DDT-based indoor residual spraying suboptimal for visceral leishmaniasis elimination in India.

Abstract

Indoor residual spraying (IRS) is used to control visceral leishmaniasis (VL) in India, but it is poorly quality assured. Quality assurance was performed in eight VL endemic districts in Bihar State, India, in 2014. Residual dichlorodiphenyltrichloroethane (DDT) was sampled from walls using Bostik tape discs, and DDT concentrations [grams of active ingredient per square meter (g ai/m(2))] were determined using HPLC. Pre-IRS surveys were performed in three districts, and post-IRS surveys were performed in eight districts. A 20% threshold above and below the target spray of 1.0 g ai/m(2) was defined as "in range." The entomological assessments were made in four districts in IRS and non-IRS villages. Vector densities were measured: pre-IRS and 1 and 3 mo post-IRS. Insecticide susceptibility to 4% DDT and 0.05% deltamethrin WHO-impregnated papers was determined with wild-caught sand flies. The majority (329 of 360, 91.3%) of pre-IRS samples had residual DDT concentrations of <0.1 g ai/m(2). The mean residual concentration of DDT post-IRS was 0.37 g ai/m(2); 84.9% of walls were undersprayed, 7.4% were sprayed in range, and 7.6% were oversprayed. The abundance of sand flies in IRS and non-IRS villages was significantly different at 1 mo post-IRS only. Sand flies were highly resistant to DDT but susceptible to deltamethrin. The Stockholm Convention, ratified by India in 2006, calls for the complete phasing out of DDT as soon as practical, with limited use in the interim where no viable IRS alternatives exist. Given the poor quality of the DDT-based IRS, ready availability of pyrethroids, and susceptibility profile of Indian sand flies, the continued use of DDT in this IRS program is questionable.

• Authors: Michael Coleman, Geraldine M Foster, Rinki Deb, Rudra Pratap Singh, Hanafy M Ismail, Pushkar Shivam, Ayan Kumar Ghosh, Sophie Dunkley, Vijay Kumar, Marlize Coleman, Janet Hemingway, Mark J I Paine, Pradeep Das
• Journal: Proceedings of the National Academy of Sciences of the United States of America (Proc Natl Acad Sci U S A) Vol. 112 Issue 28 Pg. 8573-8 (Jul 14 2015) ISSN: 1091-6490 [Electronic] United States
• PMID: 26124110 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Insecticides
• DDT

Topics

• Animals
• DDT
• Humans
• India (epidemiology)
• Insect Vectors
• Insecticide Resistance
• Insecticides
• Leishmaniasis, Visceral (epidemiology, prevention & control)
• Psychodidae