Evidence map›Paper›PMID 39961693›Full record

Trial reportBMJ global health2025

Targeting malaria in high-risk populations in low endemic regions in northern Namibia: a quasi-experimental controlled trial to reduce malaria in seasonal agricultural workers and cattle herders.

Jennifer L Smith, Henry Ntuku, Francois Rerolle, Ashley Morgan Burke, Tabeth Mwema, Keirstinne Turcios, Petrina Uusiku, Justine Kulla Haikali, Michael Lifasi, Cara Smith-Gueye and 6 more

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

Trial report in BMJ global 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 NCT04094727 (Targeting Malaria High-risk Populations With Tailored Intervention Packages), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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.

NCT04094727 phase4completednot on this map

Targeting Malaria High-risk Populations With Tailored Intervention Packages: A Study to Assess Feasibility and Effectiveness in Northern Namibia

TypeinterventionalSponsorUniversity of California, San FranciscoRan2019 to 2020Enrolled3,302ConditionsMalariaArmsPresumptive treatment with Artemether-lumefantrine (AL), Enhanced vector control
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
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

16 authors.

Jennifer L SmithEpidemiology & Biostatistics, University of California San Francisco, San Francisco, California, USA Jennifer.smith@ucsf.edu.ORCID http://orcid.org/0000-0002-9244-4412
Henry NtukuMalaria Elimination Initiative, University of California San Francisco, San Francisco, California, USA.ORCID http://orcid.org/0000-0001-7218-2710
Francois RerolleMalaria Elimination Initiative, University of California San Francisco, San Francisco, California, USA.
Ashley Morgan BurkeUniversity of the Witwatersrand Johannesburg Faculty of Health Sciences, Johannesburg, Gauteng, South Africa.ORCID http://orcid.org/0000-0002-2779-4678
Tabeth MwemaMultidisciplinary Research Services, University of Namibia, Windhoek, Namibia.
Keirstinne TurciosDepartment of Medicine, University of California San Francisco, San Francisco, California, USA.
Petrina UusikuNational Vector-Borne Diseases Control Program, Namibia Ministry of Health and Social Services, Windhoek, Khomas, Namibia.
Justine Kulla HaikaliOhangwena Health Directorate, Republic of Namibia Ministry of Health and Social Services, Windhoek, Khomas, Namibia.
Michael LifasiZambezi Health Directorate, Republic of Namibia Ministry of Health and Social Services, Windhoek, Khomas, Namibia.
Cara Smith-GueyeMalaria Elimination Initiative, University of California San Francisco, San Francisco, California, USA.
Elodie VajdaMalaria Elimination Initiative, University of California San Francisco, San Francisco, California, USA.
Jerry O JacobsonMalaria Elimination Initiative, University of California San Francisco, San Francisco, California, USA.
Bryan GreenhouseDepartment of Medicine, University of California San Francisco, San Francisco, California, USA.
Roly GoslingMalaria Elimination Initiative, University of California San Francisco, San Francisco, California, USA.
Adam BennettMalaria Elimination Initiative, University of California San Francisco, San Francisco, California, USA.
Davis R MumbengegwiMalaria Operational Research Program, Multidisciplinary Research Services, University of Namibia, Windhoek, Khomas, Namibia.

Funding

Mentoring translational scientists in international infectious disease researchK24AI144048 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI Bryan R Greenhouse · 2019 to 2026
$1.6M
Genetic and social network analysis to target interventions for malaria eliminationK01AI153555 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI SMITH, JENNIFER LINNEA · 2020 to 2024
$725k
Gates Foundation INV-009652NIAID NIH HHS K01 AI153555NIAID NIH HHS K24 AI144048
6 · The paper itself

Abstract

backgroundAgricultural worksites are rarely targeted by malaria control programmes, yet may play a role in maintaining local transmission due to workers' high mobility, low intervention coverage and occupational exposures.

methodsA quasi-experimental controlled intervention study was carried out in farming and cattle herding populations in northern Namibia to evaluate the impact of a targeted malaria intervention package. Eight health facility catchment areas in Zambezi and Ohangwena Regions were randomised to an intervention arm and eligible individuals within worksites in intervention areas received targeted drug administration with artemether-lumefantrine, mop-up indoor residual spraying and long-lasting insecticidal nets, combined with distribution of topical repellent in Zambezi Region. Impact on malaria outcomes and intervention coverage was evaluated over a single transmission season using pre-intervention and post-intervention cross-sectional surveys in a random subset of worksites and community incidence from passively detected cases. Entomological collections and residual efficacy assays on canvas and tarpaulin were conducted.

resultsDelivery of a single intervention round was associated with a reduction in the prevalence of malaria (OR 0.24, 95% CI 0.1 to 0.5; risk difference (RD) -6.0%, 95% CI -9.4 to -2.8). Coverage of at least one intervention increased (RD 51.6%, 95% CI 44.4 to 58.2) among the target population in intervention compared with control areas. This effect was largely driven by results in Zambezi Region, which also observed a decline in community incidence (-1.29 cases/1000 person-weeks, 95% CI -2.2 to -0.3). Residual efficacy of pirimiphos-methyl (Actellic) on tarpaulin and canvas was high at 24hours but declined to 44.6% at 4 months.

conclusionThe study shows that targeted delivery of malaria interventions to cattle herders and agricultural workers at worksites has potential to impact local transmission. Findings highlight the need for further research on the role of key populations in TRIAL REGISTRATION NUMBER: NCT04094727.

Indexed as

AntimalarialsFarmersMalariaMosquito ControlAdolescentAdultAnimalsArtemether, Lumefantrine Drug CombinationCattleChildCross-Sectional StudiesFemaleHumansInsecticidesInsecticide-Treated BednetsMaleAntimalarialsArtemether, Lumefantrine Drug CombinationInsecticidesepidemiologyglobal healthintervention studymalariamedical entomology

Identifiers

PMID39961693
PMCPMC11836845

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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.