Reducing the Burden of Malaria by Targeting Hotspots of Malaria Transmission
NCT ID: NCT01575613
Last Updated: 2012-11-27
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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COMPLETED
NA
17506 participants
INTERVENTIONAL
2012-04-30
2012-11-30
Brief Summary
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In addition to malaria surveys in the human population, an entomological evaluation will take place where the densities of mosquito larvae and adult mosquitoes are monitored longitudinally.
Detailed Description
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Clusters for the intervention are defined as a hotspot and the area surrounding this hotspot in each direction up to 500 meters.
INTERVENTION Half of the clusters will be randomized to hotspot-targeted interventions, while the other half will serve as control. The plausible impact of hotspot targeted interventions will be evaluated by comparing malaria indices in intervention clusters with their baseline and with control clusters.
In each phase four hotspot-targeted interventions will be superimposed on ongoing control measures: hotspots will be targeted with a combination IRS, long-lasting insecticide treated nets (LLINs), larviciding and a focal screening and treatment (FSAT).
EVALUATION The primary outcome will be parasite prevalence in evaluation zones (i.e. the area surrounding malaria hotspots) of targeted and untargeted clusters. In addition, parasite prevalence will be determined inside hotspots of malaria transmission and in evaluation zones in relation to distance to the hotspot boundary. For this, community surveys are planned prior to the intervention and at two time-points after the intervention.
An entomological evaluation will take place concurrently in which mosquito breeding sites are monitored for productivity and mosquitoes will be sampled indoors and outdoors.
Malaria morbidity is assessed by passive case detection.
Conditions
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Keywords
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Study Design
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RANDOMIZED
PARALLEL
PREVENTION
NONE
Study Groups
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Hotspot Targeting
Four hotspot-targeted interventions will be superimposed on ongoing control measures: hotspots will be targeted with a combination of IRS, long-lasting insecticide treated nets (LLINs), larviciding and a focal screening and treatment (FSAT)campaign.
Artemether-lumefantrine combination
Focal screening and treatment in all households in malaria hotspots prior to the peak transmission season. Screening of a sentinel age group by rapid diagnostic tests; all parasitaemic individuals and household members of parasitaemic individuals will be treated.
Bacillus thuringiensis
Treatment of all waterbodies within hotspots with Bti or Bs on weekly basis
Long lasting insecticide treated net (LLINs)
Distribution of LLINs in all households in malaria hotspots; instruction about correct use.
Indoor Residual Spraying (IRS)
6-monthly IRS with deltamethrin in all households malaria hotspots.
Control
Standard of care as determined by the Division of Malaria Control of the Kenyan Ministry of Health
No interventions assigned to this group
Interventions
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Artemether-lumefantrine combination
Focal screening and treatment in all households in malaria hotspots prior to the peak transmission season. Screening of a sentinel age group by rapid diagnostic tests; all parasitaemic individuals and household members of parasitaemic individuals will be treated.
Bacillus thuringiensis
Treatment of all waterbodies within hotspots with Bti or Bs on weekly basis
Long lasting insecticide treated net (LLINs)
Distribution of LLINs in all households in malaria hotspots; instruction about correct use.
Indoor Residual Spraying (IRS)
6-monthly IRS with deltamethrin in all households malaria hotspots.
Eligibility Criteria
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Exclusion Criteria
6 Months
ALL
Yes
Sponsors
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London School of Hygiene and Tropical Medicine
OTHER
Kenya Medical Research Institute
OTHER
Centers for Disease Control and Prevention
FED
International Centre of Insect Physiology and Ecology (ICIPE)
OTHER
Division of Malaria Control, Ministry of Health, Nairobi, Kenya
UNKNOWN
Radboud University Medical Center
OTHER
Responsible Party
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Principal Investigators
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Teun Bousema, PhD
Role: PRINCIPAL_INVESTIGATOR
Radboud University Medical Center
Jon Cox, PhD
Role: PRINCIPAL_INVESTIGATOR
London School of Hygiene and Tropical Medicine
Jennifer Stevenson, PhD
Role: PRINCIPAL_INVESTIGATOR
London School of Hygiene and Tropical Medicine
Locations
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Rachuonyo District, , Kenya
Countries
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References
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Bousema T, Griffin JT, Sauerwein RW, Smith DL, Churcher TS, Takken W, Ghani A, Drakeley C, Gosling R. Hitting hotspots: spatial targeting of malaria for control and elimination. PLoS Med. 2012 Jan;9(1):e1001165. doi: 10.1371/journal.pmed.1001165. Epub 2012 Jan 31.
Bousema T, Stresman G, Baidjoe AY, Bradley J, Knight P, Stone W, Osoti V, Makori E, Owaga C, Odongo W, China P, Shagari S, Doumbo OK, Sauerwein RW, Kariuki S, Drakeley C, Stevenson J, Cox J. The Impact of Hotspot-Targeted Interventions on Malaria Transmission in Rachuonyo South District in the Western Kenyan Highlands: A Cluster-Randomized Controlled Trial. PLoS Med. 2016 Apr 12;13(4):e1001993. doi: 10.1371/journal.pmed.1001993. eCollection 2016 Apr.
Bousema T, Stevenson J, Baidjoe A, Stresman G, Griffin JT, Kleinschmidt I, Remarque EJ, Vulule J, Bayoh N, Laserson K, Desai M, Sauerwein R, Drakeley C, Cox J. The impact of hotspot-targeted interventions on malaria transmission: study protocol for a cluster-randomized controlled trial. Trials. 2013 Feb 2;14:36. doi: 10.1186/1745-6215-14-36.
Other Identifiers
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REDHOT_OPP1024438
Identifier Type: -
Identifier Source: org_study_id