Three-arm Cluster Randomised Control Trial Evaluation of Guardian Spatial Emanator as a Complimentary Vector Control Tool in Papua New Guinea (WinMal)

WinMal Trial: Spatial Emanator Deployment Strategies for Malaria Control in Papua New Guinea

Malaria cases are increasing in Papua New Guinea, partly because insecticide-treated nets do not fully protect people, especially from mosquitoes that bite outdoors. Spatial emanators are new devices that release insecticide into the air to repel or kill mosquitoes. This study will test whether these devices reduce malaria infections in rural villages in Madang Province by comparing households using indoor or outdoor devices with those without them. The results will help guide national malaria control strategies.

Study Overview

Status

Not yet recruiting

Conditions

Detailed Description

The WinMal trial is a large-scale cluster randomised control trial investigating whether spatial emanators reduce transmission of malaria infections. The study is being conducted with 150 rural villages in Bogia, Sumkar, Madang and Rai Coast districts of Madang Province, Papua New Guinea.

The trial will address the question: 'Do Guardian spatial emanators reduce malaria transmission when deployed in protected outdoor spaces or inside houses in PNG?'

The trial will evaluate the effectiveness, acceptability and feasibility of Guardian SE deployed indoors and outdoors for malaria prevention in PNG.

The WinMal trial will provide evidence to guide PNG National Department of Health decisions on how spatial emanators could be deployed alongside ITNs to address gaps in protection from outdoor biting.

Study Type

Interventional

Enrollment (Estimated)

4350

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

    • Madang Province
      • Madang, Madang Province, Papua New Guinea
        • Sumkar, Bogia, Rai Coast and Madang Districts of Madang Province, Papua New Guinea

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

9 years to 14 years (Child)

Accepts Healthy Volunteers

Yes

Genders Eligible for Study

All

Description

Inclusion Criteria:

  • Children aged 9-14 years at enrolment
  • Sleeps in a household within allocated cluster >90% of the nights during any given month

Exclusion Criteria:

  • Dissent (by child) to participate in the study
  • No parental consent provided through the signing of informed consent form
  • Unwillingness to take G6PD-guided radical cure treatment at enrolment with no previous ADRs to AL or PQ
  • Plans for extended travel (>2 weeks) outside of household/cluster during the study
  • G6PD activity ≤6.0 U/g Hb at screening
  • Measured baseline of ≤8 mg/dL or who have signs of clinical decompensation
  • Participating or planning to participate in another clinical trial investigating a drug, vaccine, medical device, or procedure during the study period
  • Currently taking malaria prophylaxis

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Prevention
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Outdoor intervention arm

Guardian spatial emanators deployed in protected outdoor spaces, households will continue to use ITNs as per routine National Malaria Control Program

Guardian spatial emanators deployed in protected outdoor spaces

Experimental: Indoor intervention arm

Guardian spatial emanators deployed inside houses, households will continue to use ITNs as per routine National Malaria Control Program

Guardian spatial emanators deployed inside houses

No Intervention: Control arm

No spatial emanators deployed, households will continue to use ITNs as per routine National Malaria Control Program

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Effectiveness of Guardian Spatial Emanator
Time Frame: 12 months

Time to first Plasmodium spp. infection detected by PCR at monthly follow-up visits or symptomatic ad-hoc visit between follow-ups over the 12-month intervention period in cohort participants from the core of the clusters.

12 months

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Effectiveness of Guardian Spatial Emanator
Time Frame: 12 months

Time to first PCR-confirmed P. falciparum infection over the 12 months of follow-up.

Time to first PCR-confirmed P. vivax infection over the 12 months of follow-up.

12 months
Effectiveness of Guardian Spatial Emanator
Time Frame: 6 months

Time to first PCR-confirmed Plasmodium spp infection over the first 6 months of follow-up.

Time to first PCR-confirmed P. falciparum infection over the first 6 months of follow-up.

Time to first PCR-confirmed P. vivax infection over the first 6 months of follow-up.

6 months
Effectiveness of Guardian Spatial Emanator
Time Frame: 12 months

Incidence of PCR-confirmed Plasmodium spp infections (first-time & recurrent together) in first 6m & full 12m.

Incidence of PCR-confirmed Pf infections (first-time & recurrent together) in first 6m & full 12m.

Incidence of PCR-confirmed Pv infections (first-time & recurrent together) in first 6m & full 12m Incidence of clinical episodes of malaria (first-time & recurrent together) in first 6m & full 12m Incidence of Pf clinical episodes of malaria (first-time & recurrent together) in first 6m & full 12m Incidence of Pv clinical episodes of malaria (first-time & recurrent together) in first 6m & full 12m Incidence of new Pf blood stage infections (molecular force of blood-stage infection - Pf molFOB) in first 6m & full 12m Incidence of new Pv blood stage infections (molecular force of blood-stage infection - Pv molFOB) in first 6m & full 12m Incidence of new blood stage infections (molecular force of blood-stage infection for Pf and Pv molFOB combined) in first 6m & full 12m

12 months
Difference between indoor and outdoor arms
Time Frame: 12 months

Time to first Plasmodium spp. infection detected by PCR at monthly follow-up or symptomatic ad-hoc visit between follow-ups visits over the 12-month intervention period in cohort participants from the core of the clusters.

12 months
Sensitivity of the estimates for epidemiological outcomes
Time Frame: 12 months

Spillover-adjusted estimates of intervention effectiveness for epidemiological endpoints, incorporating data from cluster buffer zone participants.

12 months
Anopheles species composition
Time Frame: 12 months

Anopheles species composition in a subset of clusters, in the pre-deployment baseline period and at the end of the intervention.

12 months
Presence of insecticide resistance mutations
Time Frame: 12 months

Prevalence of insecticide resistance markers in a subset of clusters in the pre-deployment baseline period and at the end of the intervention.

12 months
Acceptability of spatial emanators
Time Frame: 12 months

Qualitative outcomes from Photovoice methodology, and associated focus group discussions with community members, followed by thematic analysis of drivers of behaviour change, barriers and enablers of spatial emanator acceptance and consistent use.

12 months
Feasibility of spatial emanators
Time Frame: 12 months

Qualitative outcomes from key informant interviews with key study staff and health system stakeholders at district, provincial, and national level followed by descriptive summary of barriers and enablers to distribution, implementation & scale-up.

12 months
Cost effectiveness of Guardian spatial emanators
Time Frame: 12 months

The costs of deploying spatial emanators (either indoor or outdoor) and the incremental cost-effectiveness ratios when compared with current practice.

12 months
Self-reported adverse events
Time Frame: 12 months

Incidence of self-reported adverse events (AEs) and/or serious adverse events (SAEs) assessed as possibly or likely related to Guardian spatial emanators among cohort participants (through monthly follow-up) and wider community through passive surveillance.

12 months
Coverage, attrition and re-location of spatial emanators
Time Frame: 12 months

Proportion of households with emanators in place at scheduled monitoring visits, the attrition rate per cluster per scheduled monitoring visit period, timing of redistribution events recorded per cluster.

12 months
Transfluthrin quantity, installation environment and bioefficacy
Time Frame: 12 months

Mass percent transfluthrin retained in the spatial emanators related to installation environment and bioefficacy measure/s (e.g., knock down and mortality of colony mosquitoes exposed to spatial emanators).

12 months

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Investigators

  • Principal Investigator: Leanne Robinson, MPH PhD, Burnet Institute
  • Principal Investigator: Moses Laman, MBBS PHD, Papua New Guinea Institute of Medical Research
  • Principal Investigator: Stephan Karl, PhD, James Cook University, Queensland, Australia
  • Principal Investigator: Jacob Kisomb, MBBS, National Department of Health, Papua New Guinea
  • Principal Investigator: Maria Ome-Kaius, MBBS PhD, Papua New Guinea Institute of Medical Research

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Estimated)

February 1, 2027

Primary Completion (Estimated)

October 1, 2028

Study Completion (Estimated)

December 1, 2028

Study Registration Dates

First Submitted

October 27, 2026

First Submitted That Met QC Criteria

October 27, 2026

First Posted (Actual)

November 3, 2026

Study Record Updates

Last Update Posted (Actual)

November 3, 2026

Last Update Submitted That Met QC Criteria

October 27, 2026

Last Verified

October 1, 2026

More Information

Terms related to this study

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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