Impact of four years of annually repeated indoor residual spraying (IRS) with Actellic 300CS on routinely reported malaria cases in an agricultural setting in Malawi

PLOS Glob Public Health. 2024 Apr 24;4(4):e0002264. doi: 10.1371/journal.pgph.0002264. eCollection 2024.

Abstract

Indoor residual spraying (IRS) is one of the main vector control tools used in malaria prevention. This study evaluates IRS in the context of a privately run campaign conducted across a low-lying, irrigated, sugarcane estate from Illovo Sugar, in the Chikwawa district of Malawi. The effect of Actellic 300CS annual spraying over four years (2015-2018) was assessed using a negative binomial mixed effects model, in an area where pyrethroid resistance has previously been identified. With an unadjusted incidence rate ratio (IRR) of 0.38 (95% CI: 0.32-0.45) and an adjusted IRR of 0.50 (95% CI: 0.42-0.59), IRS has significantly contributed to a reduction in case incidence rates at Illovo, as compared to control clinics and time points outside of the six month protective period. This study shows how the consistency of a privately run IRS campaign can improve the health of employees. More research is needed on the duration of protection and optimal timing of IRS programmes.

Grants and funding

This work was funded by the Medical Research Council through the Medical Research Council Doctoral Training Partnership (1965090) awarded to Remy Hoek Spaans through the Liverpool School of Tropical Medicine and Lancaster University. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.