{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T14:08:14Z","timestamp":1779890894315,"version":"3.53.1"},"reference-count":0,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000683","name":"Royal Society of Tropical Medicine and Hygiene","doi-asserted-by":"publisher","award":["CIFF2448"],"award-info":[{"award-number":["CIFF2448"]}],"id":[{"id":"10.13039\/501100000683","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010409","name":"Children's Investment Fund Foundation","doi-asserted-by":"publisher","award":["CIFF2448"],"award-info":[{"award-number":["CIFF2448"]}],"id":[{"id":"10.13039\/100010409","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Trop Med Health"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Visceral leishmaniasis (VL) is a significant public health challenge in East Africa. Achieving the WHO 2030 target of reducing VL mortality to below 1% requires novel control strategies. In this study, we evaluated the efficacy and cost-effectiveness of three insecticide formulations for outdoor residual insecticide spraying (ORS) in selected villages of Amudat district, Uganda.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A pragmatic clustered randomised controlled field trial was conducted in five clusters. Three clusters were randomly allocated to receive ORS with either \u03b1-cypermethrin, pirimiphos-methyl, or deltamethrin, while two clusters served as untreated controls. The primary outcome was the change in sandfly counts per trap-night, measured using CDC light and sticky traps before and after the intervention. These were compared using the Wilcoxon signed-rank test to assess reductions independent of other villages. Then, we used negative binomial regression with a log link of trap-nights to model sandfly counts, which were included as an offset to account for variation in sampling effort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      After spraying the insecticides in the intervention villages, the sandfly population declined by 62%, 60%, and 49% with \u03b1-cypermethrin, pirimiphos-methyl, and deltamethrin, respectively. Sandfly captures increased by fourfold (353%) in the control villages in the same period. Using a negative binomial regression with village-clustered standard errors, \u03b1-cypermethrin reduced sandfly counts by 92% compared to the change in control villages (IRR\u2009=\u20090.08, 95% CI 0.07\u20130.38,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Pirimiphos-methyl and deltamethrin reduced counts by 91% (IRR\u2009=\u20090.09, 95% CI 0.07\u20130.45) and 89% (IRR\u2009=\u20090.11, 95% CI 0.10\u20130.56), respectively. A cost-effectiveness analysis showed that \u03b1-cypermethrin emerged as a more cost-effective option, followed by deltamethrin and lastly pirimiphos-methyl, with annual cost per village of $382, $390 and $408, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our findings provide tentative observations that may guide vector control programmes. The relatively high efficacy and favourable cost-effectiveness of \u03b1-cypermethrin are suggestive that it could be a suitable option for inclusion in integrated vector management strategies targeting outdoor sandfly populations in this region.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s41182-026-00985-9","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T13:34:10Z","timestamp":1779888850000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and cost-effectiveness of outdoor residual spraying with \u03b1-cypermethrin, pirimiphos-methyl, and deltamethrin against sand flies: a pragmatic cluster randomised controlled field trial in Uganda"],"prefix":"10.1186","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7822-4245","authenticated-orcid":false,"given":"Kamoga","family":"Livingstone","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edwin","family":"Kigozi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nelson","family":"Ssewante","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blaise","family":"Kiyimba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shamim","family":"Nabidda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elvis","family":"Seremba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Munerya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Achuma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Damiano","family":"Lomokol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nantume","family":"Olivia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick Banadda","family":"Matovu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Tamale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Sagaki","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Epuitai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felix","family":"Bongomin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scovia Nalugo","family":"Mbalinda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,27]]},"container-title":["Tropical Medicine and Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s41182-026-00985-9","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T13:34:11Z","timestamp":1779888851000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s41182-026-00985-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,27]]},"references-count":0,"alternative-id":["985"],"URL":"https:\/\/doi.org\/10.1186\/s41182-026-00985-9","relation":{},"ISSN":["1349-4147"],"issn-type":[{"value":"1349-4147","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,27]]},"assertion":[{"value":"25 February 2026","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 May 2026","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 May 2026","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This project proposal was submitted to the Mulago Hospital Research Ethics Committee for approval (Approval number: MHREC 2872). Then, local administrative clearance was also sought from the Amudat local government district health board, the Chief Administrative Officer and the Resident District Commissioner of Amudat local government district and the local council committee leaders in the villages for the study to be conducted in their area. Written informed consent was obtained from all household heads before their inclusion in the study, so that their compounds were used to set the traps and to spray the insecticides. The study was further registered in the Pan-African Clinical Trials Registry (PACTR2025045411011835).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"The authors declare no competing interests.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}