Effects and factors associated with indoor residual spraying with Actellic 300 CS on malaria morbidity in Lira District, Northern Uganda

• Published in: Malaria journal 2019-02, Vol.18 (1), p.44-44, Article 44
• Main Authors: Tugume, Abdulaziz, Muneza, Fiston, Oporia, Frederick, Kiconco, Arthur, Kihembo, Christine, Kisakye, Angela Nakanwagi, Nsubuga, Peter, Deogratias, Sekimpi, Yeka, Adoke
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aerosols - administration & dosage; Case studies; Comorbidity; Data collection; Development and progression; Diagnostic tests; Disease Transmission, Infectious - prevention & control; Female; Health; Health facilities; Households; Human diseases; Humans; Incidence; Indoor residual spraying (IRS); Insecticides; Insecticides - administration & dosage; Integrated approach; Knowledge management; Malaria; Malaria - epidemiology; Malaria - prevention & control; Male; Medical tests; Methods; Microscopy; Middle Aged; Money; Morbidity; Morbidity trends; Mosquito Control - methods; Mosquitoes; Organothiophosphorus Compounds - administration & dosage; Patient outcomes; Percentage point (pp); Pesticides; Prevalence; Public health; Retrospective Studies; Spraying; Studies; Surveying; Surveys and Questionnaires; Test positivity rate (TPR); Trends; Uganda - epidemiology; Vector-borne diseases; Young Adult
• ISSN: 1475-2875; 1475-2875
• DOI: 10.1186/s12936-019-2681-6

Indoor residual spraying (IRS) with Actellic 300 CS was conducted in Lira District between July and August 2016. No formal assessment has been conducted to estimate the effect of spraying with Actellic 300 CS on malaria morbidity in the Ugandan settings. This study assessed malaria morbidity trends before and after IRS with Actellic 300 CS in Lira District in Northern Uganda. The study employed a mixed methods design. Malaria morbidity records from four health facilities were reviewed, focusing on 6 months before and after the IRS intervention. The outcome of interest was malaria morbidity defined as; proportion of outpatient attendance due to total malaria, proportion of outpatient attendance due to confirmed malaria and proportion of malaria case numbers confirmed by microscopy or rapid diagnostic test. Since malaria morbidity was based on count data, an ordinary Poisson regression model was used to obtain percentage point change (pp) in monthly malaria cases before and after IRS. A household survey was also conducted in 159 households to determine IRS coverage and factors associated with spraying. A modified Poisson regression model was fitted to determine factors associated with household spray status. The proportion of outpatient attendance due to malaria dropped from 18.7% before spraying to 15.1% after IRS. The proportion of outpatient attendance due to confirmed malaria also dropped from 5.1% before spraying to 4.0% after the IRS intervention. There was a decreasing trend in malaria test positivity rate (TPR) for every unit increase in month after spraying. The decreasing trend in TPR was more prominent 5-6 months after the IRS intervention (Adj. pp = - 0.60, P-value = 0.015; Adj. pp = - 1.19, P-value