Can piperonyl butoxide (PBO) insecticide treated nets (ITNs) be an effective vector control tool in Ethiopia? If justified, can it eventually replace IRS?

Objectives

The primary objectives of this study are:

1. To evaluate the relative impacts of (1) PermaNet 3.0 PBO ITNs alone and (2) a combined intervention IRS using pirimiphos-methyl plus standard pyrethroid ITNs (IRS + Std ITN) on malaria case incidence in a low to very low malaria transmission setting with mixed parasite circulation;
2. To evaluate the relative impacts of (1) PermaNet 3.0 PBO ITNs alone and (2) a combined intervention IRS using pirimiphos-methyl plus standard pyrethroid ITNs (IRS + Std ITN) on indoor host-seeking density of Anopheles mosquitoes in a low to very low malaria transmission setting with mixed parasite circulation.
3. To determine whether the impact of PermaNet 3.0 PBO ITNs alone on malaria case incidence is not significantly less than the impact of IRS with pirimiphos-methyl plus standard ITNs.

The secondary objective of this study is:

1. To evaluate the relative impacts of (1) PermaNet 3.0 PBO ITNs alone and (2) a combined intervention IRS using pirimiphos-methyl plus standard pyrethroid ITNs (IRS + Std ITN) on selected entomological indices of malaria transmission, including sporozoite infection rate.