Second spatial repellent trial for Unitaid-funded research program begins in Mali

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Led by the University of Notre Dame and in partnership with Catholic Relief Services (CRS) and the Malaria Research and Training Center (MRTC) University of Sciences, Techniques and Technologies of Bamako, the Advancing Evidence for the Global Implementation of Spatial Repellent (AEGIS) research team has launched the second epidemiological trial in Mali – one of three clinical trials planned in the AEGIS program. A spatial repellent product will be evaluated to determine its ability to reduce malaria infections. By releasing an active ingredient into the air, spatial repellent products can inhibit certain insect behaviors, such as biting or feeding which are required for malaria parasite transmission.

“Spatial repellent products have yet to be fully recommended for inclusion in public health programs,” said John P. Grieco, research professor in the Department of Biological Sciences, affiliated faculty of the Eck Institute for Global Health at Notre Dame, and principal investigator on the project. “Our team has now been provided the unique opportunity and responsibility to advance these products for use by those populations in greatest need.”

After months of staffing, training, procurement, and other preparatory activities, the Mali clinical trial has begun its baseline, which will last six months before advancing into intervention deployment. Throughout this phase, the study team will monitor malaria infections in participants across different seasons of transmission.

Partnering with MRTC has been integral for a successful baseline phase and study. As the technical arm of the National Malaria Control Program in Mali, they have made extensive contributions to the development of many major malaria control strategies in the past. “MRTC is proud to contribute to this important consortium to test the safety and efficacy of this very promising innovative vector control strategy in Kolondieba, Mali, where malaria burden is among the highest in the country” said Issaka Sagara, Mali site principal investigator. “We hope that this will be an important addition to the current tools for better control of malaria.”

The overall five-year AEGIS program funded by Unitaid will evaluate the efficacy and cost-effectiveness of a scalable spatial repellent, Mosquito Shield™. This spatial repellent product, developed and donated by SC Johnson for public health purposes, was designed to reduce and protect against new infections of mosquito-borne diseases such as malaria and dengue. Resulting outcomes from AEGIS trials will provide required evidence for informing public health strategies using spatial repellents in disease-endemic settings.

“Based on evidence from recent clinical studies, we know that SC Johnson’s Mosquito Shield can help lessen the transmission of mosquito-borne diseases,” said Thomas Mascari, Ph.D., Entomologist at SC Johnson. “We are pleased to see epidemiological trials continue in Mali as we build toward our goal of receiving a World Health Organization recommendation for spatial repellents in public health channels.”

The Mali trial follows the launch of the AEGIS Kenya trial. Later research components planned within the program include a clinical trial in Sri Lanka (against dengue and other Aedes-borne viruses) and an operational study in refugee settlements in Uganda. The goal of the AEGIS program is to generate evidence to support a recommendation by the World Health Organization for a global public health policy for inclusion of spatial repellent products in vector-borne disease control programs and to inform the optimal delivery and implementation within humanitarian response situations.

CRS, an AEGIS consortium member, supported MRTC with the site readiness process in Mali. “We’re thrilled to see this trial start in Southern Mali, specifically targeting remote communities,” said Momar Mbodji, CRS’s senior program manager in Mali. “We’re hoping the results will help make progress towards malaria elimination and give us an alternative to traditional vector-control tools for remote populations, especially those that are displaced.” CRS will also lead the operational study in Uganda which is designed to evaluate SR effectiveness against malaria infections in an operational setting linked to displaced persons where traditional mosquito control measures, such as insecticide treated nets, are often not available or easy to implement. The Uganda study will also shed light on the optimal SR product delivery system in order to develop operational guidelines for national malaria programs.

“With progress against malaria slowing, the tools that were crucial in fighting back this disease are not enough to maintain our progress. Unitaid is proud to be supporting this research into spatial repellents, which will add to our arsenal of antimalarial tools,” said Katerina Galluzzo, Technical Manager (Strategy) at Unitaid. “These simple, low-tech products provide a new option for warding off mosquitos – especially in fragile settings, where options to prevent malaria are limited – and will help protect people not just from malaria but dengue, zika and other vector-borne diseases.”

This project is made possible thanks to Unitaid funding and support. Unitaid is a global health agency engaged in finding innovative solutions to prevent, diagnose, and treat diseases more quickly, effectively, and for affordable prices, in low- and middle-income countries. Unitaid’s work includes funding initiatives to address major diseases such as HIV/AIDS, malaria, and tuberculosis, as well as HIV co-infections and co-morbidities such as cervical cancer and hepatitis C, and cross-cutting areas, such as fever management. Unitaid is now applying its expertise to address challenges in advancing new therapies and diagnostics for the COVID-19 pandemic, serving as a key member of the Access to COVID Tools Accelerator. Unitaid is hosted by the World Health Organization.

In addition to Grieco, other Notre Dame faculty team members include Nicole L. Achee, Research Professor, Biological Sciences, Alex Perkins, Associate Professor, Biological Sciences, Sean Moore, Research Assistant Professor, Biological Sciences, Fang Liu, Professor, Applied and Computational Mathematics and Statistics, and Jarek Nabrzyski, Director, Center for Research Computing.  The AEGIS consortium members and project partners include fhiClinical, SC Johnson, the Kenya Medical Research Institute, the Centers for Disease Control and Prevention, Johns Hopkins Bloomberg School of Public Health and the Johns Hopkins Center for Communication Programs, and National Dengue Control Unit of Sri Lanka.

Originally published by Ashley Scott at aegis.nd.edu on August 11, 2021.