Browsing by Author "Muganga, Joseph"

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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, John
Background 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, Tanzania
Efficacy of the BiteBarrier transfluthrin emanator against susceptible and resistant malaria and arbovirus vectors in the semi-field system in Tanzania
(bioRxiv, 2025-02-28) Maasayi, Masudi; Swai, Johnson; Muganga, Joseph; Moore, Jason; Stevenson, Jennifer; Coleman, Michael; Lobo, Neil; Moore, Sarah; Mgeni Mohamed Tambwe
Controlling mosquito-borne diseases is increasingly challenging due to factors such as outdoor and early biting mosquitoes and logistical or behavioral barriers, particularly in displaced populations where the use and efficacy of core interventions are inadequate. This study evaluated the impact of BiteBarrier, a transfluthrin-based spatial emanator, over eight weeks of aging against multiple mosquito species in semi-field system simulating both indoor and outdoor settings. We assessed the protective efficacy using both landing rate and feeding success methods across five mosquito species, including pyrethroid susceptible Anopheles gambiae sensu stricto (s.s.) and Aedes aegypti, An. gambiae s.s. with knock down resistance (KDR), and pyrethroid resistant An. funestus and Culex quinquefasciatus with upregulation of mixed function oxidases. The results show that the feeding endpoint provides more robust estimates of protective efficacy compared to the landing endpoint. The BiteBarrier provided over 93% (95% CI: 92 - 93) protection indoors and 80% (95% CI: 78 - 81) outdoors against mosquito bites and substantial mortality 47% (95% CI: 43 - 53) indoor and 26% (95% CI: 22 - 30) outdoors, regardless of mosquito species or resistance status. Overall, the BiteBarrier shows potential as a tool for reducing mosquito bites and vectorial capacity, offering protection over at least eight weeks of use for both indoor and outdoor environments.
Fabric integrity, net type and risk index predicts attrition of insecticide-treated nets: evidence from a community durability trial of piperonyl butoxide (PBO) nets in Tanzania
(Malaria Journal, 2025-11-26) Mvungi, Nolvin; Olukayode, Odufuwa; Ruzige, Philipo; Muganga, Joseph; Mmasi, Dorin; Machange, Jane; Kamande, Dismas; Madumla,Edith; Moore, Jason; Mwema, Mwema; Moore, Sarah; Mbuba, Emmanuel
The fabric integrity of insecticide-treated nets (ITNs) deteriorates over time during household use, often leading households to discard or stop using damaged nets. This study quantified the extent to which net loss from households is attributable to declining fabric integrity, accounting for variation in user behaviour and environmental conditions. Methods This secondary analysis used data from an ITN durability trial in Bagamoyo, Tanzania. A total of 2,514 ITNs (three pyrethroid-PBO and one pyrethroid-only) distributed among 1,509 households were included because they had the outcome of interest (attrition). Fabric integrity was classified as good, damaged, or too-torn according to WHO ITN guidelines and assessed at 12-month intervals. The association between fabric integrity and net attrition over the subsequent 12 months was evaluated using an adjusted logistic regression model, accounting for net type, household risk index, household size, and age of the household head as fixed effects, with household as a random effect. Results Attrition increased over time, from 20% at one year to 53% at two years, and 83% at three years post-distribution, and it was associated with net type, household risk index, household size, and age of the household head. Damaged ITNs at one year were more likely to be lost by year two. Compared to nets in good condition, damaged nets had higher odds of attrition (OR: 1.73, 95% CI: 1.06-2.82), and too-torn nets were at greater risk (OR: 9.82, 95% CI: 5.87-16.4). Similar patterns were observed between years two and three (damaged: OR =1.55, 95% CI: 0.83-2.90; too- torn: OR=11.7, 95% CI: 6.16-22.3).ACCEPTED MANUSCRIPTARTICLE IN PRESS ARTICLE IN PRESSConclusion Fabric integrity was the main driver of rapid ITN attrition and the strongest predictor of loss. Damaged nets were approximately twice as likely to be discarded after one year and at least ten times more likely to be lost in years two and three. These findings highlight the importance of promoting proper net care practices and procuring durable nets that withstand harsh household conditions, ensuring sustained population coverage.
PRONet Duo insecticide-treated net incorporated with chlorfenapyr and bifenthrin is superior to Interceptor® G2 nets against pyrethroid-resistant Anopheles gambiae sensu lato: a randomized experimental hut trial in Côte d’Ivoire and Tanzania using non-inferiority design
(Frontiers, 2025-03-14) Assenga, Alphonce; Ahoua Alou, Ludovic; Camara, Soromane; Koffi, Alphonsine; N’Guessan, Raphael; Kamande, Dismas; Ngonyani, Safina; Kibondo, Ummi; Odufuwa, Olukayode; Ntabaliba, Watson; Lekundayo, Ruth; Abilah, Faraji; Madumla, Edith; Muganga, Joseph; Moore, Jason; Moore, Sarah
Background: The widespread development of pyrethroid-resistant Anopheles populations, has reduced the efficacy of pyrethroid insecticide-treated nets (ITNs), hindering malaria control efforts. This study tested PRONet Duo, a new ITN with two active ingredients-bifenthrin and chlorfenapyr. Bifenthrin is a fluorinated pyrethroid that is highly stable and more slowly detoxified by pyrethroid-resistant mosquitoes. Chlorfenapyr disrupts cellular energy production. The efficacy of PRONet Duo was compared to Interceptor® G2, an alpha-cypermethrin and chlorfenapyr ITN with proven efficacy in malaria reduction. Methods: The study was conducted in two identical 9x9 Latin square experimental hut trials against wild free-flying Anopheles gambiae sensu lato in M’Bé, Côte d’Ivoire, and Lupiro, Tanzania using 18 experimental huts over 108 nights. The primary endpoint was the proportion of 72-hour mosquito mortality (M72) and the secondary endpoint was the proportion of mosquito blood-feeding. The study was done following World Health Organization guidelines. Data were analyzed using mixed-effect linear regression with a 7% margin of non-inferiority. Data were classified as non-inferior using delta and superior using the line of no difference. Results: PRONet Duo demonstrated a non-inferior and superior mosquito mortality compared to Interceptor® G2 in both study sites. In Côte d’Ivoire, the M72 of PRONet Duo was 84% [81,88], higher than that of Interceptor® G2 (72% [68,76], OR: 1.54 [1.27,1.88]) and it was superior to MAGNet® (30% [27,34], OR: 13.74 [11.35,16.63], p<0.0001). In Tanzania, M72 of PRONet Duo was 68% [62,73], higher than that induced by Interceptor® G2 (44% [40,49], Odds Ratio (OR): 2.77 [2.31, 3.33]), and MAGNet® (36% [32,41], OR:4.82 [4.06,5.72] p<0.0001). PRONet Duo also induced non-inferior and superior prevention of blood-feeding compared to Interceptor® G2, with less than 11% feeding success observed in either trial site. Conclusion: PRONet Duo ITNs are non-inferior and superior to the first-in-class Interceptor® G2 in terms of mosquito mortality and prevention of blood-feeding demonstrating the added benefit of bifenthrin for insecticide resistance management. Both chlorfenapyr nets offered superior mortality compared to the pyrethroid-only ITN. PRONet Duo offers an additional highly effective ITN for control of pyrethroid-resistant mosquitoes in malaria endemic regions.