Adaptive Interventions for Optimizing Malaria Control: A Cluster-Randomized SMART Trial
LLIN, PBO LLIN, IRS, Larviciding
About this trial
This is an interventional prevention trial for LLIN, PBO LLIN, IRS, Larviciding focused on measuring Adaptive intervention, Multiple assignment randomized trial (SMART), Cluster-randomized SMART trial, Optimal intervention strategy, Clinical malaria incidence, Cost-effectiveness
Eligibility Criteria
Household inclusion criteria:
- Households with residents at the time of survey
- Agreement of the adult resident to provide informed consent for the intervention and survey
Study subjects inclusion criteria:
- Passive case detection by health facilities will include all residents in the study clusters; active case detection will include residents of >6 months
- Agreement of parent/guardian to provide informed consent and minors to provide assent.
Household exclusion criteria:
- Household vacant
- No adult resident home on more than 3 occasions
Study subjects exclusion criteria:
• Participants not home on day of survey
Sites / Locations
- Program in Public Health
- Tom-Mboya University College, Maseno UniversityRecruiting
Arms of the Study
Arm 1
Arm 2
Arm 3
Arm 4
Arm 5
Arm 6
Arm 7
Placebo Comparator
Experimental
Experimental
Experimental
Experimental
Experimental
Experimental
Regular long-lasting insecticidal nets
Piperonyl butoxide-treated LLIN
PBO-LLIN plus larval source management
PBO-LLIN plus enhanced methods
LLIN plus indoor residual spraying
LLIN+IRS+LSM
LLIN+IRS plus enhanced method
All participants will have LLIN coverage through routine MoH distribution of long-lasting insecticidal nets (LLINs), no other interventions will be applied. Regular LLIN: Olyset nets containing 2% permethrin or PermaNet 2.0 containing 1.8 and 1.4 g/kg, respectively, for 75 and 100 denier yarn.
All participants will received piperonyl butoxide-treated LLINs (PBO-LLINs) at Stage 1 and Stage 2 interventions provided that PBO-LLINs are effective at Stage 1 interventions. Each household will be provided on PBO-LLIN per two people with appropriate eduction. PBO-LLIN: Olyset Plus, containing 2% permethrin and 1% PBO.
All participants will received piperonyl butoxide-treated LLINs (PBO-LLINs) at Stage 1, however, Stage 1 intervention is not effective. All participants will received PBO-LLINs plus larval source management (LSM) at Stage 2. LSM will be implemented in selected clusters, including both physical and chemical methods by physical filling or removal of temporary larval habitats and larviciding of semi-permanent and permanent habitats, per the National Malaria Strategic Plan of Kenya. We will use the long-lasting microbial larvicides manufactured by Central Life Sciences. Semi-permanent and permanent habitats will be treated with FourStar® 180-day Briquets using the recommended dosage of 100 ft2 water surface per briquet.
All participants will received piperonyl butoxide-treated LLINs (PBO-LLINs) at Stage 1, however, Stage 1 intervention is not effective. All participants will received PBO-LLINs plus an enhanced intervention at Stage 2. The enhanced intervention is determined by machine learning method.
All participants will received regular LLINs plus indoor residual spraying (IRS) (LLIN+IRS) at Stage 1 and Stage 2 interventions provided that LLIN+IRS is effective at Stage 1 interventions. For LLIN+IRS clusters, each dwelling's interior walls and ceilings will be sprayed with micro-encapsulated pirimiphos-methyl (Actellic 300CS) at the recommended dosage of 1g/m² and at the recommended frequency of once a year.
All participants will received regular LLINs plus IRS at Stage 1, provided that LLIN+IRS is not effective. LSM will be added on these clusters at Stage 2 interventions. LSM at Stage 2 will be the long-lasting microbial larvicides manufactured by Central Life Sciences. Semi-permanent and permanent habitats will be treated with FourStar® 180-day Briquets using the recommended dosage of 100 ft2 water surface per briquet.
All participants will received regular LLINs plus IRS at Stage 1, provided that LLIN+IRS is not effective. Enhanced method will be added on these clusters at Stage 2 interventions.The enhanced intervention is determined by machine learning method.