@article{fdi:010057082,
  title = {{C}ombination of malaria vector control interventions in pyrethroid resistance area in {B}enin : a cluster randomised controlled trial},
  author = {{C}orbel, {V}incent and {A}kogbeto, {M}. and {D}amien, {G}eorgia and {D}jenontin, {A}. and {C}handre, {F}abrice and {R}ogier, {C}. and {M}oiroux, {N}icolas and {C}habi, {J}. and {B}anganna, {B}. and {P}adonou, {G}. {G}. and {H}enry, {M}. {C}.},
  editor = {},
  language = {{ENG}},
  abstract = {{B}ackground {M}alaria control efforts and elimination in {A}frica are being challenged by the development of resistance of parasites to antimalarial drugs and vectors to insecticides. {W}e investigated whether the combination of long-lasting insecticidal mosquito nets ({LLIN}s) with indoor residual spraying ({IRS}) or carbamate-treated plastic sheeting ({CTPS}) conferred enhanced protection against malaria and better management of pyrethroid-resistance in vectors than did {LLIN}s alone. {M}ethods {W}e did a cluster randomised controlled trial in 28 villages in southern {B}enin, west {A}frica. {I}nclusion criteria of the villages were moderate level of pyrethroid resistance in malaria vectors and minimum distance between villages of 2 km. {W}e assessed four malaria vector control interventions: {LLIN} targeted coverage to pregnant women and children younger than 6 years ({TLLIN}, reference group), {LLIN} universal coverage of all sleeping units ({ULLIN}), {TLLIN} plus full coverage of carbamate-{IRS} applied every 8 months ({TLLIN}+{IRS}), and {ULLIN} plus full coverage of {CTPS} lined up to the upper part of the household walls ({ULLIN}+{CTPS}). {T}he interventions were allocated to villages by a block randomisation on the basis of preliminary surveys and children of each village were randomly selected to participate with computer-generated numbers. {T}he primary endpoint was the incidence density rate of {P}lasmodium falciparum clinical malaria in children younger than 6 years as was analysed by {P}oisson regression taking into account the effect of age and the sampling design with a generalised estimating equation approach. {C}linical and parasitological information were obtained by active case detection of malaria episodes during 12 periods of 6 consecutive days scheduled at six weekly intervals and by cross-sectional surveys of asymptomatic plasmodial infections. {C}hildren or study investigators were not masked to study group. {T}his study is registered with {C}urrent {C}ontrolled {T}rials, number {ISRCTN}07404145. {F}indings {O}f 58 villages assessed, 28 were randomly assigned to intervention groups. 413-429 children were followed up in each intervention group for 18 months. {T}he clinical incidence density of malaria was not reduced in the children from the {ULLIN} group (incidence density rate 0.95, 95% {CI} 0.67-1.36, p=0.79), nor in those from the {TLLIN}+{IRS} group (1.32, 0.90-1.93, p=0.15) or from the {ULLIN}+{CTPS} group (1.05, 0.75-1.48, p=0.77) compared with the reference group ({TLLIN}). {T}he same trend was observed with the prevalence and parasite density of asymptomatic infections (non significant regression coefficients). {I}nterpretation {N}o significant benefit for reducing malaria morbidity, infection, and transmission was reported when combining {LLIN}+{IRS} or {LLIN}+{CTPS} compared with a background of {LLIN} coverage. {T}hese findings are important for national malaria control programmes and should help the design of more cost-effective strategies for malaria control and elimination.},
  keywords = {},
  booktitle = {},
  journal = {{L}ancet {I}nfectious {D}iseases},
  volume = {12},
  numero = {8},
  pages = {617--626},
  ISSN = {1473-3099},
  year = {2012},
  DOI = {10.1016/s1473-3099(12)70081-6},
  URL = {https://www.documentation.ird.fr/hor/fdi:010057082},
}