Yura (Yongra) Ko

In sub-Saharan Africa, malaria is a major public health challenge exacerbated by the emergence of artemisinin-resistant (ART-R) Plasmodium falciparum, recalling the dark history of a sharp increase in malaria deaths due to the spread of chloroquine-resistant parasites. The effectiveness of insecticide-treated bed nets (ITNs) is threatened by the spread of insecticide-resistant vectors and inconsistent usage. Urgent actions are required. Insecticide-treated ceiling nets (ITCNs) are novel fixed structural vector control interventions that block the entry of mosquitoes and kill indoor-resting mosquitoes, offering protection to all inhabitants. In this study, we aim to evaluate the effectiveness of two dual-active-ingredient ITCNs (Olyset® Plus and Interceptor® G2) in reducing malaria in Kagera, Tanzania, a region with medium to intense transmission and emerging ART-R parasites. Using a three-arm cluster-randomized field trial, we aim to assess the impact of ITCNs on parasite prevalence and incidence, entomological inoculation rate, and vector density. We will conduct cost-effectiveness and implementation feasibility assessments to determine intervention scalability. We will assess the physical and chemical integrity of the ITCNs and monitor the genetic alleles associated with drug resistance in parasites and insecticide resistance in vectors over time. Results from this study will provide comprehensive evidence for the evaluation and policy recommendation by WHO.