Assessment of the effect of larval source management and house improvement on malaria transmission when added to standard malaria control strategies in southern Malawi: study protocol for a cluster-randomised controlled trial

摘要: Due to outdoor and residual transmission insecticide resistance, long-lasting insecticidal nets (LLINs) indoor spraying (IRS) will be insufficient as stand-alone malaria vector control interventions in many settings programmes shift toward elimination. Combining additional part of an integrated strategy would potentially overcome these challenges. Larval source management (LSM) structural house improvements (HI) are appealing components plan because their long histories use, evidence on effectiveness appropriate settings, unique modes action compared LLINs IRS. Implementation LSM HI through a community-based approach could provide path for rolling-out sustainably large scale. We implement HI, the current national strategies, using randomised block, 2 × 2 factorial, cluster-randomised design rural, southern Malawi. These continued two years. The trial catchment area covers about 25,000 people living 65 villages. Community participation is encouraged by training community volunteers health animators, supporting organisation village-level committees collaboration with Hunger Project, non-governmental organisation. Household-level cross-sectional surveys, including parasitological entomological sampling, conducted rolling, 2-monthly schedule measure outcomes over years (2016 2018). Coverage also assessed throughout area. and/or together currently implemented Malawi National Malaria Control Programme anticipated reduce below level reached alone. provides opportunity optimum adaptation local ecological social setting, enhances potential sustainability. Registered Pan African Clinical Trials Registry 3 March 2016, number PACTR201604001501493.