Modified Endotracheal Connector

Abstract

<h3>Abstract</h3> A randomized cluster, double-blinded, placebo-controlled trial was conducted to estimate protective efficacy of a spatial repellent against malaria infection at Sumba, Indonesia. Following radical cure in 1,332 children aged 6mo-5yrs in 24 clusters, households were given transfluthrin or placebo passive emanators. Monthly blood screening and biweekly human-landing mosquito catches (HLC) were performed during 10-months baseline (June 2015 to March 2016) and a 24-month intervention period (April 2016 to April 2018). Screening detected 164 first-time malaria infections and an accumulative total of 459 infections in 667 subjects in placebo-control households; and 134 first-time and 253 accumulative total infections among 665 subjects in active intervention households. The 24-cluster protective effect of 27.7% and 31.3%, for time to first-event and overall (total new) infections, respectively, was not statistically significant. Purportedly, this due in part to zero to low incidence in some clusters during intervention undermining the ability to detect an effect. Subgroup analysis of 19 clusters where at least one malaria infection occurred showed 36.0% and 40.9% (statistically significant at 1-sided 5% significance level; p=0.0236) protective effect for time to first-event and overall infections, respectively. Primary entomological analysis of impact proved not statistically significant, with indoor and outdoor anopheline HLC reduced by 16.4% and 11.3%, respectively. Among 12 high-risk clusters, a significant impact on infection was detected (about 60% protective efficacy). While this study suggests protective effects of the intervention, additional evidence is required to demonstrate that spatial repellents provide a practical and effective means in reducing malaria transmission.