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. 2019 Aug 14;8(8):CD012736.
doi: 10.1002/14651858.CD012736.pub2.

Larviciding to prevent malaria transmission

Leslie Choi #  1 , Silas Majambere, Anne L Wilson #
Affiliations

Larviciding to prevent malaria transmission

Leslie Choi et al. Cochrane Database Syst Rev. .

Abstract

Background: Larviciding refers to the regular application of chemical or microbial insecticides to water bodies or water containers to kill the aquatic immature forms of the mosquito (the larvae and pupae).

Objectives: To summarize research evidence evaluating whether larviciding with chemical or microbial insecticides prevents malaria transmission.

Search methods: We searched the Cochrane Infectious Diseases Group Specialized Register; the Cochrane Central Register of Controlled Trials (CENTRAL), published in the Cochrane Library; MEDLINE; Embase; CAB Abstracts; LILACS; the World Health Organization International Clinical Trials Registry Platform (WHO ICTRP); ClinicalTrials.gov; and the ISRCTN registry up to 6 June 2019.

Selection criteria: We included cluster-randomized controlled trials (cRCTs), interrupted time series (ITS), randomized cross-over studies, non-randomized cross-over studies, and controlled before-and-after studies (CBAs) that compared larviciding with no larviciding.

Data collection and analysis: We independently assessed trials for eligibility and risk of bias, and extracted data. We assessed the certainty of evidence using the GRADE approach.

Main results: Four studies (one cRCT, two CBAs, and one non-randomized cross-over design) met the inclusion criteria. All used ground application of larvicides (people hand-delivering larvicides); one evaluated chemical and three evaluated microbial agents. Studies were carried out in The Gambia, Tanzania, Kenya, and Sri Lanka. Three studies were conducted in areas where mosquito aquatic habitats were less extensive (< 1 km²), and one where habitats were more extensive (> 1 km²; a cross-over study from The Gambia).For aquatic habitats of less than 1 km², one cRCT randomized eight villages in Sri Lanka to evaluate chemical larviciding using insect growth regulator; and two CBA studies undertaken in Kenya and Tanzania evaluated microbial larvicides. In the cRCT, larviciding across all villages was associated with lower malaria incidence (rate ratio 0.24, 4649 participants, low-certainty evidence) and parasite prevalence (risk ratio (RR) 0.26, 5897 participants, low-certainty evidence) compared to no larviciding. The two CBA studies reported lower malaria prevalence during the intervention period (parasite prevalence RR 0.79, 95% confidence interval (CI) 0.71 to 0.89; 70,902 participants; low-certainty evidence). The Kenyan study also reported a reduction in the incidence of new malaria cases (RR 0.62, 95% CI 0.38 to 1.01; 720 participants; very low-certainty evidence).For aquatic habitats of more than 1 km², the non-randomized cross-over trial using microbial larvicides did not detect an effect for malaria incidence (RR 1.58, 95% CI 0.94 to 2.65; 4226 participants), or parasite prevalence (RR 1.15, 95% CI 0.41 to 3.20; 3547 participants); both were very low-certainty evidence. The Gambia trial also reported the mean haemoglobin level, and there was no difference across the four comparisons (mean difference -0.13, 95% CI -0.40 to 0.13; 3586 participants).We were unable to summarize or pool entomological outcomes due to unreported and missing data.

Authors' conclusions: Most controlled studies on larviciding have been performed with microbial agents. Ground larviciding for non-extensive larval habitats may have an effect on malaria transmission, and we do not know if there is an effect in large-scale aquatic habitats. We found no studies using larviciding application techniques that could cover large aquatic habitats, such as aerial spraying using aircraft.

PubMed Disclaimer

Conflict of interest statement

LC has no known conflicts of interest.

SM is an independent consultant, and occasionally advises governments on malaria control. His main sources of consultancy work are from a research project funded by the Innovative Vector Control Consortium (IVCC). The title of the review is related to the use of insecticide applications for malaria vector control. The IVCC as an organization has a programme of working with industry on the development of novel insecticides and other vector control tools. He is a co‐chair of the Larval Source Management workstream of the Roll Back Malaria's Vector Control Working Group. SM was a primary investigator and author of one study reviewed. He was not involved in the screening, data extraction, risk of bias assessment, and analysis for this particular study.

AW sits on the Innovative Vector Control Consortium (IVCC) External Scientific Advisory Committee 1 (ESAC1), which provides the IVCC management team with independent scientific advice on all projects proposed to the IVCC relating to the development of new products for malaria vector control.

Figures

1
1
Logic model of the proposed effect of larviciding on various entomological and epidemiological outcomes. EIR: entomological inoculation rate.
2
2
Study flow diagram.
3
3
Risk of bias summary: review authors' judgements about each risk of bias item for each included study.
1.1
1.1. Analysis
Comparison 1 Larviciding versus no larviciding, Outcome 1 Malaria incidence (cluster‐randomized controlled trial (cRCT)).
1.2
1.2. Analysis
Comparison 1 Larviciding versus no larviciding, Outcome 2 Malaria incidence with subgrouping by extent of aquatic habitat (non‐randomized study (NRS)).
1.3
1.3. Analysis
Comparison 1 Larviciding versus no larviciding, Outcome 3 Parasite prevalence (cRCTs).
1.4
1.4. Analysis
Comparison 1 Larviciding versus no larviciding, Outcome 4 Parasite prevalence (NRS).
1.5
1.5. Analysis
Comparison 1 Larviciding versus no larviciding, Outcome 5 Parasite prevalence with subgrouping by extent of aquatic habitat.
1.6
1.6. Analysis
Comparison 1 Larviciding versus no larviciding, Outcome 6 Mean haemoglobin level.
See this image and copyright information in PMC

Update of

  • doi: 10.1002/14651858.CD012736

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References to other published versions of this review

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