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. 2008 Jun 6:9:33.
doi: 10.1186/1745-6215-9-33.

Study protocol for a three-armed randomized controlled trial to assess whether house screening can reduce exposure to malaria vectors and reduce malaria transmission in The Gambia

Matthew J Kirby  1 , Paul J Milligan, David J Conway, Steve W Lindsay
Affiliations

Study protocol for a three-armed randomized controlled trial to assess whether house screening can reduce exposure to malaria vectors and reduce malaria transmission in The Gambia

Matthew J Kirby et al. Trials. .

Abstract

Background: Mosquito-proofing homes was one of the principal methods of environmental management in the early 1900s. House screening provides protection against malaria by reducing exposure to malaria parasites and has the added benefit of protecting everyone sleeping in the house, avoiding issues of inequity within the household. The aim of this study is to determine whether house screening protects people against malaria in Africa. It is hoped that this study will mark the beginning of a series of trials assessing a range of environmental interventions for malaria control in Africa.

Design: A 3-armed randomised-controlled trial will be conducted in and around Farafenni town in The Gambia, West Africa, to assess whether screening windows, doors and closing eaves or installing netting ceilings in local houses can substantially reduce malaria transmission and anaemia compared to homes with no screening. Eligible houses will be sorted and stratified by location and the number of children in each house, then randomly allocated to the interventions in blocks of 5 houses (2 with full screening, 2 with screened ceilings and 1 control house without screening). Risk of malaria transmission will be assessed in each house by routine collections of mosquitoes using light traps and an anaemia prevalence study in children at the end of the main transmission period.

Discussion: Practical issues concerning intervention implementation, as well as the potential benefits and risks of the study, are discussed.

Trial registration: ISRCTN51184253 - Screening-homes to prevent malaria.

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Figures

Figure 1
Figure 1
A screened entrance to a thatched house in rural Italy in 1900, in an experiment where screening reduced malaria by 96% [20]. This illustrates that even extremely poor housing can be protected from mosquitoes.
Figure 2
Figure 2
Installation of full screening intervention: a) screened door, b) screened window, c) closed eaves.
Figure 3
Figure 3
Installation of netting ceiling intervention: a) assessing rose height, b) installing ceiling and rose, c) installing battens.
See this image and copyright information in PMC

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