Back to Search
Start Over
Reducing Malaria Transmission through Reactive Indoor Residual Spraying: A Systematic Review.
- Source :
-
The American journal of tropical medicine and hygiene [Am J Trop Med Hyg] 2023 Dec 20; Vol. 110 (4_Suppl), pp. 94-100. Date of Electronic Publication: 2023 Dec 20 (Print Publication: 2024). - Publication Year :
- 2023
-
Abstract
- In the final stages of malaria elimination, interventions to reduce malaria transmission are often centered around a confirmed case of malaria, as cases tend to cluster together at very low levels of transmission. The WHO commissioned a systematic review of the literature and synthesis of evidence for reactive indoor residual spraying (IRS) to develop official recommendations for countries. Several electronic databases were searched in November 2020. A total of 455 records were identified and screened; 20 full-text articles were assessed for eligibility. Two cluster-randomized trials met the inclusion criteria for epidemiological outcomes. Risk of bias was assessed using standard criteria. Because one study was a superiority trial in which the comparator included reactive case detection or mass drug administration and the other was a noninferiority trial in which the comparator was proactive, focal IRS, results could not be pooled. In the superiority trial, reactive IRS reduced malaria prevalence by 68% (risk ratio [RR]: 0.32; 95% CI: 0.13-0.80; certainty of evidence: HIGH) compared with no reactive IRS. No difference was observed for clinical malaria (RR: 0.65; 95% CI: 0.38-1.11; certainty of evidence: MODERATE). In the noninferiority study, the mean difference in incidence between reactive IRS and proactive IRS was 0.10 additional case per 1,000 person-years, which was within the prespecified noninferiority bound (95% CI: -0.38 to 0.58; certainty of evidence: MODERATE). The evidence indicates that reactive IRS may be a cost-effective tool for the prevention of malaria in elimination settings. As only two cluster-randomized controlled trials from sub-Saharan Africa were found, additional high-quality studies should be encouraged.
Details
- Language :
- English
- ISSN :
- 1476-1645
- Volume :
- 110
- Issue :
- 4_Suppl
- Database :
- MEDLINE
- Journal :
- The American journal of tropical medicine and hygiene
- Publication Type :
- Academic Journal
- Accession number :
- 38118168
- Full Text :
- https://doi.org/10.4269/ajtmh.22-0745