Understanding behavioral, market and practical factors affecting the potential of household spatial repellent use for malaria control in western Kenya: study protocol v1

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Background Vector control strategies, namely mass distribution of insecticide-treated nets and indoor residual spraying, have contributed to declines in malaria morbidity and mortality. Despite these gains, malaria kills over half a million people each year. Complementary tools are needed to close existing gaps in protection. Spatial repellents are products designed to release vapor-phase active chemicals into the air to prevent malaria-causing mosquitoes from entering an enclosed space, interrupting host detection and/or human blood-feeding thereby supplementing existing vector control strategies by providing a malaria prevention alternative in contexts where current methods are less effective. For spatial repellents to be successful at scale, it is important to understand factors that can influence acceptance and uptake of the product, considerations for procurement and implementation, and how spatial repellents will fit into the broader malaria prevention landscape. To meet this objective, we are conducting social science research following the protocol presented here. Methods The social science study is set in Busia County in western Kenya. It includes a retail audit to identify mosquito control products available in the local market, free-listing and ranking of mosquito control products and practices used by residents, observations of nighttime activities and sleeping patterns, trials of improved practices to better understand participant experiences with and perceptions of spatial repellents over time, and key informant interviews with national-level stakeholders. Discussion Social science findings will complement data from a concurrent cluster-randomized placebo-controlled trial in the same location. Trial data will contribute to a determination by the World Health Organization Vector Control Advisory Group on spatial repellents as a new product category for vector control. If the spatial repellent product is effective, it may be deployed in malaria endemic areas to complement other vector control interventions. Social science study results will inform programmatically useful recommendations for spatial repellents procurement, promotion, and distribution in Kenya and beyond.

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