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Epstein, Adrienne, Maiteki-Sebuguzi, Catherine, Namuganga, Jane F., Nankabirwa, Joaniter I., Gonahasa, Samuel, Opigo, Jimmy, Staedke, Sarah G., Rutazaana, Damian, Arinaitwe, Emmanuel, Kamya, Moses R., Bhatt, Samir, Rodrı´guez-Barraquer, Isabel, Greenhouse, Bryan, Donnelly, Martin 
ORCID: https://orcid.org/0000-0001-5218-1497 and Dorsey, Grant
(2022)
'Resurgence of malaria in Uganda despite sustained indoor residual spraying and repeated long lasting insecticidal net distributions'. PLOS Global Public Health, Vol 2, Issue 9, e0000676.
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Resurgence of malaria in Uganda despite sustained indoor residual spraying and repeated long lasting insecticidal net distributions.pdf - Published Version Available under License Creative Commons Attribution. Download (1MB) | Preview |
Abstract
Five years of sustained indoor residual spraying (IRS) of insecticide from 2014 to 2019, first using a carbamate followed by an organophosphate, was associated with a marked reduction in the incidence of malaria in five districts of Uganda. We assessed changes in malaria incidence over an additional 21 months, corresponding to a change in IRS formulations
using clothianidin with and without deltamethrin. Using enhanced health facility surveillance data, our objectives were to 1) estimate the impact of IRS on monthly malaria case counts at five surveillance sites over a 6.75 year period, and 2) compare monthly case counts at five facilities receiving IRS to ten facilities in neighboring districts not receiving IRS. For both
objectives, we specified mixed effects negative binomial regression models with random intercepts for surveillance site adjusting for rainfall, season, care-seeking, and malaria diagnostic. Following the implementation of IRS, cases were 84% lower in years 4–5 (adjusted
incidence rate ratio [aIRR] = 0.16, 95% CI 0.12–0.22), 43% lower in year 6 (aIRR = 0.57, 95% CI 0.44–0.74), and 39% higher in the first 9 months of year 7 (aIRR = 1.39, 95% CI 0.97–1.97) compared to pre-IRS levels. Cases were 67% lower in IRS sites than non-IRS sites in year 6 (aIRR = 0.33, 95% CI 0.17–0.63) but 38% higher in the first 9 months of year 7 (aIRR = 1.38, 95% CI 0.90–2.11). We observed a resurgence in malaria to pre-IRS levels
despite sustained IRS. The timing of this resurgence corresponded to a change of active ingredient. Further research is needed to determine causality.
| Item Type: | Article |
|---|---|
| Subjects: | QX Parasitology > Insects. Other Parasites > QX 600 Insect control. Tick control WA Public Health > Preventive Medicine > WA 110 Prevention and control of communicable diseases. Transmission of infectious diseases WA Public Health > WA 20.5 Research (General) WA Public Health > Preventive Medicine > WA 240 Disinfection. Disinfestation. Pesticides (including diseases caused by) WC Communicable Diseases > Tropical and Parasitic Diseases > WC 750 Malaria WC Communicable Diseases > Tropical and Parasitic Diseases > WC 765 Prevention and control |
| Faculty: Department: | Biological Sciences > Vector Biology Department |
| Digital Object Identifer (DOI): | https://doi.org/10.1371/journal.pgph.0000676 |
| Depositing User: | Luciene Salas Jennings |
| Date Deposited: | 04 Oct 2022 12:27 |
| Last Modified: | 04 Oct 2022 12:27 |
| URI: | https://archive.lstmed.ac.uk/id/eprint/21220 |
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