title: Insecticide impregnated curtains to control domestic transmission of cutaneous leishmaniasis in Venezuela: cluster randomised trial.
abstract: OBJECTIVE
  To measure the impact on transmission of leishmaniasis of curtains impregnated with insecticide.
  
  
  METHODS
  Cluster randomised controlled trial: household interview survey, observational study of people's behaviour, entomological study with light trap captures of sandflies inside houses.
  
  
  METHODS
  14 urban sectors in Trujillo, Venezuela.
  
  
  METHODS
  2913 inhabitants of 569 houses.
  
  
  METHODS
  Sectors were paired according to their 12 month cumulative incidence of cutaneous leishmaniasis, one sector in each pair was randomly allocated to receive polyester curtains impregnated with lambdacyhalothrin (intervention group) while the other sector received curtains without insecticide or no curtains (control groups). After 12 months a follow up household survey was conducted.
  
  
  METHODS
  Reduction in abundance of sandflies indoors and 12 month incidence of clinical cases of cutaneous leishmaniasis.
  
  
  RESULTS
  Transmission of cutaneous leishmaniasis occurred mainly in the domestic setting, with the incidence over 12 months of 4%. The mean number of sandflies per trap per night was 16. After follow up the 12 month incidence of cutaneous leishmaniasis was 0% in the intervention group and 8% in the six pairs in the control group that received unimpregnated curtains (mean difference 8, 95% confidence interval 4.22 to 11.78; P=0.001). There were significantly fewer sandflies in the intervention group (2 v 15, mean difference 13 sandflies per trap; 9 to 17; P<0.001).
  
  
  CONCLUSIONS
  Curtains impregnated with insecticide provide a high degree of protection against indoor transmission of cutaneous leishmaniasis.
authors.affiliation: School of Tropical Medicine, Liverpool L3 5QA. A.Kroeger@liverpool.ac.uk
authors.forename: Axel
authors.initials: A
authors.lastname: Kroeger
authors.forename: Elci Villegas
authors.initials: EV
authors.lastname: Avila
authors.forename: Linda
authors.initials: L
authors.lastname: Morison
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000818:Animals; D001512:Bedding and Linens; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007300:Insect Control / Q000379:methods*; D007306:Insecticides; D016773:Leishmaniasis, Cutaneous / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D008297:Male; D008875:Middle Aged; D009570:Nitriles; D011576:Psychodidae / Q000469:parasitology; D011722:Pyrethrins; D014504:Urban Health; D014687:Venezuela / Q000453:epidemiology
chemical_list: D007306:Insecticides; D009570:Nitriles; D011722:Pyrethrins; C037304:cyhalothrin