Browsing by Author "Bradley, John"
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Item A household randomized-control trial of insecticide-treated screening for malaria control in unimproved houses in Tanzania(Springer Nature, 2025-06-08) Odufuwa, Olukayode; Moore, Sarah Jane; Mboma, Zawadi; Mwanga, Rehema; Matwewe, Fatuma; Hofer, Lorenz; Moore, Jason; Nguyen, Hien; Bosselmann, Rune; Skovmand, Ole; Stevenson,Jennifer; Muganga, Joseph; Bradley, JohnBackground Installing insecticidal netting on open eaves, windows, and holes in walls of unimproved houses is a potential malaria control tool. It prevents mosquito house-entry, induces lethal and sub-lethal effects on malaria vectors, and may reduce malaria transmission. Therefore, a household epidemiological trial was conducted to assess the efficacy of insecticide- treated screening (ITS) on malaria infection and indoor vectors in Tanzania. Methods In Chalinze district, Tanzania, 421 households were randomized into two arms. In June-July 2021, one group of households’ houses was fitted with ITS (incorporated with deltamethrin and piperonyl butoxide) on eaves, windows, and wall holes, while the second group did not receive screening. After installation, consenting household members (aged ≥ 6 months) were tested for malaria infection using quantitative polymerase chain reaction after the long rainy season (June/July 2022, primary outcome) and the short rainy season (January/February 2022, secondary outcome). Secondary outcomes included indoor total mosquito per trap/night (June–July 2022), adverse effects after one month of ITS installation (August 2021), and chemical bioavailability and retention of ITS samples after one year of field use (June/July 2022). At the end of the trial, the control group received ITS. Results Malaria prevalence among residents in the ITS arm was 19.9% (50/251) and 28.3% (65/230) in the control arm after the long rains, however, this difference was not significant [adjusted odds ratio (OR) 0.67 (95% CI 0.35–1.28), p = 0.227]. Similarly, no protection was seen for ITS after the short rains, [OR 1.27 (95% CI 0.68–2.38), p = 0.452]. However, school-age children in the ITS arm had lower malaria after the long rains [OR 0.11 (95% CI 0.02–0.73), p = 0.022]. No serious adverse effects were reported. The mean number of female Anopheles mosquitoes caught per trap/night was not significantly different between arms [1.7 vs 2.4, crude relative risk: 0.71 (95% CI 0.16–3.09), p = 0.650]. ITS showed reduced chemical bioavailability and retention post-field use. The trial reported high household refusals (17–30%) in both arms in both surveys. Conclusion The trial was inconclusive because households’ refusal resulted in low power. A large cluster randomized trial of the intervention, preferably with screens treated with longer-lasting insecticides installed in houses, is needed. Trial registry: The trial was registered at ClinicalTrials.gov (NCT05125133) on October 2021 Keywords Insecticide-treated screening, ITS, Insecticide-treated nets, ITNs, Eave nets, Malaria prevalence, Mosquitoes, Trial, House modification, TanzaniaItem Meta-analysis on the entomological effects of differentially treated ITNs in a multi-site experimental hut study in sub-Saharan Africa(BMC, 2025-02-04) Lissenden, Natalie; Bradley, John; Menze, Benjamin; Wondji, Charles; Edi, Constant; Koudou, Benjamin; N’Guessan, Raphael; Bayili, Koama; Diabaté, Abdoulaye; Mbewe, Njelembo; Emidi, Basiliana; Mosha, Jacklin; Manjurano, Alphaxard; Small, Graham; Oumbouke, Welbeck; Moore, Sarah; Nimmo, Derric; Snetselaar, JannekeBackground Restricting the placement of active ingredients (AIs) to specific panels on insecticide-treated nets (ITNs) has the potential to reduce the amount of AI required to treat a net. If the restricted placement of the AIs can exploit mosquito behaviour, particularly where they interact with the bed net interface, and not impact the net’s effectiveness, then the reduction in AI could result in cost reductions. Methods Nine individual experimental hut trials were conducted to compare the efficacy of three different partially-treated net relative to fully treated nets; roof-only treated nets, side-only treated nets, and nets with treated roof and pyrethroid-only side panels. These trials were conducted on a range of net products with different AIs, across a range of geographies in Africa (East and West), vector species (Anopheles gambiae, Anopheles coluzzii, Anopheles arabiensis, and Anopheles funestus), hut designs (East and West African style) and hosts (cows and humans). The combined data from these trials were analysed in a meta-analysis, and odds ratios for the effect of the different net designs on mortality and blood-feeding were estimated using mixed effects logistic regression. Results The results of this meta-analysis demonstrated that fully treated nets provide greater mosquito killing and reduction in blood-feeding effects than any configuration of insecticide treatment restricted to specific panels. Conclusions This meta-analysis showed that partially-treated net that restrict the insecticide treatment to specific panels of an ITN do not give equivalency or superiority in either mortality or blood-feeding inhibition to fully treated nets. The implications of these findings are discussed.Item SC Johnson Guardian™ spatial repellent shows 1-year efficacy against wild pyrethroid-resistant Anopheles arabiensis, with a similar blood-feeding inhibition efficacy to Mosquito Shield™ in a Tanzanian experimental hut trial(Frontiers, 2025-06-23) Swai, Johnson; Ntabaliba, Watson; Mbuba, Emmanuel; Ngoyani, Hassan; Makungwa, Noely; Mseka, Antony; Bradley, John; Chura, Madeleine; Mascari, Thomas; Moore, Sarah JaneBackground: Spatial repellents (SRs) that passively emanate airborne concentrations of an active ingredient within a space disrupt mosquito behaviors to reduce human-vector contact. A clinical trial of SC Johnson’s Mosquito Shield™ (Mosquito Shield) demonstrated a 33% protective efficacy against malaria in Kenya. Mosquito Shield lasts for 1 month, but a longer duration product is needed for malaria control programs. SC Johnson’s Guardian™ (Guardian) is designed to provide longer continuous protection from disease-transmitting mosquitoes. Methods: We conducted experimental hut trials to i) evaluate the efficacy of Guardian over 12 months (between May 2022 and May 2023) and ii) assess the potential public health utility of Guardian by comparing it to Mosquito Shield over 1 month (midway through the Guardian evaluation in November 2022) against wild pyrethroid-resistant malaria vector mosquitoes. The primary endpoint was the number of blood-fed Anopheles arabiensis, while secondary endpoints were the proportion of dead An. arabiensis at 24 hours and the proportion of blood-fed mosquitoes. For Guardian, the number of mosquito landings was also evaluated by human landing catch, a method routinely used in community or implementation studies. Results: Over 12 months of continuous use, Guardian reduced the number of An. arabiensis blood-feeding by 82.7% [95% confidence interval (78.5%–86.1%)] and landing by 65.1% (59.4%– 70.0%). Guardian also induced 20.1% mortality (18.4%–21.8%). Guardian was found to be superior to Mosquito Shield in reducing the number of blood-fed An. arabiensis with similar proportions of blood-fed and dead mosquitoes at 24 hours. Conclusion: Guardian was effective in reducing blood-feeding and landing of wild pyrethroid-resistant malaria vectors for 12 months and shows superior protective efficacy compared to Mosquito Shield in reducing the overall number of blood-feeding mosquitoes. Experimental hut studies are suitable for comparative evaluations of new spatial repellent products because they precisely estimate entomological endpoints elicited by spatial repellents known to significantly impact vectorial capacity and disease transmission.