1. Indoor Residual Spraying for Malaria Control in Sub-Saharan Africa 1997 to 2017: An Adjusted Retrospective Analysis
- Author
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Adilson José DePina, Anna Trett, Chantal Hendriks, Jennifer Rozier, Meghan Tammaro, Ignatius Williams, Michael Coleman, Maria Devine, Hmooda Toto Kafy, Achamylesh Sisay, Catherine L. Moyes, Allan Were, Elizabeth Chizema, Julie Anne A. Tangena, and Ramandimbiarijaona Herizo
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Insecticides ,lcsh:Arctic medicine. Tropical medicine ,Mosquito Control ,Sub saharan ,lcsh:RC955-962 ,Malaria control ,030231 tropical medicine ,Indoor residual spraying ,World health ,lcsh:Infectious and parasitic diseases ,Insecticide Resistance ,03 medical and health sciences ,0302 clinical medicine ,Environmental health ,parasitic diseases ,0502 economics and business ,Organochlorines ,medicine ,Retrospective analysis ,Pyrethroids ,lcsh:RC109-216 ,050207 economics ,Africa South of the Sahara ,Retrospective Studies ,050208 finance ,Public health ,Research ,05 social sciences ,Conflict of interest ,Coverage data ,medicine.disease ,Organophosphates ,Malaria ,3. Good health ,030104 developmental biology ,Infectious Diseases ,Geography ,Insecticide resistance ,Communicable Disease Control ,Parasitology ,Carbamates - Abstract
Background Indoor residual spraying (IRS) is a key tool for controlling and eliminating malaria by targeting vectors. To support the development of effective intervention strategies it is important to understand the impact of vector control tools on malaria incidence and on the spread of insecticide resistance. In 2006, the World Health Organization (WHO) stated that countries should report on coverage and impact of IRS, yet IRS coverage data are still sparse and unspecific. Here, the subnational coverage of IRS across sub-Saharan Africa for the four main insecticide classes from 1997 to 2017 were estimated. Methods Data on IRS deployment were collated from a variety of sources, including the President’s Malaria Initiative spray reports and National Malaria Control Programme reports, for all 46 malaria-endemic countries in sub-Saharan Africa from 1997 to 2017. The data were mapped to the applicable administrative divisions and the proportion of households sprayed for each of the four main insecticide classes; carbamates, organochlorines, organophosphates and pyrethroids was calculated. Results The number of countries implementing IRS increased considerably over time, although the focal nature of deployment means the number of people protected remains low. From 1997 to 2010, DDT and pyrethroids were commonly used, then partly replaced by carbamates from 2011 and by organophosphates from 2013. IRS deployment since the publication of resistance management guidelines has typically avoided overlap between pyrethroid IRS and ITN use. However, annual rotations of insecticide classes with differing modes of action are not routinely used. Conclusion This study highlights the gaps between policy and practice, emphasizing the continuing potential of IRS to drive resistance. The data presented here can improve studies on the impact of IRS on malaria incidence and help to guide future malaria control efforts.
- Published
- 2019
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