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. 2018 Dec 17;12(12):CD011654.
doi: 10.1002/14651858.CD011654.pub2.

Fly control to prevent diarrhoea in children

Jai K Das  1 , Yousaf Bashir Hadi, Rehana A Salam, Mehar Hoda, Zohra S Lassi, Zulfiqar A Bhutta
Affiliations

Fly control to prevent diarrhoea in children

Jai K Das et al. Cochrane Database Syst Rev. .

Abstract

Background: Diarrhoeal disease accounts for millions of child deaths every year. Although the role of flies as vectors of infectious diarrhoea has been established, fly control is not often mentioned as an approach to decrease childhood diarrhoea. Theoretically, fly control for decreasing diarrhoea incidence can be achieved by intervening at four different levels: reduction or elimination of fly breeding sites; reduction of sources that attract houseflies; prevention of contact between flies and disease-causing organisms; and protection of people, food, and food utensils from contact with flies.

Objectives: To assess the impact of various housefly control measures on the incidence of diarrhoea and its related morbidity and mortality in children under five years of age.

Search methods: We searched electronic databases including the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library, MEDLINE, Embase, CINAHL, and LILACS, from database inception to 24 May 2018. We also searched trial registries for relevant grey literature and ongoing trials. We checked the references of the identified studies and reviews. We did not apply any filters for language, publication status (published, unpublished, in press, and ongoing), or publication date.

Selection criteria: We planned to include randomized controlled trials (RCTs), quasi-RCTs, and controlled before-and-after studies that studied the effect of fly control on diarrhoea in children under five years of age.

Data collection and analysis: Two review authors extracted the data and independently assessed the risk of bias in the included study. We planned to contact study authors for additional information, where necessary. We assessed the certainty of the evidence using the GRADE approach.

Main results: We included one cluster-RCT (491 participants) conducted in Pakistan that evaluated insecticide spraying in the first two years and baited fly traps in the third year. Insecticide spraying reduced the fly population (house index) in the intervention group during the four months of the year when both flies and cases of diarrhoea were more common, but not at other times. On average, this was associated with a reduction in the incidence of diarrhoea in the first year (illustrative mean episodes per child-year in the intervention group was 6.3 while in the control group was 7.1) and second year of the intervention (illustrative mean episodes per child‒year in the intervention group was 4.4 while in the control group was 6.5; rate ratio (RaR) 0.77, 95% confidence interval (CI) 0.67 to 0.89, low-certainty evidence). In the third year of the intervention, the baited fly traps did not demonstrate an effect on the fly population or on diarrhoea incidence (RaR 1.15, 95% CI 0.90 to 1.47, low-certainty evidence).

Authors' conclusions: The trial, conducted in a setting where there were clear seasonal peaks in fly numbers and associated diarrhoea, shows insecticide spraying may reduce diarrhoea in children. Further research on whether this finding is applicable to other setting is required, as well as work on other fly control methods, their effects, feasibility, costs, and acceptability.

PubMed Disclaimer

Conflict of interest statement

JKD: none known. YBH: none known. RAS: none known. MH: none known. ZSL: none known. ZAB: none known.

Figures

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1
Pathways for fly control and impact on diarrhoea incidence.
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2
PRISMA diagram.
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3
‘Risk of bias' summary: review authors' judgements about each ‘Risk of bias' item for each included study.
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD011654

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References to other published versions of this review

Das 2015
    1. Das JK, Salam RA, Hoda M, Lassi ZS, Bhutta ZA. Interventions to control flies for preventing diarrhoea in children under five years of age. Cochrane Database of Systematic Reviews 2015, Issue 4. [DOI: 10.1002/14651858.CD011654] - DOI

Publication types