Reducing malaria transmission in forest-going mobile and migrant populations in Lao PDR and Cambodia: protocol for stepped-wedge cluster-randomised controlled trial.

Autor: Htike W; Disease Elimination Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia. win.htike@burnet.edu.au., Oo WH; Disease Elimination Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia., Lynn T; Health Poverty Action, London, UK., Sovanda L; Health Poverty Action, London, UK., Agius PA; Disease Elimination Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia.; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia., Oo MC; Disease Elimination Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia., Galau NH; Disease Elimination Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia., Thu KM; Disease Elimination Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia., Zaw AK; Disease Elimination Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia., Htwe EP; Disease Elimination Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia., Cutts JC; Disease Elimination Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia.; Department of Medicine at the Doherty Institute, University of Melbourne, Melbourne, Australia., Kearney EA; Disease Elimination Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia.; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia., Scott N; Disease Elimination Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia., O'Flaherty K; Disease Elimination Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia., Wang B; Health Poverty Action, London, UK., Khamlome B; Center of Malariology Parasitology and Entomology, Ministry of Health, Vientiane, Lao PDR., Vilay P; Center of Malariology Parasitology and Entomology, Ministry of Health, Vientiane, Lao PDR., Siv S; National Center for Parasitology Entomology and Malaria Control, Ministry of Health, Phnom Penh, Cambodia., Fowkes FJI; Disease Elimination Program, Burnet Institute, 85 Commercial Road, Melbourne, VIC, 3004, Australia. freya.fowkes@burnet.edu.au.; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia. freya.fowkes@burnet.edu.au.; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia. freya.fowkes@burnet.edu.au.
Jazyk: angličtina
Zdroj: BMC infectious diseases [BMC Infect Dis] 2022 Sep 24; Vol. 22 (1), pp. 747. Date of Electronic Publication: 2022 Sep 24.
DOI: 10.1186/s12879-022-07724-5
Abstrakt: Background: Countries of the Greater Mekong Sub-region aim to achieve malaria elimination by 2030. In the region, malaria is concentrated in high-risk areas and populations such as forest-going mobile and migrant populations (MMPs). However, routine protective measures such as long-lasting insecticidal nets do not prevent all infectious bites in these high-risk populations. Evidence for the effectiveness of a personal protection package tailored to forest-going MMPs which is acceptable, feasible, and cost-effective for reducing malaria transmission is required to inform the malaria elimination toolkit in the region.
Methods: A personal protection package consisting of long-lasting insecticidal hammock net, insect repellent and health communication pamphlet was developed in consultation with relevant implementing partners from Cambodia and Lao PDR. An open stepped-wedge cluster-randomised controlled trial will be conducted over a period of 12 months in a minimum of 488 villages (~ 428 in Lao PDR and ~ 60 in Cambodia) to evaluate the effectiveness of the personal protection package. Villages will be randomised into 11 blocks, with blocks transitioned in random order from control to intervention states at monthly intervals, following a 1-month baseline period. The primary outcome of the trial is the prevalence of Plasmodium spp. infection diagnosed by rapid diagnostic test. Difference in prevalence of malaria infection will be estimated across intervention and control periods using generalized linear mixed modelling. Nested within the stepped-wedge cluster-randomised controlled trial is a mixed-methods study to explore the acceptability of the personal protection package, feasibility of implementing a personal protection package as a vector control intervention, and knowledge, attitude and practice of MMPs regarding malaria prevention; and cost-analysis to determine the cost-effectiveness of implementing a personal protection package.
Discussion: This study, using a rigorous design and mixed-methods methodology, will evaluate whether a personal protection package can reduce residual malaria transmission among forest-going MMPs in Cambodia and Lao PDR. It will also measure implementation research outcomes such as effectiveness of the intervention package, cost-effectiveness, acceptability, and feasibility, in order to inform potential national and regional policy. Trial registration This trial was prospectively registered on ClinicalTrials.gov (NCT05117567) on 11th November 2021.
(© 2022. The Author(s).)
Databáze: MEDLINE
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