An evidence-based vector control strategy for military deployments: the British Army experience

Area of Science:

• Military Entomology
• Public Health
• Tropical Medicine

Background:

• Overseas military deployments face risks from arthropod-borne diseases.
• Effective vector control is crucial for troop health and operational readiness.

Purpose of the Study:

• To outline the British Army's current strategy for arthropod vector control.
• To define a hierarchy of evidence-based vector control guidelines for military use.

Main Methods:

• Review of scientific evidence for vector control efficacy.
• Assessment of benefits and harms of different control technologies.
• Prioritization of guidelines based on research, especially randomized controlled trials (RCTs) and systematic reviews.

Main Results:

• Pyrethroid-treated bed nets and screens are highly effective against nocturnal arthropods, reducing disease incidence (malaria, leishmaniasis, filariasis, Chagas' disease).
• Insecticide-treated clothing, protective clothing, and DEET repellents are effective.
• Aerosol insecticides, biological controls, and electrocuters show limited or no effectiveness.

Conclusions:

• A combination of practical insect avoidance, pyrethroid-treated nets/clothing, and DEET repellents provides near-complete protection against biting arthropods.
• Etofenprox and deltamethrin are the safest pyrethroids; permethrin is least safe.
• Military commanders and medical officers share complementary roles in vector control.