Assessment of the effect of larval source management and house improvement on malaria transmission when added to standard malaria control strategies in southern Malawi: study protocol for a cluster-randomised controlled trial

BMC Infectious Diseases

Study Protocol

Michèle van Vugt¹  Themba Mzilahowa²  Kamija S. Phiri²  Steven Gowelo²  Alinune N. Kabaghe³  Michael G. Chipeta⁴  Nicolas Maire⁵  Aurelio Di Pasquale⁵  Peter J. Diggle⁶  Dianne J. Terlouw⁷  Willem Takken⁸  Henk van den Berg⁸  Monicah M. Mburu⁹  Robert S. McCann^1,10 

[1] Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands;College of Medicine, University of Malawi, Blantyre, Malawi;College of Medicine, University of Malawi, Blantyre, Malawi;Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands;College of Medicine, University of Malawi, Blantyre, Malawi;Lancaster University, Lancaster, UK;Malawi-Liverpool Wellcome Trust, Blantyre, Malawi;Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland;University of Basel, Basel, Switzerland;Lancaster University, Lancaster, UK;Liverpool School of Tropical Medicine, Liverpool, UK;Malawi-Liverpool Wellcome Trust, Blantyre, Malawi;Wageningen University and Research, Wageningen, The Netherlands;Wageningen University and Research, Wageningen, The Netherlands;College of Medicine, University of Malawi, Blantyre, Malawi;Wageningen University and Research, Wageningen, The Netherlands;College of Medicine, University of Malawi, Blantyre, Malawi;Laboratory of Entomology, Wageningen University and Research, PO Box 16, 6700, Wageningen, AA, The Netherlands;

关键词: Anopheles;    Integrated vector management;    Larval source management;    House improvement;    Vector control;    Malaria transmission;    Community participation;   

DOI  :  10.1186/s12879-017-2749-2

 received in 2017-01-31, accepted in 2017-09-19,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundDue to outdoor and residual transmission and insecticide resistance, long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) will be insufficient as stand-alone malaria vector control interventions in many settings as programmes shift toward malaria elimination. Combining additional vector control interventions as part of an integrated strategy would potentially overcome these challenges. Larval source management (LSM) and structural house improvements (HI) are appealing as additional components of an integrated vector management plan because of their long histories of use, evidence on effectiveness in appropriate settings, and unique modes of action compared to LLINs and IRS. Implementation of LSM and HI through a community-based approach could provide a path for rolling-out these interventions sustainably and on a large scale.Methods/designWe will implement community-based LSM and HI, as additional interventions to the current national malaria control strategies, using a randomised block, 2 × 2 factorial, cluster-randomised design in rural, southern Malawi. These interventions will be continued for two years. The trial catchment area covers about 25,000 people living in 65 villages. Community participation is encouraged by training community volunteers as health animators, and supporting the organisation of village-level committees in collaboration with The Hunger Project, a non-governmental organisation. Household-level cross-sectional surveys, including parasitological and entomological sampling, will be conducted on a rolling, 2-monthly schedule to measure outcomes over two years (2016 to 2018). Coverage of LSM and HI will also be assessed throughout the trial area.DiscussionCombining LSM and/or HI together with the interventions currently implemented by the Malawi National Malaria Control Programme is anticipated to reduce malaria transmission below the level reached by current interventions alone. Implementation of LSM and HI through a community-based approach provides an opportunity for optimum adaptation to the local ecological and social setting, and enhances the potential for sustainability.Trial RegistrationRegistered with The Pan African Clinical Trials Registry on 3 March 2016, trial number PACTR201604001501493.

【 授权许可】

CC BY   
© The Author(s). 2017