Evaluation of Insecticide-treated Eave Nets and Window Screens for Malaria Control in Tanzania.

NCT ID: NCT05125133

Last Updated: 2021-12-02

Study Results

Results pending

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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Recruitment Status

UNKNOWN

Clinical Phase

NA

Total Enrollment

1800 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-07-09

Study Completion Date

2022-09-30

Brief Summary

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This is a household randomized trial of a new tool for house modification, Insecticide-Treated Eave nets (ITENs) in combination with insecticide-treated window screens (ITWS), coated with a dual active ingredient (dual AI): Deltamethrin at 3g AI/kg, which corresponds to 144 mg/m² and PBO synergist at 10g/kg which corresponds to 480 mg/m², as used in the so-called dual-AI LLIN or "resistance breaking" nets for resistance malaria vector control.

Four hundred and fifty (450) households with intact walls, opened eaves, and those without screens or nets on the windows in Chalinze district, Tanzania will be eligible and only recruited upon written informed consent. The households will be randomly allocated into two arms: one with ITENs and ITWS installed and the other without.

The primary outcome will be malaria parasite detection in household residents aged over 6 months old using a quantitative Polymerase Chain Reaction (qPCR) at approximately 12 months post-installation, coinciding with the long rainy season.

Detailed Description

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In Tanzania, long-lasting insecticidal nets (LLINs) contributed to the high reduction of malaria in the last decade. However, malaria reduction in Tanzania is threatened due to increasing insecticidal resistance of malaria vectors, low access to LLIN, LLINs not lasting up to three years, and net usage compliance. Therefore, it is evident that an additional cost-effective vector control tool is required that may confer protection against resistant malaria vectors, protect every member of the household, requires little or less compliance to use after distribution, and lasts longer.

The proposed additional vector control tool for trial is the Insecticide-Treated Eave nets (ITENs) in combination with Insecticide Treated Window screens (ITWS) for house modification. The tool is coated with a dual active ingredient (dual AI): Deltamethrin at 3g AI/kg, which corresponds to 144 mg/m², and PBO synergist at 10g/kg which corresponds to 480 mg/m², which are coated at the same concentration in insecticide-treated nets that are already in use in the population to control pyrethroid-resistant mosquitoes. These can protect everyone in the house by blocking mosquito entry and killing mosquitos that contact them to protect everyone in the community.

In this trial, 450 households will be randomly allocated into two arms. One arm with ITENs \& ITWS installed and the other without to serve as the control arm. The 450 households are recruited and assigned codes during baseline data collection. The assigned codes are randomized to either of the two arms by simple randomization in STATA and stratified by sub-village.

Approximately 6 months and 12 months post-installation, coinciding with the rainy seasons, clinical officers will screen for malaria parasites in household residents of over 6 months old (it is estimated that 4.4 persons reside in each household, thus approx. 1,800 persons will be screened for malaria per survey) in both arms and confirmation of malaria parasite will be done using qPCR analysis as the primary assessment of the primary outcome. As a point of care, SD Bioline Malaria Ag Pf/Pan rapid diagnostic test (RDT) as per Tanzanian guidelines will also be conducted on all household residents. Any participant (s) with an axillary temperature of 37.5 degrees (fever) and that test positive using mRDT will be considered as a clinical malaria case. All malaria-positive participants will be treated using free Artemether Lumefantrine (ALu). This drug is approved by the national guideline for the treatment of uncomplicated malaria.

Other secondary objectives are:

* To evaluate malaria prevalence in households with ITENs \& ITWS and those without at approximately 6 months post-installation, coinciding with the short rainy season.
* To determine the prevalence of clinical malaria defined by an axillary temperature of 37.5 degrees and above (fever) and mRDT malaria positive cases at approximately 6 months and 12 months post-installation, coinciding with the rainy seasons.
* To investigate the effect of ITENs and ITWS on the density of malaria vectors and nuisance (Culex quinquefasciatus) mosquitoes in the community at approximately 6 months and 12 months post-installation, coinciding with the rainy seasons using Centres for Disease Control (CDC) light traps.
* To assess the number of fabric in meters and time of installing the intervention (feasibility of scaling-up ITENs and ITWS use) in local houses in the field during installation.
* To assess the adverse effects of ITENs and ITWS in the community.
* To determine the attrition and fabric integrity of ITENs and ITWS in the field post 6 months and 12 months of installation.
* To determine the mortality induced by (bioefficacy) ITENs and ITWS on laboratory-reared mosquitoes post 12 months of installation.
* To determine the insecticide retainment of ITENs and ITWS post 12 months of installation.
* To assess the acceptability of ITENs and ITWS to the local community post 6 months and 12 months of installation.

Conditions

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Malaria,Falciparum

Keywords

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Insecticide-treated nets, Eaves, windows, Malaria, Tanzania.

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Households allocated into Two arms to receive ITENs+ITWS installed or none with a 1:1 ratio at sub-village level.
Primary Study Purpose

PREVENTION

Blinding Strategy

NONE

Study Groups

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ITENs + ITWS

Deltamethrin at 3g AI/kg, which corresponds to 144 mg/m², and PBO synergist at 10g/kg which corresponds to 480 mg/m² are coated in ITENs and ITWS nets that will be installed to cover opened eaves and windows. This was manufactured by Moon Netting FZCO, United Arab Emirates.

Group Type EXPERIMENTAL

ITENs + ITWS

Intervention Type OTHER

A dual active ingredient (dual AI) Insecticide-Treated Eave nets (ITENs) in combination with Insecticide Treated Window screens (ITWS) for house modification.

Negative arm

The houses allocated NOT to receive ITENs and ITWS.

Group Type NO_INTERVENTION

No interventions assigned to this group

Interventions

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ITENs + ITWS

A dual active ingredient (dual AI) Insecticide-Treated Eave nets (ITENs) in combination with Insecticide Treated Window screens (ITWS) for house modification.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Residents of study households' members.

Exclusion Criteria

* None residence.
* Pregnant women.
Minimum Eligible Age

6 Months

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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London School of Hygiene and Tropical Medicine

OTHER

Sponsor Role collaborator

Swiss Tropical & Public Health Institute

OTHER

Sponsor Role collaborator

Ifakara Health Institute

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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John Bradley, PhD

Role: STUDY_DIRECTOR

London School of Hygiene and Tropical Medicine

Locations

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Vector Control Product Testing Unit Facility

Bagamoyo, , Tanzania

Site Status RECRUITING

Countries

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Tanzania

Central Contacts

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Zawadi Mboma, PhD

Role: CONTACT

Phone: +255 787 428218

Email: [email protected]

Rose Philipo, MSc

Role: CONTACT

Phone: +255 714583404

Email: [email protected]

Facility Contacts

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Rose Philipo, MSc

Role: primary

References

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Gnanguenon V, Azondekon R, Oke-Agbo F, Beach R, Akogbeto M. Durability assessment results suggest a serviceable life of two, rather than three, years for the current long-lasting insecticidal (mosquito) net (LLIN) intervention in Benin. BMC Infect Dis. 2014 Feb 8;14:69. doi: 10.1186/1471-2334-14-69.

Reference Type BACKGROUND
PMID: 24507444 (View on PubMed)

Matiya DJ, Philbert AB, Kidima W, Matowo JJ. Dynamics and monitoring of insecticide resistance in malaria vectors across mainland Tanzania from 1997 to 2017: a systematic review. Malar J. 2019 Mar 26;18(1):102. doi: 10.1186/s12936-019-2738-6.

Reference Type BACKGROUND
PMID: 30914051 (View on PubMed)

Mboera LE, Mweya CN, Rumisha SF, Tungu PK, Stanley G, Makange MR, Misinzo G, De Nardo P, Vairo F, Oriyo NM. The Risk of Dengue Virus Transmission in Dar es Salaam, Tanzania during an Epidemic Period of 2014. PLoS Negl Trop Dis. 2016 Jan 26;10(1):e0004313. doi: 10.1371/journal.pntd.0004313. eCollection 2016 Jan.

Reference Type BACKGROUND
PMID: 26812489 (View on PubMed)

Mboma ZM, Overgaard HJ, Moore S, Bradley J, Moore J, Massue DJ, Kramer K, Lines J, Lorenz LM. Mosquito net coverage in years between mass distributions: a case study of Tanzania, 2013. Malar J. 2018 Mar 1;17(1):100. doi: 10.1186/s12936-018-2247-z.

Reference Type BACKGROUND
PMID: 29490649 (View on PubMed)

Gleave K, Lissenden N, Richardson M, Choi L, Ranson H. Piperonyl butoxide (PBO) combined with pyrethroids in insecticide-treated nets to prevent malaria in Africa. Cochrane Database Syst Rev. 2018 Nov 29;11(11):CD012776. doi: 10.1002/14651858.CD012776.pub2.

Reference Type RESULT
PMID: 30488945 (View on PubMed)

Odufuwa OG, Moore SJ, Mboma ZM, Mwanga R, Matwewe F, Hofer LM, Matanila I, Abbasi S, Rashid MA, Philipo R, Kihwele F, Moore J, Nguyen H, Bosselmann R, Skovmand O, Stevenson JC, Muganga JB, Bradley J. A household randomized-control trial of insecticide-treated screening for malaria control in unimproved houses in Tanzania. Malar J. 2025 Jun 8;24(1):182. doi: 10.1186/s12936-025-05434-2.

Reference Type DERIVED
PMID: 40484966 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Informed Consent Form

View Document

Other Identifiers

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ITENs

Identifier Type: -

Identifier Source: org_study_id