# The impact of vector control interventions on adverse birth outcomes.

> **NIH NIH F31** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2020 · $21,263

## Abstract

PROJECT SUMMARY
 In sub-Saharan Africa, infection with malaria parasites during pregnancy is estimated to be the cause of
nearly 1 million low birth weight (LBW) babies, 220,000 stillbirths, and 110,000 neonatal deaths every year1-5.
Vector control strategies, including long-lasting insecticide-treated bed nets (LLINs) and indoor residual
spraying of insecticide (IRS) are powerful public health tools for malaria prevention, yet, their current impact on
adverse birth outcomes is unknown. LLINs are recommended for all pregnant women in malaria-endemic
Africa, but given widespread resistance to the pyrethroid class of insecticide used in LLINs, their efficacy may
be waning. An alternative bed net, a pyrethroid-PBO LLIN, shows promise in replacing current LLINs. A recent
modeling study showed pyrethroid-PBO LLINs may be highly effective, with the potential to avert up to 500
clinical malaria cases per 1000 person-years compared to standard (i.e. non PBO-treated) LLINs6. To evaluate
the public health impact that pyrethroid-PBO LLINs may have for pregnant mothers, epidemiological evidence
is needed to augment previous findings from modeling studies. IRS is another important public health strategy
shown to be highly effective at reducing the burden of malaria7-12, but has traditionally been under-utilized due
to high costs. Exploratory findings from our group suggest IRS is associated with reductions in LBW, preterm
birth, and fetal/neonatal death13,14. However, whether IRS is an effective method of preventing malaria-
associated adverse birth outcomes requires further evaluation using a more rigorous study design.
 The goal of this proposal is to investigate the effectiveness of current and new vector-control
tools for preventing malaria-associated adverse birth outcomes. Uganda will be used as a case study for
this proposal as the recent community distribution of IRS, standard LLINs, and pyrethroid-PBO LLINs provides
a unique quasi-experimental opportunity to study these effects. The study will estimate the number of LBW and
newborn deaths averted as a direct result of IRS (Aim 1) and standard LLINs (Aim 2a). The study will also
assess whether pyrethroid-PBO LLINs confer a greater protective benefit than standard LLINs (Aim 2b).
Analyses will use existing data, routinely collected by the Ministry of Health, and rigorous contemporary causal
inference methods. The proposal will provide valuable and timely insight on whether existing vector-control
strategies are effective or whether new LLINs to should be recommended for use in pregnant women over
standard LLINs. Knowledge gained from this research will directly advance the NICHD’s mission of identifying
interdisciplinary approaches that will reduce global perinatal deaths. The proposed training, guided by an
exemplary mentorship team, will enhance the applicant’s methodological skills, research competency, and
content expertise needed for her career as a future independent academic researcher focused o...

## Key facts

- **NIH application ID:** 9995384
- **Project number:** 5F31HD096861-03
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Michelle Roh
- **Activity code:** F31 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $21,263
- **Award type:** 5
- **Project period:** 2018-09-01 → 2020-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9995384

## Citation

> US National Institutes of Health, RePORTER application 9995384, The impact of vector control interventions on adverse birth outcomes. (5F31HD096861-03). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9995384. Licensed CC0.

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