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Effect of insecticide-treated bed nets on visceral leishmaniasis incidence in Bangladesh. A retrospective cohort analysis

PLoS Neglected Tropical Diseases Sep 21, 2019

Chowdhury R, Chowdhury V, Faria S, et al. - Researchers investigated how visceral leishmaniasis (VL) incidence in a highly endemic sub-district (upazila) in Bangladesh is affected by long lasting insecticide treated bed nets (LLIN) and bed nets impregnated with slow-release insecticide tablet K-O TAB 1-2-3 (jointly insecticide-treated nets or ITN). Under three research projects, LLIN or K-O TAB 1-2-3 was distributed for self-impregnation of bed nets at home in Fulbaria upazila, Mymensigh district from 2004 to 2008, respectively funded by CDC, Atlanta, USA (2004) and WHO-TDR, Geneva, Switzerland (2006 & 2008). The “exposed cohort” comprised all households (n = 8,142) in the 20 villages that had benefited in the past from one of these interventions (1,295 donated LLIN and 11,918 local bed nets impregnated with K-O TAB 1-2-3). In the “non-exposed cohort”, they included villages with contemporaneously similar incidence rates who had not received such vector control interventions (7,729 HHs from nine villages). The ITN intervention cohort had significantly lower VL incidence rate relative to control in Bangladesh. Although some bias due to more intense screen-and-treat activities or other interventions in the intervention area cannot be ruled out, consideration should be given to ITNs for integrated vector control during the maintenance phase of the VL elimination program as these are feasible and sustainable.
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