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Durham University

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Publication details for Prof Steve Lindsay

Fillinger, U., Ndenga, B., Githeko, A. & Lindsay, S.W. (2009). Integrated malaria vector control with microbial larvicides and insecticide-treated nets in the western Kenya: a controlled trial. Bulletin of the World Health Organization 87: 655-665.

Author(s) from Durham


Objective To assess the contributions of both microbial larvicides and insecticide-treated nets (ITNs) in terms of reducing malaria
incidence in an integrated vector management programme in an area moderately endemic for malaria in the western Kenyan highlands.
Methods A pre-post, control group design was used. Larval and adult vector populations were surveyed weekly in six separate valley
communities. The incidence of Plasmodium infections in children 6 months to 13 years of age was measured during the long and
short rainy seasons each year. Baseline data were collected for 17 months, after which Bacillus-based larvicides were applied weekly
to aquatic habitats in three of the valleys for another 19 months. At around the same time the larviciding was initiated, ITNs were
introduced gradually into all study communities by the National Malaria Control Programme. The effect of larviciding, ITNs and other
determinants of malaria risk was assessed by means of generalized estimating equations.
Findings The risk of acquiring new parasite infections in children was substantially and independently reduced by ITN use (odds
ratio, OR: 0.69; 95% confidence interval, CI: 0.48–0.99) and larvicide application (OR: 0.44; 95% CI: 0.23–0.82), after adjusting
for confounders.
Conclusion Vector control with microbial larvicides enhanced the malaria control achieved with ITNs alone. Anti-larval measures are
a promising complement to ITN distribution in the economically important highland areas and similar transmission settings in Africa.