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Combining Indoor Residual Spraying and Insecticide-Treated Net Interventions

2009; American Society of Tropical Medicine and Hygiene; Volume: 81; Issue: 3 Linguagem: Inglês

10.4269/ajtmh.2009.81.519

1476-1645

Immo Kleinschmidt, Christopher Schwabe, Murugasampilay Shiva, José Luis Peña Segura, Victor Sima, Samuel Mabunda, Michael M. Coleman,

Insect Pest Control Strategies

Does scaling up of malaria control by combining indoor residual spraying (IRS) and long-lasting insecticidal nets (LLIN) enhance protection to populations? Results from a literature search and from recent household surveys in Bioko, Equatorial Guinea, and Zambezia, Mozambique are presented. Five out of eight previous studies reported a reduced risk of infection in those protected by both interventions compared with one intervention alone. Surveys in Bioko and Zambezia showed strong evidence of a protective effect of IRS combined with nets relative to IRS alone (odds ratio [OR] = 0.71, 95% confidence interval [CI] = 0.59-0.86 for Bioko, and OR = 0.63, 95% CI = 0.50-0.79, for Zambezia). The effect of both interventions combined, compared with those who had neither, was OR = 0.46, (95% CI = 0.76-0.81) in Bioko and 0.34 (95% CI = 0.21-0.56) in Zambezia. Although the effects of confounding cannot be excluded, these results provide encouragement that the additional resources for combining IRS and LLIN are justified.