Evaluation of Attractive Targeted Sugar Baits, a new outdoor vector control strategy against malaria: Results from a cluster randomised open-label parallel arm controlled trial in Southwestern Mali

IF 11.9 1区医学 Q1 INFECTIOUS DISEASES

Journal of Infection Pub Date : 2025-06-05 DOI:10.1016/j.jinf.2025.106524

Sophie Sarrassat , Mahamoudou Toure , Ayouba Diarra , Makan Keita , Hamady Coulibaly , Abdoul Zamilou Arou , Mohamed Traore , Cheick Oumar Tangara , John Bradley , Gunter Muller , Silas Majambere , John C. Beier , John Vontas , Sekou F. Traore , Samba Diop , Immo Kleinschmidt , Seydou Doumbia

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引用次数: 0

Abstract

Background

The Attractive Targeted Sugar Bait (ATSB) is a new malaria outdoor vector control tool targeting sugar-feeding behaviours of vector mosquitoes. In Mali, a two-year open-label two-arm cluster randomised controlled trial compared the efficacy and safety of ATSB plus insecticide treated mosquito nets (ITN) versus ITN alone on malaria burden.

Methods

76 clusters were formed, of which 38 were randomly allocated to the intervention. Cohort studies and household surveys were performed to assess clinical malaria incidence (primary outcome) in children aged 5 to 14 years and malaria infection prevalence in individuals aged 6 months or older, respectively. Primary analyses were performed on an intention-to-treat basis. The trial was designed to detect a minimum 30% reduction in the two outcomes over a two-year period with a power of at least 80%. The trial is registered at ClinicalTrial.gov (NCT04149119).

Findings

The proportion of sleeping buildings with at least 2 ATSB ranged between 70% and 80%. Coverage of ATSB in good condition was lower (50% or less). Over the two-year trial period, the clinical malaria incidence rate in the control and intervention arm was 0.726 and 0.660 cases per person-year, respectively, with no statistical evidence for an intervention effect (Incidence Rate Ratio (IRR) = 0.90; 95%CI 0.77, 1.05; p = 0.188). Malaria infection prevalence was approximately 37% in both arms (Odds Ratio (OR) = 0.96; 95%CI 0.76, 1.21; p = 0.729). In clusters with coverage of stations in good condition above 80%, there was evidence for a 26% reduction in malaria incidence compared to control clusters after controlling for confounders (adjusted IRR = 0.74; 95%CI 0.61, 0.90; p = 0.002).

Interpretation

Overall, the trial did not demonstrate evidence of additional protection against malaria of ATSB compared to using ITN alone. Suboptimal coverage and maintenance of ATSB in good condition in the field may explain the lack of an intervention effect.

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评估有吸引力的靶向糖饵，一种新的室外疟疾病媒控制策略：来自马里西南部一项随机、开放标签平行对照试验的结果

背景诱捕定向糖饵（ATSB）是一种针对媒介蚊虫食糖行为的新型室外疟疾病媒控制工具。在马里，一项为期两年的开放标签双组随机对照试验比较了ATSB加经杀虫剂处理的蚊帐（ITN）与单独使用经杀虫剂处理的蚊帐对疟疾负担的有效性和安全性。方法选取76个组，其中38个组随机分为干预组。分别进行了队列研究和家庭调查，以评估5至14岁儿童的临床疟疾发病率（主要结局）和6个月或以上个体的疟疾感染流行率。在意向治疗基础上进行初步分析。该试验旨在检测两项结果在两年期间至少减少30%，功率至少为80%。该试验已在ClinicalTrial.gov注册（NCT04149119）。发现至少有2个ATSB的睡眠建筑比例在70%到80%之间。状态良好的ATSB覆盖率较低（50%或更低）。在2年的试验期内，对照组和干预组的临床疟疾发病率分别为0.726例/人/年和0.660例/人/年，干预效果无统计学证据(发病率比(IRR) = 0.90；95%ci 0.77, 1.05；p = 0.188)。两组的疟疾感染率约为37%(优势比(OR) = 0.96；95%ci 0.76, 1.21；p = 0.729)。在状况良好的站点覆盖率超过80%的集群中，有证据表明，在控制混杂因素后，与对照集群相比，疟疾发病率降低了26%(调整IRR = 0.74；95%ci 0.61, 0.90；p = 0.002)。总的来说，与单独使用ITN相比，该试验没有证明ATSB对疟疾有额外保护的证据。在现场，ATSB的覆盖率不够理想，并且维持良好状态，这可能解释了干预效果的缺乏。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Infection 医学-传染病学

CiteScore

45.90

自引率

3.20%

发文量

475

审稿时长

16 days

期刊介绍： The Journal of Infection publishes original papers on all aspects of infection - clinical, microbiological and epidemiological. The Journal seeks to bring together knowledge from all specialties involved in infection research and clinical practice, and present the best work in the ever-changing field of infection. Each issue brings you Editorials that describe current or controversial topics of interest, high quality Reviews to keep you in touch with the latest developments in specific fields of interest, an Epidemiology section reporting studies in the hospital and the general community, and a lively correspondence section.