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London School of Hygiene & Tropical Medicine Malaria Centre

Malaria research in epidemiology

Global project on the impact of insecticide resistance.

LSHTM investigators:
Immo Kleinschmidt.
External collaborators:
World Health Organization; Liverpool School of Tropical Medicine, UK; Ministries of Health of Sudan, Kenya, Cameroon, Benin & India.
Funding body:
The Bill & Melinda Gates Foundation through the World Health Organization Global Malaria Programme.

This study will assess the impact that insecticide resistance has on the effectiveness of malaria vector control tools LLIN and IRS.

In two countries this is done by cluster randomised trials of universal coverage LLINs versus universal coverage LLINs in combination with IRS, with levels of insecticide resistance of the main vector balanced between the two study arms. In each cluster resistance to the insecticide used on LLINs is monitored, and malaria incidence is estimated from cluster specific cohorts of children followed up over the duration of the study. In three countries, clusters are established and malaria vector mosquitoes in each cluster assessed for resistance to the insecticide used. Clusters with either very high susceptibility or very high resistance to the insecticides in use are retained for the study, and cohorts of children recruited for follow-up and estimation of malaria incidence. Resistance impact will be assessed from the ratio of incidence rates in clusters with high compared to those with low resistance. Resistance mechanisms will be determined in subsets of study clusters. Initial findings from one country may be available by the end of 2012.