Malaria World this week includes a reference to a protocol of a very interesting literature review to be carried out. ‘Integrated malaria vector control strategies and their effectiveness in sub-Saharan Africa: a systematic review protocol for interventional studies’ by Kombate et al will systematically retrieve published and grey literature from electronic databases and clinical trial registries. A meta-analysis will be conducted based on studies that have reported a high level of evidence.
The study will look for interventions that integrate malaria-specific vector control approaches. This implies a combination of two or more of the following strategies:
- ITNs (insecticide treated nets)
- Installation of screens on windows
- Ventilation openings and open roof eaves to prevent mosquitos from entering homes
- Closing windows and doors at sunset to reduce mosquito entry into homes
- IRS (indoor residual spraying)
- Environmental management and source reduction
- LSM (larval source management)
- Topical and spatial mosquito repellents
- Mosquito coils
- Insecticide sprays
The control data will be provided by studies with a comparator or control group using single-intervention strategies or no intervention.
The target outcomes are
- Malaria incidence: measured as the number of new cases of malaria diagnosed in a specific population over a given period of time.
- Malaria prevalence: measured as the proportion of surveyed children and pregnant women who are infected with malaria at a specific point in time at the community level.
The analysis will include papers published in English and French from 01 January 2004 and 01 May 2024. It will include cluster-randomised controlled trials (RCTS), cluster-randomised studies using a stepped-wedge design, cluster-randomised cross-over studies, cohort studies (prospective or retrospective), non-randomised cross-over studies, controlled before and after studies, programmatic evaluations, cross-sectional studies, case–control studies, interrupted time series, and case series.
The analysis will use the accepted methods for similar meta-analyses which are fully described in the protocol.
I look forward to the resulting paper when the study is complete. I previously discussed a Cochrane review that examined the effect of indoor residual spraying and found no convincing evidence of its effectiveness. It will be interesting to see what this study focusing on multiple vector control methods finds. If malaria is spread by mosquitos reducing their number and the number of bites should reduce incidence and prevalence?