Vector control by insecticide-treated nets in the fight against visceral leishmaniasis in the Indian subcontinent, what is the evidence?
Visceral leishmaniasis (VL) is a deadly vector-borne disease that causes an estimated 500 000 new cases a year. In India, Nepal and Bangladesh, VL is caused by Leishmania donovani, which is transmitted from man to man by the sandfly Phlebotomus argentipes. In 2005, these three countries signed a memorandum of understanding to eliminate VL from the region. Integrated vector management is one of the pillars of this elimination strategy, alongside early case detection and treatment. We reviewed the evidence of effectiveness of different vector control methods, to examine the potential role of insecticide treated bednets (ITNs). Indoor residual spraying has shown poor impact for various reasons and resistance to DDT is emerging in Bihar. Environmental management performed poorly compared to insecticide based methods. ITNs could give individual protection but this still needs to be proven in randomized trials. Given the constraints of indoor residual spraying, it is worthwhile to further explore the use of ITNs, in particular long lasting ITNs, as an additional tool in the VL elimination initiative.
Institute of Tropical Medicine, Antwerp, Belgium. bostyn@itg.be
Bart
B
Ostyn
Veerle
V
Vanlerberghe
Albert
A
Picado
Diwakar Singh
DS
Dinesh
Shyam
S
Sundar
François
F
Chappuis
Suman
S
Rijal
Jean-Claude
JC
Dujardin
Marc
M
Coosemans
Marleen
M
Boelaert
Clive
C
Davies
D000818:Animals; D001459:Bangladesh; D001512:Bedding and Linens; D006801:Humans; D007194:India; D007300:Insect Control / Q000379:methods*; D007302:Insect Repellents; D007303:Insect Vectors / Q000469:parasitology*; D007306:Insecticides; D007893:Leishmania donovani / Q000302:isolation & purification; D007898:Leishmaniasis, Visceral / Q000517:prevention & control* / Q000635:transmission; D009390:Nepal; D010691:Phlebotomus / Q000469:parasitology*
D007302:Insect Repellents; D007306:Insecticides