Design of epidemiological trials for vector control products, Report of a WHO Expert Advisory Group
Château de Penthes, Geneva, 24–25 April 2017
The World Health Organization (WHO) is mandated to provide guidance to Member States on matters of public health policy, including evidence-based policy recommendations for new vector control interventions. To that end, the Vector Control Advisory Group (VCAG) advises WHO on the value to public health of new vector control tools, including new products, technologies and approaches, intended to protect humans against pathogens transmitted by vectors. WHO recommends products for use in public health based on demonstrated evidence of their impact on diseases as well as safety and quality, but must reconcile the requirements for robust data to assess public health value with the urgent need for new tools to address critical threats (e.g. insecticide resistance and spread of Aedes transmitted viruses). In response, WHO has called for an Expert Advisory Group (EAG) to review trial methodologies for evaluating data on the impact of new tools to prevent and control vector-borne diseases.
The recommendations developed by consensus of the Group emphasized the importance of randomized trials with robust study designs. Specific recommendations are provided on end-points, design considerations, and generation of evidence on the efficacy of longlasting insecticidal nets (LLINs) that incorporate a non-pyrethroid class of insecticide (either alone or in combination with a pyrethroid insecticide) and on products that use indoor residual spraying (IRS) of insecticides with a novel entomological mode of action (e.g. slowacting insecticides or insect growth regulators), which differ from the insecticides currently used for public health. The outcomes of this meeting will be used to inform the development of a WHO manual on trial designs for evaluating new vector control tools that are currently not covered by a WHO policy recommendation, for publication in 2017.