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Design of a study to determine the impact of insecticide resistance on malaria vector control: a multi-country investigation

Kleinschmidt I 1 , Mnzava AP 2 , Kafy HT 3 , Mbogo C 4 , Bashir AI 5 , Bigoga J 6 Show all authors , Adechoubou A 7 , Raghavendra K 8 , Knox TB 9 , Malik EM 10 , Nkuni ZJ 11 , Bayoh N 12 , Ochomo E 13 , Fondjo E 14 , Kouambeng C 15 , Awono-Ambene HP 16 , Etang J 17 , Akogbeto M 18 , Bhatt R 19 , Swain DK 20 , Kinyari T 21 , Njagi K 22 , Muthami L 23 , Subramaniam K 24 , Bradley J 25 , West P 26 , Massougbodji A 27 , Okê-Sopoh M 28 , Hounto A 29 , Elmardi K 30 , Valecha N 31 , Kamau L 32 , Mathenge E 33 , Donnelly MJ 34

Affiliations 

  • 1 MRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK. Immo.Kleinschmidt@lshtm.ac.uk
  • 2 Global Malaria Programme, World Health Organization, Avenue Appia, Geneva, Switzerland. mnzavaa@who.int
  • 3 Federal Ministry of Health, PO Box 1204, Khartoum, Sudan. hmoodatuok@gmail.com
  • 4 KEMRI Centre for Geographic Medicine Research Coast, P.O. Box 230, Kilifi, 80108, Kenya. CMbogo@kemri-wellcome.org
  • 5 Khartoum State Malaria Control Programme, VBDC, P.O. Box 1517, Khartoum, Sudan. bashiradam69@yahoo.co.uk
  • 6 National Reference Unit (NRU) for Vector Control, The Biotechnology Center, University of Yaoundé I, Messa, P.O. Box 3851, Yaoundé, Cameroon. jbigoga@gmail.com
  • 7 Programme National de Lutte conte le Paludisme (PNLP), Ministère de la Santé, Cotonou, Benin. aliounadechoubou@hotmail.com
  • 8 Department of Health Research, National Institute of Malaria Research, (GoI), Sector 8, Dwarka, Delhi, 110 077, India. kamarajur2000@yahoo.com
  • 9 Global Malaria Programme, World Health Organization, Avenue Appia, Geneva, Switzerland. knoxt@who.int
  • 10 Ministry of Health, Wad Madani, Gezera State, Sudan. fatihmmalik@gmail.com
  • 11 Global Malaria Programme, World Health Organization, Avenue Appia, Geneva, Switzerland. nkuni50@yahoo.com
  • 12 KEMRI/CDC Research and Public Health Collaboration, PO Box 1578, Kisumu, 40100, Kenya. NBayoh@kemricdc.org
  • 13 KEMRI/CDC Research and Public Health Collaboration, PO Box 1578, Kisumu, 40100, Kenya. EOchomo@kemricdc.org
  • 14 National Malaria Control Programme, Ministry of Public Health, PO Box 14386, Yaoundé, Cameroon. fondjoetienne@yahoo.fr
  • 15 National Malaria Control Programme, Ministry of Public Health, PO Box 14386, Yaoundé, Cameroon. kouambeng@gmail.com
  • 16 Organisation de Coordination pour la Lutte contre les Endémies en Afrique Centrale (OCEAC), Yaoundé, Cameroon. hpaawono@yahoo.fr
  • 17 Organisation de Coordination pour la Lutte contre les Endémies en Afrique Centrale (OCEAC), Yaoundé, Cameroon. josyet2@gmail.com
  • 18 Centre de Recherche Entomologique de Cotonou, Cotonou, Benin. akogbetom@yahoo.fr
  • 19 Department of Health Research, National Institute of Malaria Research, (GoI), Sector 8, Dwarka, Delhi, 110 077, India. rmbhatt@rediffmail.com
  • 20 Department of Health Research, National Institute of Malaria Research, (GoI), Sector 8, Dwarka, Delhi, 110 077, India. dipakswain@gmail.com
  • 21 Department of Medical Physiology, School of Medicine, College of Health Sciences, University of Nairobi, Nairobi, Kenya. teresakinyari@yahoo.com
  • 22 Ministry of Health, Malaria Control Unit, PO Box 1992, Nairobi, 00202, Kenya. knjagi@domckenya.or.ke
  • 23 KEMRI Centre for Public Health Research, Nairobi, Kenya. muthamilawrence@yahoo.com
  • 24 Department of Vector Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK. Krishanthi.Subramaniam@lstmed.ac.uk
  • 25 MRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK. John.Bradley@lshtm.ac.uk
  • 26 MRC Tropical Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK. Philippa.West@lshtm.ac.uk
  • 27 Faculté des Sciences de la Santé, Université d'Abomey Calavi, Cotonou, Benin. massougbodjiachille@yahoo.fr
  • 28 Programme National de Lutte conte le Paludisme (PNLP), Ministère de la Santé, Cotonou, Benin. mariamoke@yahoo.fr
  • 29 Faculté des Sciences de la Santé, Université d'Abomey Calavi, Cotonou, Benin. aurorefel@yahoo.fr
  • 30 Federal Ministry of Health, PO Box 1204, Khartoum, Sudan. khalid.elmardi@gmail.com
  • 31 Department of Health Research, National Institute of Malaria Research, (GoI), Sector 8, Dwarka, Delhi, 110 077, India. neenavalecha@gmail.com
  • 32 KEMRI-Centre for Biotechnology and Research Development, Nairobi, Kenya. LKamau@kemri.org
  • 33 KEMRI-Eastern and Southern Africa Centre of International Parasite Control, Nairobi, Kenya. mathengeevan@gmail.com
  • 34 Department of Vector Biology, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, L3 5QA, UK. martin.donnelly@lstmed.ac.uk
Malar J, 2015 Jul 22;14:282.
PMID: 26194648 DOI: 10.1186/s12936-015-0782-4

Abstract

BACKGROUND: Progress in reducing the malaria disease burden through the substantial scale up of insecticide-based vector control in recent years could be reversed by the widespread emergence of insecticide resistance. The impact of insecticide resistance on the protective effectiveness of insecticide-treated nets (ITN) and indoor residual spraying (IRS) is not known. A multi-country study was undertaken in Sudan, Kenya, India, Cameroon and Benin to quantify the potential loss of epidemiological effectiveness of ITNs and IRS due to decreased susceptibility of malaria vectors to insecticides. The design of the study is described in this paper.

METHODS: Malaria disease incidence rates by active case detection in cohorts of children, and indicators of insecticide resistance in local vectors were monitored in each of approximately 300 separate locations (clusters) with high coverage of malaria vector control over multiple malaria seasons. Phenotypic and genotypic resistance was assessed annually. In two countries, Sudan and India, clusters were randomly assigned to receive universal coverage of ITNs only, or universal coverage of ITNs combined with high coverage of IRS. Association between malaria incidence and insecticide resistance, and protective effectiveness of vector control methods and insecticide resistance were estimated, respectively.

RESULTS: Cohorts have been set up in all five countries, and phenotypic resistance data have been collected in all clusters. In Sudan, Kenya, Cameroon and Benin data collection is due to be completed in 2015. In India data collection will be completed in 2016.

DISCUSSION: The paper discusses challenges faced in the design and execution of the study, the analysis plan, the strengths and weaknesses, and the possible alternatives to the chosen study design.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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