The Combination of Indoor Residual Spraying and Insecticide-Treated Nets Provides Added Protection against Malaria Compared with Insecticide-Treated Nets Alone

Mary J. Hamel Kenya Medical Research Center/Centers for Disease Control and Prevention Research and Public Health Collaboration Kisumu, Kenya; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia

Search for other papers by Mary J. Hamel in
Current site
Google Scholar
PubMed
Close
,
Peter Otieno Kenya Medical Research Center/Centers for Disease Control and Prevention Research and Public Health Collaboration Kisumu, Kenya; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia

Search for other papers by Peter Otieno in
Current site
Google Scholar
PubMed
Close
,
Nabie Bayoh Kenya Medical Research Center/Centers for Disease Control and Prevention Research and Public Health Collaboration Kisumu, Kenya; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia

Search for other papers by Nabie Bayoh in
Current site
Google Scholar
PubMed
Close
,
Simon Kariuki Kenya Medical Research Center/Centers for Disease Control and Prevention Research and Public Health Collaboration Kisumu, Kenya; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia

Search for other papers by Simon Kariuki in
Current site
Google Scholar
PubMed
Close
,
Vincent Were Kenya Medical Research Center/Centers for Disease Control and Prevention Research and Public Health Collaboration Kisumu, Kenya; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia

Search for other papers by Vincent Were in
Current site
Google Scholar
PubMed
Close
,
Doris Marwanga Kenya Medical Research Center/Centers for Disease Control and Prevention Research and Public Health Collaboration Kisumu, Kenya; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia

Search for other papers by Doris Marwanga in
Current site
Google Scholar
PubMed
Close
,
Kayla F. Laserson Kenya Medical Research Center/Centers for Disease Control and Prevention Research and Public Health Collaboration Kisumu, Kenya; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia

Search for other papers by Kayla F. Laserson in
Current site
Google Scholar
PubMed
Close
,
John Williamson Kenya Medical Research Center/Centers for Disease Control and Prevention Research and Public Health Collaboration Kisumu, Kenya; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia

Search for other papers by John Williamson in
Current site
Google Scholar
PubMed
Close
,
Laurence Slutsker Kenya Medical Research Center/Centers for Disease Control and Prevention Research and Public Health Collaboration Kisumu, Kenya; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia

Search for other papers by Laurence Slutsker in
Current site
Google Scholar
PubMed
Close
, and
John Gimnig Kenya Medical Research Center/Centers for Disease Control and Prevention Research and Public Health Collaboration Kisumu, Kenya; Division of Parasitic Diseases and Malaria, Centers for Disease Control and Prevention, Atlanta, Georgia

Search for other papers by John Gimnig in
Current site
Google Scholar
PubMed
Close
Restricted access

Both insecticide-treated bed nets (ITNs) and indoor residual spraying (IRS) reduce malaria in high malaria transmission areas.– The combined effect of these interventions is unknown. We conducted a non-randomized prospective cohort study to determine protective efficacy of IRS with ITNs (ITN + IRS) compared with ITNs alone (ITN only) in preventing Plasmodium falciparum parasitemia. At baseline, participants provided blood samples for malaria smears, were presumptively treated for malaria, and received ITNs. Blood smears were made monthly and at sick visits. In total, 1,804 participants were enrolled. Incidence of P. falciparum parasitemia in the ITN + IRS and ITN only groups was 18 and 44 infections per 100 persons-years at risk, respectively (unadjusted rate ratio = 0.41; 95% confidence interval [CI] = 0.31–0.56). Adjusted protective efficacy of ITN + IRS compared with ITN only was 62% (95% CI = 0.50–0.72). The combination of IRS and ITN might be a feasible strategy to further reduce malaria transmission in areas of persistent perennial malaria transmission.

Author Notes

*Address correspondence to Mary J. Hamel, Centers for Disease Control and Prevention, 1600 Clifton Rd, Atlanta, GA 30301. E-mail: mhamel@cdc.gov

Financial support: This work was supported by the Bill and Melinda Gates Foundation through the Malaria Transmission Consortium (Grant 45114).

Authors' addresses: Mary J. Hamel, Laurence Slutsker, and John Gimnig, Centers for Disease Control and Prevention, Atlanta, GA, E-mails: mhamel@cdc.gov, lslutsker@cdc.gov, and jgimnig@cdc.gov. Peter Otieno, Nabie Bayoh, Simon Kariuki, Vincent Were, Doris Marwanga, Kayla F. Laserson, and John Williamson, Kenya Medical Research Institute/Centers for Disease Control and Prevention Research and Public Health Collaboration, Kisumu, Kenya, E-mails: potieno@ke.cdc.gov, nbayoh@ke.cdc.gov, skariuki@ke.cdc.gov, vwere@ke.cdc.gov, dmarwanga@ke.cdc.gov, klaserson@ke.cdc.gov, and jwilliamson@ke.cdc.gov.

  • 1.

    Lengeler C, 2004. Insecticide-treated bed nets and curtains for preventing malaria. Cochrane Database Syst Rev 2: CD000363.

  • 2.

    Pluess B, Tanser FC, Lengeler C, Sharp BL, 2010. Indoor residual spraying for preventing malaria. Cochrane Database Syst Rev 4: CD006657.

  • 3.

    Payne D, Grab B, Fontaine RE, Hempel JH, 1976. Impact of control measures on malaria transmission and general mortality. Bull World Health Organ 54: 369377.

    • Search Google Scholar
    • Export Citation
  • 4.

    World Health Organization, 2010. Malaria Key Facts Sheet. Available at: http://www.who.int/mediacentre/factsheets/fs094/en/. Accessed May 25, 2011.

    • Search Google Scholar
    • Export Citation
  • 5.

    United Nations, 2009. The Millenium Development Goals Report. New York, NY: United Nations, 60.

  • 6.

    Kleinschmidt I, Schwabe C, Shiva M, Segura JL, Sima V, Mabunda SJ, Coleman M, 2009. Combining indoor residual spraying and insecticide-treated net interventions. Am J Trop Med Hyg 81: 519524.

    • Search Google Scholar
    • Export Citation
  • 7.

    O'Meara WP, Bejon P, Mwangi TW, Okiro EA, Peshu N, Snow RW, Newton CR, Marsh K, 2008. Effect of a fall in malaria transmission on morbidity and mortality in Kilifi, Kenya. Lancet 372: 15551562.

    • Search Google Scholar
    • Export Citation
  • 8.

    Curtis CF, Mnzava AE, 2000. Comparison of house spraying and insecticide-treated nets for malaria control. Bull World Health Organ 78: 13891400.

    • Search Google Scholar
    • Export Citation
  • 9.

    WHOPES, 2007. Report of the 10th WHOPES Working Group Meeting: Review of Spinosad 0.5% GR & 12% SC, Lambda-Cyhalothrin 10% CS, K-O TAB 1-2-3, Interceptor. Geneva, Switzerland: World Health Organization.

    • Search Google Scholar
    • Export Citation
  • 10.

    Misra SP, Webber R, Lines J, Jaffar S, Bradley DJ, 1999. Malaria control: bednets or spraying? Spray versus treated nets using deltamethrin—a community randomized trial in India. Trans R Soc Trop Med Hyg 93: 456457.

    • Search Google Scholar
    • Export Citation
  • 11.

    Rowland M, 1999. Malaria control: bednets or spraying? Malaria control in the Afghan refugee camps of western Pakistan. Trans R Soc Trop Med Hyg 93: 458459.

    • Search Google Scholar
    • Export Citation
  • 12.

    Malaria Atlas Project, 2010. Malaria Atlas Project. Available at: http://www.map.ox.ac.uk. Accessed May 25, 2011.

  • 13.

    Bayoh MN, Mathias DK, Odiere MR, Mutuku FM, Kamau L, Gimnig JE, Vulule JM, Hawley WA, Hamel MJ, Walker ED, 2010. Anopheles gambiae: historical population decline associated with regional distribution of insecticide-treated bed nets in western Nyanza Province, Kenya. Malar J 9: 62.

    • Search Google Scholar
    • Export Citation
  • 14.

    Phillips-Howard PA, Nahlen BL, Kolczak MS, Hightower AW, ter Kuile FO, Alaii JA, Gimnig JE, Arudo J, Vulule JM, Odhacha A, Kachur SP, Schoute E, Rosen DH, Sexton JD, Oloo AJ, Hawley WA, 2003. Efficacy of permethrin-treated bed nets in the prevention of mortality in young children in an area of high perennial malaria transmission in western Kenya. Am J Trop Med Hyg 68: 2329.

    • Search Google Scholar
    • Export Citation
  • 15.

    Phillips-Howard PA, Nahlen B, Alaii JA, ter Kuile FO, Gimnig JE, Terlouw DJ, Kachur SP, Hightower AW, Lal AA, Schoute E, Oloo AJ, Hawley WA, 2003. The efficacy of permethrin-treated bed nets on child mortality and morbidity in western Kenya I. Development of infrastructure and description of study site. Am J Trop Med Hyg 68 (4 Suppl): 39.

    • Search Google Scholar
    • Export Citation
  • 16.

    World Health Organization, 2000. Report of the 4th WHOPES Working Group Meeting. Geneva, Switzerland: World Health Organization.

  • 17.

    Gillies MT, Coetzee M, 1987. A Supplement to the Anophelinae of Africa South of the Sahara: South African Institute for Medical Research, Publication 55. Johannesburg, South Africa: South African Institute of Medical Research.

    • Search Google Scholar
    • Export Citation
  • 18.

    Gillies MT, De Meillon B, 1968. The Anophelinae of Africa, South of the Sahara. Johannesburg, South Africa: South African Institute of Medical Research.

    • Search Google Scholar
    • Export Citation
  • 19.

    Scott JA, Brogdon WG, Collins FH, 1993. Identification of single specimens of the Anopheles gambiae complex by the polymerase chain reaction. Am J Trop Med Hyg 49: 520529.

    • Search Google Scholar
    • Export Citation
  • 20.

    World Health Organization, 1975. Manual on Practical Entomology in Malaria. Part II. Methods and Techniques. Geneva, Switzerland: World Health Organization.

    • Search Google Scholar
    • Export Citation
  • 21.

    Ezzet F, van Vugt M, Nosten F, Looareesuwan S, White NJ, 2000. Pharmacokinetics and pharmacodynamics of lumefantrine (benflumetol) in acute falciparum malaria. Antimicrob Agents Chemother 44: 697704.

    • Search Google Scholar
    • Export Citation
  • 22.

    Oyewole IO, Awolola TS, Ibidapo CA, Oduola AO, Okwa OO, Obansa JA, 2007. Behaviour and population dynamics of the major anopheline vectors in a malaria endemic area in southern Nigeria. J Vector Borne Dis 44: 5664.

    • Search Google Scholar
    • Export Citation
  • 23.

    Cuamba N, Morgan JC, Irving H, Steven A, Wondji CS, 2010. High level of pyrethroid resistance in an Anopheles funestus population of the Chokwe District in Mozambique. PLoS One 5: e11010.

    • Search Google Scholar
    • Export Citation
  • 24.

    Morgan JC, Irving H, Okedi LM, Steven A, Wondji CS, 2010. Pyrethroid resistance in an Anopheles funestus population from Uganda. PLoS One 5: e11872.

  • 25.

    Ranson H, N'Guessan R, Lines J, Moiroux N, Nkuni Z, Corbel V, 2011. Pyrethroid resistance in African anopheline mosquitoes: what are the implications for malaria control? Trends Parasitol 27: 9198.

    • Search Google Scholar
    • Export Citation
  • 26.

    Vulule JM, Beach RF, Atieli FK, Roberts JM, Mount DL, Mwangi RW, 1994. Reduced susceptibility of Anopheles gambiae to permethrin associated with the use of permethrin-impregnated bednets and curtains in Kenya. Med Vet Entomol 8: 7175.

    • Search Google Scholar
    • Export Citation
  • 27.

    Sharp BL, Ridl FC, Govender D, Kuklinski J, Kleinschmidt I, 2007. Malaria vector control by indoor residual insecticide spraying on the tropical island of Bioko, Equatorial Guinea. Malar J 6: 52.

    • Search Google Scholar
    • Export Citation
  • 28.

    Hargreaves K, Koekemoer LL, Brooke BD, Hunt RH, Mthembu J, Coetzee M, 2000. Anopheles funestus resistant to pyrethroid insecticides in South Africa. Med Vet Entomol 14: 181189.

    • Search Google Scholar
    • Export Citation
  • 29.

    Kleinschmidt I, Schwabe C, Benavente L, Torrez M, Ridl FC, Segura JL, Ehmer P, Nchama GN, 2009. Marked increase in child survival after four years of intensive malaria control. Am J Trop Med Hyg 80: 882888.

    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 53 53 13
Full Text Views 610 158 2
PDF Downloads 243 57 1
 
Membership Banner
 
 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save