RESUMEN
BACKGROUND: Concerted effort to control malaria has had a substantial impact on the transmission of the disease in the past two decades. In areas where reduced malaria transmission is being sustained through insecticide-based vector control interventions, primarily long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS), non-insecticidal complementary tools will likely be needed to push towards malaria elimination. Once interruption in local disease transmission is achieved, insecticide-based measures can be scaled down gradually and eventually phased out, saving on costs of sustaining control programs and mitigating any unintended negative health and environmental impacts posed by insecticides. These non-insecticidal methods could eventually replace insecticidal methods of vector control. House screening, a non-insecticidal method, has a long history in malaria control, but is still not widely adopted in sub-Saharan Africa. This study aims to add to the evidence base for this intervention in low transmission settings by assessing the efficacy, impact, and feasibility of house screening in areas where LLINs are conventionally used for malaria control. METHODS: A two-armed, household randomized clinical trial will be conducted in Mozambique, Zambia, and Zimbabwe to evaluate whether combined the use of house screens and LLINs affords better protection against clinical malaria in children between 6 months and 13 years compared to the sole use of LLINs. Eight hundred households will be enrolled in each study area, where 400 households will be randomly assigned the intervention, house screening, and LLINs while the control households will be provided with LLINs only. Clinical malaria incidence will be estimated by actively following up one child from each household for 6 months over the malaria transmission season. Cross-sectional parasite prevalence will be estimated by testing all participating children for malaria parasites at the beginning and end of each transmission season using rapid diagnostic tests. CDC light traps and pyrethrum spray catches (PSC) will be used to sample adult mosquitoes and evaluate the impact of house screening on indoor mosquito density, species distribution, and sporozoite rates. DISCUSSION: This study will contribute epidemiological data on the impact of house screening on malaria transmission and assess the feasibility of its implementation on a programmatic scale. TRIAL REGISTRATION: ClinicalTrials.gov PACTR202008524310568 . Registered on August 11, 2020.
Asunto(s)
Mosquiteros Tratados con Insecticida , Malaria , Adulto , África Austral , Animales , Niño , Estudios Transversales , Estudios de Factibilidad , Humanos , Malaria/prevención & control , Control de Mosquitos , Mosquitos Vectores , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
A Mineração Artesanal e de Pequena Escala de Ouro (MAPEO) é, em termos gerais, a exploração de pequenos depósitos de ouro por indivíduos, pequenos grupos ou pequenas cooperativas (1). A MAPEO é, geralmente, um trabalho intensivo com nenhuma ou limitada mecanização, e pode ter baixos índices de recuperação. O sector é geralmente caracterizado por baixos níveis de capital, produtividade, segurança ocupacional e acesso limitado aos mercados de terra e comércio. A MAPEO é praticada em mais de 70 países em todo o mundo. Estima-se que 10-15 milhões de pessoas estejam envolvidas na MAPEO, incluindo 4-5 milhões de mulheres e 1 milhão de crianças, enquanto outros 80 a 100 milhões de meios de subsistência de pessoas estão afectados pela MAPEO (2, 3). A MAPEO é uma actividade importante em muitos países em desenvolvimento, uma vez que representa uma fonte primária e adicional de renda, particularmente em regiões rurais onde as alternativas económicas à agricultura são limitadas. Estima-se que o sector de MAPEO contribua com cerca de 25% da produção global de ouro (2)
