The RooPfs study to assess whether improved housing provides additional protection against clinical malaria over current best practice in The Gambia: study protocol for a randomized controlled study and ancillary studies
Open accessAbstract
BACKGROUND: In malaria-endemic areas, residents of modern houses have less malaria than those living in traditional houses. This study will determine if modern housing provides incremental protection against clinical malaria over the current best practice of long-lasting insecticidal nets (LLINs) and prompt treatment in The Gambia, determine the incremental cost-effectiveness of the interventions, and analyze the housing market in The Gambia. METHODS/DESIGN: A two-armed, household, cluster-randomized, controlled study will be conducted to assess whether improved housing and LLINs combine to provide better protection against clinical malaria in children than LLINs alone in The Gambia. The unit of randomization will be the household, defined as a house and its occupants. A total of 800 households will be enrolled and will receive LLINs, and 400 will receive improved housing before clinical follow-up. One child aged 6 months to 13 years will be enrolled from each household and followed for clinical malaria using active case detection to estimate malaria incidence for two malaria transmission seasons. Episodes of clinical malaria will be the primary endpoint. Study children will be surveyed at the end of each transmission season to estimate the prevalence of Plasmodium falciparum infection, parasite density, and the prevalence of anemia. Exposure to malaria parasites will be assessed using light traps, followed by detection of Anopheles gambiae species and sporozoite infection. Ancillary economic and social science studies will undertake a cost-effectiveness analysis and use qualitative and participatory methods to explore the acceptability of the housing modifications and to design strategies for scaling-up housing interventions. DISCUSSION: The study is the first of its kind to measure the efficacy of housing on reducing clinical malaria, assess the incremental cost-effectiveness of improved housing, and identify mechanisms for scaling up housing interventions. Trial findings will help inform policy makers on improved housing for malaria control in sub-Saharan Africa. TRIAL REGISTRATION: ISRCTN Registry, ISRCTN02622179 . Registered on 23 September 2014.
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The study was powered to detect a 50% reduction in mosquito density, requiring seven houses per cluster for human landing catch captures.
“For the entomological sampling, we powered the study to detect a 50% reduction in mosquito density, consistent with semi-field testing of Eave Tubes19, 20 and other randomised controlled trials evaluating the entomological effect of house modifications.12, 29 On the basis of baseline data, this sample size calculation required seven houses per cluster for the human landing catch captures.”
From Impact and cost-effectiveness of a lethal house lure against malaria transmission in central Côte d'Ivoire: a two-arm, cluster-randomised controlled trial (2021) · cites this paper as [29]
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- Authors
- Pinder, M., Conteh, L., Jeffries, D., Jones, C., Knudsen, J., Kandeh, B., Jawara, M., Sicuri, E., D’Alessandro, U., & Lindsay, S. W.
- Affiliations
- Durham University (GB)
- Imperial College London (GB)
- MRC Unit the Gambia (GM)
- University of Oxford (GB)
- Royal Danish Academy – Architecture, Design, Conservation (DK)
- Corresponding author
- Lindsay, Steve W.
- ORCID
- Venue
- Trials
- Published
- 2016-06-03
- Volume
- 17
- Issue
- 1
- Pages
- 275-275
- ISSN
- 1745-6215 (ISSN-L)
- PMC
- PMC4891825
- OpenAlex
- W2415720269
- Cited by
- 44
- References
- 31
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 4 · 2023: 4 · 2022: 7 · 2021: 7 · 2020: 7 · 2019: 3 · 2018: 5 · 2017: 2 · 2016: 2
- FWCI
- 3.94
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- Trials (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Architecture, Design and Conservation (Aarhus School of Architecture, Design School Kolding, The Royal Danish Academy of Fine Arts, Schools of Architecture, Design and Conservation (KADK)) (publishedVersion, other-oa)
- Durham Research Online (Durham University) (acceptedVersion, cc-by)
- LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
- Durham Research Online (Durham University) (submittedVersion, cc-by)
- Funders
- MRC-DfID-Wellcome Trust (MR/M007383/1)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Malaria Research and Control
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Life Sciences › Immunology and Microbiology › Parasitology › Bird parasitology and diseases
- Keywords
- improved housing, clinical malaria, Plasmodium falciparum, long-lasting insecticidal nets, malaria control, children, cost-effectiveness, housing market, Anopheles gambiae, sporozoite infection, parasite density, anemia, home modification, scaling up interventions, Gambia
- MeSH terms
- Adolescent, Age Factors, Anemia, Child, Child, Preschool, Cost-Benefit Analysis, Female, Gambia, Housing, Humans, Infant, Male, Mosquito Control, Research Design, Risk Factors, Seasons, Time Factors, Incidence, Prevalence, Malaria, Falciparum, Health Care Costs, Insecticide-Treated Bednets
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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