Malaria, Falciparum
Conditions
Keywords
Mosquito Control, Insecticide Resistance
Brief summary
The purpose of the study is to determine whether long lasting insecticidal nets and indoor residual insecticide spraying, alone or in combination, are effective for controlling insecticide resistant anopheles mosquitoes for malaria prevention.
Detailed description
The study will assess the impact that insecticide resistance has on the effectiveness of malaria vector control tools LLIN and IRS. This is done by a cluster randomised trials of universal coverage LLINs versus universal coverage LLINs in combination with IRS, with levels of baseline insecticide resistance in the main vector balanced between the two study arms. In each cluster resistance to the insecticide used on LLINs is monitored, and malaria incidence is estimated from cluster specific cohorts of children followed up over the duration of the study. Resistance impact will be assessed from the ratio of incidence rates in clusters with high compared to those with low resistance and from a continuous measure of resistance expressed as percentage loss of mosquito mortality when exposed to insecticide in standardised WHO tests. Resistance mechanisms will be studied in subsets of study clusters.
Interventions
OTHERIndoor residual insecticide spraying (IRS)
Application of insecticide to interior walls of domiciliary structures to kill malaria vector mosquitoes which rest on walls after taking human blood meal
DEVICELong Lasting Insecticidal Nets (LLIN)
Provision of LLIN to all community members in the clusters allocated to the study arm. LLIN protect individuals from bites by malaria vector mosquitoes by providing a physical barrier and insecticidal and repellent effect.
Sponsors
Federal Ministry of Health, Sudan
World Health Organization
Liverpool School of Tropical Medicine
London School of Hygiene and Tropical Medicine
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
6 Months to 10 Years
Healthy volunteers
Yes
Inclusion criteria
* Children older than 6 months and younger than 10 years in approximately 100 randomly selected households in all 140 study clusters selected in the four study areas
Exclusion criteria
* Children living in households within 1 km from the edge of a neighbouring cluster (the buffer zone)
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Malaria Incidence | 3 years | Infection with malarial parasites determined by rapid diagnostic tests/microscopy in cohort members who report or have fever (\>37.5C) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Prevalence of P.falciparum Infection | 3 years | Infection with plasmodial parasites (falciparum and/or vivax) in randomly selected members of the study cohort in each study cluster during the peak of the malaria transmission season by rapid diagnostic test |
| Entomological Innoculation rate | Average for months Sept, Oct, Nov for years 2011, 2012, 2013 | Anopheles arabiensis mosquitoes collected in sentinel clusters by light trap, window trap, clay pot and pyrethrum sheet collection and determination of sporozoite, human blood index, feeding and resting behaviour. |
| Frequency of insecticide resistance associated genotypes (kdr) in anopheles arabiensis | Yearly average 2011, 2012, 2013, 2014 | Molecular analysis of mosquito specimens caught in subset of clusters by pyrethrum spray collection. |
Countries
Sudan
Contacts
Primary ContactHmooda T Kafy, MSc (London)
Backup ContactBashir A Ismail, MSc (USM)
Outcome results
None listed