评估实验性小屋试验中评估经杀虫剂处理的蚊帐抗疟疾病媒的可变性

Joseph D. Challenger , Rebecca K. Nash , Corine Ngufor , Antoine Sanou , K. Hyacinthe Toé , Sarah Moore , Patrick K. Tungu , Mark Rowland , Geraldine M. Foster , Raphael N’Guessan , Ellie Sherrard-Smith , Thomas S. Churcher
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引用次数: 2

摘要

实验小屋试验(EHT)用于评估在受控环境中针对疟疾媒介的室内媒介控制干预措施。分析中存在的变异性水平将影响给定研究是否有充分的能力回答所考虑的研究问题。我们利用之前15次EHT的分类数据来深入了解通常观察到的行为。使用广义线性混合模型的模拟来获得EHT的功率估计,我们展示了每晚进入小屋的蚊子数量和所包含的随机效应的大小等因素如何影响研究功率。观察到每个小屋每晚收集的蚊子平均数量(从1.6到32.5只不等)和蚊子死亡率的过度分散都存在很大的行为差异。这种死亡率的变异性大大大于偶然预期,应纳入所有统计分析,以防止结果的错误准确性。我们利用优势和非劣势试验来说明我们的方法,将蚊子死亡率作为感兴趣的结果。该框架允许可靠地评估测定的测量误差,并能够识别异常结果,这可能需要进一步的调查。EHT在室内病媒控制干预措施的评估和监管中发挥着越来越重要的作用,因此确保这些研究得到充分的支持是很重要的。
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Assessing the variability in experimental hut trials evaluating insecticide-treated nets against malaria vectors

Experimental hut trials (EHTs) are used to evaluate indoor vector control interventions against malaria vectors in a controlled setting. The level of variability present in the assay will influence whether a given study is well powered to answer the research question being considered. We utilised disaggregated data from 15 previous EHTs to gain insight into the behaviour typically observed. Using simulations from generalised linear mixed models to obtain power estimates for EHTs, we show how factors such as the number of mosquitoes entering the huts each night and the magnitude of included random effects can influence study power. A wide variation in behaviour is observed in both the mean number of mosquitoes collected per hut per night (ranging from 1.6 to 32.5) and overdispersion in mosquito mortality. This variability in mortality is substantially greater than would be expected by chance and should be included in all statistical analyses to prevent false precision of results. We utilise both superiority and non-inferiority trials to illustrate our methodology, using mosquito mortality as the outcome of interest. The framework allows the measurement error of the assay to be reliably assessed and enables the identification of outlier results which could warrant further investigation. EHTs are increasingly playing an important role in the evaluation and regulation of indoor vector control interventions so it is important to ensure that these studies are adequately powered.

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