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Atraktivní cílená zkouška s cukrovou návnadou v Mali

3. listopadu 2026 aktualizováno: University Clinical Research Center, Mali

Atraktivní cílená zkouška cukrové návnady fáze III v Mali

Globally, the female mosquitoes to be effective at transmitting malaria parasites, must have a number of characteristics including: abundance, longevity (individual mosquitoes must survive long enough after feeding on infected blood to allow the parasite time to develop and travel to the mosquito's salivary glands), capacity (each female mosquito must be both susceptible to infection with Plasmodium and able to carry enough malaria parasites in the salivary glands), contact with humans (frequently feed on humans).

Vectors in SSA are often anthropophagic and anthropophilic, and exhibit indoor biting and indoor resting behavior. Highly effective interventions against vectors have been developed and implemented at scale (e.g., indoor Residual Spraying of Insecticides [IRS] and Long Lasting Insecticide-treated Nets [LLINs]). While these interventions have contributed importantly to the reduction of malaria transmission and disease (68% and 11% respectively), none of them target outdoor-biting g and outdoor-resting mosquitoes. Given the increase in resistance to current generation of insecticides and the behavioral plasticity of vectors that results in continued malaria transmission despite high coverage of LLINs or IRS, there is a need for interventions that can supplement and complement LLINs and IRS by killing mosquitoes outside houses using other biologic mechanisms (e.g., targeting sugar feeding behavior). Finally, insecticides with novel modes of action that may be capable of restoring sensitivity to pyrethroids by killing both pyrethroid resistant and sensitive mosquitoes are required. Attractive Target Sugar Baits (ATSBs) that kill mosquitoes through the ingestion of the toxicant dinotefuran (and possibly by other ingestion toxicants that are effective when ingested) potentially fill the need for outdoor interventions with novel killing effects. This study aims to establish the efficacy and contribution of the ATSBs for controlling malaria transmission where An. gambiae s.l. and An. Funestus are the major vectors for malaria.

Přehled studie

Postavení

Dokončeno

Podmínky

Detailní popis

The current dominant malaria vector control tools remain critically important and have saved many lives. Yet, they are not well-suited for malaria vectors that avoid contact with indoor insecticides by predominantly biting outdoors, by frequently biting animals, and by resting outdoors or remaining within houses only briefly when they do enter. These behaviors allow residual populations of vector mosquitoes to survive, expand, and to increasingly contribute to malaria transmission, despite high coverage. These vectors can sustain endemic transmission even if they rarely bite humans. An. arabiensis is a particularly important source of persistent residual transmission despite Long Lasting Insecticide-treated Net (LLIN) scale-up; this mosquito prefers to feed on animals, and, often bites and rests outside, and has limited indoor exposure. There is need for new vector control tools to target residual outdoor transmission.

In addition to the biological need for female Anopheles species to take a blood meal to obtain protein necessary for egg production, all Anopheles must feed regularly and frequently on liquid and carbohydrates (sugars) to survive. Common sources of liquid and sugar meals include plant tissue and floral nectar. Mosquitoes are guided to sugar sources by chemical attractants. The Attractive Target Sugar Baits (ATSBs) is designed specifically to attract the mosquito with a source of liquid and sugar and include an ingestion toxicant to then kill the mosquito. Using sugar sources to attract mosquitoes to an ingestion toxicant is a relatively simple and inexpensive, strategy that has been shown to be highly efficacious for mosquito control in a limited number of trials. Limited data suggest efficacy, even in sugar-rich environments, due to the high frequency of sugar feeding.

Early studies examined the effect of spraying ingestion toxicants on attractive flowers to use their scent as bait. While these flowers effectively attract the target mosquitoes, the impact on non-target insects, especially pollinators, can be devastating. Furthermore, this approach is not suitable where there is a lack of flowering vegetation. Subsequent studies evaluated locally available plants and fruits as attractants. While such attractants can be sprayed onto non-flowering green vegetation, further studies evaluated products (bait stations) that could be used across a wide variety of settings including indoors and in areas without suitable vegetation.

Westham Compagny recently developed a bait station that contains a plant-based mosquito attractant, sugar as a feeding stimulant, and an active ingredient (the neonicotinoid, dinotefuran) to kill the foraging vectors. The bait station has a protective membrane that covers and protects the bait from rain and dust, but that allows mosquitoes to feed through it. The Westham ATSB can remain effective in the field for at least six months and has a shelf life of greater than three years with no specific requirements for storage. This Attractive Target Sugar Bait (ATSB) is now being produced at an industrial scale, uses simple and widely available ingredients, and is environmentally friendly. The bait station was designed to have the lowest practicable material content with a high proportion of the mass being fully biodegradable. The protective membrane allows mosquitoes to feed, but it serves as a barrier to pollinators. Field studies to-date have also shown that the ATSB has a minimal impact on non-target organisms. This includes evidence specifically for the toxicant that will be used, dinotefuran. Initial environmental assessment and subsequent field trials in Mali have demonstrated that when deployed within the ATSB, the toxicant does not pose safety risks to non-target organisms, including pollinators and humans.

ATSBs may be a particularly important vector control tool in the context of insecticide resistance. Insecticide resistance for the six insecticide classes currently used in LLINs and IRS threatens malaria prevention efforts. Resistance to pyrethroids (used in LLINs and IRS) is commonly reported. If pyrethroids lose most of their efficacy, more than 55% of the benefits of vector control could be lost. ATSBs can help mitigate insecticide resistance to these contact insecticides because they can use ingestion toxicants from very different chemical classes. There are many existing ingestion toxicants that may be used in a bait station, which could facilitate resistance prevention strategies, such as rotation or combination approaches.

Typ studie

Intervenční

Zápis (Aktuální)

6068

Fáze

  • Nelze použít

Kontakty a umístění

Tato část poskytuje kontaktní údaje pro ty, kteří studii provádějí, a informace o tom, kde se tato studie provádí.

Studijní místa

    • Mali
      • Bamako, Mali, Mali, 5445
        • University Clinical Research Center

Kritéria účasti

Výzkumníci hledají lidi, kteří odpovídají určitému popisu, kterému se říká kritéria způsobilosti. Některé příklady těchto kritérií jsou celkový zdravotní stav osoby nebo předchozí léčba.

Kritéria způsobilosti

Věk způsobilý ke studiu

5 let až 14 let (Dítě)

Přijímá zdravé dobrovolníky

Ano

Pohlaví způsobilá ke studiu

Všechno

Popis

Inclusion criteria

  • . Household resident of the selected villages
  • Aged 5 to 14 years of age at the time of enrollment
  • All parents or guardians provide consent for their child's participant (5-14 years old)
  • If age 12 - 14 years, the child also provides assent for participation
  • Absence of pregnancy

Exclusion criteria

  • Not resident of any household within the selected villages
  • Children below 5 years old
  • Aged 15 years and older
  • Pregnancy
  • Do not consent or assent (14 years old)

Studijní plán

Tato část poskytuje podrobnosti o studijním plánu, včetně toho, jak je studie navržena a co studie měří.

Jak je studie koncipována?

Detaily designu

  • Primární účel: Prevence
  • Přidělení: Randomizované
  • Intervenční model: Faktorové přiřazení
  • Maskování: Žádné (otevřený štítek)

Zbraně a zásahy

Skupina účastníků / Arm
Intervence / Léčba
Experimentální: Intervention arm

ATSB+LLINs+Standard Care for Malaria case management

Within the intervention area, a total of four ATSB station will be deployed (external wall). ATSB stations will be monitored by community health workers through weekly visit and all stations will be replaced 6months after deployment.

Žádný zásah: Standard arm or arm 2

LLINs+Standard Care for MalarIA case management

Co je měření studie?

Primární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Malaria incidence per person times
Časové okno: Through study completion (average 2 years

Malaria case incidence (the total number of incident malaria cases detected by RDT divided by the total person-time followed up in cohorts) will be assessed among people aged 5 to < 15 years old

Through study completion (average 2 years

Sekundární výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Incidence of malaria per person times using molecular analysis tools
Časové okno: Through study completion (average 2 years

PCR will be use to assess Incidence of malaria infection among cohort participants aged 5 to <15 years.

2. Prevalence of malaria infection among a cross sectional sample 3. Incidence rate of passively reported clinical malaria among participants of all ages, defined as the number of malaria confirmed cases (by RDT or microscopy) per 1,000 population per year, 4. Vector age structure: survivorship will be monitored by ovarian dissection to examine ovarian dilatations.

5. Vector densities, Sporozoite rate by CS ELISA, Entomological inoculation rates (EIR), Biting profiles, Vector species composition.

6. Durability of the ATSB stations: 1) the effectiveness of the attractant; and 2) the effective toxicity of the ATSB.

7. Resistance to the ATSB toxicant: susceptibility to the ingestion toxicant (dinotefuran) will be evaluated on an annual basis.

a. Insecticide resistance: Physiological resistance phenotypes, Intensity of resistance, Behavioral resistance

Through study completion (average 2 years

Další výstupní opatření

Měření výsledku
Popis opatření
Časové okno
Community acceptance of ATSBs in intervention area
Časové okno: Through study completion (average 2 years

Removal, alteration of ATSBs stations after deployement will be assessed and reported as acceptance in terms of proportion among intervention sites during the study period (2 years)

Through study completion (average 2 years

Spolupracovníci a vyšetřovatelé

Zde najdete lidi a organizace zapojené do této studie.

Vyšetřovatelé

  • Ředitel studie: Seydou Doumbia, PhD, University Clinical Research Center - USTTB - Mali

Publikace a užitečné odkazy

Osoba odpovědná za zadávání informací o studiu tyto publikace poskytuje dobrovolně. Mohou se týkat čehokoli, co souvisí se studiem.

Obecné publikace

Termíny studijních záznamů

Tato data sledují průběh záznamů studie a předkládání souhrnných výsledků na ClinicalTrials.gov. Záznamy ze studií a hlášené výsledky jsou před zveřejněním na veřejné webové stránce přezkoumány Národní lékařskou knihovnou (NLM), aby se ujistily, že splňují specifické standardy kontroly kvality.

Hlavní termíny studia

Začátek studia (Aktuální)

6. června 2022

Primární dokončení (Aktuální)

24. ledna 2024

Dokončení studie (Aktuální)

7. února 2024

Termíny zápisu do studia

První předloženo

1. října 2019

První předloženo, které splnilo kritéria kontroly kvality

1. listopadu 2019

První zveřejněno (Aktuální)

4. listopadu 2019

Aktualizace studijních záznamů

Poslední zveřejněná aktualizace (Aktuální)

4. listopadu 2026

Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality

3. listopadu 2026

Naposledy ověřeno

1. listopadu 2026

Více informací

Termíny související s touto studií

Další identifikační čísla studie

  • 6719882

Plán pro data jednotlivých účastníků (IPD)

Plánujete sdílet data jednotlivých účastníků (IPD)?

NE

Popis plánu IPD

The sections below provide details of data management for individual study components. All data will be stored on a secure drive in Mali and shared with PATH. All investigators and the sponsor, Inovated Vector Control Consortium (IVCC), will have access to the data. At London School of Hygien and Tropical Medicine (LSHTM), data will be retained for a minimum of 10 years following project completion as mandated by the LSHTM's policies. Data documentation and the labelled dataset will be deposited in the LSHTM data repository (http://datacompass.lshtm.ac.uk/ ) for long-term curation and preservation at the end of the project.

Informace o lécích a zařízeních, studijní dokumenty

Studuje lékový produkt regulovaný americkým FDA

Ne

Studuje produkt zařízení regulovaný americkým úřadem FDA

Ne

Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .

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