Net Transition Initiative: Efficacy of Two Next-generation Nets for Control of Malaria in Cote d'Ivoire

Summary

The investigator plan to conduct a three-arm cluster-randomized control trial which compares two next generation of long-lasting Insecticidal Nets (LLINs); Veeralin®LLIN (PBO-py LLIN), Interceptor G2 (chlorfenapyr-py LLIN) to a standard py-LLIN in the department of Tiebissou Southern Bouake city, central Côte d'Ivoire.

The primary objective of the project is to evaluate the efficacy of chlorfenapyr-pyrethroid and piperonyl-butoxide (PBO) synergist-pyrethroid LLINs on malaria case incidence in children aged 6 months to 10 years compared to standard pyrethroid-only LLINs. The secondary objectives are to evaluate the efficacy of the two intervention LLINs compared to the standard LLIN on a) malaria infection prevalence in the general population (both children and adults), b) vector density and c) entomological inoculation rate (EIR) (as a proxy for malaria transmission). In addition, changes in phenotypic resistance intensity and selection for molecular resistance mechanisms at baseline and 12 months post-LLIN distribution, in sentinel villages in each treatment arm will be investigate.

It is vital to demonstrate that these next generation LLINs which are becoming the standard of care in Sub Saharan AFRICA, are superior to standard py-LLIN in the most extreme resistance areas as this is likely where alternative interventions will be most needed to keep malaria control on track. The trial will generate the first epidemiological evidence on the efficacy of PBO nets compared to py-LLIN in West Africa.

UPDATE: Following 1 year of follow-up, the trial was extended to assess the impact of the nets over a 3 year follow-up. In addition, we introduced school-based net top ups in half of the clusters- to evaluate the impact of top-up strategies on net ownership, access and usage and malaria outcomes.

Conditions

• Malaria

Interventions

OTHER

Alpha-cypermethrin and PBO LLIN

Veeralin Long lasting insecticidal net with Alpha-cypermethrin Pyrethroid insecticide and PBO

OTHER

Alpha-cypermethrin and Clorfenapyr LLIN

Interceptor G2 dual active ingredient LLIN with with Alpha-cypermethrin Pyrethroid insecticide and Clorfenapyr

OTHER

Alpha-cypermethrin only LLIN

reference: standard pyrethroid LLIN

OTHER

School-based net top ups in year 2 and year 3

Nets (of the same type in the original arms) will be distributed via schools in years 2 and 3

Sponsors & Collaborators

• Institut Pierre Richet

  collaborator OTHER_GOV

• University of Ottawa

  collaborator OTHER

• University of Nevada, Las Vegas

  collaborator OTHER

• Swiss Tropical & Public Health Institute

  collaborator OTHER

• London School of Hygiene and Tropical Medicine

  lead OTHER

Study Design

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

DOUBLE

Model

PARALLEL

Eligibility

Min Age

6 Months

Sex

ALL

Healthy Volunteers

Yes

Timeline & Regulatory

Start

2023-10-02

Primary Completion

2027-03-31

Completion

2027-07-31

Countries

• Côte d’Ivoire

Study Locations