Publication
Title
Impact of population based indoor residual spraying in combination with mass drug administration on malaria incidence and test positivity in a high transmission setting in north eastern Uganda
Author
Abstract
Background Mass drug administration (MDA) and indoor residual spraying (IRS) are potent malaria burden reduction tools. The impact of combining MDA and IRS is not well documented. We evaluated the impact of MDA + IRS compared to IRS alone at a high transmission site in Eastern Uganda.Methods A quasi-experimental study was implemented in Toroma and Kapujan subcounties in north eastern Uganda. Both subcounties received four rounds of IRS using primiphos-methyl (Acttellic SC300) 6-8 months apart from December 2016 to December 2018. Eligible residents of Kapujan simultaneously received MDA using dihydroartemesinin-piperaquine (DHA-PQ). Health facility data was used to monitor malaria case incidence rate and test positivity rates.Results In the MDA + IRS arm, malaria incidence dropped by 83% (IRR: 017 (0.16-0.18); p < 0.001) in children under 5 year and by 78% (IRR: 022 (0.22-0.23); p < 0.001) in persons aged >= 5 years from the pre-intervention to the intervention period. In the IRS arm malaria incidence dropped by 47% (IRR: 0.53 (0.51, 0.56); p < 0.001) in children under 5 years and by 71% 0.29 (0.28, 0.30); p < 0.001) in persons aged >= 5 years. A drastic drop occurred immediately after the intervention after which cases slowly increased in both arms. Malaria test positivity rate (TPR) dropped at a rate of 21 (p = 0.003) percentage points per 1000 persons in the MDA + IRS arm compared to the IRS arm. There was a mean decrease of 60 (p-value, 0.040) malaria cases among children under five years and a mean decrease in TPR of 1616 (p-value, 0.001) in the MDA + IRS arm compared to IRS arm.Interpretation MDA significantly reduced malaria burden among children < 5 years however the duration of this impact needs to be further investigated.
Language
English
Source (journal)
Malaria journal. - London
Publication
London : 2023
ISSN
1475-2875
DOI
10.1186/S12936-023-04799-6
Volume/pages
22 :1 (2023) , p. 1-9
Article Reference
378
ISI
001124809100003
Pubmed ID
38093286
Full text (Publisher's DOI)
Full text (open access)
UAntwerpen
Faculty/Department
Research group
Publication type
Subject
Affiliation
Publications with a UAntwerp address
External links
Web of Science
Record
Identifier
Creation 09.01.2024
Last edited 11.01.2024
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