Real-World Effectiveness of Deltamethrin-Clothianidin (FLUDORA FUSION) in Indoor Residual Spraying in Sub-Saharan Africa: A Systematic Review Protocol

Abstract

ABSTRACT Background Indoor residual spraying (IRS) is a core insecticide-based vector control tool employed in most malaria-affected settings globally. However, mosquito vectors have developed resistance to nearly all the insecticides currently used in IRS. This has necessitated a transition to new classes of insecticides from mostly using Dichlorodiphenyltrichloroethane (DDT) and pyrethroids from 1997 to 2010, to carbamates from 2011 and organophosphates from 2013. In addition, other vector control measures like the use of long-lasting insecticide-treated bed nets (LLINs) have also been employed for malaria control. Despite the implementation of these mosquito vector control interventions, malaria remains a disease of public health concern especially in sub-Saharan Africa which bears over 90% of the disease burden. This review will thus collate evidence on the effectiveness of IRS for malaria control in sub-Saharan Africa. Methods and analysis The systematic review will be done following a priori criteria developed using PRISMA guidelines. Articles will be obtained through a search of Medline via PubMed, Scopus, and Embase databases. The Mesh terms and Boolean operators (“AND,” “OR”) will be used in the article search. Additionally, websites of malaria research institutions will be searched. Article search will be done by two independent librarians (AAK and RS). All identified articles will be transferred to Epi-reviewer v6.15.1.0 software. Article screening and data abstraction will be done in duplicate by four reviewers (KO, LN, GK and MO) and any further disagreements will be resolved through discussion and consensus. Data analysis will be done using STATA v 17.0. Heterogeneity in the articles will be assessed using the I 2 statistic. Publication bias will be assessed using a funnel plot. Results The findings of this review will help generate evidence on the effectiveness of indoor residual spraying using WHO pre-qualified insecticides in malaria control in sub-Saharan Africa. This protocol was registered in PROSPERO ( https://www.crd.york.ac.uk/prospero/ ) registration number CRD42024517119