial groups (year 3 pyrethroid-only LLIN cluster 21: 141·01 [111·70–181·90] and cluster 31: 115·15 [93·90–143·09]; chlorfenapyr–pyrethroid LLIN cluster 43: 97·00 [77·24–123·54] and cluster 55: 126·99 [102·34–161·26]; and pyriproxyfen–pyrethroid LLIN cluster 36: 142·29 [112·32–184·84] and cluster 53: 109·88 [79·31–157·70]). We observed minimal reductions in chlorfenapyr susceptibility and variable but significant reductions in fertility after pyriproxyfen exposure, with an overall trend of increasing susceptibility across trial years. Several metabolic genes were implicated in resistance selection, including <em>CYP6P4</em> in the pyriproxyfen–pyrethroid LLIN group, which
{"title":"The effect of next-generation, dual-active-ingredient, long-lasting insecticidal net deployment on insecticide resistance in malaria vectors in Benin: results of a 3-year, three-arm, cluster-randomised, controlled trial","authors":"Arthur Sovi PhD , Constantin J Adoha MSc , Boulais Yovogan MSc , Chad L Cross PhD , Dominic P Dee MSc , Alphonse Keller Konkon PhD , Aboubakar Sidick MSc , Manfred Accrombessi PhD , Minassou Juvenal Ahouandjinou MSc , Razaki Ossè PhD , Edouard Dangbénon MSc , Linda Towakinou BSc , Clément Agbangla PhD , Germain Gil Padonou MSc , Thomas S Churcher PhD , Corine Ngufor PhD , Jackie Cook PhD , Natacha Protopopoff PhD , Martin C Akogbéto , Prof Louisa A Messenger PhD","doi":"10.1016/S2542-5196(24)00232-8","DOIUrl":"10.1016/S2542-5196(24)00232-8","url":null,"abstract":"<div><h3>Background</h3><div>Insecticide resistance among malaria vector species now occurs in 84 malaria-endemic countries and territories worldwide. Novel vector-control interventions, including long-lasting insecticidal nets (LLINs) that incorporate new active ingredients with distinct modes of action, are urgently needed to delay the evolution and spread of resistance and to alleviate reversals in malaria-control gains. We aimed to assess the longitudinal effect of two dual-active-ingredient LLINs on insecticide resistance during a cluster-randomised, controlled trial in Benin.</div></div><div><h3>Methods</h3><div>This 3-year, three-arm, cluster-randomised, controlled trial was conducted between Oct 17, 2019, and Oct 24, 2022, in three districts in southern Benin, to compare the effects of LLINs containing chlorfenapyr–pyrethroid or pyriproxyfen–pyrethroid with LLINs containing pyrethroid only. In 19 292 mosquitoes (<em>Anopheles gambiae</em> sensu lato) collected over 36 months—3 months of baseline followed by 3 years post-intervention—we measured longitudinal phenotypic insecticide resistance profiles using bioassays and genotypic resistance profiles using quantitative, real-time, reverse transcriptase PCR of metabolic resistance genes in two clusters per trial group. The trial was registered with <span><span>ClinicalTrials.gov</span><svg><path></path></svg></span>, <span><span>NCT03931473</span><svg><path></path></svg></span>.</div></div><div><h3>Findings</h3><div>In all three trial groups, a significant effect of LLINs on insecticide resistance selection was evident, with the median lethal dose (LD<sub>50</sub>) of α-cypermethrin approximately halving between baseline and 12 months post-LLIN distribution (pyrethroid-only LLIN cluster 21: LD<em><sub>50</sub></em> 78·78 μg/ml [95% CI 65·75–94·48] <em>vs</em> 35·93 [29·41–43.86] and cluster 31: 79·26 [65·40–96·44] <em>vs</em> 38·71 [30·88–48·53]; chlorfenapyr–pyrethroid LLIN cluster 43: 104·30 [82·97–133·58] <em>vs</em> 43·99 [35·30–54·86]; and pyriproxyfen–pyrethroid LLIN cluster 36: 63·76 [52·14–77·75] <em>vs</em> 37·96 [30·88–46·69] and cluster 53: 77·67 [57·63–104·56] <em>vs</em> 39·72 [29·26–53·97]). Over the subsequent 2 years, the LD<em><sub>50</sub></em> of α-cypermethrin increased past baseline values in all three trial groups (year 3 pyrethroid-only LLIN cluster 21: 141·01 [111·70–181·90] and cluster 31: 115·15 [93·90–143·09]; chlorfenapyr–pyrethroid LLIN cluster 43: 97·00 [77·24–123·54] and cluster 55: 126·99 [102·34–161·26]; and pyriproxyfen–pyrethroid LLIN cluster 36: 142·29 [112·32–184·84] and cluster 53: 109·88 [79·31–157·70]). We observed minimal reductions in chlorfenapyr susceptibility and variable but significant reductions in fertility after pyriproxyfen exposure, with an overall trend of increasing susceptibility across trial years. Several metabolic genes were implicated in resistance selection, including <em>CYP6P4</em> in the pyriproxyfen–pyrethroid LLIN group, which ","PeriodicalId":48548,"journal":{"name":"Lancet Planetary Health","volume":"8 11","pages":"Pages e894-e905"},"PeriodicalIF":24.1,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142592652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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