Limitations
EBOLA
The trial implementation period coincided with the largest Ebola epidemic in recorded history, affecting much of Liberia, neighbouring countries and some more distant countries connected by air travel. The main limitation of this, was that planned outcome monitoring in November 2015 was blocked due to Ebola lock down regulations at that time point. Results of follow on time points indicate that November 2015 would have been the time when DWL insecticide efficacy would have been at its maximum, and a stronger effect may have been seen than at 12 months (April 2015). Bomi County is a post-conflict setting with range of housing styles and a high degree of community disruption in the past decade. Housing included row-house style camps built in rubber and palm oil plantations as well as remote villages with more traditional housing. Pairing and randomization did not account for these differences. No other major limitations occurred across the 20 pairs of clusters.