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


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; (2013) The impact of hotspot-targeted interventions on malaria transmission: study protocol for a cluster-randomized controlled trial. Trials, 14. p. 36. ISSN 1745-6215 DOI: https://doi.org/10.1186/1745-6215-14-36

[img]
Preview
Text - Published Version
License:

Download (1MB) | Preview

Abstract

UNLABELLED 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.

Item Type: Article
Faculty and Department: Faculty of Infectious and Tropical Diseases > Dept of Disease Control
Faculty of Infectious and Tropical Diseases > Dept of Immunology and Infection
Faculty of Epidemiology and Population Health > Dept of Infectious Disease Epidemiology
Research Centre: Malaria Centre
Tropical Epidemiology Group
PubMed ID: 23374910
Web of Science ID: 315119400002
URI: http://researchonline.lshtm.ac.uk/id/eprint/616532

Statistics


Download activity - last 12 months
Downloads since deposit
261Downloads
369Hits
Accesses by country - last 12 months
Accesses by referrer - last 12 months
Impact and interest
Additional statistics for this record are available via IRStats2

Actions (login required)

Edit Item Edit Item