In the past decade, massive scale-up of insecticide-treated nets (ITN) and indoor residual spraying (IRS), together with the introduction of artemisinin-combination treatments, have led to substantial reductions in malaria prevalence and incidence in African highlands. However, rising insecticide resistance and increased outdoor transmission have greatly hampered the effectiveness of ITN and IRS because the current indoor-based interventions do not target the outdoor-biting mosquitoes. Consequently, most highland sites maintain sustained low- level transmission while some others have recently experienced resurgence in malaria rates. Therefore, new supplemental interventions that can tackle outdoor transmission and pyrethroid insecticide resistance are urgently needed. The central objective of this competing renewal application is to determine the efficacy and cost-effectiveness of EPA-approved long-lasting microbial larvicides in reducing malaria transmission and clinical malaria incidence in western Kenya highlands. The three specific aims are: 1) to examine mechanisms regulating larval habitat productivity, 2) to determine the efficacy of long-lasting microbial larvicides on the reduction of malaria transmission and clinical malaria incidence using a cluster randomized study, and 3) to determine the cost-effectiveness of the long-lasting microbial larviciding program as compared to other malaria control interventions and evaluate its impact on non-target organisms. Through comprehensive evaluation of potentially cost-effective long-lasting microbial larvicides, this project will provide critically needed data on whether long-lasting microbial larvicides can be scaled up as a supplemental malaria control tool to further reduce malaria incidence in African highlands. Malaria outdoor transmission control is presently a highly significant and urgent issue in malaria control across Africa, and thus, our results will have broad implications on malaria prevention and control in endemic and epidemic regions of Africa.

Public Health Relevance

Insecticide resistance and outdoor transmission are major new challenges in malaria control in Africa today. This project will determine the efficacy and cost-effectiveness of long-lasting microbial larvicides in malaria control in western Kenya highland, proving critically needed data on whether of long-lasting microbial larviciding should be scaled up to supplement existing malaria control tools.

Agency
National Institute of Health (NIH)
Institute
National Institute of Allergy and Infectious Diseases (NIAID)
Type
Research Project (R01)
Project #
5R01AI050243-16
Application #
9435068
Study Section
Vector Biology Study Section (VB)
Program Officer
Costero-Saint Denis, Adriana
Project Start
2001-09-01
Project End
2019-02-28
Budget Start
2018-03-01
Budget End
2019-02-28
Support Year
16
Fiscal Year
2018
Total Cost
Indirect Cost
Name
University of California Irvine
Department
Public Health & Prev Medicine
Type
Schools of Public Health
DUNS #
046705849
City
Irvine
State
CA
Country
United States
Zip Code
92617
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Zhou, Guofa; Wiseman, Virginia; Atieli, Harrysone E et al. (2016) The impact of long-lasting microbial larvicides in reducing malaria transmission and clinical malaria incidence: study protocol for a cluster randomized controlled trial. Trials 17:423
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