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Published in: Trials 1/2013

Open Access 01-12-2013 | Study protocol

The impact of hotspot-targeted interventions on malaria transmission: study protocol for a cluster-randomized controlled trial

Authors: Teun Bousema, Jennifer Stevenson, Amrish Baidjoe, Gillian Stresman, Jamie T Griffin, Immo Kleinschmidt, Edmond J Remarque, John Vulule, Nabie Bayoh, Kayla Laserson, Meghna Desai, Robert Sauerwein, Chris Drakeley, Jonathan Cox

Published in: Trials | Issue 1/2013

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Abstract

Background

Malaria transmission is highly heterogeneous in most settings, resulting in the formation of recognizable malaria hotspots. Targeting these hotspots might represent a highly efficacious way of controlling or eliminating malaria if the hotspots fuel malaria transmission to the wider community.

Methods/design

Hotspots of malaria will be determined based on spatial patterns in age-adjusted prevalence and density of antibodies against malaria antigens apical membrane antigen-1 and merozoite surface protein-1. The community effect of interventions targeted at these hotspots will be determined. The intervention will comprise larviciding, focal screening and treatment of the human population, distribution of long-lasting insecticide-treated nets and indoor residual spraying. The impact of the intervention will be determined inside and up to 500 m outside the targeted hotspots by PCR-based parasite prevalence in cross-sectional surveys, malaria morbidity by passive case detection in selected facilities and entomological monitoring of larval and adult Anopheles populations.

Discussion

This study aims to provide direct evidence for a community effect of hotspot-targeted interventions. The trial is powered to detect large effects on malaria transmission in the context of ongoing malaria interventions. Follow-up studies will be needed to determine the effect of individual components of the interventions and the cost-effectiveness of a hotspot-targeted approach, where savings made by reducing the number of compounds that need to receive interventions should outweigh the costs of hotspot-detection.

Trial registration

NCT01575613. The protocol was registered online on 20 March 2012; the first community was randomized on 26 March 2012.
Appendix
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Metadata
Title
The impact of hotspot-targeted interventions on malaria transmission: study protocol for a cluster-randomized controlled trial
Authors
Teun Bousema
Jennifer Stevenson
Amrish Baidjoe
Gillian Stresman
Jamie T Griffin
Immo Kleinschmidt
Edmond J Remarque
John Vulule
Nabie Bayoh
Kayla Laserson
Meghna Desai
Robert Sauerwein
Chris Drakeley
Jonathan Cox
Publication date
01-12-2013
Publisher
BioMed Central
Published in
Trials / Issue 1/2013
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/1745-6215-14-36

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