Spatial Targeted Vector Control Is Able to Reduce Malaria Prevalence in the Highlands of Burundi

Protopopoff, Natacha; Bortel, Wim Van; Marcotty, Tanguy; Herp, Michel Van; Maes, Peter; Baza, Dismas; D’Alessandro, Umberto; Coosemans, Marc

doi:10.4269/ajtmh.2008.79.12

Cited by 66 publications

(68 citation statements)

References 30 publications

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“…In another observational study from western Kenya, in a setting with high transmission intensity and moderate ITN coverage, two rounds of IRS with pyrethroid insecticides was associated with a lower odds of parasitemia from cross-sectional surveys compared to ITNs alone [39]. In contrast, observational studies from Eritrea and Burundi demonstrated a protective effect of IRS and ITNs when used together, but failed to show any added benefit of the combination compared to either intervention alone [40,41]. …”

Section: Discussionmentioning

confidence: 99%

Measures of Malaria Burden after Long-Lasting Insecticidal Net Distribution and Indoor Residual Spraying at Three Sites in Uganda: A Prospective Observational Study

et al. 2016

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BackgroundLong-lasting insecticidal nets (LLINs) and indoor residual spraying of insecticide (IRS) are the primary vector control interventions used to prevent malaria in Africa. Although both interventions are effective in some settings, high-quality evidence is rarely available to evaluate their effectiveness following deployment by a national malaria control program. In Uganda, we measured changes in key malaria indicators following universal LLIN distribution in three sites, with the addition of IRS at one of these sites.Methods and FindingsComprehensive malaria surveillance was conducted from October 1, 2011, to March 31, 2016, in three sub-counties with relatively low (Walukuba), moderate (Kihihi), and high transmission (Nagongera). Between 2013 and 2014, universal LLIN distribution campaigns were conducted in all sites, and in December 2014, IRS with the carbamate bendiocarb was initiated in Nagongera. High-quality surveillance evaluated malaria metrics and mosquito exposure before and after interventions through (a) enhanced health-facility-based surveillance to estimate malaria test positivity rate (TPR), expressed as the number testing positive for malaria/number tested for malaria (number of children tested for malaria: Walukuba = 42,833, Kihihi = 28,790, and Nagongera = 38,690); (b) cohort studies to estimate the incidence of malaria, expressed as the number of episodes per person-year [PPY] at risk (number of children observed: Walukuba = 340, Kihihi = 380, and Nagongera = 361); and (c) entomology surveys to estimate household-level human biting rate (HBR), expressed as the number of female Anopheles mosquitoes collected per house-night of collection (number of households observed: Walukuba = 117, Kihihi = 107, and Nagongera = 107). The LLIN distribution campaign substantially increased LLIN coverage levels at the three sites to between 65.0% and 95.5% of households with at least one LLIN. In Walukuba, over the 28-mo post-intervention period, universal LLIN distribution was associated with no change in the incidence of malaria (0.39 episodes PPY pre-intervention versus 0.20 post-intervention; adjusted rate ratio [aRR] = 1.02, 95% CI 0.36–2.91, p = 0.97) and non-significant reductions in the TPR (26.5% pre-intervention versus 26.2% post-intervention; aRR = 0.70, 95% CI 0.46–1.06, p = 0.09) and HBR (1.07 mosquitoes per house-night pre-intervention versus 0.71 post-intervention; aRR = 0.41, 95% CI 0.14–1.18, p = 0.10). In Kihihi, over the 21-mo post-intervention period, universal LLIN distribution was associated with a reduction in the incidence of malaria (1.77 pre-intervention versus 1.89 post-intervention; aRR = 0.65, 95% CI 0.43–0.98, p = 0.04) but no significant change in the TPR (49.3% pre-intervention versus 45.9% post-intervention; aRR = 0.83, 95% 0.58–1.18, p = 0.30) or HBR (4.06 pre-intervention versus 2.44 post-intervention; aRR = 0.71, 95% CI 0.30–1.64, p = 0.40). In Nagongera, over the 12-mo post-intervention period, universal LLIN distribution was associated with a reduction in the TPR (45...

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Section: Discussionmentioning

confidence: 99%

Measures of Malaria Burden after Long-Lasting Insecticidal Net Distribution and Indoor Residual Spraying at Three Sites in Uganda: A Prospective Observational Study

et al. 2016

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“…[24][25][26][27][28][29] Three studies did not measure human health outcomes. [30][31][32] Two studies did not measure a change caused by IRS but rather established a baseline prevalence rate 33 or a change over time after termination of IRS. 34 Two studies reported the same data but with a different focus of analysis; one was included 35 and the other was excluded.…”

Section: Methodsmentioning

confidence: 99%

Reduction of Malaria Prevalence by Indoor Residual Spraying: A Meta-Regression Analysis

Kim

Fedak

Kramer

2012

The American Society of Tropical Medicine and Hygiene

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Abstract. Indoor residual spraying (IRS) has become an increasingly popular method of insecticide use for malaria control, and many recent studies have reported on its effectiveness in reducing malaria burden in a single community or region. There is a need for systematic review and integration of the published literature on IRS and the contextual determining factors of its success in controlling malaria. This study reports the findings of a meta-regression analysis based on 13 published studies, which were chosen from more than 400 articles through a systematic search and selection process. The summary relative risk for reducing malaria prevalence was 0.38 (95% confidence interval = 0.31-0.46), which indicated a risk reduction of 62%. However, an excessive degree of heterogeneity was found between the studies. The meta-regression analysis indicates that IRS is more effective with high initial prevalence, multiple rounds of spraying, use of DDT, and in regions with a combination of Plasmodium falciparum and P. vivax malaria.

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“…However, these reports have come from island communities, 4,5 relatively low seasonal transmission settings in Southern Africa, [6][7][8] or epidemic-prone highland areas. 9 In addition, they were based on specifically designed comparisons of pre-and post-intervention data from cross-sectional surveys or retrospective analysis of health facility records. Our surveillance system has the advantage of using available quality data with minimal additional investment for assessing the impact of not only IRS, but other population-level interventions as well.…”

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confidence: 99%

Assessing the Impact of Indoor Residual Spraying on Malaria Morbidity Using a Sentinel Site Surveillance System in Western Uganda

Bukirwa¹,

Yau²,

Kigozi³

et al. 2009

The American Journal of Tropical Medicine and Hygiene

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Abstract. A single round of indoor residual spraying (IRS) using lambda-cyhalothrin was implemented in a district of Uganda with moderate transmission intensity in 2007. Individual patient data were collected from one health facility within the district 8 months before and 16 months after IRS. There was a consistent decrease in the proportion of patients diagnosed with clinical malaria after IRS for patients < 5 and > 5 years of age (52% versus 26%, P < 0.001 and 36% versus 23%, P < 0.001, respectively). There was a large decrease in the proportion of positive blood smears in the first 4 months after IRS for patients < 5 (47% versus 14%, P < 0.001) and > 5 (26% versus 9%, P < 0.001) years of age, but this effect waned over the subsequent 12 months. IRS was effective in reducing malaria morbidity, but this was not sustained beyond 1 year for the proportion of blood smears read as positive.Malaria is the leading cause of morbidity and mortality in Uganda, responsible for up to 40% of outpatient visits, 25% of hospital admissions, and 14% of hospital deaths (Uganda Ministry of Health, unpublished data). Malaria control efforts in Uganda include case management with artemisinin-based combination therapy (ACT), widespread coverage with longlasting insecticide treated nets (LLINs), and intermittent preventive therapy in pregnancy. To expand its malaria control activities, the Uganda National Malaria Control Strategic Plan 2005-2010 has included indoor residual spraying (IRS) as one of the major malaria control interventions. Uganda aims to establish and sustain a system of high-quality IRS services that cover at least 85% of all targeted structures in areas of unstable transmission while piloting and potentially scaling up IRS in stable malaria transmission areas.Kanungu District is a district in southwest Uganda where IRS was implemented with support from the President's Malaria Initiative ( www.pmi.gov ). This district experiences perennial malaria with moderate transmission intensity and an entomologic inoculation rate estimated to be six infectious bites per person year in 2002.1 During February and March 2007, ~45,000 households covering a population of 190,000 persons were sprayed with the synthetic pyrethroid lambda-cyhalothrin wettable powder formulation (ICON 10% WP; Syngenta, Sweden ). IRS was targeted to ~70% households that are situated in areas below an altitude of 1,200 m, resulting in coverage of ~90% of targeted households. This first round of spraying in Kanungu was to be followed by serial IRS in the targeted subcounties. Because of logistical constraints, the next round of IRS has been delayed but is scheduled to occur in mid-2009.Accurate evaluation of the impact of interventions is necessary to optimize malaria control efforts. In 2006, the Uganda Malaria Surveillance Project (UMSP) established a sentinel site surveillance system that routinely collects individual-level data on all patients presenting to the outpatient department of selected government health facilities representing areas of varyi...

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Spatial Targeted Vector Control Is Able to Reduce Malaria Prevalence in the Highlands of Burundi

Cited by 66 publications

References 30 publications

Measures of Malaria Burden after Long-Lasting Insecticidal Net Distribution and Indoor Residual Spraying at Three Sites in Uganda: A Prospective Observational Study

Measures of Malaria Burden after Long-Lasting Insecticidal Net Distribution and Indoor Residual Spraying at Three Sites in Uganda: A Prospective Observational Study

Reduction of Malaria Prevalence by Indoor Residual Spraying: A Meta-Regression Analysis

Assessing the Impact of Indoor Residual Spraying on Malaria Morbidity Using a Sentinel Site Surveillance System in Western Uganda

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