Effects and factors associated with indoor residual spraying with Actellic 300 CS on malaria morbidity in Lira District, Northern Uganda
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Date
2019
Journal Title
Journal ISSN
Volume Title
Publisher
Malaria Journal
Abstract
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
Description
Keywords
Malaria, Indoor residual spraying (IRS), Morbidity trends, Percentage point (pp), Test positivity rate (TPR)
Citation
Tugume, A., Muneza, F., Oporia, F., Kiconco, A., Kihembo, C., Kisakye, A. N., ... & Yeka, A. (2019). Effects and factors associated with indoor residual spraying with Actellic 300 CS on malaria morbidity in Lira District, Northern Uganda. Malaria Journal, 18(1), 1-10.https://doi.org/10.1186/s12936-019-2681-6