Open-source satellite enumeration to map households: planning and targeting indoor residual spraying for malaria

BACKGROUND: Defining the number and location of sprayable structures (houses) is foundational to plan and monitor indoor residual spray (IRS) implementation, a primary intervention used to control the transmission of malaria. Only by mapping the location and type of all sprayable structures can IRS operations be planned, estimates of spray coverage determined, and targeted delivery of IRS to specific locations be achieved. Previously, field-based enumeration has been used to guide IRS campaigns, however, this approach is costly, time-consuming and difficult to scale. As a result, field-based enumeration typically fails to map all structures in a given area, making estimations less reliable and reducing the enumerated coverage. METHODS: Using open source satellite imagery and Geographic Information System software, satellite enumeration was conducted to guide IRS operations in 15 districts (91,302 km(2)) in northern Zambia during the 2014 spray season. Cost of satellite enumeration was compared to standard enumeration. Enumerated households were sampled to estimate sprayable surface area and wall type from the satellite enumeration using linear and logistic regression, respectively. RESULTS: In comparison to the traditional field-based enumeration procedure, satellite-based enumeration was 22 times faster, and 10 times less costly. An estimated 98 % of the satellite enumerated buildings correctly classified roof type. Predicted surface area of each household correlated at a value of 0.91 with measured surface area of each household. CONCLUSION: For IRS campaigns, high quality and high coverage enumeration data aid in planning, through informed insecticide procurement. Through the identification of geographical areas and populations to target, enumeration data guide operations and assist monitoring and evaluation of IRS through the unbiased estimation of coverage achieved. Satellite enumeration represents a quick, cheap and accurate system to provide these data, and has potential applications beyond IRS for delivery of other targeted or non-targeted interventions (e.g. net distributions, mass drug administration, immunization campaigns, or even sampling frames for field studies).