Malaria Clinical Trial
Official title:
Cluster Randomised Trial to Compare Effectiveness of Bendiocarb and Deltamethrin (LongāLasting) in Preventing Malaria Infection
Twenty-four (24) clusters, each containing between 250-300 houses were selected throughout Bioko Island to be sprayed with either a long lasting pyrethroid insecticide, K-Othrine SC 62.5, or a bendiocarb insecticide, FICAM. Parasite prevalence in children aged 2-14 was measured before and after the application of insecticide.
In 2013, a new long lasting pyrethroid insecticide, K-Othrine SC 62.5, that has been
developed by Bayer AG, was used for the IRS program in Bioko Island, Equatorial Guinea, for
the first time. This change coincided with a marked increase in parasite prevalence in 2-14
year olds as measured in the Annual Malaria Indicator Survey (14% to 28%, respectively). In
order to determine whether the change in insecticide caused the increase in prevalence, a
cluster randomized control trial was designed.
Twenty-four (24) clusters, each containing between 250-300 houses were selected throughout
Bioko Island. Clusters were chosen with an attempt to maximize the geographical space
between clusters (to minimize possible residual effects from insecticides), while ensuring
that areas with historically higher acceptance rates for Indoor Residual Spraying (IRS) were
selected. Each cluster had a buffer zone of 300m (or halfway between clusters less than 600m
apart).
A team of 10 local surveyors conducted a baseline survey in each cluster area, measuring
prevalence through malaria Rapid Diagnostic Test (RDT) positivity, net ownership, spray
coverage, and hemoglobin levels. Approximately 100 children in each cluster were tested.
These data were then used for a restricted randomization. Each cluster was then sprayed with
either deltamethrin or bendiocarb, depending on randomization. The IRS team put equal amount
of effort into each cluster, as determined by number of sprayers/house/day in an attempt to
minimize bias.
An end-line survey was conducted using an ODK Collect application in the same cluster areas.
Prevalence was measured by RDT, and hemoglobin data was gathered. In addition, the head of
household was asked about the acceptability to IRS and their willingness to receive the
insecticide in a future round.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Prevention
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