Evidence map›Paper›PMID 39875853›Full record

Trial reportBMC public health2025

Community benefits of mass distribution of three types of dual-active-ingredient long-lasting insecticidal nets against malaria prevalence in Tanzania: evidence from a 3-year cluster-randomized controlled trial.

Eliud Andrea Lukole, Jackie Cook, Jacklin F Mosha, Nancy S Matowo, Manisha A Kulkarni, Elizabeth Mallya, Tatu Aziz, Jacklin Martin, Mark Rowland, Immo Kleinschmidt and 3 more

Registry-linked trialAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03554616 (Efficacy of Three Different Bi-treated Long Lasting Insecticidal Nets and Deployment Strategy for Control of Malaria Transmitted by Pyrethroid Resistant Vectors), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–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.

NCT03554616 nacompletednot on this map

Efficacy of Three Different Bi-treated Long Lasting Insecticidal Nets and Deployment Strategy for Control of Malaria Transmitted by Pyrethroid Resistant Vectors: A Randomised Controlled Trial

TypeinterventionalSponsorLondon School of Hygiene and Tropical MedicineRan2019 to 2023Enrolled4,200ConditionsMalaria, AnaemiaArmsChlorfenapyr LLIN, pyriproxyfen LLIN, Piperonyl butoxide LLIN, Standard LLIN
3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Article
  3. Review
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

13 authors.

Eliud Andrea LukoleDepartment of Parasitology, Mwanza Medical Research Centre, National Institute for Medical Research, Mwanza, Tanzania. ellylufi@ymail.com.
Jackie CookMRC International Statistics and Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
Jacklin F MoshaDepartment of Parasitology, Mwanza Medical Research Centre, National Institute for Medical Research, Mwanza, Tanzania.
Nancy S MatowoDepartment of Disease Control, London School of Hygiene and Tropical Medicine, London, UK.
Manisha A KulkarniSchool of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.
Elizabeth MallyaKilimanjaro Christian Medical University College, Moshi, Tanzania.
Tatu AzizDepartment of Parasitology, Mwanza Medical Research Centre, National Institute for Medical Research, Mwanza, Tanzania.
Jacklin MartinKilimanjaro Christian Medical University College, Moshi, Tanzania.
Mark RowlandDepartment of Disease Control, London School of Hygiene and Tropical Medicine, London, UK.
Immo KleinschmidtMRC International Statistics and Epidemiology Group, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK.
Alphaxard ManjuranoDepartment of Parasitology, Mwanza Medical Research Centre, National Institute for Medical Research, Mwanza, Tanzania.
Franklin W MoshaKilimanjaro Christian Medical University College, Moshi, Tanzania.
Natacha ProtopopoffDepartment of Disease Control, London School of Hygiene and Tropical Medicine, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLong-lasting insecticidal nets (LLINs) were once fully effective for the prevention of malaria; however, mosquitoes have developed resistance to pyrethroids, the main class of insecticides used on nets. Dual active ingredient LLINs (dual-AI LLINs) have been rolled out as an alternative to pyrethroid (PY)-only LLINs to counteract this. Understanding the minimum community usage at which these LLINs elicit an effect that also benefits non-users against malaria infection is important.

methodsWe conducted a secondary analysis of a 3-year randomized controlled trial (RCT) in 84 clusters in North-western Tanzania to evaluate the effectiveness of three dual-AI LLINs: pyriproxyfen and alpha(α)-cypermethrin, chlorfenapyr and α-cypermethrin, and the piperonyl-butoxide (PBO) and permethrin compared to α-cypermethrin only LLINs. We measured malaria infection prevalence using 5 cross-sectional surveys between 2020 and 2022. We assessed net usage at the cluster level and malaria infection in children aged from 6 months to 14 years in 45 households per cluster. The trial was registered as a clinical trial on www. CLINICALTRIALS: gov : ClinicalTrials.gov (NCT03554616) on 2018-06-13.

resultsA total of 22,479 children from 12,654 households were tested for malaria using rapid diagnostic tests in January 2020, 2021, & 2022 and July 2020 & 2021. Among non-users, community-level usage of > 40% of dual-AI LLIN was significantly associated with protection against malaria infection: chlorfenapyr arm (OR: 0.44 (95% CI: 0.27-0.71), p = 0.0009), PBO arm (OR: 0.55 (95% CI: 0.33-0.94), p = 0.0277) and pyriproxyfen arm (OR: 0.61 (95% CI: 0.37-0.99), p = 0.0470) compared with non-users in clusters with > 40% usage of pyrethroid-only LLINs. There were indications of some protection against malaria infection to non-users in the chlorfenapyr arm when community-level usage was ≤ 40% (OR: 0.65 (95% CI: 0.42-1.01), p = 0.0528) compared to those living in clusters with > 40% usage of pyrethroid-only LLINs.

conclusionOur study demonstrated that at a community usage of 40% or more of dual-AI LLINs non-users benefited from the presence of these nets. Noticeably, even when usage was ≤ 40% in the chlorfenapyr arm, non-users were better protected than non-users in the higher coverage pyrethroid-only arm. The greater difference in malaria risk observed between users and non-users indicates that LLINs play a crucial role in providing personal protection against malaria infection for the people using the net.

Indexed as

InsecticidesInsecticide-Treated BednetsMalariaMosquito ControlAdolescentChildChild, PreschoolCross-Sectional StudiesFemaleHumansInfantMalePermethrinPiperonyl ButoxidePrevalencePyrethrinschlorfenapyrcypermethrinInsecticidesPermethrinPiperonyl ButoxidePyrethrinsPyridinespyriproxyfenCommunity effectDual active ingredient LLINsMalaria prevalenceTanzania

Identifiers

PMID39875853
PMCPMC11773712

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.