The impact of stopping and starting indoor residual spraying on malaria burden in Uganda

Jane F. Namuganga, Adrienne Epstein (), Joaniter I. Nankabirwa, Arthur Mpimbaza, Moses Kiggundu, Asadu Sserwanga, James Kapisi, Emmanuel Arinaitwe, Samuel Gonahasa, Jimmy Opigo, Chris Ebong, Sarah G. Staedke, Josephat Shililu, Michael Okia, Damian Rutazaana, Catherine Maiteki-Sebuguzi, Kassahun Belay, Moses R. Kamya, Grant Dorsey and Isabel Rodriguez-Barraquer
Additional contact information
Jane F. Namuganga: Infectious Diseases Research Collaboration
Adrienne Epstein: University of California San Francisco
Joaniter I. Nankabirwa: Infectious Diseases Research Collaboration
Arthur Mpimbaza: Infectious Diseases Research Collaboration
Moses Kiggundu: Infectious Diseases Research Collaboration
Asadu Sserwanga: Infectious Diseases Research Collaboration
James Kapisi: Infectious Diseases Research Collaboration
Emmanuel Arinaitwe: Infectious Diseases Research Collaboration
Samuel Gonahasa: Infectious Diseases Research Collaboration
Jimmy Opigo: Ministry of Health
Chris Ebong: Infectious Diseases Research Collaboration
Sarah G. Staedke: London School of Hygiene and Tropical Medicine
Josephat Shililu: US President’s Malaria Initiative – VectorLink Uganda Project
Michael Okia: US President’s Malaria Initiative – VectorLink Uganda Project
Damian Rutazaana: Ministry of Health
Catherine Maiteki-Sebuguzi: Ministry of Health
Kassahun Belay: US President’s Malaria Initiative, USAID/Uganda Senior Malaria Advisor
Moses R. Kamya: Infectious Diseases Research Collaboration
Grant Dorsey: University of California San Francisco
Isabel Rodriguez-Barraquer: University of California San Francisco

Nature Communications, 2021, vol. 12, issue 1, 1-9

Abstract: Abstract The scale-up of malaria control efforts has led to marked reductions in malaria burden over the past twenty years, but progress has slowed. Implementation of indoor residual spraying (IRS) of insecticide, a proven vector control intervention, has been limited and difficult to sustain partly because questions remain on its added impact over widely accepted interventions such as bed nets. Using data from 14 enhanced surveillance health facilities in Uganda, a country with high bed net coverage yet high malaria burden, we estimate the impact of starting and stopping IRS on changes in malaria incidence. We show that stopping IRS was associated with a 5-fold increase in malaria incidence within 10 months, but reinstating IRS was associated with an over 5-fold decrease within 8 months. In areas where IRS was initiated and sustained, malaria incidence dropped by 85% after year 4. IRS could play a critical role in achieving global malaria targets, particularly in areas where progress has stalled.

Date: 2021
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DOI: 10.1038/s41467-021-22896-5

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