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The Bioko Island Malaria Control Project (BIMCP) has carried out intensive interventions since early 2004 to reduce malaria transmission through indoor residual spraying (IRS) and case management. Annual parasite prevalence surveys have been carried out to monitor the effectiveness of the program. Significant overall reductions in prevalence of infection have been observed, with 42% fewer infections occurring in 2006 compared with baseline. Nevertheless, there is evidence of considerable heterogeneity in impact of the intervention. Prevalence of infection was significantly associated with spray status of the child’s house, spray coverage with effective insecticide of the neighborhood of the house, bed net use, and time elapsed since last spray. Careful scheduling of spray coverage is therefore essential to maximize the effectiveness of IRS and to ensure consistent reductions in parasite prevalence. This can only be achieved if comprehensive monitoring systems are in place for both the management and evaluation of the intervention.
Received September 28, 2006. Accepted for publication March 1, 2007.
Acknowledgments: The authors thank Drs. Adel Chaouch, Brian Linder, and Susan Rynard from Marathon Oil Company for their constructive involvement in the execution of the BIMCP and Mr. Jaime Kuklinski and Mr. Ruben Biebeda from One World Development Group for their efficient management of IRS and the spray-information system.
* Address correspondence to Immo Kleinschmidt, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom. E-mail: Immo.Kleinschmidt{at}lshtm.ac.uk
Authors’ addresses: Immo Kleinschmidt, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom, Telephone: +44 20 7612 7872, Fax: +44 20 7636 8739, E-mail: Immo.Kleinschmidt{at}lshtm.ac.uk. Miguel Torrez, Christopher Schwabe, Luis E. Benavente, and David Jituboh, Medical Care Development International, 8401 Colesville Rd., Suite 425, Silver Spring, MD 20910, Telephone: +1 (301) 562-1920, Fax: +1 (301) 562-1921, E-mails: mitorrez{at}mixmail.com, chris{at}schwabe.us, lbenavente{at}mcd.org, and teddyblaze{at}gmail.com. Ishen Seocharan and Brian Sharp, Medical Research Council, 491 Ridge Rd., Over-port, Durban 4091, South Africa, Telephone: +27 31 203 4806, Fax: +27 31 203 4704, E-mails: iseocharan{at}mrc.ac.za and sharpb{at}mrc.ac.za. Gloria Nseng, Ministry of Health and Social Welfare, Malabo, Bioko, Equatorial Guinea, E-mail: glorianseng{at}yahoo.es.
Reprint requests: Immo Kleinschmidt, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom, Telephone: +44 20 7612 7872, Fax: +44 20 7636 8739, e-mail: Immo.Kleinschmidt{at}lshtm.ac.uk.
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