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Completion Report Executive Summary : Anti-Malaria Home Proofing ( August 2020)

  • Investee: Med Biotech Laboratories (MBL)
  • Main implementation country: Uganda
  • Additional implementation countries: n/a
  • Funding amount agreed: $230,000 grant
  • Funding amount disbursed: $230,000
  • Co-funding: $230,000 (Grand Challenges Canada)
  • Expected implementation period: 3 year trial from March 2017
  • Actual implementation period: 6 months
  • Expected PYI at year 10 (forecasted): 208,000
  • Expected PYI at year 10 (revised after completion): 0

Innovation

With over 400,000 attributable deaths in 2016, malaria is one of the leading killers worldwide, but the two leading solutions – insecticide-treated nets and indoor residual spraying – have issues around either adoption or cost-effectiveness. Med Biotech Laboratories (MBL) set out to malaria-proof traditional Ugandan huts – where a plaster of soil, dung and ash is traditionally used to decorate walls and other surfaces – by incorporating insecticide into the mix to provide a cost-effective alternative to residual indoor spraying. MBL conducted laboratory tests with promising results.

Goal of investment

Test the acceptability, safety and efficacy of MBL’s anti-malaria decoration in Uganda by:

  • assessing household acceptability of the concept
  • testing the safety of the product for household inhabitants and for smearers
  • testing the effectiveness of the smears in killing mosquitos
  • assess, via a randomized controlled trial, the impact on malaria infections, anemia, and mosquito density in the home

Investment rationale

  • Malaria disproportionately impacts GIF’s target beneficiaries and this intervention provided the potential to i) generate comparable prevention to current methods ii) be cost-effective, iii) be more behaviourally suited to Ugandan context.
  • There is a wide range of potential applications in addition to home proofing for malaria, such as paint to fight other insect-borne diseases, and MBL possessed a strong team of local Ugandan researchers.

Results

  • Households accepted the concept.
  • This method was less effective at killing mosquitos than the standard spraying procedure, so the trial was ended.
  • A change in the study design from household-level to village-level randomization meant that the survey was not powered to detect impact on malaria, anemia, or mosquito density.
  • Safety tests for smearers were not informative due to lack of baseline measurement.
  • Unanticipated positive outcomes included the first known test of a new rapid diagnostic test, establishment of a new research site, and research finding high levels of asymptomatic malaria in children under 5 years old.

Key learnings

  • Even small-scale studies need to closely align project objectives with measurement strategy.
  • Close monitoring of implementation is essential.
  • An ancillary finding was that high levels of asymptomatic malaria are prevalent among infants. This is a potentially important finding for epidemiology and malaria control.

Route to Scale

Given the lack of efficacy, the question of scale-up does not arise. However, a number of international research partnerships were forged by MBL which may lead to new research opportunities and areas of collaboration for future impact.