Evidence map›Paper›PMID 24736370›Full record

Trial reportPLoS medicine2014

Indoor residual spraying in combination with insecticide-treated nets compared to insecticide-treated nets alone for protection against malaria: a cluster randomised trial in Tanzania.

Philippa A West, Natacha Protopopoff, Alexandra Wright, Zuhura Kivaju, Robinson Tigererwa, Franklin W Mosha, William Kisinza, Mark Rowland, Immo Kleinschmidt

2 registry-linked trialsAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in PLoS medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 110 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
110citing papers in PubMed, 8 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01697852 phase4unknown statusnot on this map

Cluster Randomised Trial to Compare Effectiveness of the Combined Use of Indoor Residual Spraying (IRS) and Long-lasting Insecticidal Nets (LLINs) to LLINs Alone for Malaria Prevention in Muleba District, Kagera Region, Tanzania

TypeinterventionalSponsorLondon School of Hygiene and Tropical MedicineRan2011 to 2012Enrolled22,300ConditionsMalariaArmsIndoor residual spraying with bendiocarb, LLIN by universal coverage campaign
NCT02288637 nacompletednot on this map

Evaluation of a Novel Long Lasting Insecticidal Net and Indoor Residual Spray Product, Separately and Together, Against Malaria Transmitted by Pyrethroid Resistant Mosquitoes.

TypeinterventionalSponsorLondon School of Hygiene and Tropical MedicineRan2014 to 2018Enrolled3,840ConditionsMalaria, AnaemiaArmsOlyset Plus LLIN, Conventional Olyset LLIN, IRS
3 · Its place in the literature

Who cites it

110 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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50 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Philippa A WestDepartment of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom.
Natacha ProtopopoffDepartment of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom.
Alexandra WrightDepartment of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom.
Zuhura KivajuNational Institute for Medical Research, Amani Medical Research Centre, Muheza, Tanzania.
Robinson TigererwaMuleba District Medical Office, Department of Health, Muleba, Tanzania.
Franklin W MoshaKilimanjaro Christian Medical College, Tumaini University, Moshi, Tanzania.
William KisinzaNational Institute for Medical Research, Amani Medical Research Centre, Muheza, Tanzania.
Mark RowlandDepartment of Disease Control, London School of Hygiene & Tropical Medicine, London, United Kingdom.
Immo KleinschmidtMedical Research Council Tropical Epidemiology Group, London School of Hygiene & Tropical Medicine, London, United Kingdom.

Funding

Medical Research Council MR/K012126/1
6 · The paper itself

Abstract

backgroundInsecticide-treated nets (ITNs) and indoor residual spraying (IRS) of houses provide effective malaria transmission control. There is conflicting evidence about whether it is more beneficial to provide both interventions in combination. A cluster randomised controlled trial was conducted to investigate whether the combination provides added protection compared to ITNs alone. METHODS AND

findingsIn northwest Tanzania, 50 clusters (village areas) were randomly allocated to ITNs only or ITNs and IRS. Dwellings in the ITN+IRS arm were sprayed with two rounds of bendiocarb in 2012. Plasmodium falciparum prevalence rate (PfPR) in children 0.5-14 y old (primary outcome) and anaemia in children <5 y old (secondary outcome) were compared between study arms using three cross-sectional household surveys in 2012. Entomological inoculation rate (secondary outcome) was compared between study arms. IRS coverage was approximately 90%. ITN use ranged from 36% to 50%. In intention-to-treat analysis, mean PfPR was 13% in the ITN+IRS arm and 26% in the ITN only arm, odds ratio = 0.43 (95% CI 0.19-0.97, n = 13,146). The strongest effect was observed in the peak transmission season, 6 mo after the first IRS. Subgroup analysis showed that ITN users were additionally protected if their houses were sprayed. Mean monthly entomological inoculation rate was non-significantly lower in the ITN+IRS arm than in the ITN only arm, rate ratio = 0.17 (95% CI 0.03-1.08).

conclusionsThis is the first randomised trial to our knowledge that reports significant added protection from combining IRS and ITNs compared to ITNs alone. The effect is likely to be attributable to IRS providing added protection to ITN users as well as compensating for inadequate ITN use. Policy makers should consider deploying IRS in combination with ITNs to control transmission if local ITN strategies on their own are insufficiently effective. Given the uncertain generalisability of these findings, it would be prudent for malaria control programmes to evaluate the cost-effectiveness of deploying the combination.

trial registrationwww.ClinicalTrials.gov NCT01697852 Please see later in the article for the Editors' Summary.

Indexed as

CulicidaeInsecticidesPhenylcarbamatesAdolescentAnimalsChildChild, PreschoolCluster AnalysisCross-Sectional StudiesHumansInfantInfant, NewbornInsecticide-Treated BednetsMalariaMosquito ControlPlasmodium falciparumbendiocarbInsecticidesPhenylcarbamates

Identifiers

PMID24736370
PMCPMC3988001

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.