Impact of long-lasting insecticide treated bednets with and without PBO on malaria indicators in Uganda: a cluster randomised trial
Malaria is an infectious disease which is common in tropical and subtropical countries, caused by a microscopic parasite which is spread from person to person by mosquitos. Every year, millions of people become infected with malaria parasites and hundreds of thousands of people die from the infection. Many of these infectious bites happen at night, when people are sleeping inside their homes. Over the last 15 years, malaria control programs have been scaled-up dramatically across Africa, resulting in an estimated 40% decrease in the incidence of disease between 2000 and 2015. However, despite these encouraging trends, decreases in the burden of malaria have not been uniform across Africa and have been slowest in countries with the highest burden, such as Uganda. In Uganda, coverage of key malaria control strategies, including long-lasting insecticidal nets (LLINs), indoor residual spraying of insecticide (IRS), and treatment of malaria cases using two or more drugs with different modes of action (artemisinin-based combination therapy; ACTs), has increased substantially. However, overall progress toward control of malaria in Uganda has been slow, and recent evidence suggests that gains may be fragile in high transmission areas, if effective control measures are not sustained. LLINs have been shown to be an effective malaria prevention strategy, however they are not always effective as many mosquitos are resistant to the insecticide (pyrethroid insecticide) that the nets are treated with. One possible approach to resolving this problem is to use a combination of chemicals to treat nets. The aim of this study is to compare four nets that are given out by the Ministry of Health to find out which type of net works the best.