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Malaria is an infectious disease spread by mosquitoes that causes significant illness and death in tropical regions worldwide. In some areas of South-East Asia, including Myanmar, malaria drugs do not work as well as they did in the past. This is because malaria is developing resistance to the drugs. Because of drug resistance it is really important to improve ways to control malaria. Individuals may be able to protect themselves from getting malaria by using personal insect repellent. Currently there is limited published evidence to support the use of mosquito repellents for malaria control in Myanmar and indeed South-East Asia.
The purpose of this study is to find out whether distributing personal insect repellent through Village Health Volunteers (VHV) reduces malaria. Participants living in selected villages in South-East Myanmar will receive personal insect repellent from VHV to apply to their skin to prevent mosquitoes biting them. VHVs and Malaria Officers of Karuna Mission Social Solidarity (KMSS) will be responsible for distributing repellent. In addition, VHVs will perform malaria testing by using rapid diagnostic tests (RDT) on people in the village to see whether they have malaria. We will compare malaria incidence in those using repellent compared to those who are not. In this way, we will be able to see whether insect repellent distributed through VHV protects people against malaria.
RDTs are good for testing whether someone is infected with malaria at the time of the test, but RDTs cannot test 1) whether someone carries drug resistant malaria, or 2) if they have been exposed to malaria at another time. Other tests based on malaria genetic and antibody analysis respectively can be used to determine this. At the same time that VHVs are performing RDTs, another two drops of blood will be collected from the person’s finger and absorbed onto a piece of filter paper. These samples will be collected and sent to Burnet Institute, Melbourne for laboratory analysis of genetic and antibody markers. In this way, we will also be able to find out whether repellent reduces the number of drug resistant malaria parasites and malaria exposure in this area of Myanmar.