The impact of stopping and starting indoor residual spraying on malaria burden in 14 districts of Uganda

2020 ◽  
Author(s):  
Jane Namuganga ◽  
Adrienne Epstein ◽  
Joaniter Nankabirwa ◽  
Arthur Mpimbaza ◽  
Moses Kiggundu ◽  
...  
Keyword(s):  
Malaria Incidence ◽  
Critical Role ◽  
Scale Up ◽  
Indoor Residual Spraying ◽  
Fold Increase ◽  
Bed Nets ◽  
Malaria Burden ◽  
Vector Control Intervention ◽  
Using Data ◽  
The Impact

Abstract The scale-up of malaria control efforts has led to marked reductions in malaria burden over the past twenty years, but progress has slowed. Implementation of indoor residual spraying (IRS) of insecticide, a proven vector control intervention, has been limited and difficult to sustain partly because questions remain on its added impact over widely accepted interventions such as bed nets. Using data from 14 enhanced surveillance health facilities in Uganda, a country with high bet net coverage yet high malaria burden, we estimate the impact of starting and stopping IRS. We show that stopping IRS resulted in a 5-fold increase in malaria incidence within 10 months, but reinstating IRS led to an over 5-fold decrease within 8 months. In areas where IRS was initiated and sustained, malaria incidence dropped by 85% after year 4. IRS could play a critical role in achieving global malaria targets, particularly in areas where progress has stalled.

scholarly journals The impact of stopping and starting indoor residual spraying on malaria burden in Uganda

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Jane F. Namuganga ◽  
Adrienne Epstein ◽  
Joaniter I. Nankabirwa ◽  
Arthur Mpimbaza ◽  
Moses Kiggundu ◽  
...  
Keyword(s):  
Malaria Incidence ◽  
Critical Role ◽  
Scale Up ◽  
Indoor Residual Spraying ◽  
Fold Increase ◽  
Bed Nets ◽  
Malaria Burden ◽  
Vector Control Intervention ◽  
Using Data ◽  
The Impact

AbstractThe scale-up of malaria control efforts has led to marked reductions in malaria burden over the past twenty years, but progress has slowed. Implementation of indoor residual spraying (IRS) of insecticide, a proven vector control intervention, has been limited and difficult to sustain partly because questions remain on its added impact over widely accepted interventions such as bed nets. Using data from 14 enhanced surveillance health facilities in Uganda, a country with high bed net coverage yet high malaria burden, we estimate the impact of starting and stopping IRS on changes in malaria incidence. We show that stopping IRS was associated with a 5-fold increase in malaria incidence within 10 months, but reinstating IRS was associated with an over 5-fold decrease within 8 months. In areas where IRS was initiated and sustained, malaria incidence dropped by 85% after year 4. IRS could play a critical role in achieving global malaria targets, particularly in areas where progress has stalled.

scholarly journals Accounting for regional transmission variability and the impact of malaria control interventions in Ghana: A population level mathematical modelling approach.

2020 ◽  
Author(s):  
Timothy Awine ◽  
Sheetal P Silal
Keyword(s):  
Malaria Control ◽  
Malaria Incidence ◽  
Protective Efficacy ◽  
Indoor Residual Spraying ◽  
Information Management System ◽  
Control Measures ◽  
Bed Nets ◽  
Model Parameters ◽  
Insecticide Treated Bed Nets ◽  
The Impact

Abstract Background Assessing the effectiveness of malaria control measures in Ghana will require taking transmission dynamics of the disease into account given the influence of climate variability in the region of interest. The impact of preventative interventions on malaria incidence and the prospects of meeting program timelines in Ghana have been investigated using mathematical models based on regionally diverse climatic zones. Methods An ordinary non-linear differential equation model with its associated rate parameters was developed incorporating the transitions between various disease compartments for three ecological zones in Ghana. Model parameters were estimated using data captured on the District Health Information Management System in Ghana from 2008 to 2017.The impact of insecticide treated bed nets and indoor residual spraying on the incidence of malaria were simulated at various levels of coverage and protective effectiveness in each ecological zone. To fit the model, Approximate Bayesian Computational sampling approach was adopted. Results Increasing the coverage levels of both long lasting insecticide treated bed nets or indoor residual spraying activities without a corresponding increase in their proper use or patronage does not impact highly on averting predicted incidence of malaria in Ghana. Improving on the protective efficacy of long lasting insecticide treated bed nets through proper usage could lead to substantial reductions in the predicted incidence of malaria. Similar results were obtained with indoor residual spraying across all zones. Conclusions Projected goals set in the National Strategic plan for malaria control 2014-2020 as well as WHO targets for malaria pre-elimination by 2030 are only likely be achieved if a substantial improvement in treated bed net usage is achieved coupled with targeted deployment of indoor residual spraying with high efficacy.

scholarly journals Accounting for regional transmission variability and the impact of malaria control interventions in Ghana: A population level mathematical modelling approach.

2020 ◽  
Author(s):  
Timothy Awine ◽  
Sheetal P Silal
Keyword(s):  
Malaria Control ◽  
Malaria Incidence ◽  
Protective Efficacy ◽  
Indoor Residual Spraying ◽  
Information Management System ◽  
Control Measures ◽  
Bed Nets ◽  
Model Parameters ◽  
Insecticide Treated Bed Nets ◽  
The Impact

Abstract Background Assessing the effectiveness of malaria control measures in Ghana will require taking transmission dynamics of the disease into account given the influence of climate variability in the region of interest. The impact of preventative interventions on malaria incidence and the prospects of meeting program timelines in Ghana were investigated using mathematical models based on regionally diverse climatic zones. Methods An ordinary non-linear differential equation models with their associated rate parameters were developed incorporating the transitions between various disease compartments for three ecological zones in Ghana. Models were fitted using data from the District Health Information Management System in Ghana from 2008 to 2017 and historical intervention coverage levels. To calibrate the models, Approximate Bayesian Computational sampling approach with a distance based rejection criteria was adopted. A leave-one-out approach was used to validate model parameters and the most sensitive evaluated using a multivariate regression sensitivity analysis. The impact of insecticide treated bed nets and their usage and indoor residual spraying as well as their protective efficacy on the incidence of malaria were simulated at various levels of coverage and protective effectiveness in each ecological zone to investigate the prospects of achieving goals of the malaria control strategy for 2014-2020. Results Increasing the coverage levels of both long lasting insecticide treated bed nets and indoor residual spraying activities without a corresponding increase in their recommended usage does not impact highly on averting predicted incidence of malaria. Improving upon the protective efficacy of long lasting insecticide treated bed nets through proper usage could lead to substantial reductions in the predicted incidence of malaria. Similar results were obtained with indoor residual spraying across all zones.Conclusions Projected goals set in the national strategic plan for malaria control 2014-2020 as well as WHO targets for malaria pre-elimination by 2030 are only likely to be achieved if a substantial improvement in treated bed net usage is achieved coupled with targeted deployment of indoor residual spraying with high community acceptability and efficacy. Key words: model, malaria, interventions, long lasting insecticide bednets, indoor residual spraying

scholarly journals Design and methods for a quasi-experimental pilot study to evaluate the impact of dual active ingredient insecticide-treated nets on malaria burden in five regions in sub-Saharan Africa

2022 ◽  
Vol 21 (1) ◽  
Author(s):  
Adama Gansané ◽  
Baltazar Candrinho ◽  
Aimable Mbituyumuremyi ◽  
Perpetua Uhomoibhi ◽  
Sagnon NFalé ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
Malaria Transmission ◽  
Malaria Control ◽  
Active Ingredient ◽  
Indoor Residual Spraying ◽  
Sub Saharan Africa ◽  
Bed Nets ◽  
Pilot Studies ◽  
Malaria Burden ◽  
The Impact

Abstract Background Vector control tools have contributed significantly to a reduction in malaria burden since 2000, primarily through insecticidal-treated bed nets (ITNs) and indoor residual spraying. In the face of increasing insecticide resistance in key malaria vector species, global progress in malaria control has stalled. Innovative tools, such as dual active ingredient (dual-AI) ITNs that are effective at killing insecticide-resistant mosquitoes have recently been introduced. However, large-scale uptake has been slow for several reasons, including higher costs and limited evidence on their incremental effectiveness and cost-effectiveness. The present report describes the design of several observational studies aimed to determine the effectiveness and cost-effectiveness of dual-AI ITNs, compared to standard pyrethroid-only ITNs, at reducing malaria transmission across a variety of transmission settings. Methods Observational pilot studies are ongoing in Burkina Faso, Mozambique, Nigeria, and Rwanda, leveraging dual-AI ITN rollouts nested within the 2019 and 2020 mass distribution campaigns in each country. Enhanced surveillance occurring in select study districts include annual cross-sectional surveys during peak transmission seasons, monthly entomological surveillance, passive case detection using routine health facility surveillance systems, and studies on human behaviour and ITN use patterns. Data will compare changes in malaria transmission and disease burden in districts receiving dual-AI ITNs to similar districts receiving standard pyrethroid-only ITNs over three years. The costs of net distribution will be calculated using the provider perspective including financial and economic costs, and a cost-effectiveness analysis will assess incremental cost-effectiveness ratios for Interceptor® G2, Royal Guard®, and piperonyl butoxide ITNs in comparison to standard pyrethroid-only ITNs, based on incidence rate ratios calculated from routine data. Conclusions Evidence of the effectiveness and cost-effectiveness of the dual-AI ITNs from these pilot studies will complement evidence from two contemporary cluster randomized control trials, one in Benin and one in Tanzania, to provide key information to malaria control programmes, policymakers, and donors to help guide decision-making and planning for local malaria control and elimination strategies. Understanding the breadth of contexts where these dual-AI ITNs are most effective and collecting robust information on factors influencing comparative effectiveness could improve uptake and availability and help maximize their impact.

scholarly journals The malaria burden of Amerindian groups of three Venezuelan states: a descriptive study based on programmatic data

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Juan C. Gabaldón-Figueira ◽  
Carlos Chaccour ◽  
Jorge Moreno ◽  
Maria Villegas ◽  
Leopoldo Villegas
Keyword(s):  
Risk Factors ◽  
Plasmodium Falciparum ◽  
Malaria Incidence ◽  
Hot Spot ◽  
Public Health Problem ◽  
Epidemiological Data ◽  
Descriptive Study ◽  
Malaria Burden ◽  
Indigenous Groups ◽  
The Impact

Abstract Background Fifty-three percent of all cases of malaria in the Americas in 2019 came from Venezuela, where the epidemic is heavily focused south of the Orinoco river, and where most of the country’s Amerindian groups live. Although the disease is known to represent a significant public health problem among these populations, little epidemiological data exists on the subject. This study aims to provide information on malaria incidence, geospatial clustering, and risk factors associated to Plasmodium falciparum infection among these groups. Methods This is a descriptive study based on the analysis of published and unpublished programmatic data collected by Venezuelan health authorities and non-government organizations between 2014 and 2018. The Annual Parasite Index among indigenous groups (API-i) in municipalities of three states (Amazonas, Bolivar, and Sucre) were calculated and compared using the Kruskal Wallis test, risk factors for Plasmodium falciparum infection were identified via binomial logistic regression and maps were constructed to identify clusters of malaria cases among indigenous patients via Moran’s I and Getis-Ord’s hot spot analysis. Results 116,097 cases of malaria in Amerindian groups were registered during the study period. An increasing trend was observed between 2014 and 2016 but reverted in 2018. Malaria incidence remains higher than in 2014 and hot spots were identified in the three states, although more importantly in the south of Bolivar. Most cases (73.3%) were caused by Plasmodium vivax, but the Hoti, Yanomami, and Eñepa indigenous groups presented higher odds for infection with Plasmodium falciparum. Conclusion Malaria cases among Amerindian populations increased between 2014 and 2018 and seem to have a different geographic distribution than those among the general population. These findings suggest that tailored interventions will be necessary to curb the impact of malaria transmission in these groups.

scholarly journals Impact of insecticide resistance in Anopheles arabiensis on malaria incidence and prevalence in Sudan and the costs of mitigation

2017 ◽  
Vol 114 (52) ◽  
pp. E11267-E11275 ◽  
Author(s):  
Hmooda Toto Kafy ◽  
Bashir Adam Ismail ◽  
Abraham Peter Mnzava ◽  
Jonathan Lines ◽  
Mogahid Shiekh Eldin Abdin ◽  
...  
Keyword(s):  
Insecticide Resistance ◽  
Pyrethroid Resistance ◽  
Malaria Incidence ◽  
Disease Incidence ◽  
Indoor Residual Spraying ◽  
Sub Saharan Africa ◽  
Malaria Vectors ◽  
Incidence And Mortality ◽  
Additional Protection ◽  
The Impact

Insecticide-based interventions have contributed to ∼78% of the reduction in the malaria burden in sub-Saharan Africa since 2000. Insecticide resistance in malaria vectors could presage a catastrophic rebound in disease incidence and mortality. A major impediment to the implementation of insecticide resistance management strategies is that evidence of the impact of resistance on malaria disease burden is limited. A cluster randomized trial was conducted in Sudan with pyrethroid-resistant and carbamate-susceptible malaria vectors. Clusters were randomly allocated to receive either long-lasting insecticidal nets (LLINs) alone or LLINs in combination with indoor residual spraying (IRS) with a pyrethroid (deltamethrin) insecticide in the first year and a carbamate (bendiocarb) insecticide in the two subsequent years. Malaria incidence was monitored for 3 y through active case detection in cohorts of children aged 1 to <10 y. When deltamethrin was used for IRS, incidence rates in the LLIN + IRS arm and the LLIN-only arm were similar, with the IRS providing no additional protection [incidence rate ratio (IRR) = 1.0 (95% confidence interval [CI]: 0.36–3.0; P = 0.96)]. When bendiocarb was used for IRS, there was some evidence of additional protection [interaction IRR = 0.55 (95% CI: 0.40–0.76; P < 0.001)]. In conclusion, pyrethroid resistance may have had an impact on pyrethroid-based IRS. The study was not designed to assess whether resistance had an impact on LLINs. These data alone should not be used as the basis for any policy change in vector control interventions.

scholarly journals The Impact of 3 Years of Targeted Indoor Residual Spraying With Pirimiphos-Methyl on Malaria Parasite Prevalence in a High-Transmission Area of Northern Zambia

2019 ◽  
Vol 188 (12) ◽  
pp. 2120-2130 ◽  
Author(s):  
Marisa A Hast ◽  
Mike Chaponda ◽  
Mbanga Muleba ◽  
Jean-Bertin Kabuya ◽  
James Lupiya ◽  
...  
Keyword(s):  
Malaria Transmission ◽  
Malaria Control ◽  
Malaria Parasite ◽  
Control Measure ◽  
Indoor Residual Spraying ◽  
Parasite Prevalence ◽  
Organophosphate Insecticide ◽  
Malaria Burden ◽  
Pirimiphos Methyl ◽  
The Impact

Abstract Malaria transmission in northern Zambia has increased in the past decade, despite malaria control activities. Evidence-based intervention strategies are needed to effectively reduce malaria transmission. Zambia’s National Malaria Control Centre conducted targeted indoor residual spraying (IRS) in Nchelenge District, Luapula Province, from 2014 to 2016 using the organophosphate insecticide pirimiphos-methyl. An evaluation of the IRS campaign was conducted by the Southern Africa International Centers of Excellence for Malaria Research using actively detected malaria cases in bimonthly household surveys carried out from April 2012 to July 2017. Changes in malaria parasite prevalence after IRS were assessed by season using Poisson regression models with robust standard errors, controlling for clustering of participants in households and demographic, geographical, and climatological covariates. In targeted areas, parasite prevalence declined approximately 25% during the rainy season following IRS with pirimiphos-methyl but did not decline during the dry season or in the overall study area. Within targeted areas, parasite prevalence declined in unsprayed households, suggesting both direct and indirect effects of IRS. The moderate decrease in parasite prevalence within sprayed areas indicates that IRS with pirimiphos-methyl is an effective malaria control measure, but a more comprehensive package of interventions is needed to effectively reduce the malaria burden in this setting.

scholarly journals Impact of The COVID-19 Pandemic on the Malaria Burden in Northern Ghana: Analysis of Routine Surveillance Data

2021 ◽  
Author(s):  
Anna-Katharina Heuschen ◽  
Alhassan Abdul-Mumin ◽  
Martin Nyaaba Adokiya ◽  
Guangyu Lu ◽  
Albrecht Jahn ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Malaria Incidence ◽  
Information Management System ◽  
Northern Region ◽  
Surveillance Data ◽  
Northern Ghana ◽  
Malaria Burden ◽  
Routine Surveillance ◽  
Outpatient Departments ◽  
The Impact

Abstract Introduction: The COVID-19 pandemic and its collateral damage severely impact health systems globally and risk to worsen the malaria situation in endemic countries. Malaria is a leading cause of morbidity and mortality in Ghana. This study aims to analyze routine surveillance data to assess possible effects on the malaria burden in the first year of the COVID-19 pandemic in the Northern Region of Ghana. Methods: Monthly routine data from the District Health Information Management System II (DHIMS2) of the Northern Region of Ghana were analyzed. Overall outpatient department visits and malaria incidence rates from the years 2015 to 2019 were compared to the corresponding data of the year 2020. Results: Compared to the corresponding periods of the years 2015 to 2019, overall visits and malaria incidence in pediatric and adult outpatient departments in northern Ghana decreased in March and April 2020, when major movement and social restrictions were implemented in response to the pandemic. Incidence slightly rebounded afterwards in 2020 but stayed below the average of the previous years. Data from inpatient departments showed a similar but more pronounced trend when compared to outpatient departments. In pregnant women, however, malaria incidence in outpatient departments increased after the first COVID-19 wave. Discussion: The findings from this study show that the COVID-19 pandemic affects the malaria burden in health facilities of Ghana, with declines in in- and outpatient rates. Pregnant women may experience reduced access to intermittent preventive malaria treatment and insecticide treated nets, resulting in subsequent higher malaria morbidity. Further data from other African countries, particularly on community-based studies, are needed to fully determine the impact of the pandemic on the malaria situation.

scholarly journals Household Predictors of Malaria Episode in Northern Uganda: Its Implication for Future Malaria Control

2021 ◽  
Author(s):  
Richard Echodu ◽  
William Sam Oyet ◽  
Tereza Iwiru ◽  
Felister Apili ◽  
Julius Julian Lutwama ◽  
...  
Keyword(s):  
Malaria Incidence ◽  
Indoor Residual Spraying ◽  
Malaria Episode ◽  
Bed Nets ◽  
Northern Uganda ◽  
Bed Net ◽  
Test Bed ◽  
Time Data ◽  
Previous Night ◽  
Malaria Episodes

Abstract Background: Uses of indoor residual spraying (IRS), long-lasting insecticidal nets (LLINS) and treatment with artemisinin-based combination therapy (ACT) are greatly promoted in northern part of Uganda as mitigating strategies for malaria episodes. Unfortunately, the region still records the highest malaria prevalence of 63%. This study assesses household predicators of malaria in the region and their impact on malaria episodes at the household levels.Methods: A cross-sectional study was conducted in four districts of Gulu, Oyam, Kitgum and Agago covering sixteen villages in northern Uganda. In total, 193 households were surveyed. Data was collected through pre-tested structured questionnaire and systematically coded for analysis using R software.Results:Women headed 58% of the 193 households surveyed. Six hundred and five (605) individuals were declared to have spent the previous night in these households. On average, there were two bed nets per household and 502 (86%) spent the night prior to interview under a bed net. Overall, malaria episodes were strongly related to lack of bed nets or lack of use thereof, and directly linked to the number of individuals in a household. Children were prone to malaria more than adults by a ratio of 2:1. When given a choice between insecticides (IRS) and treated bed nets, 1 in 3 households preferred treated bed nets. At the same time, data suggests that bed nets were perceived unnecessary once IRS was applied. If true, the driving force to spraying insecticides indoor then becomes lack of a bed net. Conclusions:Household predicators of incidence of malaria in northern Uganda includes bed nets, use of treated bed nets, and indoor residual spraying with households not practicing any of these bearing the heaviest burden of malaria. Hierarchical clustering on principal components (HCPC) clusters households into four types in northern Uganda, 1) household that use bed nets and sleep in houses sprayed with insecticides; 2) households that use bed nets but no indoor residual spraying with insecticides; 3) households that have no bed nets and no indoor residual spraying; and 4) test bed nets before use. Malaria incidence was higher in children as compared to the adults.

scholarly journals Transgenic Mosquitoes Fight against Malaria: A Review

2019 ◽  
Vol 7 (1) ◽  
pp. 59-65 ◽  
Author(s):  
Amit Kumar Shrivastava ◽  
Laxmi Shrestha ◽  
Shraddha Prakash ◽  
Roshan Kumar Mehta
Keyword(s):  
Malaria Control ◽  
Indoor Residual Spraying ◽  
Control Program ◽  
Bed Nets ◽  
Mosquito Vector ◽  
Gene Drive ◽  
Malaria Control Program ◽  
Malaria Burden ◽  
Insecticide Treated Bed Nets ◽  
Transgenic Mosquitoes

Malaria control with transgenic mosquitoes will be challenging; however, recent advances suggest that it may be a possibility in the foreseeable future. Progress towards discovering refractory genes for rodent malaria and gene drive systems for Drosophila provide hope that similar advances may be made for human malaria in mosquito vector species. That said, the African malaria burden has proved exceptionally difficult to diminish by all means tried thus far; and it is unlikely that transgenic mosquitoes will provide an all-in-one solution. Transgenic mosquitoes should be considered within the context of an integrated vector management strategy which should also include insecticide-treated bed-nets, indoor residual spraying with insecticides and treatment of infected individuals with antimalarial drugs. Integrated strategies will be a necessity for any successful african malaria control program and transgenic mosquitoes should be considered as a potential ingredient in the future goal of continent-wide disease control.

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