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Malaria Journal
Published in: Malaria Journal 1/2015

Open Access 01-12-2015 | Case study

Design of a study to determine the impact of insecticide resistance on malaria vector control: a multi-country investigation

Authors: Immo Kleinschmidt, Abraham Peter Mnzava, Hmooda Toto Kafy, Charles Mbogo, Adam Ismail Bashir, Jude Bigoga, Alioun Adechoubou, Kamaraju Raghavendra, Tessa Bellamy Knox, Elfatih M Malik, Zinga José Nkuni, Nabie Bayoh, Eric Ochomo, Etienne Fondjo, Celestin Kouambeng, Herman Parfait Awono-Ambene, Josiane Etang, Martin Akogbeto, Rajendra Bhatt, Dipak K Swain, Teresa Kinyari, Kiambo Njagi, Lawrence Muthami, Krishanthi Subramaniam, John Bradley, Philippa West, Achile Massougbodji, Mariam Okê-Sopoh, Aurore Hounto, Khalid Elmardi, Neena Valecha, Luna Kamau, Evan Mathenge, Martin James Donnelly

Published in: Malaria Journal | Issue 1/2015

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Abstract

Background

Progress in reducing the malaria disease burden through the substantial scale up of insecticide-based vector control in recent years could be reversed by the widespread emergence of insecticide resistance. The impact of insecticide resistance on the protective effectiveness of insecticide-treated nets (ITN) and indoor residual spraying (IRS) is not known. A multi-country study was undertaken in Sudan, Kenya, India, Cameroon and Benin to quantify the potential loss of epidemiological effectiveness of ITNs and IRS due to decreased susceptibility of malaria vectors to insecticides. The design of the study is described in this paper.

Methods

Malaria disease incidence rates by active case detection in cohorts of children, and indicators of insecticide resistance in local vectors were monitored in each of approximately 300 separate locations (clusters) with high coverage of malaria vector control over multiple malaria seasons. Phenotypic and genotypic resistance was assessed annually. In two countries, Sudan and India, clusters were randomly assigned to receive universal coverage of ITNs only, or universal coverage of ITNs combined with high coverage of IRS. Association between malaria incidence and insecticide resistance, and protective effectiveness of vector control methods and insecticide resistance were estimated, respectively.

Results

Cohorts have been set up in all five countries, and phenotypic resistance data have been collected in all clusters. In Sudan, Kenya, Cameroon and Benin data collection is due to be completed in 2015. In India data collection will be completed in 2016.

Discussion

The paper discusses challenges faced in the design and execution of the study, the analysis plan, the strengths and weaknesses, and the possible alternatives to the chosen study design.
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Metadata
Title
Design of a study to determine the impact of insecticide resistance on malaria vector control: a multi-country investigation
Authors
Immo Kleinschmidt
Abraham Peter Mnzava
Hmooda Toto Kafy
Charles Mbogo
Adam Ismail Bashir
Jude Bigoga
Alioun Adechoubou
Kamaraju Raghavendra
Tessa Bellamy Knox
Elfatih M Malik
Zinga José Nkuni
Nabie Bayoh
Eric Ochomo
Etienne Fondjo
Celestin Kouambeng
Herman Parfait Awono-Ambene
Josiane Etang
Martin Akogbeto
Rajendra Bhatt
Dipak K Swain
Teresa Kinyari
Kiambo Njagi
Lawrence Muthami
Krishanthi Subramaniam
John Bradley
Philippa West
Achile Massougbodji
Mariam Okê-Sopoh
Aurore Hounto
Khalid Elmardi
Neena Valecha
Luna Kamau
Evan Mathenge
Martin James Donnelly
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Malaria Journal / Issue 1/2015
Electronic ISSN: 1475-2875
DOI
https://doi.org/10.1186/s12936-015-0782-4

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