Operational Research

Photo of a woman underneath an ITN

Operational research is critically important to the success of President’s Malaria Initiative (PMI) programs. During the course of implementation, and with the changing epidemiology of malaria, unforeseen obstacles and new questions emerge. PMI-supported operational research focuses on how to improve uptake and scale-up of interventions; cost-effectively implement combinations of interventions; preserve the effectiveness of interventions in the face of resistance; and measure the success and impact of interventions. Additionally, PMI evaluates and assesses how to incorporate new interventions and when to withdraw less effective ones. PMI’s operational research approach includes working with local institutions as implementers and strengthening host countries’ capacity to design and conduct operational research. PMI-funded operational research studies range from small studies answering country-specific concerns to large multicountry studies addressing initiative-wide questions.

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Since 2006, PMI has supported numerous operational research studies centered on the primary malaria control and prevention interventions: insecticide-treated nets (ITNs), indoor residual spraying (IRS), intermittent preventive treatment for pregnant women (IPTp) and accurate diagnosis and effective treatment. PMI also funds cross-cutting studies related to behavior change communication, monitoring and evaluation and surveillance.

Filter Projects


  Project Name Country Program Area Status
Operational research to increase the effectiveness of the malaria surveillance and response system in Zanzibar Tanzania Pre-elimination and Transmission Reduction (PE) Approved
 

Objective: 1) To determine the effective coverage of the surveillance-response system (MEEDS & MCN) in place in Zanzibar in terms of the proportion of the intended target population actually covered by the intervention. a. What are the demographic and behavioural characteristics of the missed population? 2) To evaluate the surveillance-response system in Zanzibar and identify modifications to the system which could improve performance especially as regards the probability of infection detection. a. What proportion of the target population of persons infected with parasites are identified by the system? b. What changes to the current system could increase population coverage and infection coverage? 3) To estimate the cost and cost-effectiveness of the surveillance-response system approach utilized in Zanzibar as well as the marginal cost of adding additional households.

Start Date: 2016

Malaria Prevention and Care-Seeking Behavior in Southeast Asian Migrant Populations in Angola Angola Case Management (CM) Approved
 

Objective: • Characterize malaria prevention practices in SE Asian migrants in Angola • Characterize care-seeking practices in SE Asian migrants in Angola • Identify barriers to reaching the SE Asian migrant population with prevention strategies and providing access to appropriate testing and treatment of malaria cases

Start Date: 2017

Testing the feasibility of community delivery of intermittent preventive treatment during pregnancy with sulfadoxine pyrimethamine (IPTp-SP) in Burkina Faso Burkina Faso Malaria in pregnancy (MIP) Approved
 

Objective: 1. Determine the effect of delivery of IPTp-SP by CHWs on IPTp-SP coverage (including IPTp1, IPTp2, IPTp3 and IPTp4) in rural Burkina Faso. 2. Document the effect of delivery of IPTp-SP by CHWs on ANC attendance (including ANC1, ANC2, ANC3 and ANC4) in a rural area of Burkina Faso. 3. Identify social and cultural factors in addition to intervention that influence levels of IPTp-SP uptake and ANC attendance.

Start Date: 2016

Evaluation of the performance of a highly-sensitive RDT versus conventional RDT, compared with PCR as the gold standard, in reactive case detection of malaria in a low transmission area. Burma Case Management (CM); Pre-elimination and Transmission Reduction Approved
 

Objective: The primary objective of this study is to assess the performance of the new highly-sensitive rapid diagnostic test (hsRDT) developed by SD Bioline versus conventional RDT, compared with PCR as the gold standard, in detecting malaria infections around index cases identified through passive surveillance in a low transmission area. Initial prototype testing of this hsRDT designed to detect the Plasmodium falciparum-specific antigen HRP2 in a format similar to the current conventional RDTs resulted in a limit of detection (LOD) of HRP2 of about 80 pg/mL compared to conventional RDTs with a LOD of 800-1000 pg/mL.

Start Date: 2017

Assessing the effectiveness of community delivery of IPTp in Malawi Malawi Malaria in pregnancy (MIP) Approved
 

Objective: The primary objective will be to increase coverage of IPTp-SP3, without decreasing ANC attendance.

Start Date: 2017

Investigating the magnitude and drivers of residual malaria transmission in Tanzania Tanzania Vector Control - Insecticide treated nets (ITNs); Vector control - Indoor residual spraying (IRS) Approved
 

Objective: This study will investigate the magnitude of residual transmission and characterize it on the basis of where and when it occurs, and what its main anthropological determinants are in Zanzibar.

Start Date: 2016

Increasing Intermittent Preventive Treatment uptake through enhanced antenatal clinic service delivery to improve maternal and child health Mali Malaria in pregnancy (MIP) Approved
 

Objective: This study will seek to evaluate a ‘MIP Improvement Package’ consisting of enhanced, MIP-focused training and supervision of health workers plus community-based promotion campaign (intervention groups) to improve the coverage of at least three doses of IPTp-SP in comparison with standard training and implementation (control).

Start Date: 2016

Hematologic monitoring to assess the safety of the primaquine radical cure for Plasmodium vivax roll-out Ethiopia Case Management (CM) Approved
 

Objective: To assess hematologic response and adverse events in those receiving primaquine radical cure for vivax by systematic monitoring at selected health centers with active follow up and hematological testing.

Start Date: 2017

Evaluation of targeted mass drug administration and reactive case detection on malaria transmission and elimination in Ethiopia Ethiopia Pre-elimination and Transmission Reduction (PE) Approved
 

Objective: Will the addition of tMDA or reactive case detection conducted within a 100m radius of the index case in a setting of optimized malaria control interventions impact community level malaria transmission?

Start Date: 2017

Targeted IRS Phase 2: Comparison trial of three separate targeting strategies for IRS Zambia Vector Control - Indoor residual spraying (IRS) Approved
 

Objective: 1. Compare the impact of 2 different IRS targeting strategies relative to each other and to blanket coverage IRS 2. Compare the operational cost of 2 different IRS targeting strategies, including costs associated with undertaking the targeting, relative to each other and blanket coverage

Start Date: 2017

Effect of Indoor Residual Spraying on Anopheles vector behaviors and their impact on malaria transmission in the northern region of Ghana Ghana Vector Control - Indoor residual spraying (IRS) Approved
 

Objective: 1. Determine the extent to which Anopheles mosquito vectors feed and rest outdoors versus indoors in IRS vs. non-IRS areas. Past and current efforts have concentrated on indoor collections using only HLC and PSC methods. This study will use entry/exit trap and resting collection data to sample a mosquito population that has not been adequately sampled to date. 2. Determine if insecticide resistance is important for vector survival or avoidance of vector control interventions. 3. Determine if resistance status for the indoor/outdoor biting and resting populations are factors affecting mosquito infection status. 4. Determine the extent to which human outdoor activities overlap with mosquito biting activities that may impact malaria transmission risk.

Start Date: 2016

Evaluating Clinician Adherence to Diagnostic Testing to Provide Effective Case Management in Nigeria Nigeria Case Management (CM) Approved
 

Objective: a. The extent of public sector clinician adherence to appropriate diagnostic malaria testing and treatment in Nigeria; and b. The determinants associated with clinician non-adherence to diagnostic malaria testing and treatment in Nigeria.

Start Date: 2017

Determining the effect of holes of different sizes and varying concentrations of insecticide in bednets on personal and community protection using Pyrethroid resistant and Pyrethroid susceptible Anopheles arabiensis Tanzania Vector Control - Insecticide treated nets (ITNs) Approved
 

Objective: Our proposed study, combining qualitative and quantitative methods, investigates the life history of nets inside households for a larger sample and over a longer time period than previously reported. This will help to better understand local user choices on net use and allocation, how they vary within and between households and over time, and at what point and why nets are replaced or discarded. Objectives: 1) Investigate how decisions are made about who sleeps under which net within a household, when to exchange old nets for new ones, and how existing nets are re-allocated to sleeping spaces when the household obtains a new net, and whether this depends on its distribution mechanism, i.e. universal coverage, targeted campaigns or via the commercial market. 2) Investigate characteristics of nets determining net replacement and disposal decisions using discrete choice experiments. 3) Correlate net use and allocation decisions with the physical status of the net .

Start Date: 2016

Cost-effectiveness Evaluation of Vector Control Strategies in Mozambique Mozambique Vector Control - Insecticide treated nets (ITNs); Vector control - Indoor residual spraying (IRS) Approved
 

Objective: The main evaluation objective is to determine the cost-effectiveness of different vector control interventions in a malaria endemic region of Mozambique. This includes a prospective evaluation of indoor residual spraying (IRS) with the organophosphate, Actellic, within a context of high coverage of insecticide-treated nets (ITNs). Cost-effectiveness will be determined by calculating the cost per case of malaria averted at community level and the cost per disability-adjusted life years (DALY) saved. It is expected to show the added benefit and cost associated with spraying with Actellic in areas with ITNs.

Start Date: 2016

A comparison of reactive case detection and focal mass drug administration strategies in the Central Highlands areas of Madagascar to inform the national malaria control strategy toward elimination Madagascar Pre-elimination and Transmission Reduction (PE) Approved
 

Objective: The primary objective of this OR study is to compare the feasibility and effectiveness of two different reactive case detection approaches in the Central Highlands of Madagascar for reducing malaria transmission, measured by the number of additional cases detected and by reductions in transmission over time using PCR and serology.

Start Date: 2016

Development of a Pilot Dry Season Vector Control Strategy in Mali Mali Vector Control - Indoor residual spraying (IRS) Completed
 

Objective: 1. To characterize and monitor malaria transmission parameters to provide baseline information on entomological parameters of malaria transmission 2. To perform selective IRS during the dry season in hamlets spanning the Niger River between Kirina and Kenieroba 3. To assess the impact of IRS on malaria transmission by monitoring entomological parameters of malaria transmission, after performing the selective IRS, in threes set of hamlets and inland villages

Start Date: 2009

Field Testing of Dried Malaria Positive Blood as Quality Control Samples for malaria RDTs. Benin Case Management (CM) Completed
 

Objective: Determine operational feasibility of using dried tube specimens (DTS) as quality control and proficiency testing samples for malaria RDTs. DTS and RDTs stored at a reference laboratory were compared to DTS and RDTs stored at two health facilities to determine the ability of DTS to detect failing RDTs and also how a QC activity based on DTS can be incorporated into a larger RDT quality assurance program.

Start Date: 2014

Field assessment of dried Plasmodium falciparum samples for malaria rapid diagnostic test quality control and proficiency testing in Ethiopia Ethiopia Case Management (CM) Completed
 

Objective: Determine operational feasibility of using dried tube specimens (DTS) as quality control and proficiency testing samples for malaria RDTs. DTS and RDTs stored at a reference laboratory were compared to DTS and RDTs stored at two health facilities to determine the ability of DTS to detect failing RDTs and also how a QC activity based on DTS can be incorporated into a larger RDT quality assurance program.

Start Date: 2013

Field Testing of Dried Malaria Positive Blood as Quality Control Samples for malaria RDTs. Liberia Case Management (CM) Completed
 

Objective: Determine operational feasibility of using dried tube specimens (DTS) as quality control and proficiency testing samples for malaria RDTs. DTS and RDTs stored at a reference laboratory were compared to DTS and RDTs stored at two health facilities to determine the ability of DTS to detect failing RDTs and also how a QC activity based on DTS can be incorporated into a larger RDT quality assurance program.

Start Date: 2013

Integrated vector management: Interaction of larval control and Indoor Residual Spraying on Anopheles gambiae density and vectorial capacity for human malaria Mali Vector Control - Indoor residual spraying (IRS) Completed
 

Objective: Determine the added benefit to larviciding water sources surrounding sprayed houses in a subset of villages under IRS control.

Start Date: 2009

Scale-up of home-based management of malaria based on rapid diagnostic tests and artemisinin-based combination therapy in a resource-poor country: results in Senegal Senegal Case Management (CM) Completed
 

Objective: To evaluate scale up of home-based management of malaria including diagnosis with RDT and treatment based on test results to improve access of remote populations to prompt and effective management of uncomplicated malaria

Start Date: 2012

Acceptability of seasonal malaria chemoprevention (SMC) administered by mass campaign in southeastern Senegal: a qualitative approach Senegal Case Management (CM) Completed
 

Objective: 1) Document the intervention by observation of medication delivery and administration: interactions between health volunteers delivering the intervention (relais), caregivers and mothers, children. 2) Understand adherence or resistance by populations and health workers in regards to the acceptability of this new strategy, and in particular understand the reasons for adherence/resistance. 3) Understand perceptions of the intervention, the implementation (approach to preparation, communications, involvement of health workers and communities, application of measures against adverse effects and perceptions of the risk of adverse reaction) 4) Identify factors that facilitate acceptability of SMC at the community level and factors that limit adherence to SMC

Start Date: 2014

Socio-cultural and behavioral determinants of ongoing high malaria burden in a district in which all interventions have been scaled up Senegal Behavior Change Communication (BCC) Completed
 

Objective: 1) To study whether behaviors considered normative during the night, particularly sleeping/socializing outside, during malaria transmission season are placing the people at risk of infective bites, based on known habits of malaria vectors in the district 2) To determine whether insecticide-treated nets are being used appropriately, and if they are being used outside during night time hours, and explore beliefs surrounding use of insecticide-treated nets that may explain this and suggest possible messaging interventions 3) To explore beliefs, behaviors, and barriers surrounding care seeking and treatment that may lead to no, alternative, or delayed care seeking 4) To gather information regarding cross border movements and care seeking by populations not resident in the district

Start Date: 2014

Efficacy of sulphadoxine-pyrimethamine for intermittent preventive treatment of malaria in pregnancy, Mansa, Zambia Zambia Malaria in pregnancy (MIP) Completed
 

Objective: 1) To determine the effectiveness of SP for IPTp as evaluated by pregnancy outcomes following IPTp; 2) To determine the efficacy of SP for IPTp in clearing peripheral parasitemia in asymptomatic pregnant women; 3) To characterize baseline resistance of P. falciparum to SP in select locations in Zambia using molecular markers; 4)To assess the relationship of therapeutic efficacy and SP for IPTp effectiveness with molecular markers for SP resistance.

Start Date: 2010

Assessment of the burden of malaria and malaria prevention and treatment seeking practices among migrant populations in Senegal Senegal Pre-elimination and Transmission Reduction (PE), Case Management (CM) Completed
 

Objective: 1) Determine the prevalence of malaria among migrant populations 2) Determine the beliefs and practices regarding malaria prevention and care seeking among migrant populations 3) Determine the proportion of malaria cases seen at health posts that are from migrant populations.

Start Date: 2014

Validity of Expanded Program on Immunization Contact Method Health Behavior Estimates in Mali Mali Monitoring and evaluation (M&E) Completed
 

Objective: 1) To assess the validity of the EPI Contact Method as a tool for monitoring bednet usage and treatment of common childhood illnesses by comparing data collected using the EPI Contact method to that collected during baseline and follow-up representative cross-sectional household surveys; 2) To evaluate the effectiveness of the EPI Contact Method as an intervention to improve bednet use and the appropriate treatment of common childhood illnesses; 3) To describe potential determinants of health worker performance of the EPI Contact Method; 4) To explore barriers to and motivations of net use at the household level

Start Date: 2008

Community Case Management of Fever Due to Malaria and Pneumonia in Children Under Five in Zambia: A Cluster Randomized Controlled Trial Zambia Case Management (CM) Completed
 

Objective: 1) To determine the efficacy of SP IPTp in clearing peripheral parasitemia in asymptomatic pregnant women; 2) To determine the effectiveness of SP IPTp as determined by pregnancy outcomes following IPTp; 3) To characterize baseline resistance of P. falciparum to SP in select locations in Zambia using molecular markers; 4) To assess the relationship of therapeutic efficacy and SP IPTp effectiveness with molecular markers for SP resistance

Start Date: 2007

A pilot of interventions to improve patient adherence to a treatment regimen of artemether-lumefantrine in Malawi Malawi Case Management (CM) Completed
 

Objective: To determine adherence to artemether-lumefantrine as prescribed by health care workers and determine predictors for adherence such as patient factors, health worker practices, and counseling messages.

Start Date: 2009

The financial implications of removing user fees for Malaria treatment for under five (U5) children in Mali Mali Case Management (CM); Health Systems Strengthening (HSS) Completed
 

Objective: To estimate the financial implication of removing U5 malaria user fees in primary care level/ private nonprofit facilities (CSCom) and first reference levels public facilities (CSRef) in Mali; assess the attitudes of health providers and key stakeholders with regards to removing user fees for malaria treatment; and identify the major barriers to removal of user fees from malaria treatment among children U5.

Start Date: 2010

Durability assessment results suggest a serviceable life of two, rather than three, years for the current long-lasting insecticidal (mosquito) net (LLIN) intervention in Benin Benin Vector Control - Insecticide treated nets (ITNs) Completed
 

Objective: To evaluate the efficacy of non-pyrethroid IRS on malaria transmission and malaria morbidity, its effects on the development of resistance and on the behaviour of Anopheles mosquitoes, and the involvement of communities in such a strategy.

Start Date: 2011

Combination of malaria vector control interventions in pyrethroid resistance area in Benin: a cluster randomised controlled trial Benin Vector control - Insecticide treated nets (ITNs); Vector control -Indoor residual spraying (IRS) Completed
 

Objective: To evaluate the efficacy of non-pyrethroid IRS on malaria transmission and malaria morbidity, its effects on the development of resistance and on the behaviour of Anopheles mosquitoes, and the involvement of communities in such a strategy.

Start Date: 2009

Continuous Distribution Pilot Assessments Nigeria Vector Control - Insecticide treated nets (ITNs) Completed
 

Objective: Objectives: To pilot-test innovative continuous distribution systems: Community Directed Interventions (CDI) (using Community Drug Distributors) and School Based Distribution.

Start Date: 2010

Assessment of Diagnostic and Treatment algorithm Senegal Case Management (CM) Completed
 

Objective: Senegal has a case management algorithm that states that patients who have signs of a febrile illness other than malaria (ie., runny nose, sore throat, rash) should not receive an RDT, but be treated for the suspected illness. If they remain symptomatic in 48 hrs, they may return for an RDT. This study aims to determine the proportion of patients not deemed eligible for an RDT who have a malaria infection, across the multiple epidemiologic strata found in Senegal and during an entire year.

Start Date: 2012

Indoor Residual Spraying in Combination with Insecticide-Treated Nets Compared to Insecticide-Treated Nets Alone for Protection against Malaria: A Cluster Randomised Trial in Tanzania Tanzania Vector control - Insecticide treated nets (ITNs); Vector control -Indoor residual spraying (IRS) Completed
 

Objective: The aim of this research is to determine whether it is necessary to maintain IRS once malaria transmission has been reduced or whether following the scaling-up of LLINs the IRS can be withdrawn and low transmission rates can be maintained equally well with LLINs alone.

Start Date: 2010

Phase III field evaluation of long-lasting insecticide treated nets Kenya Vector Control - Insecticide treated nets (ITNs) Completed
 

Objective: The aim of this study is to compare the longevity of 7 LLIN products under field conditions in Kenya.

Start Date: 2009

Reduction in symptomatic malaria prevalence through proactive community treatment in rural Senegal Senegal Case Management (CM) Completed
 

Objective: The objective is to show if active fever surveillance decreases weekly malaria incidence and the number and percent of severe malaria cases seen at the health post. Village malaria volunteers (DSDOMs), who are already trained to test febrile patients with RDTs and treat positives with ACTs, will conduct weekly house-to-house visits to identify fever cases, and offer testing and treatment, during the four months of malaria transmission season in 15 villages in the health district of Saraya. Fifteen villages that have DSDOMs will serve as comparison. In those villages, in addition to home-based care, a house-to-house sweep will be conducted at the beginning and the end of the transmission season for comparison.

Start Date: 2013

Net Care and Repair Behaviors: Formative Research in Uganda and Nigeria Nigeria Vector Control - Insecticide treated nets (ITNs); Behavior Change Communication (BCC) Completed
 

Objective: The objective of the study includes Qualitative formative: To understand the knowledge, attitudes, beliefs, and practices that motivate or impede net care and repair behaviors and to use these findings to inform a behavior change communication (BCC) intervention. Quantitative evaluation: To evaluate the impact on net integrity of a net care and repair BCC program.

Start Date: 2009

Net Care and Repair Behaviors: Formative Research in Uganda and Nigeria Uganda Vector Control - Insecticide treated nets (ITNs); Behavior Change Communication (BCC) Completed
 

Objective: The objective of the study includes Qualitative formative: To understand the knowledge, attitudes, beliefs, and practices that motivate or impede net care and repair behaviors and to use these findings to inform a behavior change communication (BCC) intervention. Quantitative evaluation: To evaluate the impact on net integrity of a net care and repair BCC program.

Start Date: 2009

Field Trial Evaluation of the Performances of Point-of-Care Tests for Screening G6PD Deficiency in Cambodia Cambodia Case Management (CM) Completed
 

Objective: The objective of this assessment is to explore the feasibility and safety of using the CareStart™ G6PD Deficiency Screening Test to guide the inclusion of primaquine therapy for those presenting with Pv.

Start Date: 2013

Durability and insecticide persistence in LLINs in Zambia: Cross-Section Study Zambia Vector Control - Insecticide treated nets (ITNs) Completed
 

Objective: The objective of this study is to determine how long LLINs last in terms of physical integrity and insecticide content using a cross sectional study in nine districts in Zambia.

Start Date: 2012

Phase III field evaluation of long-lasting insecticide treated nets Senegal Vector Control - Insecticide treated nets (ITNs) Completed
 

Objective: The objective of this study is to determine the life of 5 different insecticides used for indoor residual spraying for the prevention of malaria.

Start Date: 2009

Pregnant women and infants as sentinel groups for monitoring impact of interventions to reduce malaria transmission in the general population Tanzania Monitoring and evaluation (M&E) Completed
 

Objective: The objectives of this study are 1) to assess the operational, logistical, and epidemiological feasibility of using specific sentinel populations attending reproductive and child health (RCH) clinics to monitor impact of malaria control; and 2) to determine acceptability/completeness/timeliness of monthly reporting by two RCH staff using mobile phone-based tools.

Start Date: 2012

A project to develop and evaluate an adaptation of routine disease reporting to include malaria diagnoses by RDT result in Tanzania Tanzania Case Management (CM) Completed
 

Objective: The primary objective of this project was to assess the completeness and acceptability of recording and reporting malaria diagnoses by Paracheck™ rapid diagnostic test (RDT) results in basic health facilities through simple modifications to the exiting Health Management and Information System (HMIS) booklets (Book number 5). In primary care clinics throughout Tanzania these HMIS booklets are part of the normal reporting format but in some clinics, they have been replaced by the more detailed ‘Indent Book’. Secondary objectives included the influence of RDTs and reporting their results on prescriber behavior, and to identify health worker characteristics associated with good prescribing practice.

Start Date: 2009

Qualitative study to identify determinants of net preference and acceptability in Cambodia Cambodia Vector Control - Insecticide treated nets (ITNs) Completed
 

Objective: The primary objective of this study is to identify the determinants of net preference and use, including net characteristics and other exogenous factors, among Cambodians living in malaria risk areas. The secondary objective is to determine preferences for specific physical characteristics of mosquito nets, both treated and untreated, most strongly correlated with use and non-use by report in malaria risk populations in Cambodia. In an effort to build the evidence base to inform future procurement decisions, this study is intended as a preliminary focus group-based investigation to gather qualitative data to identify the determinants of net preference, acceptability, use and then to inform the design of a prospective study to correlate these stated net preferences with actual use.

Start Date: 2016

Use and acceptability of insecticide treated clothing among rubber plantation workers in Myanmar Burma Vector control (VC) - all Completed
 

Objective: The primary objective of this study was to determine preference and acceptability of ITC by rubber tappers for nighttime work. The secondary objectives were to investigate user perceptions related to ITC use to inform future social marketing or ITC distribution programmes; to investigate whether preference and acceptability changes over a 3-month period; to conduct a costing analysis of ITC; and to assess the bio-efficacy of ITC worn by rubber tappers.

Start Date: 2015

Evaluation of Inpatient Malaria Case Management in Malawi; Nationwide health facility survey of healthworker knowledge of severe malaria case management Malawi Case Management (CM) Completed
 

Objective: The primary objectives are: A. Assess readiness to provide severe malaria case management B. Assess quality of severe malaria case management

Start Date: 7/4/1905*

HQ-2: Validation and comparison of physician panel and candidate algorithm coding methods for verbal autopsy data using international ICD procedures Tanzania Case Management (CM) Completed
 

Objective: The purpose of this study is to compare the ‘true’ medical record cause of death with COD according to verbal autopsy derived from 4 candidate methods: physician panel coding (PC), classification trees (CT), artificial neural networks (ANN) and the symptom pattern method (SP);

Start Date: 2009

Knowledge and Adherence to Malaria Treatment Guidelines for Pregnant Patients in Rural Western Kenya Kenya Malaria in pregnancy (MIP) Completed
 

Objective: The research project aim is to assess the awareness and practice of national guidelines for malaria case management in pregnancy among healthcare providers and drug dispensers in a rural area of western Kenya.

Start Date: 2013

Durability and Insecticide Persistence in Long-Lasting Insecticide-treated Nets in Zambia: Longitudinal Study Zambia Vector Control - Insecticide treated nets (ITNs) Completed
 

Objective: The study examines the longevity of LLINs in terms of physical integrity and insecticide persistence. LLINs distributed in two different provinces, Permanets® (Luapula Province) and Olysets® (Northern province), are followed every 6 months to count and measure holes starting at one year of age, ending at 30 months of age. Households are surveyed about net care and usage.

Start Date: 2012

Phase III field evaluation of long-lasting insecticide treated nets Malawi Vector Control - Insecticide treated nets (ITNs) Completed
 

Objective: The study objective is to compare the longevity of 5 LLITN products under field conditions in Malawi.

Start Date: 2009

Longevity of insecticides used for IRS Kenya Vector Control - Indoor residual spraying (IRS) Completed
 

Objective: The study objective is to determine the life of 9 different insecticides/formulations used for indoor residual spraying for the prevention of malaria.

Start Date: 2011

Evaluation of integrated vector control in high and low transmission areas of western Kenya Kenya Vector Control - Indoor residual spraying (IRS) Completed
 

Objective: The study objectives are: 1) Measure the impact of ITNs, IRS, and the combination of ITNs and IRS on the prevalence of parasitemia and anemia through a cross-sectional survey; 2) Measure the impact of ITNs, IRS, and the combination of ITNs and IRS on entomological indices; 3) Determine whether IRS affects ITN ownership and use; 4) Assess above objectives by HH economic status.

Start Date: 2008

The effectiveness of long-lasting, insecticide-treated nets in a setting of pyrethroid resistance: a case–control study among febrile children 6 to 59 months of age in Machinga District, Malawi Malawi Vector Control - Insecticide treated nets (ITNs) Completed
 

Objective: There has been increasing concern that the effectiveness of LLINs in reducing malaria transmission may be compromised by increasing resistance of malaria vectors to pyrethroid insecticides. Although several studies have examined the effect of pyrethroid resistance on entomological indicators using experimental huts, few epidemiological studies have assessed LLIN effectiveness for malaria control in settings of pyrethroid resistance, and results have been conflicting.

Start Date: 2012

Placental Malaria Is Rare Among Zanzibari Pregnant Women Who Did Not Receive Intermittent Preventive Treatment in Pregnancy Tanzania Malaria in pregnancy (MIP) Completed
 

Objective: This study aimed to estimate the rate of placental malaria infection at delivery among Zanzibari pregnant women who had not received IPTp to help determine whether IPTp is still warranted in Zanzibar.

Start Date: 2011

Assessing adherence and factors affecting adherence to artemether-lumefantrine for routine treatment of uncomplicated malaria in Ethiopia Ethiopia Case Management (CM) Completed
 

Objective: This study aims to assess adherence and factors related to adherence to a regimen of AL for treatment of uncomplicated malaria in two healthcare settings: health facilities and community health posts.

Start Date: 2009

Evaluation of Seasonal Malaria Chemoprevention (SMC) pilot in Kita District, Mali Mali Case Management (CM) Completed
 

Objective: This study aims to evaluate the programmatic coverage and effectiveness of SMC when delivered through routine programming at the community level.

Start Date: 2014

Association between malaria control and paediatric blood transfusions in rural Zambia: an interrupted time-series analysis Zambia Health Systems Strengthening (HSS) Completed
 

Objective: This study explores the extent to which the use of paediatric blood transfusions is affected by the number of paediatric malaria visits and admissions. It assesses whether the scale-up of malaria control interventions in a facility catchment area explains the use of paediatric blood transfusions.

Start Date: 2013

Outdoor-sleeping and other night-time activities in northern Ghana: implications for residual transmission and malaria prevention Ghana Behavior Change Communication (BCC) Completed
 

Objective: This study was designed to explore and document night-time activities, including outdoor sleeping, that might increase exposure to malaria infection. Study findings may also inform the design of potential behaviour change communication or other interventions to reduce risk of outdoor malaria infection.

Start Date: 2013

Evaluation of intermittent mass screening and treatment to reduce malaria transmission in western Kenya Kenya Pre-elimination and Transmission Reduction (PE) Completed
 

Objective: This study will evaluate the additional impact of IMSaT on malaria transmission and clinical malaria in an area with a moderate burden of malaria parasitemia and high coverage of ITNs and effective case management.

Start Date: 2013

Association between malaria control scale-up and micro-economic outcomes: evidence from a retrospective analysis in Zambia Zambia Health Systems Strengthening (HSS) Completed
 

Objective: This study will examine whether the scale-up of malaria control activities (specifically the distribution of insecticide treated nets (ITNs) and indoor residual spraying (IRS))is associated with improved micro-economic outcomes at the household level, specifically household spending on food, household spending on medical care, schooling attendance, agricultural production, and household savings and borrowing. The results of this study will demonstrate whether an association exists and the magnitude of the relationship.

Start Date: 2014

Prevalence of Plasmodium falciparum parasitemia and anemia in children under-five years of age at baseline and following annual vs. biannual indoor residual spraying (IRS) in Bunkpurugu-Yunyoo district, northern Ghana Ghana Vector Control - Indoor residual spraying (IRS) Completed
 

Objective: To assess the prevalence of Plasmodium falciparum parasitemia and anemia in children underfive years of age at baseline and following annual vs. biannual indoor residual spraying (IRS) in Bunkpurugu-Yunyoo district, northern Ghana

Start Date: 2011

Determining the prevalence of glucose-6-phosphate dehydrogenase deficiency in Ethiopia Ethiopia Case Management (CM) Completed
 

Objective: To determine prevalence of the major mutations of glucose-6-phosphate dehydrogenase deficiency in Ethiopia, including ideally creating a risk map and providing an evidence base to inform needed policies related to proposed scale up of primaquine therapy for malaria infection.

Start Date: 2014

Intermittent Screening and Treatment (IST) or Intermittent Preventive Treatment (IPT) with Dihydroartemisinin-Piperaquine, versus IPT with Sulphadoxine-Pyrimethamine for the control of malaria in pregnancy in Kenya: Assessment of Acceptibility, Feasibility and Cost-effectiveness within a randomized controlled trial Kenya Malaria in pregnancy (MIP) Completed
 

Objective: To determine the acceptability and feasibility of implementation of ISTp-DP and IPTp-DP versus IPTp-SP, specifically, to determine the acceptability of IPTp-DP and ISTp-DP versus IPTp-SP among health providers and pregnant women in trial and operational contexts, to implement IPTp-DP and ISTp-DP and assess the systems effectiveness of delivery and identify potential facilitating and blocking factors under operational conditions, and to develop guidelines for implementation of IPTp-DP or ISTp-DP at scale based on the findings of the trial and feasibility study.

Start Date: 2013

A Study to determine the current prevalence of malaria detectable among pregnant women registering for ANC in 6 districts in Rwanda: Evidence for developing and implementing a new malaria in pregnancy strategy in the context of reducing malaria prevalence. Rwanda Malaria in pregnancy (MIP) Completed
 

Objective: To determine the current prevalence of malaria detectable among pregnant women registering for ANC in 6 districts in Rwanda and to gather the evidence for developing and implementing a new malaria in pregnancy strategy in the context of reducing malaria prevalence.

Start Date: 2011

Effectiveness of post-campaign door-to-door hang-up and communication interventions to increase LLIN utilization Uganda Vector Control - Insecticide treated nets (ITNs) Completed
 

Objective: To evaluate the effectiveness of different approaches of post LLIN campaign home visits by volunteers to enhance LLIN hang-up and utilization, to estimate the retention/attrition rate of LLIN distributed by campaign at different points in time, and to estimate the cost of the different hang-up interventions to the service provider.

Start Date: 2009

IRS and LLIN: Integration of methods and insecticide mode of actions for control of African malaria vector mosquitoes Tanzania Vector control - Insecticide treated nets (ITNs); Vector control -Indoor residual spraying (IRS) Completed
 

Objective: To study the behavior of African mosquito vectors exposed to insecticides used in IRS and ITNs in order to determine the mode of action of insecticides, to determine the efficacy of IRS and LLINs related to modes of action, and to quantify changes in mosquito behavior associated with insecticide resistance.

Start Date: 2009

Focal IRS Phase 1: targeting strategies to maximize protection while minimizing cost Zambia Vector Control - Indoor residual spraying (IRS) Ongoing
 

Objective: 1. Measure variations in impact of focal IRS with pirimiphos-methyl among different target areas in Nchelenge District on the outcomes of parasite prevalence, vector density, insecticide resistance and the number of confirmed malaria cases presenting to health facilities. 2. Measure variations in the cost-effectiveness of focal IRS with pirimiphos-methyl among different target areas in Nchelenge District. 3. Identify demographic, epidemiological, entomological and ecological factors associated with the effectiveness of focal IRS with pirimiphos-methyl among different target areas in Nchelenge District.

Start Date: 2014

Impact of intensification of malaria control activities on household microeconomics and health services Kenya Health Systems Strengthening (HSS) Ongoing
 

Objective: 1. To estimate the health costs of the intensive malaria intervention programme; 2. To estimate economic and financial program impact of malaria infections on households; 3. To assess the cost effectiveness of malaria control programme using decision rules and threshold analyses; 4. To establish health service and poverty impact of selected policy options for enhanced malaria reduction.

Start Date: 2013

Universal versus conditional three-day follow-up visit for children with unclassified fever at the community level Democratic Republic of the Congo Case Management (CM) Ongoing
 

Objective: Assess the non-inferiority, in terms of safety, of a three-day follow-up visit conditional on non-resolution of symptoms for RDT-negative children with no cough/difficulty breathing and fast breathing, diarrhea, or danger signs, managed at the community level, compared to a systematic visit for all these children at Day 3.

Start Date: 2015

Universal versus conditional three-day follow-up visit for children with unclassified fever at the community level Ethiopia Case Management (CM) Ongoing
 

Objective: Primary objective: Assess the non-inferiority, in terms of safety, of a three-day follow-up visit conditional on non-resolution of symptoms for RDT-negative children with no cough/difficulty breathing and fast breathing, diarrhea, or danger signs, managed at the community level, compared to a systematic visit for all these children at Day 3.

Start Date: 2015

Pilot to Improve Case Management of Febrile Illness within the Private Sector of Nigeria Nigeria Case Management (CM) Ongoing
 

Objective: To assess whether introducing RDTs and appropriate treatments for malaria, pneumonia, and diarrhea through PPMVs will improve quality of case management of childhood illnesses for these three diseases in selected Local Government Areas (LGAs)

Start Date: 2013

Longevity of insecticides used for IRS Senegal Vector control -Indoor residual spraying (IRS) Ongoing
 

Objective: The objective of this study is to determine the life of 5 different insecticides used for indoor residual spraying for the prevention of malaria.

Start Date: 2009

Does a mass-distribution of ITNs increase the intensity of pyrethroid resistance? Democratic Republic of the Congo Vector Control - Insecticide treated nets (ITNs) Ongoing
 

Objective: The objective of this study is to find out if the intensity of pyrethroid resistance increases after a mass distribution campaign of mosquito nets

Start Date: 2016

Optimization of SMC Delivery and its Effects on the Acquisition of Malaria Immunity Mali Case Management (CM) Ongoing
 

Objective: The objectives of the study are to identify the most effective method to deliver SMC, and to obtain information on the long term impact of SMC on malaria immunity. The investigators aim to i) determine the optimal mode (fixed-point (FPD) vs door-to-door delivery (DDD); directly observed treatment (DOT) vs. non-DOT (NDOT)) and frequency (3 vs. 4 doses per season) of SMC delivery; ii) to compare quantitative measures of immunity in children who do and do not receive SMC over a three year period.

Start Date: 2014

Assessing the safety and tolerability of low dose primaquine for transmission blocking in Cambodian patients with acute uncomplicated Plasmodium falciparum malaria Cambodia Pre-elimination and Transmission Reduction (PE) Ongoing
 

Objective: The overall aim of this project is to assess the safety and tolerability of the WHO recommended addition of low dose (0.25mg/kg) primaquine, as a measure to help reduce the transmission of artemisinin resistant P. falciparum parasites, in Cambodian patients with uncomplicated P. falciparum who are glucose-6-phosphate dehydrogenase deficient (G6PDd). The objective is to measure and compare the Day 7 hemoglobin concentration between G6PDd and G6PD normal patients who are treated with dihydroartemisinin-piperaquine alone or combined with low dose primaquine.

Start Date: 2015

Correlating resistance to damage (RD) scores with long-lasting insecticide-treated net performance and longevity in various field conditions in Africa Benin Vector control - Insecticide treated nets (ITNs) Ongoing
 

Objective: The overall objective is to estimate the survivorship over time of different long-lasting nets under field conditions based upon their rates of attrition and physical integrity. The survivorship of each net type will then be correlated with resistance-to-damage scores as estimated from laboratory textile tests.

Start Date: 2015

Correlating resistance to damage (RD) scores with long-lasting insecticide-treated net performance and longevity in various field conditions in Africa Malawi Vector Control - Insecticide treated nets (ITNs) Ongoing
 

Objective: The overall objective is to estimate the survivorship over time of different long-lasting nets under field conditions based upon their rates of attrition and physical integrity. The survivorship of each net type will then be correlated with resistance-to-damage scores as estimated from laboratory textile tests.

Start Date: 2015

Assessing the Effect of Strengthening the Referral of Children from the Private Health Sector and its Impact on Child Survival in Uganda Uganda Case Management (CM) Ongoing
 

Objective: The primary objective is to assess the effect of strengthening the referral system on timely uptake of referral of sick children who seek care in the private sector. The secondary objectives are: 1) to assess appropriate case management for malaria, pneumonia and diarrhea; 2) to explore factors which influence the referral or non-referral of sick children from the private sector; and 3) to assess the cost effectiveness of uptake of referral of sick children who seek care in the private sector.

Start Date: 2014

Use of Serology to Validate Health Facility-Based Data for Prioritizing IRS in the Central Highlands of Madagascar Madagascar Monitoring and evaluation (M&E),Vector Control - Indoor Residual Spraying (IRS) Ongoing
 

Objective: The primary objective of this protocol is to identify the simplest and most cost-effective methods for characterizing transmission intensity in Madagascar for the purposes of IRS stratification. We will use school-based malaria serology surveys as a gold standard to validate the recently implemented approach of using health facility-based and routinely reported malaria incidence data to prioritize communes for focalized IRS, in addition to evaluating the performance of several additional potential measures of transmission intensity.

Start Date: 2014

The effect of mobile phone text-message reminders on health workers' adherence to malaria case management guidelines in Malawi Malawi Monitoring and evaluation (M&E); Case Management (CM) Ongoing
 

Objective: The primary objective of this study in Malawi is to evaluate the effectiveness of text message reminders to health workers in Malawi to improve case management of malaria and other common illnesses. Secondary objectives include: 1) to determine whether messages on a broader range of diseases are as effective in improving malaria case management as messages on malaria case management alone; and 2) to determine the effect of text message reminders on the case management quality of other common diseases in Malawi.

Start Date: 2015

Decoding Perceptions, Barriers, and Motivators of Net Care and Repair in Tanzania Tanzania Vector Control - Insecticide treated nets (ITNs) Ongoing
 

Objective: The study objectives are: 1. To understand local understanding of net care and repair behaviours in Tanzania. 2. To investigate actions associated with different net damage attributes (number, size and location of holes). 3. To elucidate motivators and barriers to repairing nets. 4. To explore perceptions on how to overcome barriers to net care and repair.

Start Date: 2015

Serologic assessment of the Ethiopian Malaria Indicator Survey, 2011 Ethiopia Monitoring and evaluation (M&E) Ongoing
 

Objective: This project proposes to assess the serologic responses from the nationally representative sample of dried blood spots (DBSs) that have already been collected during the 2011 Malaria Indicator Survey (MIS) in Ethiopia.

Start Date: 2015

The Effectiveness of Insecticide-Treated Durable Wall Liners as a Method for Malaria Control in endemic Rural Tanzania: Cluster Randomized Trial Tanzania Vector control (VC) - all Ongoing
 

Objective: This study is a cluster randomized trial investigating the comparative effectiveness of ITWLs to indoor residual spraying (IRS) under the context of universal coverage of long-lasting insecticide-treated bed nets (LLINs). The objectives of the study are to evaluate the impact of ITWL and IRS on malaria transmission as measured by the incidence and prevalence of asexual malaria parasitemia, the prevalence of moderate to severe anemia, entomological indices, and cost-effectiveness.

Start Date: 2013

Monitoring molecular markers of SP resistance Malawi Malaria in pregnancy (MIP) Ongoing
 

Objective: This study will support monitoring of key P. falciparum resistance markers among pregnant women at ANC and delivery to identify increases in the prevalence and distribution of the sextuple mutant.

Start Date: 2014

Comparing the efficacy and safety of IPTp-SP vs IPTp-DP for the prevention of malaria in pregnancy Malawi Malaria in pregnancy (MIP) Ongoing
 

Objective: To assess the efficacy and safety of IPTp-DP compared to IPTp-SP to augment existing data and assist Malawi in determining the best way forward for its malaria in pregnancy control strategy.

Start Date: 2016

Improving the quality of health facility data to monitor trends in malaria burden: Effectiveness of the Improvement Collaborative Approach Uganda Monitoring and evaluation (M&E) Ongoing
 

Objective: To study the effectiveness of IC as an approach toon improveing the quality of health facility data Specific objectives: (1) Identify key barriers to collecting high quality health facility data; (2) Identify interventions that can be carried out without additional external resources (i.e., direct funding, commodities, staff); (3) Identify monitoring and evaluation indicators that can be used to determine whether the IC approach is improving the quality of health facility malaria data.

Start Date: 2015

A field study comparing impact of new 'combination' long-lasting insecticidal net (LLIN) products on entomological measures of malaria transmission: Olyset Plus® and PermaNet 3.0® versus their 'conventional' LLIN analogues Mali Vector Control - Insecticide treated nets (ITNs) Ongoing
 

Objective: Vector- pyrethroid (insecticide) resistance (pyrR) threatens the effectiveness of PMIs long-lasting insecticidal (mosquito bed) net (LLIN) intervention. This protocol compares two available and approved combination LLINs, the PermaNet 3.0® and the Olyset Plus® LLINs, in village-scale comparison assessments. The methodology involves estimating and comparing the impact of the LLINs on entomological measures of malaria vectorial capacity: vector density, vector longevity, and vector sporozoite rate positivity, during a 12 month period. In addition, LLIN fabric integrity will be evaluated based on WHO critieria for assessment of LLIN durability. Results will be used to compare the relative impact of each product to existing LLIN technology (PermaNet 2.0®, and Olyset®).

Start Date: 2013

School and community-based surveillance of malaria – Investigation of approaches for outbreak detection and response Ethiopia Monitoring and evaluation (M&E) Completed
 

Objective: The objective of this assessment is to explore the feasibility and potential benefits of school-based malaria surveillance of malaria, as a strategy for outbreak identification and response. Specific objectives include: (i) to test the sensitivity and specificity of developed malaria school-based surveillance in detecting malaria morbidity trends at community level; and (ii) calculate the surveillance systems cost-effectiveness.

Start Date: 2012

Photo source: Maggie Hallahan Photography