None listed
Conditions
Brief summary
Malaria is an infectious disease spread by mosquitoes that causes significant illness and death in tropical regions worldwide. In some areas of South-East Asia, including Myanmar, malaria drugs do not work as well as they did in the past. This is because malaria is developing resistance to the drugs. Because of drug resistance it is important to improve ways to control malaria. Individuals may be able to protect themselves from getting malaria by using personal insect repellent. Currently there is limited published evidence to support the use of mosquito repellents for malaria control in Myanmar and indeed South-East Asia. The purpose of this study is to find out whether distributing personal insect repellent to high risk populations (mobile and migrant people and forest dwellers) through Village Health Volunteers (VHV) reduces malaria. Mobile and migrant people and forest dwellers living in selected villages in South-East Myanmar will receive personal insect repellent from VHV to apply to their skin to prevent mosquitoes biting them. For research purposes we will decide in advance the date when people in each village receive repellent and this date will be different for different villages. The length of time that people in villages have been using repellent will be compared to the number of cases of malaria in that village over time. In this way, we will be able to see whether insect repellent distributed through VHV protects people against malaria. The 116 villages that have been selected for this study represent isolated or hard-to-reach territories identified by the Myanmar National Malaria Control Program (NMCP) as lacking malaria services. Each village will have its own VHV who will be trained in providing malaria services to their village. Malaria Officers of Karuna Mission Social Solidarity (KMSS) and VHVs will be responsible for distributing repellent in villages and surrounding areas. In addition, VHVs will perform malaria testing by using rapid diagnostic tests (RDT) on people in the village and surrounding areas to see whether they have malaria. This will be done if a person goes to see their VHV because they are sick and suspect that they may have malaria or actively by the VHV as a screening approach in the village and surrounding areas. RDTs involve taking a small pin-prick of blood from person’s finger to determine if it contains malaria infection. Information about testing and cases of malaria in each village will be collected on a monthly basis. RDTs are good for testing whether someone is infected with malaria at the time of the test, but RDTs cannot test 1) whether someone carries drug resistant malaria, or 2) if they have been exposed to malaria at another time. Other tests based on malaria genetic and antibody analysis respectively can be used to determine this. At the same time that VHVs are performing RDTs, another two drops of blood will be collected from the person’s finger and absorbed onto a piece of filter paper.
Interventions
The type of insect repellent to be distributed is N, N-diethyl-benzamide – 12% w/w, cream, 100g tube. Malaria Officers and Village Health Volunteers (VHV) will deliver repellent to migrant and mobile workers and forest dwellers by visiting dwellings where they are staying. At the time of delivery, the proper use of repellent will be explained in ethnic language (including: what is repellent and how it works; how to use/apply it (frequency, body area to apply, body parts not to apply etc); any da
The type of insect repellent to be distributed is N, N-diethyl-benzamide – 12% w/w, cream, 100g tube. Malaria Officers and Village Health Volunteers (VHV) will deliver repellent to migrant and mobile workers and forest dwellers by visiting dwellings where they are staying. At the time of delivery, the proper use of repellent will be explained in ethnic language (including: what is repellent and how it works; how to use/apply it (frequency, body area to apply, body parts not to apply etc); any danger/side effect and procedure for any unwanted event; contraindications; how to store it and replenish it). Participants will receive 2 tubes of repellent. When the first tube is finished recipients of the repellent will go to their VHV and exchange the depleted tube with a new tube to continue the usage of repellent.). Recipients of the repellent will be told to inform their VHV before they run out of repellent and it will be replenished to continue the usage of repellent. Given the study design, blocks of villages are stepped into the intervention at monthly intervals such that a village may be exposed to repellent distribution for a minimum of one-month or a maximum of 14-months. Chief Investigators will undertake additional sensitivity analyses exploring the extent to which the intervention was effectively distributed to and applied by village residents. Data pertaining to repellent distribution, application and knowledge of both VHVs and village residents will be sampled through surveys and will be used to conduct these additional analyses.
Sponsors
Burnet Institute
Study design
Allocation
Randomised controlled trial
Intervention model
Other
Primary purpose
Prevention
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Healthy volunteers
Yes
Inclusion criteria
Study sites: Villages included in the 3 Millenium Development Goal Village Health Volunteer project will be considered for inclusion in this study. Participants: Men and women of all ages (including children) who are willing to undergo RDT test for malaria will be included. High risk populations (mobile and migrant people and residents who are also forest dwellers) will be identified by questionnaries, mapped and targeted to receive the repellent.
Exclusion criteria
Study sites: Villages included in the 3 Millenium Development Goal Village Health Volunteer project which had already received repellent.
Outcome results
None listed