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Comparison of Insecticide-Treated Nets and Indoor Residual Spraying to Control the Vector of Visceral Leishmaniasis in Mymensingh District, Bangladesh

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  • Regional Office for South-East Asia, World Health Organization, New Delhi, India; National Institute of Preventive and Social Medicine, Mohakhali 1212 Dhaka, Bangladesh; Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia; Department of Zoology, University of Dhaka, Dhaka, Bangladesh; Special Programme for Research and Training in Tropical Diseases, World Health Organization, Geneva, Switzerland; Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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Integrated vector management is a pillar of the South Asian visceral leishmaniasis (VL) elimination program, but the best approach remains a matter of debate. Sand fly seasonality was determined in 40 houses sampled monthly. The impact of interventions on Phlebotomus argentipes density was tested from 2006–2007 in a cluster-randomized trial with four arms: indoor residual spraying (IRS), insecticide-treated nets (ITNs), environmental management (EVM), and no intervention. Phlebotomus argentipes density peaked in March with the highest proportion of gravid females in May. The EVM (mud plastering of wall and floor cracks) showed no impact. The IRS and ITNs were associated with a 70–80% decrease in male and female P. argentipes density up to 5 months post intervention. Vector density rebounded by 11 months post-IRS, whereas ITN-treated households continued to show significantly lower density compared with households without intervention. Our data suggest that both IRS and ITNs may help to improve VL control in Bangladesh.

Author Notes

*Address correspondence to Caryn Bern, 4770 Buford Highway NE (MS F-22), Centers for Disease Control and Prevention, Atlanta, GA 30341. E-mail: cxb9@cdc.gov

Financial support: The 2002–2003 study was funded by a grant from the Centers for Disease Control and Prevention Emerging Infections Initiative. The 2006–2007 study was funded by the Special Programme for Research and Training in Tropical Diseases, World Health Organization.

Authors' addresses: Rajib Chowdhury, Regional Office for South-East Asia, World Health Organization, Indraprastha Estate, Mahatma Gandhi Marg, New Delhi, India, E-mail:rajib478@yahoo.com. Ellen Dotson, Anna J. Blackstock, Shannon McClintock, and Caryn Bern, Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention (DPD/CDC), Atlanta, GA, E-mails: ebd6@cdc.gov, hyp9@cdc.gov, smcclin@emory.edu, and cxb9@cdc/gov. Narayan P. Maheswary, Shyla Faria, Saiful Islam, and Shireen Akhter, National Institute of Preventive and Social Medicine, Dhaka, Bangladesh, E-mails: narayanmaheswary@yahoo.com, shylafaria@yahoo.com, tapu_fh@yahoo.com, and shireen_nipsom@yahoo.com. Tangin Akter, Department of Zoology, University of Dhaka, Dhaka, Bangladesh, E-mail: aktertl@yahoo.com. Axel Kroeger, Special Programme for Research and Training in Tropical Diseases, World Health Organization, Geneva, Switzerland, E-mail: kroegera@who.int.

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