TY - JOUR
T1 - The Impact of Multiple Rounds of Indoor Residual Spraying on Malaria Incidence and Hemoglobin Levels in a High-Transmission Setting
AU - Zinszer, Kate
AU - Charland, Katia
AU - Vahey, Sarah
AU - Jahagirdar, Deepa
AU - Rek, John C.
AU - Arinaitwe, Emmanuel
AU - Nankabirwa, Joaniter
AU - Morrison, Kathryn
AU - Sadoine, Margaux L.
AU - Tutt-Guérette, Marc Antoine
AU - Staedke, Sarah
AU - Kamya, Moses R.
AU - Greenhouse, Bryan
AU - Rodriguez-Barraquer, Isabel
AU - Dorsey, Grant
PY - 2019/12/1
Y1 - 2019/12/1
N2 - Indoor residual spraying (IRS) is widely used as a vector control measure, although there are conflicting findings of its effectiveness in reducing malaria incidence. The objective of this study was to estimate the effect of multiple IRS rounds on malaria incidence and hemoglobin levels in a cohort of children in rural southeastern Uganda. Methods: The study was based upon a dynamic cohort of children aged 0.5-10 years enrolled from August 2011 to June 2017 in Nagongera Subcounty. Confirmed malaria infections and hemoglobin levels were recorded over time for each participant. After each of 4 rounds of IRS, malaria incidence, hemoglobin levels, and parasite density were evaluated and compared with pre-IRS levels. Analyses were carried out at the participant level while accounting for repeated measures and clustering by household. Results: Incidence rate ratios comparing post-IRS to pre-IRS incidence rates for age groups 0-3, 3-5, and 5-11 were 0.108 (95% confidence interval [CI],. 078-.149), 0.173 (95% CI,. 136-.222), and 0.226 (95% CI,. 187-.274), respectively. The mean hemoglobin levels significantly increased from 11.01 (pre-IRS) to 12.18 g/dL (post-IRS). Conclusions: Our study supports the policy recommendation of IRS usage in a stable and perennial transmission area to rapidly reduce malaria transmission.
AB - Indoor residual spraying (IRS) is widely used as a vector control measure, although there are conflicting findings of its effectiveness in reducing malaria incidence. The objective of this study was to estimate the effect of multiple IRS rounds on malaria incidence and hemoglobin levels in a cohort of children in rural southeastern Uganda. Methods: The study was based upon a dynamic cohort of children aged 0.5-10 years enrolled from August 2011 to June 2017 in Nagongera Subcounty. Confirmed malaria infections and hemoglobin levels were recorded over time for each participant. After each of 4 rounds of IRS, malaria incidence, hemoglobin levels, and parasite density were evaluated and compared with pre-IRS levels. Analyses were carried out at the participant level while accounting for repeated measures and clustering by household. Results: Incidence rate ratios comparing post-IRS to pre-IRS incidence rates for age groups 0-3, 3-5, and 5-11 were 0.108 (95% confidence interval [CI],. 078-.149), 0.173 (95% CI,. 136-.222), and 0.226 (95% CI,. 187-.274), respectively. The mean hemoglobin levels significantly increased from 11.01 (pre-IRS) to 12.18 g/dL (post-IRS). Conclusions: Our study supports the policy recommendation of IRS usage in a stable and perennial transmission area to rapidly reduce malaria transmission.
KW - children
KW - hemoglobin
KW - indoor residual spraying
KW - malaria
KW - Uganda
U2 - 10.1093/infdis/jiz453
DO - 10.1093/infdis/jiz453
M3 - Article
SN - 0022-3166
VL - 149
SP - 304
EP - 312
JO - Journal of Nutrition
JF - Journal of Nutrition
ER -
