Project Details

Project Description

The massive scale-up of Long-Lasting Insecticidal Nets (LLINs) led to a major reduction in malaria burden (up to 50%) in many sub-Saharan African (SSA) countries. However, this progress was threatened by the widespread selection of insecticide-resistant malaria vectors.

The “New Nets” study was a cluster-randomised clinical trial conducted in the districts of Cove, Zagnanado, and Ouinhi, located in the Zou Department, Benin, West Africa by CREC/LSHTM team.

The first output of this research was to evaluate the efficacy of two novel dual active ingredient (AI) LLINs in a community randomised controlled trial using epidemiological outcomes. The trial was conducted over two years in an area where malaria vectors were resistant to pyrethroid insecticides.

This was a three-arm superiority, single-blinded, cluster-randomised trial, with the village serving as the unit of randomisation. The primary outcome of the trial was the incidence of malaria cases (confirmed by rapid diagnostic test [RDT]) in children aged 6 months to 10 years, who were followed for 24 months.

Secondary outcomes included:

Cross-sectional community prevalence of malaria infection (confirmed by RDT) at 12 and 24 months post-intervention Prevalence of moderate and severe anaemia in children under 5 years of age Entomological inoculation rates (EIR)

Vector density

Insecticide resistance intensity

The second output had two objectives. The first objective was to examine whether Phase II experimental hut trial outcomes could serve as a surrogate for epidemiological and transmission outcomes observed in cluster randomised trials. The second objective was to assess LLIN durability within a Phase III WHOPES/PQ study framework.