Abstract
BackgroundSince 2008 indoor residual spraying (IRS) has become one of the interventions for malaria control in Ghana. Key partners in the scale-up of IRS have been the US President’s Malaria Initiative (PMI) and AngloGold Ashanti (AGA). This study was designed to assess the impact of IRS on malaria parasitaemia among children less than 5 years-old in Bunkpurugu-Yunyoo, one of PMI-sponsored districts in northern Ghana, where rates of parasitaemia significantly exceeded the national average.MethodsTwo pre-IRS cross-sectional surveys using microscopy were conducted in November 2010 and April 2011 to provide baseline estimates of malaria parasitaemia for the high and low transmission seasons, respectively. IRS for the entire district was conducted in May/June to coincide with the beginning of the rains. Alpha-cypermethrin was used in 2011 and 2012, and changed to pirimiphos-methyl in 2013 and 2014 following declining susceptibility of local vectors to pyrethroids. Post-IRS cross-sectional surveys were conducted between 2011 and 2014 to provide estimates for the end of high (2011–2014) and the end of low (2012–2013) transmission seasons.ResultsThe end of high transmission season prevalence of asexual parasitaemia declined marginally from 52.4% (95% CI: 50.0–54.7%) to 47.7% (95% CI: 45.5–49.9%) following 2 years of IRS with alpha-cypermethrin. Prevalence declined substantially to 20.6% (95% CI: 18.4–22.9%) following one year of IRS with pirimiphos-methyl.ConclusionsThe use of a more efficacious insecticide for IRS can reduce malaria parasitaemia among children less than 5 years-old in northern Ghana.
Highlights
Since 2008 indoor residual spraying (IRS) has become one of the interventions for malaria control in Ghana
Several studies in sub-Saharan Africa and Asia have shown that IRS is associated with reduced malaria transmission in young children and protects all age groups, in combination with long-lasting insecticidal nets (LLINs) and other control interventions, such as artemisinin-based combination therapy (ACT) and intermittent preventive treatment of pregnant women
The proportion of children reported to have taken an antimalarial within two weeks prior to each survey conducted at the end of the high transmission season ranged between 2.4–13.8% (Table 1)
Summary
Since 2008 indoor residual spraying (IRS) has become one of the interventions for malaria control in Ghana. Key partners in the scale-up of IRS have been the US President’s Malaria Initiative (PMI) and AngloGold Ashanti (AGA). Indoor residual spraying (IRS) remains one of the two main vector control interventions for malaria prevention, along with long-lasting insecticidal nets (LLINs). Several studies in sub-Saharan Africa and Asia have shown that IRS is associated with reduced malaria transmission in young children and protects all age groups, in combination with LLINs and other control interventions, such as artemisinin-based combination therapy (ACT) and intermittent preventive treatment of pregnant women (IPTp) [1,2,3,4,5,6,7,8,9,10,11,12]. Key partners in the scale-up exercise were the US President’s Malaria Initiative (PMI) and AngloGold Ashanti (AGA) [14]. The US PMI’s IRS program focused on selected districts in the northern savannah zone whilst AGA’s program focused on selected districts in the northern
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