Malaria is responsible for three million deaths annually. 90% of all malaria morbidity and mortality occur in sub-Saharan Africa and 1/3 of malaria attributable deaths occur among refugees. Malaria poses the most significant disease risk among refugee children under 5 yrs, and this risk is exacerbated in complex humanitarian emergencies (CHE). Refugee camps distribute plastic sheeting provided by the UNHCR for use as shelters/homes, and recent laboratory testing has successfully demonstrated that Insecticide-Impregnated Plastic Sheeting (IIPS, using deltamethrin) is non-toxic to humans and has longevity similar to Untreated Plastic Sheeting (UPS). This trial will be the first full-scale evaluation of IIPS.
The primary objective of this trial is to determine the rates of malaria among children under 5 years of age living in IIPS shelters and among children under 5 years of age living in UPS shelters. Secondary objectives are to determine 1) the human (mosquito) landing rate, 2) the rate of sporozoite-positive Anopheles spp., 3) the rates of other vector-borne diseases, and 4) the rates of ARI, measles, diarrhea, and malnutrition.
A double-blind, controlled, cluster-randomized trial will be conducted for the first 3 - 4 months (acute phase) of a CHE. Both individual and cluster level analyses will be conducted, using statistical techniques such as two-sample t-tests, modified (for cluster randomization) chi-square tests, time-to-event (Kaplan-Meier) analyses, log-rank tests, Wilcoxon rank-sum tests, and generalized estimating equations.
Establishing the effectiveness of this novel technology will help guide malaria control efforts in complex emergency settings.
Learning Objectives: none
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.