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| Name | Class |
|---|---|
| Federal Ministry of Health, Sudan | OTHER_GOV |
| World Health Organization | OTHER |
| Liverpool School of Tropical Medicine | OTHER |
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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.
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.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Universal coverage of Long Lasting Insecticidal Nets (LLIN) | Active Comparator | Distribution of long lasting insecticidal nets to all community members in the study arm allowing for at least one net per 2 persons |
|
| LLIN Plus Indoor Residual Spraying | Experimental | Distribution of long lasting insecticidal nets to all community members in the study arm allowing for at least one net per 2 persons plus indoor residual spraying with insecticide of interior walls of all houses twice yearly. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Indoor residual insecticide spraying (IRS) | Other | Application of insecticide to interior walls of domiciliary structures to kill malaria vector mosquitoes which rest on walls after taking human blood meal |
| Measure | Description | Time Frame |
|---|---|---|
| Malaria Incidence | Infection with malarial parasites determined by rapid diagnostic tests/microscopy in cohort members who report or have fever (>37.5C) | 3 years |
| Measure | Description | Time Frame |
|---|---|---|
| Prevalence of P.falciparum Infection | 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 | 3 years |
| Entomological Innoculation rate |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Hmooda T Kafy, MSc (London) | Contact | +249 123 399 994 | hmoodak@yahoo.com | |
| Bashir A Ismail, MSc (USM) | Contact | +249 912938842 | bashiradam69@yahoo.co.uk |
| Name | Affiliation | Role |
|---|---|---|
| Immo Kleinschmidt, PhD | London School of Hygiene and Tropical Medicine | Principal Investigator |
| Martin J Donnelly, PhD | Liverpool School of Tropical Medicine | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Malaria Control Programme | Recruiting | Wad Medani | Al Jazirah | Sudan |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 29229808 | Derived | Kafy HT, Ismail BA, Mnzava AP, Lines J, Abdin MSE, Eltaher JS, Banaga AO, West P, Bradley J, Cook J, Thomas B, Subramaniam K, Hemingway J, Knox TB, Malik EM, Yukich JO, Donnelly MJ, Kleinschmidt I. Impact of insecticide resistance in Anopheles arabiensis on malaria incidence and prevalence in Sudan and the costs of mitigation. Proc Natl Acad Sci U S A. 2017 Dec 26;114(52):E11267-E11275. doi: 10.1073/pnas.1713814114. Epub 2017 Dec 11. |
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| ID | Term |
|---|---|
| D016778 | Malaria, Falciparum |
| ID | Term |
|---|---|
| D008288 | Malaria |
| D011528 | Protozoan Infections |
| D010272 | Parasitic Diseases |
| D007239 | Infections |
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| ID | Term |
|---|---|
| D010575 | Pesticides |
| C007725 | bendiocarb |
| C017180 | decamethrin |
| D057148 | Insecticide-Treated Bednets |
| ID | Term |
|---|---|
| D016573 | Agrochemicals |
| D020313 | Specialty Uses of Chemicals |
| D020164 | Chemical Actions and Uses |
| D004786 | Toxic Actions |
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|
| Long Lasting Insecticidal Nets (LLIN) | Device | 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. |
|
|
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. |
| Average for months Sept, Oct, Nov for years 2011, 2012, 2013 |
| Frequency of insecticide resistance associated genotypes (kdr) in anopheles arabiensis | Molecular analysis of mosquito specimens caught in subset of clusters by pyrethrum spray collection. | Yearly average 2011, 2012, 2013, 2014 |
| Khalid A Elmardi, MD |
| Federal Ministry of Health, Sudan |
| Study Director |
| Hmooda T Kafy, MSc | Federal Ministry of Health, Sudan | Principal Investigator |
| Bashir A Ismail, MSc | Federal Ministry of Health, Sudan | Principal Investigator |
| Mohamed Ahmed A Mohamed, MSc | Federal Ministry of Health, Sudan | Principal Investigator |
| Malaria Control Programme | Recruiting | Gedarif | Gedarif State | Sudan |
|
| Malaria Control Programme | Recruiting | Kassala | Kassala | Sudan |
|
| D000096724 |
| Mosquito-Borne Diseases |
| D000079426 | Vector Borne Diseases |
| D057147 |
| Mosquito Nets |
| D011482 | Protective Devices |
| D004864 | Equipment and Supplies |