An observational study evaluating the epidemiological and entomological impacts of piperonyl butoxide insecticide-treated nets (ITNs) compared to a combination of indoor residual spraying (IRS) plus standard pyrethroid-only ITNs in Amhara Region, Ethiopia, 2019–2023
Introduction National malaria programmes must weigh the relative benefits of different vector control and elimination tools to prioritise resource allocation with the greatest impact. This study assesses the epidemiological and entomological impacts of piperonyl butoxide insecticide-treated nets (PB...
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BMJ Publishing Group
2025-01-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/10/1/e016617.full |
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| author | Banchamlak Tegegne Delenasaw Yewhalaw Emily R Hilton Sarah Zohdy Cecilia Flatley Kelly M Davis Amha Worku Meshesha Balkew Peter Mumba Sheleme Chibsa Jon Eric Tongren Gudissa Assefa Achamyelesh Sisay Dawit Teshome Mastewal Worku Mulat Yimer Melissa Yoshimizu Isabel Swamidoss Carla Mapp Jimee Hwang Wendy Inouye Aklilu Seyoum Dereje Dengela Sarah M Burnett |
| author_facet | Banchamlak Tegegne Delenasaw Yewhalaw Emily R Hilton Sarah Zohdy Cecilia Flatley Kelly M Davis Amha Worku Meshesha Balkew Peter Mumba Sheleme Chibsa Jon Eric Tongren Gudissa Assefa Achamyelesh Sisay Dawit Teshome Mastewal Worku Mulat Yimer Melissa Yoshimizu Isabel Swamidoss Carla Mapp Jimee Hwang Wendy Inouye Aklilu Seyoum Dereje Dengela Sarah M Burnett |
| author_sort | Banchamlak Tegegne |
| collection | DOAJ |
| description | Introduction National malaria programmes must weigh the relative benefits of different vector control and elimination tools to prioritise resource allocation with the greatest impact. This study assesses the epidemiological and entomological impacts of piperonyl butoxide insecticide-treated nets (PBO ITN-only arm) compared with the combination of two annual non-pyrethroid indoor residual spraying (IRS) campaigns and standard pyrethroid ITNs (IRS+Standard Pyrethroid ITN arm) in the Amhara region of Ethiopia.Methods An open-label, stratified block-cluster randomised trial was designed to compare the impacts of the two intervention arms. ITN distribution took place from June to July 2021. IRS campaigns took place from June to July 2021 and again in June 2022. Confirmed malaria cases reported during the high transmission season (September to December) were compared in the 2 years before (2019 and 2020) vs the 2 years after (2021 and 2022) the 2021 campaigns. The difference in An. gambiae s.l. vector density per trap and indoor resting density (IRD) was assessed between the two arms during the high transmission seasons 2 years after the 2021 campaigns.Results Estimated malaria cases decreased significantly by 53.6% in the postintervention period compared with preintervention in the IRS+Standard Pyrethroid ITN arm (95% CI −72.9%, −29.8%) and by 55.9% in the PBO ITN arm (95% CI −73.0%, −32.5%), with no significant difference between these two arms (95% CI −30.9%, 24.0%). From the first to the second season postintervention, cases decreased non-significantly in the IRS+Standard Pyrethroid ITN arm (incidence rate ratio (IRR) 0.94; 95% CI 0.66, 1.47) but increased significantly in the PBO ITN arm (IRR 1.98; 95% CI 1.49, 2.67). Postintervention vector density and IRD were not found to be significantly different between intervention arms in either 2021 (vector density: IRR 0.78; 95% CI 0.47, 1.31; IRD: IRR 0.80; 95% CI 0.37, 1.75) or 2022 (vector density: IRR 1.27; 95% CI 0.75, 2.12; IRD: IRR 1.02; 95% CI 0.45, 2.28).Conclusion These findings suggest a positive impact of non-pyrethroid IRS deployed annually alongside standard pyrethroid ITNs in a setting of confirmed pyrethroid resistance. While an overall positive impact of PBO ITNs was detected, a waning impact of the nets 2 years postdistribution was observed. |
| format | Article |
| id | doaj-art-7e4a708dccd24c2b8289231dad991f09 |
| institution | Kabale University |
| issn | 2059-7908 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Global Health |
| spelling | doaj-art-7e4a708dccd24c2b8289231dad991f092025-01-30T07:00:08ZengBMJ Publishing GroupBMJ Global Health2059-79082025-01-0110110.1136/bmjgh-2024-016617An observational study evaluating the epidemiological and entomological impacts of piperonyl butoxide insecticide-treated nets (ITNs) compared to a combination of indoor residual spraying (IRS) plus standard pyrethroid-only ITNs in Amhara Region, Ethiopia, 2019–2023Banchamlak Tegegne0Delenasaw Yewhalaw1Emily R Hilton2Sarah Zohdy3Cecilia Flatley4Kelly M Davis5Amha Worku6Meshesha Balkew7Peter Mumba8Sheleme Chibsa9Jon Eric Tongren10Gudissa Assefa11Achamyelesh Sisay12Dawit Teshome13Mastewal Worku14Mulat Yimer15Melissa Yoshimizu16Isabel Swamidoss17Carla Mapp18Jimee Hwang19Wendy Inouye20Aklilu Seyoum21Dereje Dengela22Sarah M Burnett23Amhara Public Health Institute, Bahir Dar, EthiopiaTropical and Infectious Disease Research Center, Jimma University, Jimma, EthiopiaPMI Evolve Project, PATH, Seattle, Washington, USAUS President`s Malaria Initiative, US Centers for Disease Control and Prevention, Entomology Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Atlanta, Georgia, USAPMI Evolve Project, Abt Global, Rockville, Maryland, USAPMI Evolve Project, PATH, Washington, District of Columbia, USAPMI Evolve Project, Abt Global, Addis Ababa, EthiopiaPMI Evolve Project, Abt Global, Addis Ababa, EthiopiaU.S. President`s Malaria Initiative, Addis Ababa, EthiopiaU.S. President`s Malaria Initiative, Addis Ababa, EthiopiaU.S. President`s Malaria Initiative, Addis Ababa, EthiopiaMalaria and Other Vector-Borne Diseases Prevention and Control Desk, Federal Ministry of Health, Addis Ababa, EthiopiaMalaria and Other Vector-Borne Diseases Prevention and Control Desk, Federal Ministry of Health, Addis Ababa, EthiopiaPMI Evolve Project, Abt Global, Addis Ababa, EthiopiaAmhara Public Health Institute, Bahir Dar, EthiopiaBahir Dar University, Bahir Dar, EthiopiaUS President`s Malaria Initiative, US Agency for International Development, Washington, District of Columbia, USAUS President`s Malaria Initiative, US Centers for Disease Control and Prevention, Entomology Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Atlanta, Georgia, USAUS President`s Malaria Initiative, US Centers for Disease Control and Prevention, Entomology Branch, Division of Parasitic Diseases and Malaria, Center for Global Health, Atlanta, Georgia, USAU.S. President`s Malaria Initiative, Malaria Branch, US Centers for Disease Control and Prevention, Atlanta, Georgia, USAPATH, Seattle, Washington, USAPMI Evolve Project, Abt Global, Rockville, Maryland, USAPMI Evolve Project, Abt Global, Addis Ababa, EthiopiaPMI Evolve Project, PATH, Washington, District of Columbia, USAIntroduction National malaria programmes must weigh the relative benefits of different vector control and elimination tools to prioritise resource allocation with the greatest impact. This study assesses the epidemiological and entomological impacts of piperonyl butoxide insecticide-treated nets (PBO ITN-only arm) compared with the combination of two annual non-pyrethroid indoor residual spraying (IRS) campaigns and standard pyrethroid ITNs (IRS+Standard Pyrethroid ITN arm) in the Amhara region of Ethiopia.Methods An open-label, stratified block-cluster randomised trial was designed to compare the impacts of the two intervention arms. ITN distribution took place from June to July 2021. IRS campaigns took place from June to July 2021 and again in June 2022. Confirmed malaria cases reported during the high transmission season (September to December) were compared in the 2 years before (2019 and 2020) vs the 2 years after (2021 and 2022) the 2021 campaigns. The difference in An. gambiae s.l. vector density per trap and indoor resting density (IRD) was assessed between the two arms during the high transmission seasons 2 years after the 2021 campaigns.Results Estimated malaria cases decreased significantly by 53.6% in the postintervention period compared with preintervention in the IRS+Standard Pyrethroid ITN arm (95% CI −72.9%, −29.8%) and by 55.9% in the PBO ITN arm (95% CI −73.0%, −32.5%), with no significant difference between these two arms (95% CI −30.9%, 24.0%). From the first to the second season postintervention, cases decreased non-significantly in the IRS+Standard Pyrethroid ITN arm (incidence rate ratio (IRR) 0.94; 95% CI 0.66, 1.47) but increased significantly in the PBO ITN arm (IRR 1.98; 95% CI 1.49, 2.67). Postintervention vector density and IRD were not found to be significantly different between intervention arms in either 2021 (vector density: IRR 0.78; 95% CI 0.47, 1.31; IRD: IRR 0.80; 95% CI 0.37, 1.75) or 2022 (vector density: IRR 1.27; 95% CI 0.75, 2.12; IRD: IRR 1.02; 95% CI 0.45, 2.28).Conclusion These findings suggest a positive impact of non-pyrethroid IRS deployed annually alongside standard pyrethroid ITNs in a setting of confirmed pyrethroid resistance. While an overall positive impact of PBO ITNs was detected, a waning impact of the nets 2 years postdistribution was observed.https://gh.bmj.com/content/10/1/e016617.full |
| spellingShingle | Banchamlak Tegegne Delenasaw Yewhalaw Emily R Hilton Sarah Zohdy Cecilia Flatley Kelly M Davis Amha Worku Meshesha Balkew Peter Mumba Sheleme Chibsa Jon Eric Tongren Gudissa Assefa Achamyelesh Sisay Dawit Teshome Mastewal Worku Mulat Yimer Melissa Yoshimizu Isabel Swamidoss Carla Mapp Jimee Hwang Wendy Inouye Aklilu Seyoum Dereje Dengela Sarah M Burnett An observational study evaluating the epidemiological and entomological impacts of piperonyl butoxide insecticide-treated nets (ITNs) compared to a combination of indoor residual spraying (IRS) plus standard pyrethroid-only ITNs in Amhara Region, Ethiopia, 2019–2023 BMJ Global Health |
| title | An observational study evaluating the epidemiological and entomological impacts of piperonyl butoxide insecticide-treated nets (ITNs) compared to a combination of indoor residual spraying (IRS) plus standard pyrethroid-only ITNs in Amhara Region, Ethiopia, 2019–2023 |
| title_full | An observational study evaluating the epidemiological and entomological impacts of piperonyl butoxide insecticide-treated nets (ITNs) compared to a combination of indoor residual spraying (IRS) plus standard pyrethroid-only ITNs in Amhara Region, Ethiopia, 2019–2023 |
| title_fullStr | An observational study evaluating the epidemiological and entomological impacts of piperonyl butoxide insecticide-treated nets (ITNs) compared to a combination of indoor residual spraying (IRS) plus standard pyrethroid-only ITNs in Amhara Region, Ethiopia, 2019–2023 |
| title_full_unstemmed | An observational study evaluating the epidemiological and entomological impacts of piperonyl butoxide insecticide-treated nets (ITNs) compared to a combination of indoor residual spraying (IRS) plus standard pyrethroid-only ITNs in Amhara Region, Ethiopia, 2019–2023 |
| title_short | An observational study evaluating the epidemiological and entomological impacts of piperonyl butoxide insecticide-treated nets (ITNs) compared to a combination of indoor residual spraying (IRS) plus standard pyrethroid-only ITNs in Amhara Region, Ethiopia, 2019–2023 |
| title_sort | observational study evaluating the epidemiological and entomological impacts of piperonyl butoxide insecticide treated nets itns compared to a combination of indoor residual spraying irs plus standard pyrethroid only itns in amhara region ethiopia 2019 2023 |
| url | https://gh.bmj.com/content/10/1/e016617.full |
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anobservationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT dawitteshome anobservationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT mastewalworku anobservationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT mulatyimer anobservationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT melissayoshimizu anobservationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT isabelswamidoss anobservationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT carlamapp anobservationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT jimeehwang anobservationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT wendyinouye anobservationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT akliluseyoum anobservationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT derejedengela anobservationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT sarahmburnett anobservationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT banchamlaktegegne observationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT delenasawyewhalaw observationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT emilyrhilton observationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT sarahzohdy observationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT ceciliaflatley observationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT kellymdavis observationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT amhaworku observationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT mesheshabalkew observationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT petermumba observationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT shelemechibsa observationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT jonerictongren observationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT gudissaassefa observationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT achamyeleshsisay observationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT dawitteshome observationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT mastewalworku observationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT mulatyimer observationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT melissayoshimizu observationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT isabelswamidoss observationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT carlamapp observationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT jimeehwang observationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT wendyinouye observationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT akliluseyoum observationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT derejedengela observationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 AT sarahmburnett observationalstudyevaluatingtheepidemiologicalandentomologicalimpactsofpiperonylbutoxideinsecticidetreatednetsitnscomparedtoacombinationofindoorresidualsprayingirsplusstandardpyrethroidonlyitnsinamhararegionethiopia20192023 |