Malaria

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Operations research on malaria reduction and the efficacy of long-lasting insecticidal nets (LLINs) as a replacement for indoor residual spraying

Introduction

Malaria is a significant threat to health globally, affecting more than 500 million people a year and causing nearly 800,000 deaths. The U.S. President's Malaria Initiative (PMI), established in 2005, and other international groups have dedicated significant resources to combating malaria, especially in Africa where the malaria burden is very high. The PMI's specific focus countries include: Angola, Benin, the Democratic Republic of Congo, Ethiopia, Ghana, Kenya, Liberia, Madagascar, Malawi, Mali, Mozambique, Nigeria, Rwanda, Senegal, Tanzania, Uganda, and Zambia.</p> <p>In order to reduce malaria transmission, PMI has promoted indoor spraying of residual insecticides (IRS) and the use of long-lasting insecticide-treated nets (LLINs). IRS involves regularly spraying the interior walls of a home with insecticides to kill mosquitoes that come into contact with the treated walls. LLINs are hung over sleeping areas every night to repel and kill mosquitoes that land on the net. While both IRS and LLINs have been proven highly effective in reducing malaria morbidity and mortality, there is a lack of research on whether the use of LLINs alone is equally effective as the use of IRS alone, or on whether LLINs alone are as effective as the use of IRS combined with LLINs.

Background

In order to inform organizations and national malaria control programs on the most effective methods for reducing malaria transmission, TRAction is supporting research to investigate whether high coverage of LLINs can reduce the need for IRS. The research aims to determine the efficacy of using LLINs alone compared to using IRS alone and to using LLINs in combination with IRS. The results of the research will be used to inform countries on whether IRS can be phased out without compromising malaria control.

Funds for the research are provided by the United States Agency for International Development (USAID) under the President’s Malaria Initiative (PMI).

TRAction Research

TRAction has awarded funds to the London School of Hygiene and Tropical Medicine,to work in collaboration with the Tanzanian National Institute for Medical Research and the Kilimanjaro Christian Medical Center. The research is being conducted in the Muleba District of Tanzania’a Mwanza region, where P. falciparum malaria was endemic until PMI began conducting annual IRS in 2007.

The study will be conducted over two years, with the study population divided into two groups:

In the first year of the study, both arms will receive IRS and LLINs.
In the second year of the program, one arm will continue to receive IRS and LLINs, while the other will rely on LLINs alone.

Results from this study can be used by national governments and ministries of health across Africa, the President’s Malaria Initiative, and the Tanzanian National Malaria Control Program to inform decisions about how best to use malaria control resources.

Fact Sheet - Summary of LSHTM's Research on Malaria Reduction

Related Activities

Research activities will be carried out in collaboration with both national and local partners. National partners for the study are the Tanzanian National Malaria Control Program, Mennonite Economic Development Associates (MEDA), and Johns Hopkins University (JHU). MEDA, which has been a major participant in the Universal Coverage Campaign of LLIN distribution in Muleba, and JHU, which undertook qualitative research on IRS perceptions elsewhere in Tanzania’s Lake Zone, will provide guidance and support to the research team. At the local level, the regional medical office and the Research Triangle Institute (RTI) will coordinate with researchers on the schedule for IRS applications.

Resources

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