Notre Dame and partners begin first spatial repellent trials for Unitaid-funded research program

Author: Brandi Wampler

Led by the University of Notre Dame and implemented by the Kenya Medical Research Institute (KEMRI), the AEGIS research team will begin the first of four planned trials in Kenya. The researchers will evaluate spatial repellent products and their ability to reduce malaria infections. By releasing an active ingredient into the air, spatial repellent products can inhibit certain insect behaviors, such as feeding.

“After months of strategic planning and organization, we are proud to have begun this research with our study team on the ground in Kenya,” said John P. Grieco, research associate 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. “This trial will help frame our research at future study locations and provide us our initial set of data moving forward.”

The Kenya spatial repellent trial has begun its first step, which will last four months. Throughout this phase, the study team recruits participants and establishes the baseline of malaria infection in participants. 

"KEMRI is leading this field trial in Busia County in western Kenya. Busia is an area of stable, year-round malaria transmission with a child likely to suffer at least four episodes of malaria in just one year. Malaria has stagnated in most of sub-Saharan Africa despite sustained vector control with long-lasting insecticidal nets," said Eric Ochomo, senior research officer at KEMRI and site principal investigator. "Spatial repellents are a potential new paradigm that could complement malaria vector control efforts in western Kenya and other parts of the world that experience such intense malaria transmission."

In total, the five-year research 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 created to reduce and protect against new infections of malaria and dengue, particularly in endemic areas. Resulting studies will provide important data for informing public health strategies using spatial repellents in disease-endemic countries.

“As part of our commitment to helping address some of the world’s most pressing public health threats, SC Johnson is proud to support disease prevention efforts and create opportunities for a better quality of life for underserved populations,” said Fisk Johnson, chairman and CEO of SC Johnson. “Life-threatening diseases, like malaria, dengue, and Zika, are preventable, yet billions of people around the world lack access to personal protection methods. We are working to prove the effectiveness of this spatial repellent so we can get it into public health systems and save lives.”

Due to the ongoing pandemic, researchers spent nine months incorporating necessary COVID-19 mitigations, including procuring personal protective equipment for the study team in Kenya. They also worked with the Centers for Disease Control and Prevention (CDC), a research program partner, to ensure the study team was provided the best technical guidance available for the safety of the researchers and communities while administering research program protocols.

“CDC has a long history of collaboration with KEMRI on research to improve malaria prevention and control, including community-based trials of insecticide treated nets (ITNs), which are now one of the primary tools for malaria prevention. While the global malaria burden has declined substantially as a result of the scale up of ITNs and other interventions, malaria remains a major public health problem, particularly in sub-Saharan Africa,” said John E. Gimnig ‘91, research entomologist for the CDC. “We look forward to continued work with KEMRI, Notre Dame, and other consortium members to generate evidence for a new tool that can further reduce the burden of malaria.”

In addition to the epidemiological and entomological portion of the study, researchers from the Johns Hopkins Bloomberg School of Public Health (JHSPH) and the Johns Hopkins Center for Communication Programs (CCP) will look at factors that could affect successful implementation of spatial repellents at scale. Working with KEMRI’s social science team, CCP will examine barriers and facilitators to adoption of the spatial repellents. 

“If spatial repellents prove effective at preventing malaria, we want to make sure they are designed and introduced in a way that will maximize their acceptability and attractiveness to the people they are meant to protect,” said Steve Harvey, associate professor at the JHSPH and principal investigator for the social science component of the project. “Learning about how families respond to the product now will be crucial to ensuring successful implementation later.” 

The social science team will gather data at the individual, household, community, retail, and national levels to better understand perceptions and experiences with the product as well as provide useful recommendations about procurement, promotion, and distribution.

"People will be key to the success of spatial repellents at all levels,” said April Monroe, co-principal investigator from CCP. "We are grateful for the opportunity to engage with end-users and other key stakeholders in Kenya and beyond through this multi-disciplinary collaboration."

AEGIS researchers plan to conduct similar clinical trials in Mali, Sri Lanka (against dengue and other Aedes aegypti-borne viruses), and in refugee settlements in Uganda. The goal of the research 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 strategies and to inform the optimal delivery and implementation within humanitarian response situations.

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 Achee, Alex Perkins, Sean Moore, Fang Liu, and Jarek Nabrzyski. The consortium members and project partners also supporting the research program are fhiClinical, SC Johnson, Catholic Relief Services, the Malaria Research and Training Center from the University of Bamako in Mali, National Dengue Control Unit of Sri Lanka, and Notre Dame’s Center for Research Computing

To learn more about this research program, please visit aegis.nd.edu

Contact:

Ashley Hudson / Research Program Manager

AEGIS Team / University of Notre Dame

ascott12@nd.edu / +1.574.631.9227

aegis.nd.edu 

About Notre Dame Research:

The University of Notre Dame is a private research and teaching university inspired by its Catholic mission. Located in South Bend, Indiana, its researchers are advancing human understanding through research, scholarship, education, and creative endeavor in order to be a repository for knowledge and a powerful means for doing good in the world. For more information, please see research.nd.edu or @UNDResearch.