The Majete Integrated Malaria Control Project (MMP)
The project overall goal is an 80% reduction in the incidence of clinical malaria and 50% reduction in the prevalence of malaria in epicentre zones in the Majete Perimeter within 4 years of interventions. The project purpose is that through improved health and socio-economic conditions, the community will become a better partner in natural resource management.
- To build capacity for implementation and evaluation of malaria control through the epicentre approach;
- To increase community participation in malaria control;
- To implement locally-appropriate malaria vector control strategies;
- To measure impact on malaria;
- To study the efficacy and economic feasibility of various combinations of three anti-malaria techniques; and
- To introduce the best combination of techniques into the region within the final years of the project.
Community-based Larval Source Management and housing improvement will be implemented as additional interventions to the current national malaria control strategies, using a randomised block, 2 × 2 factorial, cluster-randomised design in rural, southern Malawi.
The project is relevant for malaria elimination and eradication through specific details on geographic and household variation in transmission intensity and risk, and by adding additional non-insecticide based tools for vector control. It is now known that in highly endemic malaria areas, LLINs and IRS combined rarely lead to sufficient reduction of transmission. The house improvement coupled with targeted larval source management conducted through community participation is likely to lead to a complete interruption of transmission in a sustainable manner.
Three interventions to reinforce and complement national malaria control recommendations were developed and applied within the context of a broad-based development initiative, targeting a rural population surrounding a wildlife reserve. The interventions, which were part of a 2-year research trial, and assigned to the village level, were implemented through trained local volunteers, or ‘health animators’, who educated the community and facilitated collective action.
Registered with The Pan African Clinical Trials Registry on 3 March 2016, trial number PACTR201604001501493.