'We spray and walk away': Wall modifications decrease the impact of indoor residual spray campaigns through reductions in post-spray coverage

Mercy A. Opiyo, Krijn P. Paaijmans

Research output: Contribution to journalArticle

Abstract

Malaria prevalence has significantly reduced since 2000, largely due to the scale-up of vector control interventions, mainly indoor residual spraying (IRS) and long-lasting insecticide-treated nets (LLINs). Given their success, these tools remain the frontline interventions in the fight against malaria. Their effectiveness relies on three key ingredients: the intervention, the mosquito vector and the end-user. Regarding the intervention, factors such as the insecticide active ingredient(s) used and the durability and/or bio-efficacy of the tool over time are critical. For the vectors, these factors include biting and resting behaviours and the susceptibility to insecticides. Finally, the end-users need to accept and properly use the intervention. Whilst human attitude and behaviour towards LLINs are well-documented both during and after distribution, only initial coverage is monitored for IRS and in a few geographic settings the residual efficacy of the used product. Here, the historical evidence on end-users modifying their wall surfaces post-spraying is presented, a behaviour that has the potential to reduce actual IRS coverage, effectiveness and impact, as fewer people are truly protected. Therefore, clear guidelines on how to monitor IRS acceptability and/or coverage, both before, during and after spraying, are urgently needed as part of the Monitoring and Evaluation of malaria programmes.

Original languageEnglish (US)
Article number30
JournalMalaria journal
Volume19
Issue number1
DOIs
StatePublished - Jan 17 2020

Keywords

  • Communities
  • Compliance
  • Elimination
  • Insecticide
  • Residual efficacy
  • Vector control
  • Wall modification

ASJC Scopus subject areas

  • Parasitology
  • Infectious Diseases

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