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Determining Effectiveness of Insecticide Treated Durable Wall Liners

Research Overview

The National Institute for Medical Research (NIMR), in collaboration with the Kilimanjaro Christian Medical College and London School of Hygiene and Tropical Medicine, is conducting research on insecticide-treated durable wall lining (DL) as a novel vector control measure in the Muheza and Handeni districts of the Tanga region of Tanzania. The study will assess the effectiveness of DL used in combination with long- lasting insecticide treated bednets (LLINs) compared to LLINs alone, in areas that have universal coverage of LLINs. It is estimated that the cost of DL is about the same as 2-3 rounds of indoor residual spraying (IRS).  In addition, DL lasts for about three years compared to IRS which lasts for only 3-12 months. Thus, DL could be a cost-effective substitute to IRS. This research will use a two arm study to determine the added benefit of DL on malaria transmission and control.


Project Location

Tanzania: Muheza and Handeni Districts, Tanga Region


Research Objectives

The primary objectives of the research are to: 
  • Measure the effectiveness of DL + LLINs compared with LLINs alone on the cumulative incidence of malaria parasitemia among children 6 months to 11 years of age;
  • Measure the impact of DL + LLINs compared with that of LLINs alone on malaria entomological inoculation rates.
Secondary objectives include:
  • Measure the effectiveness of DL + LLINs compared with LLINs alone on the time to first episode of malaria parasitemia and on mean hemoglobin among children 6 months to 11 years of age;
  • Monitor insecticide resistance in malaria vectors and determine the impact of DL + LLINs on abundance of outdoor host-seeking mosquitoes and host feeding preference of mosquitoes;
  • Assess community acceptability of DL;
  • Assess various socio-economic benefits of DL. 

Study Approach

Through a cluster-based randomized study design, researchers will determine the effectiveness of DL and LLINs compared to LLINs alone using two study arms: LLINs only (control arm) and LLINs with DL (intervention arm). Forty-four total cluster sites have been chosen with twenty-two clusters in each study arm. Cross-sectional surveys, including a completed baseline in December 2013 and four surveys every six months post-intervention during peak malaria transmission periods, will be used to measure prevalence of malaria in children 6 months to 11 years of age.

Results will be compared between the two study arms to determine which type of intervention is most protective against malaria transmission. Researchers will also look at which intervention is most cost effective in the context of intervention ability to interrupt transmission, and whether wall liners are well-received by the local populace.

Research Into Action

Findings from this study will contribute to best practices in malaria prevention programming and may help inform national and local level decision-making by policymakers.  TRAction has planned a series of dissemination materials including a paper and technical brief for programmers and policymakers to better understand and utilize study findings in the broader context of current malaria prevention knowledge. Press release coverage will highlight publication of study findings in the peer-reviewed literature.

Research Partners

National Institute for Medical Research, Tanzania
Principal Investigator: William Kisinza
Kilimanjaro Christian Medical College (KCMC), Tanzania
London School of Hygiene and Tropical Medicine
Co-Principal Investigator: Mark Rowland

Project Status

Country / Countries: 
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