Impact of population based Indoor Residual Spraying (IRS) in combination with chemotherapy on key malaria indicators in a high transmission setting in north eastern Uganda (Katakwi Rotary Malaria Project -KRMP-)
The main objective of this project is to establish the impact of population-based Indoor Residual Spraying (IRS) in combination with chemotherapy on key malaria indicators in a high transmission setting in northeastern Uganda (Katakwi Rotary Malaria Project (KRMP)).
- Primary objective: To evaluate the impact of population-based IRS in combination with MDA as compared with no MDA on clinical and entomological malaria indicators in Katakwi district.
- Secondary objective: To evaluate the community acceptability of the two intervention (MDA + IRS + IRS only)
In Katakwi, most families live by subsistence farming, and malaria transmission rates are staggeringly high. A baseline survey showed that almost half of kids under the age of five were infected with the parasite. In 2008-09, a pilot program suggested that an innovative combination of interventions could crash the parasite population and decrease malaria prevalence by 90%. Now, Pilgrim Africa is scaling it up. This operational research project follows three sub-counties over 3.5 years. More than 40,000 people will benefit. Computer modelling suggests that by deploying Indoor Residual Spraying and Mass Drug Administration at the same time, we will reap twice the benefit than we would if we deployed them one after another. Four rounds of this intensive combination will crash the parasite population in both its mosquito and human hosts, dramatically reducing transmission rates.
Methodology: To deploy 4 rounds of the intensive combination of Indoor Residual Spraying and Mass Drug Administration at the same time.
Intervention by arms:
- Arm 1: 4 rounds of MDA + IRS, approximately every 6 months
- Arm 2: 4 rounds of IRS
- Arm 3: Standard of care (as per concomitant interventions)
- Universal LLINs in all three arms, distributed by NCMP & partners
- Case management at health facilities, supplies and training boosted by study team
- IEC/BCC (information, education and communication activities in study community)
- Mapping and enumeration of all households
- Screening and consenting for all study interventions
- Prevalence of parasitaemia in the community as measured by RDT, microscopy, and qPCR during cross-sectional surveys of 200 hh in each arm, conducted at baseline and at roughly 6-monthly intervals following each intervention round
- Entomologic inoculation rate as measured by CDC light trap collection and sporozoite ELISAS
- Parasite positivity rates at health facilities as measured by DIHS2
- Acceptability of the interventions as measured by thematically scored key informant interviews and focus group discussions
Allocation: Non- randomized
Intervention model: Parallel assignment
Masking: None (open label)
Primary purpose: Treatment