I know it’s been almost a week since I wrote a post. I wish I could say that Julia and I have been busy having a blast traveling and the like but, sadly, I cannot. We spent the better part of the last week housebound, well actually bedbound, sleeping off some food poisoning. I didn’t eat for two or three days and went on Cipro from the getgo. At first I was sure it was food poisoning. Then I was thinking that it might be malaria after I had a mid-level fever for a couple days that didn’t subside with the Cipro. Then I got a rapid diagnostic test for malaria at a pharmacy to be sure. It was negative, but there was a chance my Malarone was cutting the malaria symptoms and parasite load so nobody could be sure. Then I stopped Cipro, had a giant meal, and came to the conclusion the most of the symptoms that I was having (including the headache) were probably the result of starvation rather than any sickness. Now I’m getting my energy back and more restless than tired after spending a week in the house.
Not much happened the last few weeks. Two of our team of six went home this week to the States because one of them wasn’t feeling well. And then there were four. As a result, we cut one of our sites for the study so that we would have enough resources. Hopefully we will be able to do one site really well.
We are still waiting for Ghana IRB approval…things take a long time in Africa.
Perhaps now is as good a time as any to explain what we’re studying: we’re doing a randomized controlled trial with a control group and three intervention groups. There are two stages. The first stage looks at the impact of incentives to reveal existing mosquito nets. The second stage looks at leakage of nets over time and the impact of using community health volunteers to hang up a net.
During the first stage we will have community health volunteers conduct a door-to-door registration of compounds in the community. They will ask for information on existing bednets, sleeping spaces, malaria incidence, etc. The total popolation is randomly broken up into two groups – one group is offered a bar of soap for every good net they declare when asked during registration, the other group is receives no offer of soap but is asked the same question. We will look to see if more nets are declared in the group that is offered soap.
The second stage is a little more complicated and looks to address leakage of nets that occurs after a point distribution as well as the impact of doing a door-to-door hang-up campaign after a point distribution. There will be a point distribution of nets based on the information received in the registration followed by door-to-door hang up of the received nets. There are four groups to which compounds are randomly assigned. Group one receives the nets and then has no hang-up; this is the control. Group two receives the nets and then has a community health volunteer show up on day 3 to hangup the nets. Group two is the same but the volunteer comes on day 7, group three on day 14. Then after one month, a survey is conducted to see how many nets that were given away are hanging, among other things. We are looking to see if there is a difference between the groups.
The issues we are studying were chosen after many meetings with administrators in the Ghana government, USAID, and NGOs working on bednet distribution. We are attempting to provide these actors with information to improve future distributions of nets…that is, if we get IRB approval!