Impact of long-lasting insecticide treated bednets with and without piperonyl butoxide (PBO) on malaria indicators in Uganda: a cluster-randomised trial
Malaria
A total of 104 clusters (defined as a health sub-district) have been included in the study, covering 48 districts in Eastern and Western Uganda. Clusters are randomised by a member of the study team who is not based in Uganda, and who will not be directly involved in the field work to one of four groups, who receive different types of LLINs. Variation in the production capacity and the number of nets available for each manufacturer, is considered in the randomisation process, resulting in unequal numbers of clusters being allocated to each of the 4 study arms. Group 1: PermaNet 2.0 Group 2: PermaNet 3.0 Group 3: Olyset Net Group 4: Olyset Plus The Ugandan National Malaria Control Programme and other stakeholders will take the lead on delivering the LLINs to health sub districts in Uganda. Here, the plans for the net distribution campaign are described to provide background information on the intervention. The research team will only be responsible for carrying out the evaluation. Households in all intervention arms will receive 1 LLIN per 2 household members, rounded up in the case of an uneven number of household members. The bednets are deployed over the sleeping spaces in each household and are used to reduce the number of potentially malaria infectious bites received by household members whilst asleep. Social behaviour change communication (SBCC)/information, education, communication (IEC) will accompany net distribution to increase compliance. At each LLIN distribution point, a demonstration area will be set up to show how to correctly hang LLINs and to disseminate key messages about malaria, use of LLINs, and the importance of caring for the nets correctly. SBCC and health education sessions will focus on correct care and maintenance of LLINs, including washing, repair of holes and tears, and avoidance of sun when washing and drying nets. The evaluation will include repeated cross-sectional community surveys to gather information on net survivorship and us
Household inclusion criteria: 1. At least one household resident between 2-10 years of age present (with an adult caregiver willing to provide informed consent for the clinical survey) 2. At least one adult aged 18 years or older present 3. Adult is a usual resident who slept in the sampled household on the night before the survey 4. Agreement of the adult resident to provide informed consent for the household survey Children inclusion criteria: 1. Child aged 5 years and over 2. Usual resident who was present in the sampled household on the night before the survey 3. Agreement of parent/guardian to provide informed consent 4. Agreement of child aged 8 years or older to provide assent
Household exclusion criteria: 1. Dwelling destroyed or not found 2. Household vacant 3. No adult resident home on more than 3 occasions Children exclusion criteria: Child not home on day of survey