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The impact of climate change, including the increased frequency of weather extremes such as flooding, on the incidence of malaria and other vector-borne diseases is an issue of substantial public health importance. Therefore, there is an urgent need to develop effective mitigation and control strategies. In May 2020, a post-flood malaria chemoprevention intervention was piloted in rural western Uganda. When compared to two neighboring villages where no intervention was deployed, there was an estimated 53% reduction (aRR 0.47, 95% CI 0.34 – 0.62, p<.01) in malaria incidence in the six months following the intervention. Building on these results, the scientific aim of this proposal is to evaluate the effectiveness of a targeted, time-limited malaria chemoprevention intervention with and without larval source management (LSM) to reduce excess disease burden in a perennial, high- transmission setting following severe flooding. The premise is that the intervention will reduce the parasite reservoir during the critical “rebound” period, when vectors are re-establishing habitats thereby maintaining relatively low levels of transmission until conditions have returned to the pre-flood baseline.

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