Efficacy of chlorfenapyr-pyrethroid and piperonyl butoxide-pyrethroid long-lasting insecticidal nets (LLINs) compared to pyrethroid-only LLINs for malaria control in Côte d'Ivoire: a three group, cluster randomised trial.

Autor: Sih C; Faculty of Epidemiology and Population Health, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK. Colette.Sih@lshtm.ac.uk., Protopopoff N; Faculty of Infectious and Tropical Diseases, Disease Control Department, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK., Koffi AA; Institut Pierre Richet (IPR)/Institut National de Santé Publique (INSP), Bouaké, Côte d'Ivoire., Ahoua Alou LP; Institut Pierre Richet (IPR)/Institut National de Santé Publique (INSP), Bouaké, Côte d'Ivoire., Dangbenon E; Institut Pierre Richet (IPR)/Institut National de Santé Publique (INSP), Bouaké, Côte d'Ivoire., Messenger LA; Faculty of Infectious and Tropical Diseases, Disease Control Department, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK.; Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV, 89154, USA., Kulkarni MA; School of Epidemiology & Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada., Zoh MG; Institut Pierre Richet (IPR)/Institut National de Santé Publique (INSP), Bouaké, Côte d'Ivoire., Camara S; Institut Pierre Richet (IPR)/Institut National de Santé Publique (INSP), Bouaké, Côte d'Ivoire., Assi SB; Institut Pierre Richet (IPR)/Institut National de Santé Publique (INSP), Bouaké, Côte d'Ivoire., N'Guessan R; Faculty of Infectious and Tropical Diseases, Disease Control Department, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK.; Institut Pierre Richet (IPR)/Institut National de Santé Publique (INSP), Bouaké, Côte d'Ivoire., Cook J; Faculty of Epidemiology and Population Health, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK.; Medical Research Council (MRC) International Statistics and Epidemiology Group, London School of Hygiene and Tropical Medicine, London, WC1E 7HT, UK.
Jazyk: angličtina
Zdroj: Trials [Trials] 2024 Feb 28; Vol. 25 (1), pp. 151. Date of Electronic Publication: 2024 Feb 28.
DOI: 10.1186/s13063-024-07969-2
Abstrakt: Background: The massive scale-up of long-lasting insecticidal nets (LLIN) has led to a major reduction in malaria burden in many sub-Saharan African (SSA) countries. The World Health Organization (WHO) has recently issued a strong recommendation for the use of chlorfenapyr-pyrethroid LLINs compared to standard pyrethroid-only LLINs in areas of high insecticide resistance intensity. However, there is still a lack of conclusive evidence on the efficacy of piperonyl butoxide-pyrethroid (PBO-py) LLINs, especially in West Africa, where vector composition and resistance mechanisms may be different from vectors in East Africa.
Methods: This is a three-arm, superiority, triple-blinded, cluster randomised trial, with village as the unit of randomisation. This study conducted in Côte d'Ivoire will evaluate the efficacy on epidemiological and entomological outcomes of (1) the control arm: MAGNet® LN, which contains the pyrethroid, alpha-cypermethrin, (2) VEERALIN® LN, a net combining the synergist PBO and alpha-cypermethrin, and (3) Interceptor® G2 LN, which incorporates chlorfenapyr and alpha-cypermethrin, two adulticides with different mechanisms of action. A total of 33 villages with an average of 200 households per village will be identified, mapped, and randomised in a ratio of 1:1:1. Nets will be distributed at a central point following national guidelines with 1 net for every 2 people. The primary outcome of the trial will be incidence of malaria cases (confirmed by rapid diagnostic test (RDT)) in a cohort of 50 children aged 6 months to 10 years in each cluster, followed for 12 months (active case detection). Secondary outcomes are cross-sectional community prevalence of malaria infection (confirmed by RDT) in the study population at 6 and 12 months post-intervention (50 randomly selected persons per cluster), vector density, entomological inoculation rate (EIR), and phenotypic and genotypic insecticide resistance at baseline and 12 months post-intervention in 3 sentinel villages in each treatment arm.
Discussion: In addition to generating further evidence for next-generation LLINs, this study will also provide the first evidence for pyrethroid-PBO nets in a West African setting. This could further inform WHO recommendations on the pragmatic use of pyrethroid-PBO nets.
Trial Registration: ClinicalTrials.gov NCT05796193. Registered on April 3, 2023.
(© 2024. The Author(s).)
Databáze: MEDLINE
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