Reducing malaria transmission in forest-going mobile and migrant populations in Lao PDR and Cambodia: protocol for stepped-wedge cluster-randomised controlled trial
Abstract Background Countries of the Greater Mekong Sub-region aim to achieve malaria elimination by 2030. In the region, malaria is concentrated in high-risk areas and populations such as forest-going mobile and migrant populations (MMPs). However, routine protective measures such as long-lasting i...
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| Format: | Article |
| Language: | English |
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BMC
2022-09-01
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| Series: | BMC Infectious Diseases |
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| Online Access: | https://doi.org/10.1186/s12879-022-07724-5 |
| _version_ | 1828373729418149888 |
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| author | Win Htike Win Han Oo Thet Lynn Lun Sovanda Paul A. Agius May Chan Oo Naw Hkawng Galau Kaung Myat Thu Aung Khine Zaw Ei Phyu Htwe Julia C. Cutts Ellen A. Kearney Nick Scott Katherine O’Flaherty Bangyuan Wang Boualam Khamlome Phoutnalong Vilay Sovannaroth Siv Freya J. I. Fowkes |
| author_facet | Win Htike Win Han Oo Thet Lynn Lun Sovanda Paul A. Agius May Chan Oo Naw Hkawng Galau Kaung Myat Thu Aung Khine Zaw Ei Phyu Htwe Julia C. Cutts Ellen A. Kearney Nick Scott Katherine O’Flaherty Bangyuan Wang Boualam Khamlome Phoutnalong Vilay Sovannaroth Siv Freya J. I. Fowkes |
| author_sort | Win Htike |
| collection | DOAJ |
| description | Abstract Background Countries of the Greater Mekong Sub-region aim to achieve malaria elimination by 2030. In the region, malaria is concentrated in high-risk areas and populations such as forest-going mobile and migrant populations (MMPs). However, routine protective measures such as long-lasting insecticidal nets do not prevent all infectious bites in these high-risk populations. Evidence for the effectiveness of a personal protection package tailored to forest-going MMPs which is acceptable, feasible, and cost-effective for reducing malaria transmission is required to inform the malaria elimination toolkit in the region. Methods A personal protection package consisting of long-lasting insecticidal hammock net, insect repellent and health communication pamphlet was developed in consultation with relevant implementing partners from Cambodia and Lao PDR. An open stepped-wedge cluster-randomised controlled trial will be conducted over a period of 12 months in a minimum of 488 villages (~ 428 in Lao PDR and ~ 60 in Cambodia) to evaluate the effectiveness of the personal protection package. Villages will be randomised into 11 blocks, with blocks transitioned in random order from control to intervention states at monthly intervals, following a 1-month baseline period. The primary outcome of the trial is the prevalence of Plasmodium spp. infection diagnosed by rapid diagnostic test. Difference in prevalence of malaria infection will be estimated across intervention and control periods using generalized linear mixed modelling. Nested within the stepped-wedge cluster-randomised controlled trial is a mixed-methods study to explore the acceptability of the personal protection package, feasibility of implementing a personal protection package as a vector control intervention, and knowledge, attitude and practice of MMPs regarding malaria prevention; and cost-analysis to determine the cost-effectiveness of implementing a personal protection package. Discussion This study, using a rigorous design and mixed-methods methodology, will evaluate whether a personal protection package can reduce residual malaria transmission among forest-going MMPs in Cambodia and Lao PDR. It will also measure implementation research outcomes such as effectiveness of the intervention package, cost-effectiveness, acceptability, and feasibility, in order to inform potential national and regional policy. Trial registration This trial was prospectively registered on ClinicalTrials.gov (NCT05117567) on 11th November 2021 |
| first_indexed | 2024-04-14T07:22:30Z |
| format | Article |
| id | doaj.art-56d10da8ae4348709c343703cee0dcb8 |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-04-14T07:22:30Z |
| publishDate | 2022-09-01 |
| publisher | BMC |
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| series | BMC Infectious Diseases |
| spelling | doaj.art-56d10da8ae4348709c343703cee0dcb82022-12-22T02:06:06ZengBMCBMC Infectious Diseases1471-23342022-09-012211810.1186/s12879-022-07724-5Reducing malaria transmission in forest-going mobile and migrant populations in Lao PDR and Cambodia: protocol for stepped-wedge cluster-randomised controlled trialWin Htike0Win Han Oo1Thet Lynn2Lun Sovanda3Paul A. Agius4May Chan Oo5Naw Hkawng Galau6Kaung Myat Thu7Aung Khine Zaw8Ei Phyu Htwe9Julia C. Cutts10Ellen A. Kearney11Nick Scott12Katherine O’Flaherty13Bangyuan Wang14Boualam Khamlome15Phoutnalong Vilay16Sovannaroth Siv17Freya J. I. Fowkes18Disease Elimination Program, Burnet InstituteDisease Elimination Program, Burnet InstituteHealth Poverty ActionHealth Poverty ActionDisease Elimination Program, Burnet InstituteDisease Elimination Program, Burnet InstituteDisease Elimination Program, Burnet InstituteDisease Elimination Program, Burnet InstituteDisease Elimination Program, Burnet InstituteDisease Elimination Program, Burnet InstituteDisease Elimination Program, Burnet InstituteDisease Elimination Program, Burnet InstituteDisease Elimination Program, Burnet InstituteDisease Elimination Program, Burnet InstituteHealth Poverty ActionCenter of Malariology Parasitology and Entomology, Ministry of HealthCenter of Malariology Parasitology and Entomology, Ministry of HealthNational Center for Parasitology Entomology and Malaria Control, Ministry of HealthDisease Elimination Program, Burnet InstituteAbstract Background Countries of the Greater Mekong Sub-region aim to achieve malaria elimination by 2030. In the region, malaria is concentrated in high-risk areas and populations such as forest-going mobile and migrant populations (MMPs). However, routine protective measures such as long-lasting insecticidal nets do not prevent all infectious bites in these high-risk populations. Evidence for the effectiveness of a personal protection package tailored to forest-going MMPs which is acceptable, feasible, and cost-effective for reducing malaria transmission is required to inform the malaria elimination toolkit in the region. Methods A personal protection package consisting of long-lasting insecticidal hammock net, insect repellent and health communication pamphlet was developed in consultation with relevant implementing partners from Cambodia and Lao PDR. An open stepped-wedge cluster-randomised controlled trial will be conducted over a period of 12 months in a minimum of 488 villages (~ 428 in Lao PDR and ~ 60 in Cambodia) to evaluate the effectiveness of the personal protection package. Villages will be randomised into 11 blocks, with blocks transitioned in random order from control to intervention states at monthly intervals, following a 1-month baseline period. The primary outcome of the trial is the prevalence of Plasmodium spp. infection diagnosed by rapid diagnostic test. Difference in prevalence of malaria infection will be estimated across intervention and control periods using generalized linear mixed modelling. Nested within the stepped-wedge cluster-randomised controlled trial is a mixed-methods study to explore the acceptability of the personal protection package, feasibility of implementing a personal protection package as a vector control intervention, and knowledge, attitude and practice of MMPs regarding malaria prevention; and cost-analysis to determine the cost-effectiveness of implementing a personal protection package. Discussion This study, using a rigorous design and mixed-methods methodology, will evaluate whether a personal protection package can reduce residual malaria transmission among forest-going MMPs in Cambodia and Lao PDR. It will also measure implementation research outcomes such as effectiveness of the intervention package, cost-effectiveness, acceptability, and feasibility, in order to inform potential national and regional policy. Trial registration This trial was prospectively registered on ClinicalTrials.gov (NCT05117567) on 11th November 2021https://doi.org/10.1186/s12879-022-07724-5MalariaPreventionVectorMigrantEliminationVivax |
| spellingShingle | Win Htike Win Han Oo Thet Lynn Lun Sovanda Paul A. Agius May Chan Oo Naw Hkawng Galau Kaung Myat Thu Aung Khine Zaw Ei Phyu Htwe Julia C. Cutts Ellen A. Kearney Nick Scott Katherine O’Flaherty Bangyuan Wang Boualam Khamlome Phoutnalong Vilay Sovannaroth Siv Freya J. I. Fowkes Reducing malaria transmission in forest-going mobile and migrant populations in Lao PDR and Cambodia: protocol for stepped-wedge cluster-randomised controlled trial BMC Infectious Diseases Malaria Prevention Vector Migrant Elimination Vivax |
| title | Reducing malaria transmission in forest-going mobile and migrant populations in Lao PDR and Cambodia: protocol for stepped-wedge cluster-randomised controlled trial |
| title_full | Reducing malaria transmission in forest-going mobile and migrant populations in Lao PDR and Cambodia: protocol for stepped-wedge cluster-randomised controlled trial |
| title_fullStr | Reducing malaria transmission in forest-going mobile and migrant populations in Lao PDR and Cambodia: protocol for stepped-wedge cluster-randomised controlled trial |
| title_full_unstemmed | Reducing malaria transmission in forest-going mobile and migrant populations in Lao PDR and Cambodia: protocol for stepped-wedge cluster-randomised controlled trial |
| title_short | Reducing malaria transmission in forest-going mobile and migrant populations in Lao PDR and Cambodia: protocol for stepped-wedge cluster-randomised controlled trial |
| title_sort | reducing malaria transmission in forest going mobile and migrant populations in lao pdr and cambodia protocol for stepped wedge cluster randomised controlled trial |
| topic | Malaria Prevention Vector Migrant Elimination Vivax |
| url | https://doi.org/10.1186/s12879-022-07724-5 |
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