Reducing the Burden of Malaria by Targeting Hotspots of Malaria Transmission
London School of Hygiene & Tropical Medicine, London, UK
London School of Hygiene and Tropical Medicine

      In this study, the investigators propose to determine the value of rolling out four targeted
      malaria control efforts in reducing overall malaria transmission. These targeted control
      efforts include local upscaling of IRS and ITNs in hotspots of malaria transmission. In
      addition, larviciding will be employed to target malaria vectors, also those that are less
      susceptible to IRS and ITNs as a consequence of outdoor feeding and resting. Lastly, the
      human infectious reservoir will be reduced in hotspots of malaria transmission by treating
      parasite carriers and their household members with the current first-line antimalarial drug.
      The impact of these targeted interventions on overall transmission intensity will be assessed
      in the context of currently ongoing malaria control activities in a plausibility study.
      Hotspots of malaria transmission are defined in an area of 100km2 and randomized to receive
      hotspot targeted interventions and compared with their baseline and with control clusters
      where the routine (untargeted) malaria control activities continue. The interventions will be
      evaluated based on changes in parasite prevalence measured in community surveys inside and
      outside hotspots of malaria transmission. Parasite prevalence will be compared before and
      after the intervention in intervention clusters and between intervention and control
      clusters.

      In addition to malaria surveys in the human population, an entomological evaluation will take
      place where the densities of mosquito larvae and adult mosquitoes are monitored
      longitudinally.
    
Biological