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Published in: BMC Public Health 1/2018

Open Access 01-12-2018 | Study protocol

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

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

Published in: BMC Public Health | Issue 1/2018

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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.
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Metadata
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
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
Publication date
01-12-2018
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2018
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-018-5746-5

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