Combined evaluation of long-lasting insecticidal nets, house screening and push-pull technology as appropriate interventions for integrated management of malaria vectors and cereal pests in Ethiopia: study protocol for household randomized controlled trial
Introduction: The combined application of long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) has led to mixed results (Significant reduction vs no impact) on malaria burden. Other studies have attempted to study the combined effects of house screening (HS) and LLINs have demonstrated a reduction in indoor vector densities and malaria when the interventions are combined. In addition to malaria vectored by mosquitoes, farmers living in rural settings face challenges from
... p pests, which significantly reduce agricultural productivity and negatively impact their food security. Thus, addressing the coexisting risks of malaria and crop pests could contribute to the improved livelihood of communities. Design: A three-armed household, cluster-randomized, controlled study will be conducted to assess the impact of HS, LLINs, and PPT against clinical malaria in children than LLINs alone in Ethiopia. The unit of randomization will be the household, which includes a house and its occupants. A total of 663 households will be enrolled in this study. All the households will receive the LLINs. Then other treatments will be overlaid according to the randomization sequence. Thus, 246 households will receive HS, and 250 households will receive HS and PPT before the commencement of clinical follow-up. The rest 167 houses that received LLINs only will be used as control. One child aged not more than 14 years will be enrolled from each household and followed for clinical malaria using active case detection to estimate malaria incidence for two malaria transmission seasons. Results: Episodes of clinical malaria, the prevalence of anaemia, density of malaria vector mosquitoes, sporozoite infection rate, crop infestation rate due to stem borer and fall armyworm, crop yield gain, livestock productivity, and cost-effectiveness analysis will be the endpoints 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. Conclusion 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 and will provide deep insight and evidence base for forging collaborations between health and agriculture sectors. Trial Registration: The protocol was registered online on Date 28/05/2020 on sight www.pactr.org With registration No: PACTR202006878245287.