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Assessing the effect of indoor residual spraying (IRS) on malaria morbidity in Northern Uganda: a before and after study

BACKGROUND: Indoor residual spraying (IRS) is known to reduce malaria transmission. In northern Uganda, a high endemic area, IRS has been implemented since 2006. Limited data however, exists on the effect of IRS on the malaria burden. This study sought to assess the effect of IRS on malaria morbidit...

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Autores principales: Tukei, Betty Bawuba, Beke, Andy, Lamadrid-Figueroa, Héctor
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5209922/
https://www.ncbi.nlm.nih.gov/pubmed/28049475
http://dx.doi.org/10.1186/s12936-016-1652-4
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author Tukei, Betty Bawuba
Beke, Andy
Lamadrid-Figueroa, Héctor
author_facet Tukei, Betty Bawuba
Beke, Andy
Lamadrid-Figueroa, Héctor
author_sort Tukei, Betty Bawuba
collection PubMed
description BACKGROUND: Indoor residual spraying (IRS) is known to reduce malaria transmission. In northern Uganda, a high endemic area, IRS has been implemented since 2006. Limited data however, exists on the effect of IRS on the malaria burden. This study sought to assess the effect of IRS on malaria morbidity in the high intensity area of northern Uganda. Retrospective routine data from ten health facilities in three districts which had received at least five rounds of IRS in northern Uganda was analysed. The primary outcome of interest was malaria morbidity, measured by the slide positivity rate (SPR). Descriptive statistics were used to describe the malaria morbidity stratified by age and sex. The average change in the malaria morbidity, measured by the SPR was assessed according to time, measured as calendar months. A fixed-effects linear regression model was used which included a polynomial function of time and controlled for malaria seasonality and variations between districts/facilities. RESULTS: The total out-patient department attendance in the ten health facilities for the study period was 2,779,246, of which 736,034 (26.5%) malaria cases were diagnosed with 374,826 (50.9%) cases of under 5 years and an overall SPR of 37.5%. The percentage point (p.p.) changes in SPR according to time measured as calendar months following IRS, revealed a decreasing trend in malaria morbidity in the first 3 months following each round of IRS. The highest percentage point decrease in the SPR was observed in the second month following IRS (9.5 p.p., CI −17.85 to −1.16, p = 0.026), among patients above 5 years. The SPR decline however waned by the fourth month following IRS, with an increase in the SPR of 8.4 p.p. at district level by the sixth month, p = 0.510. CONCLUSION: The study results show that IRS was associated with a significant reduction in malaria morbidity in northern Uganda in the first 3 months following IRS. The malaria reduction however waned by the fourth month following IRS. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12936-016-1652-4) contains supplementary material, which is available to authorized users.
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spelling pubmed-52099222017-01-04 Assessing the effect of indoor residual spraying (IRS) on malaria morbidity in Northern Uganda: a before and after study Tukei, Betty Bawuba Beke, Andy Lamadrid-Figueroa, Héctor Malar J Research BACKGROUND: Indoor residual spraying (IRS) is known to reduce malaria transmission. In northern Uganda, a high endemic area, IRS has been implemented since 2006. Limited data however, exists on the effect of IRS on the malaria burden. This study sought to assess the effect of IRS on malaria morbidity in the high intensity area of northern Uganda. Retrospective routine data from ten health facilities in three districts which had received at least five rounds of IRS in northern Uganda was analysed. The primary outcome of interest was malaria morbidity, measured by the slide positivity rate (SPR). Descriptive statistics were used to describe the malaria morbidity stratified by age and sex. The average change in the malaria morbidity, measured by the SPR was assessed according to time, measured as calendar months. A fixed-effects linear regression model was used which included a polynomial function of time and controlled for malaria seasonality and variations between districts/facilities. RESULTS: The total out-patient department attendance in the ten health facilities for the study period was 2,779,246, of which 736,034 (26.5%) malaria cases were diagnosed with 374,826 (50.9%) cases of under 5 years and an overall SPR of 37.5%. The percentage point (p.p.) changes in SPR according to time measured as calendar months following IRS, revealed a decreasing trend in malaria morbidity in the first 3 months following each round of IRS. The highest percentage point decrease in the SPR was observed in the second month following IRS (9.5 p.p., CI −17.85 to −1.16, p = 0.026), among patients above 5 years. The SPR decline however waned by the fourth month following IRS, with an increase in the SPR of 8.4 p.p. at district level by the sixth month, p = 0.510. CONCLUSION: The study results show that IRS was associated with a significant reduction in malaria morbidity in northern Uganda in the first 3 months following IRS. The malaria reduction however waned by the fourth month following IRS. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12936-016-1652-4) contains supplementary material, which is available to authorized users. BioMed Central 2017-01-03 /pmc/articles/PMC5209922/ /pubmed/28049475 http://dx.doi.org/10.1186/s12936-016-1652-4 Text en © The Author(s) 2017 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Tukei, Betty Bawuba
Beke, Andy
Lamadrid-Figueroa, Héctor
Assessing the effect of indoor residual spraying (IRS) on malaria morbidity in Northern Uganda: a before and after study
title Assessing the effect of indoor residual spraying (IRS) on malaria morbidity in Northern Uganda: a before and after study
title_full Assessing the effect of indoor residual spraying (IRS) on malaria morbidity in Northern Uganda: a before and after study
title_fullStr Assessing the effect of indoor residual spraying (IRS) on malaria morbidity in Northern Uganda: a before and after study
title_full_unstemmed Assessing the effect of indoor residual spraying (IRS) on malaria morbidity in Northern Uganda: a before and after study
title_short Assessing the effect of indoor residual spraying (IRS) on malaria morbidity in Northern Uganda: a before and after study
title_sort assessing the effect of indoor residual spraying (irs) on malaria morbidity in northern uganda: a before and after study
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5209922/
https://www.ncbi.nlm.nih.gov/pubmed/28049475
http://dx.doi.org/10.1186/s12936-016-1652-4
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