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

Abstract

Background 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. Methods 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. Results 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 < 0.001). The IRS coverage was estimated at 89.3%. Households of respondents who were formally employed or owned any form of business were more likely to be unsprayed; (APR = 5.81, CI 2.72–12.68); (APR = 3.84, CI 1.20–12.31), respectively. Conclusion Coverage of IRS with Actellic 300 CS was high and was associated with a significant decline in malaria related morbidity 6 months after spraying.

Effect of Free Healthcare Policy for Children under Five Years Old on the Incidence of Reported Malaria Cases in Burkina Faso by Bayesian Modelling: “Not only the Ears but also the Head of the Hippopotamus”

“…Community-based interventions were reported to increase the coverage of most malaria control interventions [57]. Besides, though its coverage is limited, indoor residual spraying with long lasting insecticides, interrupted in 2012, was resumed in 2017 in three health districts, and there is evidence for its capacity to reduce malaria morbidity at the community level [58].…”

“…The routine data we used in our study are known to be subject to biases. The use of confirmed malaria cases as the outcome, the integration of covariates in the model, and the inclusion of the population as a denominator helped to limit the bias associated with the use of routine data in the estimation of model parameters [58]. In addition, the CAR models could be subject to estimation biases due to ecological error [62].…”

Spatial-temporal patterns of malaria incidence in Uganda using HMIS data from 2015 to 2019

“…Kigezi, Ankole and Bugisu) [41,42]; regions with recent intense targeted multi-year IRS activity associated with high impacts on transmission (e.g. Bukedi, Teso, and Lango) [4,19,43,44]; and, large urban municipalities (e.g. Southern Buganda) with urbanization associated with reduced transmission [45,46].…”

Household Predictors of Incidence of Malaria in Northern Uganda: Its Implication for Future Malaria Control

“…In 2015, there was cessation of IRS activities in the region [42]. This cessation of IRS activities led to the worst epidemic of malaria affecting ten districts of Lamwo, Gulu, Kitgum, Oyam, Agago, Apc, Amuru, Kole, Nowya and Pader with an average of 5000 cases per district and 40,000 cases per week [42,43] Since then, IRS activities have continued to be implemented in the study area using Acetellic 300CS (an organophosphate insecticide) [44] much as there is insecticide resistance currently seen in the region [12].…”