The goal of this project is to improve malaria control outcomes through an implementation science approach that integrates health delivery experiments and decision support modeling to promote joint optimization of vector control and disease management strategies.

To implement an evaluation of health delivery experiments, the project conducted a large cluster-randomized health experiment in twenty four villages in the Mvomero district of Tanzania. The study employed a randomized longitudinal factorial design to evaluate one vector management intervention (larviciding) and one disease treatment intervention (home-based management consisting of early RDT detection and treatment by village health workers). Annual malariometric surveying was conducted in order to evaluate any change in malaria infection between intervention groups. The study also conducted entomological surveys, household surveying, and focus group discussions. Analysis and dissemination efforts are ongoing. The following publications are outcomes of the project to-date: R. Rahman, A. Lesser, L. Mboera, and R. Kramer, "Cost of Microbial Larviciding for Malaria Control in Rural Tanzania," Tropical Medicine & International Health 21 (2016): 1468-1475 R.A. Kramer, L.E.G. Mboera, K. Senkoro, A. Lesser, E.H. Shayo, C.J. Paul, and M.L. Miranda, "A Randomized Longitudinal Factorial Design to Assess Malaria Vector Control and Disease Management Interventions in Rural Tanzania," Int. J. Environ. Res. Public Health 11 (2014): 5317-5332. L.E.G. Mboera, R.A. Kramer, M.L. Miranda, S.P. Kilima, E.H. Shayo, and A. Lesser, Community Knowledge and Acceptance of Larviciding for Malaria Control in a Rural District of East-Central Tanzania, Int. J. Environ. Res. Public Health 11 (2014): 5137-5154.

The randomized experiments of vector control and disease management strategies in Tanzania will elucidate which intervention strategy combinations are most effective in real world settings, using an implementation science approach.