New Project BITE aims to fight malaria with new tools to prevent mosquito bites outdoors

A new consortium of partners is working to prevent malaria transmission by reducing human exposure to mosquito bites outdoors. Through the Innovative Vector Control Consortium (IVCC) as part of their Indo Pacific Initiative, with funding from the Australia Department of Foreign Affairs and Trade, the Malaria Elimination Initiative (MEI) at University of California, San Francisco, is leading Project BITE (Bite Interruption Toward Elimination) over three years, 2020-2022, to evaluate new bite prevention tools for high risk populations in the Greater Mekong Subregion (GMS). Tools under evaluation include spatial repellents, topical repellents, and insecticide treated clothing. Additional Project BITE partners include the University of Notre Dame; Swiss Tropical and Public Health Institute; the Armed Forces Research Institute of Medical Sciences; Kasetsart University; and the Cambodia National Center for Parasitology, Entomology, and Malaria Control; among others.

Despite significant progress fighting malaria, there were over 150,000 reported cases in the GMS in 2018, with the majority of these cases reported in Cambodia. Multidrug resistant malaria remains a threat to regional elimination goals and global health security, and malaria risk remains greatest among mobile and migrant populations, including forest-goers and forest rangers. Many of the mosquitoes that transmit malaria in the region bite and rest outdoors, yet there is limited available protection against mosquito biting outdoors for at-risk populations. Responding to these threats, reducing transmission among high risk populations, and accelerating the region toward elimination remain urgent priorities.

Project BITE will determine epidemiological and entomological protective efficacy, acceptability, durability, and cost of a curated forest pack of bite prevention tools compared to standard of care among high risk forest ranger and forest-going populations in Cambodia, following evaluations of the same tools through semi-field studies in Thailand. Ultimately, the goal of Project BITE is to inform scale-up of effective outdoor bite prevention tools across Cambodia, the GMS, and the Asia Pacific region to support near-term malaria elimination goals.