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

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...

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Bibliographic Details
Published in:Nature communications 2021-05, Vol.12 (1), p.2635-9, Article 2635
Main Authors: Namuganga, Jane F., Epstein, Adrienne, Nankabirwa, Joaniter I., Mpimbaza, Arthur, Kiggundu, Moses, Sserwanga, Asadu, Kapisi, James, Arinaitwe, Emmanuel, Gonahasa, Samuel, Opigo, Jimmy, Ebong, Chris, Staedke, Sarah G., Shililu, Josephat, Okia, Michael, Rutazaana, Damian, Maiteki-Sebuguzi, Catherine, Belay, Kassahun, Kamya, Moses R., Dorsey, Grant, Rodriguez-Barraquer, Isabel
Format: Article
Language:English
Subjects:
631/158/1469
692/699/255/1629
692/700/478/174
Animals
Anopheles - parasitology
Epidemiological Monitoring
Geography
Health care facilities
Humanities and Social Sciences
Humans
Incidence
Insecticides
Malaria
Malaria - epidemiology
Malaria - parasitology
Malaria - prevention & control
Malaria - transmission
Mosquito Control - methods
Mosquito Vectors - parasitology
multidisciplinary
Science
Science (multidisciplinary)
Spraying
Uganda - epidemiology
Vector-borne diseases
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Summary: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 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. Indoor residual spraying (IRS) of insecticide is one of the primary malaria vector control initiatives, but implementation is limited. Here, the authors show that discontinuation of IRS in Uganda was associated with increased malaria incidence, and introduction of IRS was associated with decreased incidence.
ISSN:2041-1723
2041-1723
DOI:10.1038/s41467-021-22896-5