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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

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McCann, Robert S, van den Berg, Henk, Diggle, Peter J, van Vugt, Michele, Terlouw, Anja ORCID: https://orcid.org/0000-0001-5327-8995, Phiri, Kamija S, Di Pasquale, Aurelio, Maire, Nicolas, Gowelo, Steven, Mburu, Monicah, Kabaghe, Alinune N, Mzilahowa, Themba, Chipeta, Michael G and Takken, Wilem (2017) '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, Vol 17, Issue 639.

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Abstract

Background: Due 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/design: We will implement community-based LSM and HI, as additional interventions to the current national malaria control strategies, using a randomised block, 2x2 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.

Discussion: Combining 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.

Item Type: Article
Subjects: QS Anatomy > QS 4 General works. Classify here works on regional anatomy
QX Parasitology > Insects. Other Parasites > QX 510 Mosquitoes
WA Public Health > Preventive Medicine > WA 110 Prevention and control of communicable diseases. Transmission of infectious diseases
WA Public Health > Preventive Medicine > WA 240 Disinfection. Disinfestation. Pesticides (including diseases caused by)
WA Public Health > WA 30 Socioeconomic factors in public health (General)
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria
WC Communicable Diseases > Tropical and Parasitic Diseases > WC 765 Prevention and control
Faculty: Department: Clinical Sciences & International Health > Clinical Sciences Department
Clinical Sciences & International Health > Malawi-Liverpool-Wellcome Programme (MLW)
Digital Object Identifer (DOI): https://doi.org/10.1186/s12879-017-2749-2
Depositing User: Stacy Murtagh
Date Deposited: 03 Oct 2017 09:45
Last Modified: 13 Sep 2019 13:10
URI: https://archive.lstmed.ac.uk/id/eprint/7650

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