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Efficacy, acceptability and cost-effectiveness of long lasting insecticidal nets in the prevention of Kala-azar.

Objective

BACKGROUND Visceral leishmaniasis (VL) is a neglected life-threatening vector-borne disease. More than 90% of the reported VL cases occur in the Indian subcontinent, where it is considered a problem of public health importance. Though a regional eliminat ion plan was launched in 2001, current approaches fail to control a VL epidemic in Bihar (India). Case-detection and treatment is the main strategy, with insecticide-spraying being applied to a variable extent. The efficacy of insecticide-treated bednets has been demonstrated so far in the prevention of cutaneous leishmaniasis, but not yet for VL.METHODS The efficacy of long-lasting impregnated bednets (LLIN) on VL prevention will be assessed in a community intervention trial in the Bihar focus, that e xtends on both sides of the Indian-Nepalese border. The study aims to demonstrate a 50% reduction in L.donovani incidence rates in the intervention group compared to control. Twenty clusters of households will be randomly allocated to the intervention or to the control arm. Complementary to the trial, technology assessment (TA) and socio-economic studies (SES) will be conducted. TA will evaluate the efficacy of competing technologies on a scale of proof-of-principle , as several formats of treated fabri cs are currently being proposed by industry. SES will evaluate the acceptability and cost-effectiveness of LLIN compared to alternative community-based vector-control methods by an appropriate mix of quantitative and qualitative methods. DISCUSSION The proposed study targets the poorest segments of society, aiming at poverty reduction in line with EU development aid policy. Research institutes from north and south will carry out the project in collaborative partnership , with specific targets for trai ning and capacity strengthening. The partnership will involve the local health policymakers and the community, as the goal is to integrate research results into disease control policy.

Call for proposal

FP6-2003-INCO-DEV-2
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Funding Scheme

IP - Integrated Project

Coordinator

PRINS LEOPOLD INSTITUUT VOOR TROPISCHE GENEESKUNDE
Address
Nationalestraat 155
Antwerp
Belgium

Participants (6)

B.P. Koirala Institute of Health Sciences
Nepal
Address
Ghopa
Dharan
Banaras Hindu University
India
Address
Bhu
Varanasi
International Centre for Diarrhoeal Disease Research, Bangladesh
Bangladesh
Address
68 Shaheed Tajuddin Ahmed Sharani, Mohakhali
Dhaka
London School of Hygiene and Tropical Medicine
United Kingdom
Address
Keppel Street
London
Rajendra Memorial Research Institute of Medical Sciences
India
Address
Agamkuan
Patna,bihar
Université de Genève
Switzerland
Address
Rue Du Général-dufour 24
Geneva