Evaluating the impact of screening plus eave tubes on malaria transmission compared to current best practice in central Côte d’Ivoire: a two armed cluster randomized controlled trial

Abstract Background Access to long-lasting insecticidal nets (LLINs) has increased and malaria has decreased globally, but malaria transmission remains high in parts of sub-Saharan Africa and insecticide resistance threatens current progress. Eave tubes are a new tool for the targeted delivery of in...

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Main Authors: Eleanore D. Sternberg, Jackie Cook, Ludovic P. Ahoua Alou, Carine J. Aoura, Serge Brice Assi, Dimi Théodore Doudou, A. Alphonsine Koffi, Raphael N’Guessan, Welbeck A. Oumbouke, Rachel A. Smith, Eve Worrall, Immo Kleinschmidt, Matthew B. Thomas
Format: Article
Language:English
Published: BMC 2018-07-01
Series:BMC Public Health
Subjects:
SET
Online Access:http://link.springer.com/article/10.1186/s12889-018-5746-5
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author Eleanore D. Sternberg
Jackie Cook
Ludovic P. Ahoua Alou
Carine J. Aoura
Serge Brice Assi
Dimi Théodore Doudou
A. Alphonsine Koffi
Raphael N’Guessan
Welbeck A. Oumbouke
Rachel A. Smith
Eve Worrall
Immo Kleinschmidt
Matthew B. Thomas
spellingShingle Eleanore D. Sternberg
Jackie Cook
Ludovic P. Ahoua Alou
Carine J. Aoura
Serge Brice Assi
Dimi Théodore Doudou
A. Alphonsine Koffi
Raphael N’Guessan
Welbeck A. Oumbouke
Rachel A. Smith
Eve Worrall
Immo Kleinschmidt
Matthew B. Thomas
Evaluating the impact of screening plus eave tubes on malaria transmission compared to current best practice in central Côte d’Ivoire: a two armed cluster randomized controlled trial
BMC Public Health
Eave tubes
Screening plus eave tubes
SET
Housing
House screening
Malaria control
author_facet Eleanore D. Sternberg
Jackie Cook
Ludovic P. Ahoua Alou
Carine J. Aoura
Serge Brice Assi
Dimi Théodore Doudou
A. Alphonsine Koffi
Raphael N’Guessan
Welbeck A. Oumbouke
Rachel A. Smith
Eve Worrall
Immo Kleinschmidt
Matthew B. Thomas
author_sort Eleanore D. Sternberg
title Evaluating the impact of screening plus eave tubes on malaria transmission compared to current best practice in central Côte d’Ivoire: a two armed cluster randomized controlled trial
title_short Evaluating the impact of screening plus eave tubes on malaria transmission compared to current best practice in central Côte d’Ivoire: a two armed cluster randomized controlled trial
title_full Evaluating the impact of screening plus eave tubes on malaria transmission compared to current best practice in central Côte d’Ivoire: a two armed cluster randomized controlled trial
title_fullStr Evaluating the impact of screening plus eave tubes on malaria transmission compared to current best practice in central Côte d’Ivoire: a two armed cluster randomized controlled trial
title_full_unstemmed Evaluating the impact of screening plus eave tubes on malaria transmission compared to current best practice in central Côte d’Ivoire: a two armed cluster randomized controlled trial
title_sort evaluating the impact of screening plus eave tubes on malaria transmission compared to current best practice in central côte d’ivoire: a two armed cluster randomized controlled trial
publisher BMC
series BMC Public Health
issn 1471-2458
publishDate 2018-07-01
description Abstract Background Access to long-lasting insecticidal nets (LLINs) has increased and malaria has decreased globally, but malaria transmission remains high in parts of sub-Saharan Africa and insecticide resistance threatens current progress. Eave tubes are a new tool for the targeted delivery of insecticides against mosquitoes attempting to enter houses. The primary objective of this trial is to test whether screening plus eave tubes (SET) provides protection against malaria, on top of universal coverage with LLINs in an area of intense pyrethroid resistance. The trial will also assess acceptability and cost-effectiveness of the intervention. Methods/design A two-armed, cluster randomized controlled trial will be conducted to evaluate the effect of SET on clinical malaria incidence in children living in central Côte d’Ivoire. Forty villages will be selected based on population size and the proportion of houses suitable for modification with SET. Using restricted randomization, half the villages will be assigned to the treatment arm (SET + LLINs) and the remainder will be assigned to the control arm (LLINs only). In both arms, LLINs will be distributed and in the treatment arm, householders will be offered SET. Fifty children aged six months to eight years old will be enrolled from randomly selected households in each of the 40 villages. Cohorts will be cleared of malaria parasites at the start of the study and one year after recruitment, and will be monitored for clinical malaria case incidence by active case detection over two years. Mosquito densities will be assessed using CDC light traps and human landing catches and a subset of Anopheles mosquitoes will be examined for parity status and tested for sporozoite infection. Acceptability of SET will be monitored using surveys and focus groups. Cost-effectiveness analysis will measure the incremental cost per case averted and per disability-adjusted life year (DALY) averted of adding SET to LLINs. Economic and financial costs will be estimated from societal and provider perspective using standard economic evaluation methods. Discussion This study will be the first evaluation of the epidemiological impact of SET. Trial findings will show whether SET is a viable, cost-effective technology for malaria control in Côte d’Ivoire and possibly elsewhere. Trial registration ISRCTN18145556, registered on 01 February 2017 – retrospectively registered.
topic Eave tubes
Screening plus eave tubes
SET
Housing
House screening
Malaria control
url http://link.springer.com/article/10.1186/s12889-018-5746-5
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spelling doaj-0ba45294a6004468bfbc8331dabea4742020-11-25T01:51:14ZengBMCBMC Public Health1471-24582018-07-0118111310.1186/s12889-018-5746-5Evaluating the impact of screening plus eave tubes on malaria transmission compared to current best practice in central Côte d’Ivoire: a two armed cluster randomized controlled trialEleanore D. Sternberg0Jackie Cook1Ludovic P. Ahoua Alou2Carine J. Aoura3Serge Brice Assi4Dimi Théodore Doudou5A. Alphonsine Koffi6Raphael N’Guessan7Welbeck A. Oumbouke8Rachel A. Smith9Eve Worrall10Immo Kleinschmidt11Matthew B. Thomas12Department of Entomology and Center for Infectious Disease Dynamics, The Pennsylvania State UniversityMRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical MedicineInstitut Pierre Richet (IPR) / Institut National de Santé Publique (INSP)Institut Pierre Richet (IPR) / Institut National de Santé Publique (INSP)Institut Pierre Richet (IPR) / Institut National de Santé Publique (INSP)Université Alassane OuattaraInstitut Pierre Richet (IPR) / Institut National de Santé Publique (INSP)Institut Pierre Richet (IPR) / Institut National de Santé Publique (INSP)Institut Pierre Richet (IPR) / Institut National de Santé Publique (INSP)Department of Communication Arts and Sciences and Center for Infectious Disease Dynamics, The Pennsylvania State UniversityDepartment of Vector Biology, Liverpool School of Tropical MedicineMRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical MedicineDepartment of Entomology and Center for Infectious Disease Dynamics, The Pennsylvania State UniversityAbstract Background Access to long-lasting insecticidal nets (LLINs) has increased and malaria has decreased globally, but malaria transmission remains high in parts of sub-Saharan Africa and insecticide resistance threatens current progress. Eave tubes are a new tool for the targeted delivery of insecticides against mosquitoes attempting to enter houses. The primary objective of this trial is to test whether screening plus eave tubes (SET) provides protection against malaria, on top of universal coverage with LLINs in an area of intense pyrethroid resistance. The trial will also assess acceptability and cost-effectiveness of the intervention. Methods/design A two-armed, cluster randomized controlled trial will be conducted to evaluate the effect of SET on clinical malaria incidence in children living in central Côte d’Ivoire. Forty villages will be selected based on population size and the proportion of houses suitable for modification with SET. Using restricted randomization, half the villages will be assigned to the treatment arm (SET + LLINs) and the remainder will be assigned to the control arm (LLINs only). In both arms, LLINs will be distributed and in the treatment arm, householders will be offered SET. Fifty children aged six months to eight years old will be enrolled from randomly selected households in each of the 40 villages. Cohorts will be cleared of malaria parasites at the start of the study and one year after recruitment, and will be monitored for clinical malaria case incidence by active case detection over two years. Mosquito densities will be assessed using CDC light traps and human landing catches and a subset of Anopheles mosquitoes will be examined for parity status and tested for sporozoite infection. Acceptability of SET will be monitored using surveys and focus groups. Cost-effectiveness analysis will measure the incremental cost per case averted and per disability-adjusted life year (DALY) averted of adding SET to LLINs. Economic and financial costs will be estimated from societal and provider perspective using standard economic evaluation methods. Discussion This study will be the first evaluation of the epidemiological impact of SET. Trial findings will show whether SET is a viable, cost-effective technology for malaria control in Côte d’Ivoire and possibly elsewhere. Trial registration ISRCTN18145556, registered on 01 February 2017 – retrospectively registered.http://link.springer.com/article/10.1186/s12889-018-5746-5Eave tubesScreening plus eave tubesSETHousingHouse screeningMalaria control