Abstract:
BACKGROUND : The combined application of long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) are
commonly used malaria interventions that target indoor Anopheles vectors. Recent studies on the effects of house
screening (HS) and LLINs have demonstrated a reduction in indoor vector densities and malaria when the interventions
are combined. In addition, complementary interventions are needed to curb co-occurring pest populations
which pose menace to agricultural crop productivity and food security. However, interventions that impact malaria
mainly centre on public health strategies, overlooking subtle but important component of agricultural measures.
Addressing the coexisting risks of malaria and crop pests could contribute to improved livelihood of communities.
METHODS : A four-armed household, cluster-randomized, controlled study will be conducted to assess the combined
impact of HS, LLINs and push-pull agricultural technology (PPT) against clinical malaria in children in Ethiopia. The
unit of randomization will be the household, which includes a house and its occupants. A total of 838 households will
be enrolled in this study. In this trial 246 households will receive LLINs and HS, 250 will receive LLINs, HS and PPT, 175
households will receive LLINs and PPT. The remaining 167 houses which receive LLINs only will be used as control.
One child aged ≤14 years will be enrolled per household in each treatment and followed for clinical malaria using
active case detection to estimate malaria incidence for two malaria transmission seasons.
DISCUSSION : Episodes of clinical malaria, density of indoor biting malaria vectors, sporozoite infection rate, improved
crop infestation rate, crop yield gain, livestock productivity and cost effectiveness analysis will be the end points of
this study. Socio-economic, social demographic, cost-effectiveness analysis will be conducted using qualitative and
participatory methods to explore the acceptability of HS and PPT. Documenting the combined impact of LLINs, HS
and PPT on the prevalence of clinical malaria and crop pest damage will be the first of its kind.
TRIAL REGISTRATION : Pan African Clinical Trials Registry, PACTR202006878245287. 24/06/2020.
