TY - JOUR
T1 - Design of a study to determine the impact of insecticide resistance on malaria vector control: a multi-country investigation
AU - Kleinschmidt, Immo
AU - Mnzava, Abraham Peter
AU - Kafy, Hmooda Toto
AU - Mbogo, Charles
AU - Bashir, Adam Ismail
AU - Bigoga, Jude
AU - Adechoubou, Alioun
AU - Raghavendra, Kamaraju
AU - Knox, Tessa Bellamy
AU - Malik, Elfatih M.
AU - Nkuni, Zinga José
AU - Bayoh, Nabie
AU - Ochomo, Eric
AU - Fondjo, Etienne
AU - Kouambeng, Celestin
AU - Awono-Ambene, Herman Parfait
AU - Etang, Josiane
AU - Akogbeto, Martin
AU - Bhatt, Rajendra
AU - Swain, Dipak K.
AU - Kinyari, Teresa
AU - Njagi, Kiambo
AU - Muthami, Lawrence
AU - Subramaniam, Krishanthi
AU - Bradley, John
AU - West, Philippa
AU - Massougbodji, Achile
AU - Okê-Sopoh, Mariam
AU - Hounto, Aurore
AU - Elmardi, Khalid
AU - Valecha, Neena
AU - Kamau, Luna
AU - Mathenge, Evan
AU - Donnelly, Martin
PY - 2015/7/22
Y1 - 2015/7/22
N2 - BackgroundProgress 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.MethodsMalaria 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.ResultsCohorts 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.DiscussionThe 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.
AB - BackgroundProgress 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.MethodsMalaria 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.ResultsCohorts 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.DiscussionThe 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.
U2 - 10.1186/s12936-015-0782-4
DO - 10.1186/s12936-015-0782-4
M3 - Article
SN - 1475-2875
VL - 14
SP - e282
JO - Malaria Journal
JF - Malaria Journal
IS - 1
M1 - 282
ER -
