Insecticide Strategies May Worsen Dengue Epidemics

Such approaches increase insecticide resistance, researchers say

TUESDAY, May 3 (HealthDay News) -- Insecticide-based strategies for dengue control may result in worse future epidemics due to increased insecticide resistance and lower herd immunity, according to research published online May 3 in The Lancet.

Paula Mendes Luz, Ph.D., of the Yale University School of Medicine in New Haven, Conn., and colleagues developed a dynamic model of dengue transmission to assess the evolution of insecticide resistance and immunity in the human population. They measured the dengue health burden in terms of disability-adjusted life-years lost and performed cost-effectiveness analyses of 43 insecticide-based vector control strategies.

The researchers found that all strategies resulted in insecticide resistance. That, together with a loss of herd immunity, will result in worse dengue epidemics in the future, the authors predict. In their model, high-efficacy larval control, applied at least once yearly, reduced the dengue burden up to two years, while adult vector control applied three or more times yearly reduced the dengue burden up to four years. The authors concluded that six high-efficacy adult vector control applications yearly would probably meet standards of cost-effectiveness established by the World Health Organization.

"Year-round larval control can be counterproductive, exacerbating epidemics in later years because of evolution of insecticide resistance and loss of herd immunity. We suggest the reassessment of vector control policies that are based on larval control only," the authors write.

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