Evaluating the efficacy, impact, and feasibility of community-based house screening as a complementary malaria control intervention in southern Africa: a study protocol for a household randomized trial

Trials

Onyango P. Sangoro¹  Theresia Estomih Nkya¹  Kassie Menale¹  Rose Marubu¹  Ulrike Fillinger¹  Brian Chisanga²  Kochelani Saili³  Clifford Maina Mutero³  Joseph Mberikunashe⁴  Candrinho Baltazar⁵  Busiku Hamainza⁶  Casper Tarumbwa⁷  Freddie Masaninga⁸  Sonia Casimiro Trigo⁹  Emmanuel Chanda^1,10 

[1] International Centre of Insect Physiology and Ecology, Nairobi, Kenya;International Centre of Insect Physiology and Ecology, Nairobi, Kenya;Department of Social Sciences, Wageningen University and Research, Wageningen, Netherlands;International Centre of Insect Physiology and Ecology, Nairobi, Kenya;School of Health Systems & Public Health, University of Pretoria, Pretoria, South Africa;National Malaria Control Programme, Harare, Zimbabwe;National Malaria Control Programme, Maputo, Mozambique;National Malaria Elimination Centre, Lusaka, Zambia;World Health Organization, Harare, Zimbabwe;World Health Organization, Lusaka, Zambia;World Health Organization, Maputo, Mozambique;World Health Organization, Regional Office for Africa, Brazzaville, Congo;

关键词: Integrated vector management;    House screening;    Malaria elimination;    Residual malaria transmission;   

DOI  :  10.1186/s13063-021-05768-7

来源: Springer

【 摘 要 】

BackgroundConcerted effort to control malaria has had a substantial impact on the transmission of the disease in the past two decades. In areas where reduced malaria transmission is being sustained through insecticide-based vector control interventions, primarily long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS), non-insecticidal complementary tools will likely be needed to push towards malaria elimination. Once interruption in local disease transmission is achieved, insecticide-based measures can be scaled down gradually and eventually phased out, saving on costs of sustaining control programs and mitigating any unintended negative health and environmental impacts posed by insecticides. These non-insecticidal methods could eventually replace insecticidal methods of vector control.House screening, a non-insecticidal method, has a long history in malaria control, but is still not widely adopted in sub-Saharan Africa. This study aims to add to the evidence base for this intervention in low transmission settings by assessing the efficacy, impact, and feasibility of house screening in areas where LLINs are conventionally used for malaria control.MethodsA two-armed, household randomized clinical trial will be conducted in Mozambique, Zambia, and Zimbabwe to evaluate whether combined the use of house screens and LLINs affords better protection against clinical malaria in children between 6 months and 13 years compared to the sole use of LLINs. Eight hundred households will be enrolled in each study area, where 400 households will be randomly assigned the intervention, house screening, and LLINs while the control households will be provided with LLINs only. Clinical malaria incidence will be estimated by actively following up one child from each household for 6 months over the malaria transmission season. Cross-sectional parasite prevalence will be estimated by testing all participating children for malaria parasites at the beginning and end of each transmission season using rapid diagnostic tests.CDC light traps and pyrethrum spray catches (PSC) will be used to sample adult mosquitoes and evaluate the impact of house screening on indoor mosquito density, species distribution, and sporozoite rates.DiscussionThis study will contribute epidemiological data on the impact of house screening on malaria transmission and assess the feasibility of its implementation on a programmatic scale.Trial registrationClinicalTrials.gov PACTR202008524310568. Registered on August 11, 2020.

【 授权许可】

CC BY