scholarly journals Combined evaluation of long-lasting insecticidal nets, house screening and push-pull technology as appropriate interventions for integrated management of malaria vectors and cereal pests in Ethiopia: study protocol for household randomized controlled trial

2021 ◽  
Author(s):  
Abebe Asale ◽  
Menale Kassie ◽  
Zewdu Abro ◽  
Bayu Enchalew ◽  
Aklilu Belay ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Indoor Residual Spraying ◽  
Clinical Malaria ◽  
Cost Effectiveness Analysis ◽  
Controlled Study ◽  
Crop Pests ◽  
Randomized Controlled ◽  
Effectiveness Analysis ◽  
The Impact ◽  
Long Lasting Insecticidal Nets

Abstract Introduction: The combined application of long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) has led to mixed results (Significant reduction vs no impact) on malaria burden. Other studies have attempted to study the combined effects of house screening (HS) and LLINs have demonstrated a reduction in indoor vector densities and malaria when the interventions are combined. In addition to malaria vectored by mosquitoes, farmers living in rural settings face challenges from crop pests, which significantly reduce agricultural productivity and negatively impact their food security. Thus, addressing the coexisting risks of malaria and crop pests could contribute to improved livelihood of communities. Design: A three armed household, cluster-randomized, controlled study will be conducted to assess the impact of HS, LLINs and PPT against clinical malaria in children than LLINs alone in Ethiopia. The unit of randomization will be the household, which include a house and its occupants. A total of 663 households will be enrolled in this study. All the households will receive the LLINs. Then other treatments will be overlaid according to the randomization sequence. Thus, 246 households will receive HS, and 250 households will receive HS and PPT before the commencement of clinical follow-up. The rest 167 houses which received LLINs only will be used as control. One child aged not more than 14 years will be enrolled from each household and followed for clinical malaria using active case detection to estimate malaria incidence for two malaria transmission seasons. Results: Episodes of clinical malaria, the prevalence of anaemia, density of malaria vector mosquitoes, sporozoite infection rate, crop infestation rate due to stem borer and fall army worm, crop yield gain, livestock productivity and cost effectiveness analysis will be the end points of this study. Socio-economic, social demographic, cost-effectiveness analysis will be conducted using qualitative and participatory methods to explore the acceptability of HS and PPT. Conclusion Documenting the combined impact of LLINs, HS and PPT on the prevalence of clinical malaria and crop pest damage will be the first of its kind and will provide deep insight and evidence base for forging collaborations between health and agriculture sectors. Trial Registration: The protocol was registered online on Date 28/05/2020 on sight www.pactr.org With registration No: PACTR202006878245287.

scholarly journals Combined evaluation of long-lasting insecticidal nets, house screening and push-pull technology as appropriate interventions for integrated management of malaria vectors and cereal pests in Ethiopia: study protocol for household randomized controlled trial

2021 ◽  
Author(s):  
Abebe Asale ◽  
Menale Kassie ◽  
Zewdu Abro ◽  
Bayu Enchalew ◽  
Aklilu Belay ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Indoor Residual Spraying ◽  
Clinical Malaria ◽  
Cost Effectiveness Analysis ◽  
Controlled Study ◽  
Crop Pests ◽  
Randomized Controlled ◽  
Effectiveness Analysis ◽  
The Impact ◽  
Long Lasting Insecticidal Nets

Abstract Introduction: The combined application of long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) has led to mixed results (Significant reduction vs no impact) on malaria burden. Other studies have attempted to study the combined effects of house screening (HS) and LLINs have demonstrated a reduction in indoor vector densities and malaria when the interventions are combined. In addition to malaria vectored by mosquitoes, farmers living in rural settings face challenges from crop pests, which significantly reduce agricultural productivity and negatively impact their food security. Thus, addressing the coexisting risks of malaria and crop pests could contribute to the improved livelihood of communities. Design: A three-armed household, cluster-randomized, controlled study will be conducted to assess the impact of HS, LLINs, and PPT against clinical malaria in children than LLINs alone in Ethiopia. The unit of randomization will be the household, which includes a house and its occupants. A total of 663 households will be enrolled in this study. All the households will receive the LLINs. Then other treatments will be overlaid according to the randomization sequence. Thus, 246 households will receive HS, and 250 households will receive HS and PPT before the commencement of clinical follow-up. The rest 167 houses that received LLINs only will be used as control. One child aged not more than 14 years will be enrolled from each household and followed for clinical malaria using active case detection to estimate malaria incidence for two malaria transmission seasons. Results: Episodes of clinical malaria, the prevalence of anaemia, density of malaria vector mosquitoes, sporozoite infection rate, crop infestation rate due to stem borer and fall armyworm, crop yield gain, livestock productivity, and cost-effectiveness analysis will be the endpoints of this study. Socio-economic, social demographic, cost-effectiveness analysis will be conducted using qualitative and participatory methods to explore the acceptability of HS and PPT. Conclusion Documenting the combined impact of LLINs, HS, and PPT on the prevalence of clinical malaria and crop pest damage will be the first of its kind and will provide deep insight and evidence base for forging collaborations between health and agriculture sectors. Trial Registration: The protocol was registered online on Date 28/05/2020 on sight www.pactr.org With registration No: PACTR202006878245287.

scholarly journals Reduced exposure to malaria vectors following indoor residual spraying of pirimiphos-methyl in a high-burden district of rural Mozambique with high ownership of long-lasting insecticidal nets: entomological surveillance results from a cluster-randomized trial

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Joseph M. Wagman ◽  
Kenyssony Varela ◽  
Rose Zulliger ◽  
Abuchahama Saifodine ◽  
Rodaly Muthoni ◽  
...  
Keyword(s):  
Controlled Trial ◽  
Indoor Residual Spraying ◽  
Malaria Vectors ◽  
Light Traps ◽  
High Burden ◽  
Randomized Controlled ◽  
Pirimiphos Methyl ◽  
Cluster Randomized ◽  
The Impact ◽  
Long Lasting Insecticidal Nets

Abstract Background The need to develop new products and novel approaches for malaria vector control is recognized as a global health priority. One approach to meeting this need has been the development of new products for indoor residual spraying (IRS) with novel active ingredients for public health. While initial results showing the impact of several of these next-generation IRS products have been encouraging, questions remain about how to best deploy them for maximum impact. To help address these questions, a 2-year cluster-randomized controlled trial to measure the impact of IRS with a microencapsulated formulation of pirimiphos-methyl (PM) in an area with high ownership of long-lasting insecticidal nets (LLINs) was conducted in a high-transmission district of central Mozambique with pyrethroid resistant vectors. Presented here are the results of the vector surveillance component of the trial. Methods The 2 year, two-armed trial was conducted in Mopeia District, Zambezia Province, Mozambique. In ten sentinel villages, five that received IRS with PM in October–November 2016 and again in October–November 2017 and five that received no IRS, indoor light trap collections and paired indoor-outdoor human landing collections catches (HLCs) were conducted monthly from September 2016 through October 2018. A universal coverage campaign in June 2017, just prior to the second spray round, distributed 131,540 standard alpha-cypermethrin LLINs across all study villages and increased overall net usage rates in children under 5 years old to over 90%. Results The primary malaria vector during the trial was Anopheles funestus sensu lato (s.l.), and standard World Health Organization (WHO) tube tests with this population indicated variable but increasing resistance to pyrethroids (including alpha-cypermethrin, from > 85% mortality in 2017 to 7% mortality in 2018) and uniform susceptibility to PM (100% mortality in both years). Over the entire duration of the study, IRS reduced An. funestus s.l. densities by 48% (CI95 33–59%; p < 0.001) in indoor light traps and by 74% (CI95 38–90%; p = 0.010) during indoor and outdoor HLC, though in each study year reductions in vector density were consistently greatest in those months immediately following the IRS campaigns and waned over time. Overall there was no strong preference for An. funestus to feed indoors or outdoors, and these biting behaviours did not differ significantly across study arms: observed indoor-outdoor biting ratios were 1.10 (CI95 1.00–1.21) in no-IRS villages and 0.88 (CI95 0.67–1.15) in IRS villages. The impact of IRS was consistent in reducing HLC exposures both indoors (75% reduction: CI95 47–88%; p = 0. < 0.001) and outdoors (68% reduction: CI95 22–87%; p = 0.012). While substantially fewer Anopheles gambiae s.l. were collected during the study, trends show a similar impact of IRS on this key vector group as well, with a 33% (CI95 7–53%; p = 0.019) reduction in mosquitoes collected in light traps and a non-statistically significant 39% reduction (p = 0.249) in HLC landing rates. Conclusion IRS with PM used in addition to pyrethroid-only LLINs substantially reduced human exposures to malaria vectors during both years of the cluster-randomized controlled trial in Mopeia—a high-burden district where the primary vector, An. funestus s.l., was equally likely to feed indoors or outdoors and demonstrated increasing resistance to pyrethroids. Findings suggest that IRS with PM can provide effective vector control, including in some settings where pyrethroid-only ITNs are widely used. Trial registrationclinicaltrials.gov, NCT02910934. Registered 22 September 2016, https://www.clinicaltrials.gov/ct2/show/NCT02910934.

scholarly journals Impact of Socioeconomic Differences on Distributional Cost-effectiveness Analysis

2020 ◽  
Vol 40 (5) ◽  
pp. 606-618
Author(s):  
Fan Yang ◽  
Colin Angus ◽  
Ana Duarte ◽  
Duncan Gillespie ◽  
Simon Walker ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Health Inequality ◽  
Local Level ◽  
National Level ◽  
Cost Effectiveness Analysis ◽  
Decision Makers ◽  
Socioeconomic Differences ◽  
Screening And Brief Intervention ◽  
Effectiveness Analysis ◽  
The Impact

Public health decision makers value interventions for their effects on overall health and health inequality. Distributional cost-effectiveness analysis (DCEA) incorporates health inequality concerns into economic evaluation by accounting for how parameters, such as effectiveness, differ across population groups. A good understanding of how and when accounting for socioeconomic differences between groups affects the assessment of intervention impacts on overall health and health inequality could inform decision makers where DCEA would add most value. We interrogated 2 DCEA models of smoking and alcohol policies using first national level and then local authority level information on various socioeconomic differences in health and intervention use. Through a series of scenario analyses, we explored the impact of altering these differences on the DCEA results. When all available evidence on socioeconomic differences was incorporated, provision of a smoking cessation service was estimated to increase overall health and increase health inequality, while the screening and brief intervention for alcohol misuse was estimated to increase overall health and reduce inequality. Ignoring all or some socioeconomic differences resulted in minimal change to the estimated impact on overall health in both models; however, there were larger effects on the estimated impact on health inequality. Across the models, there were no clear patterns in how the extent and direction of socioeconomic differences in the inputs translated into the estimated impact on health inequality. Modifying use or coverage of either intervention so that each population group matched the highest level improved the impacts to a greater degree than modifying intervention effectiveness. When local level socioeconomic differences were considered, the magnitude of the impacts was altered; in some cases, the direction of impact on inequality was also altered.

scholarly journals Global stability and cost-effectiveness analysis of COVID-19 considering the impact of the environment: using data from Ghana

2020 ◽  
Vol 140 ◽  
pp. 110103 ◽  
Author(s):  
Joshua Kiddy K. Asamoah ◽  
Mark A. Owusu ◽  
Zhen Jin ◽  
F. T. Oduro ◽  
Afeez Abidemi ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Global Stability ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis ◽  
Using Data ◽  
The Impact

scholarly journals A Systematic Review of WTA-WTP Disparity for Dental Interventions and Implications for Cost-Effectiveness Analysis

Healthcare ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 301
Author(s):  
Pedram Sendi ◽  
Arta Ramadani ◽  
Nicola U. Zitzmann ◽  
Michael M. Bornstein
Keyword(s):  
Systematic Review ◽  
Cost Effectiveness ◽  
Health Gain ◽  
Analytical Framework ◽  
Health Condition ◽  
Cost Effectiveness Analysis ◽  
Cochrane Library ◽  
Effectiveness Analysis ◽  
Substantial Risk ◽  
The Impact

Cost-effectiveness analysis is widely adopted as an analytical framework to evaluate whether health care interventions represent value for money, and its use in dentistry is increasing. Traditionally, in cost-effectiveness analysis, one assumes that the decision maker’s maximum willingness to pay (WTP) for health gain is equivalent to his minimum willingness to accept (WTA) monetary compensation for health loss. It has been documented in the literature that losses are weighted higher than equivalent gains, i.e., that WTA exceeds WTP for the same health condition, resulting in a WTA/WTP ratio greater than 1. There is a knowledge gap of published WTA/WTP ratios for dental interventions in the literature. We therefore conducted a (i) systematic review of published WTA-WTP estimates in dentistry (MEDLINE, Web of Science, Cochrane Library, London, UK) and (ii) a patient-level analysis of WTA/WTP ratios of included studies, and (iii) we demonstrate the impact of a WTA-WTP disparity on cost-effectiveness analysis. Out of 55 eligible studies, two studies were included in our review. The WTA/WTP ratio ranged from 2.58 for discontinuing water fluoridation to 5.12 for mandibular implant overdentures, indicating a higher disparity for implant rehabilitations than for dental public health interventions. A WTA-WTP disparity inflates the cost-effectiveness of dental interventions when there is a substantial risk of both lower costs and health outcomes. We therefore recommend that in these cases the results of cost-effectiveness analyses are reported using different WTA/WTP ratios in a sensitivity analysis.

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