title: Combining indoor residual spraying and insecticide-treated net interventions.
abstract: Does scaling up of malaria control by combining indoor residual spraying (IRS) and long-lasting insecticidal nets (LLIN) enhance protection to populations? Results from a literature search and from recent household surveys in Bioko, Equatorial Guinea, and Zambezia, Mozambique are presented. Five out of eight previous studies reported a reduced risk of infection in those protected by both interventions compared with one intervention alone. Surveys in Bioko and Zambezia showed strong evidence of a protective effect of IRS combined with nets relative to IRS alone (odds ratio [OR] = 0.71, 95% confidence interval [CI] = 0.59-0.86 for Bioko, and OR = 0.63, 95% CI = 0.50-0.79, for Zambezia). The effect of both interventions combined, compared with those who had neither, was OR = 0.46, (95% CI = 0.76-0.81) in Bioko and 0.34 (95% CI = 0.21-0.56) in Zambezia. Although the effects of confounding cannot be excluded, these results provide encouragement that the additional resources for combining IRS and LLIN are justified.
authors.affiliation: London School of Hygiene and Tropical Medicine, London, United Kingdom. Immo.Kleinschmidt@lshtm.ac.uk
authors.forename: Immo
authors.initials: I
authors.lastname: Kleinschmidt
authors.forename: Christopher
authors.initials: C
authors.lastname: Schwabe
authors.forename: Murugasampilay
authors.initials: M
authors.lastname: Shiva
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Segura
authors.forename: Victor
authors.initials: V
authors.lastname: Sima
authors.forename: Samuel Jose Alves
authors.initials: SJ
authors.lastname: Mabunda
authors.forename: Michael
authors.initials: M
authors.lastname: Coleman
mesh_terms: D000818:Animals; D001512:Bedding and Linens; D009033:Culicidae; D016703:Equatorial Guinea; D006801:Humans; D007306:Insecticides; D008288:Malaria / Q000517:prevention & control*; D009032:Mosquito Control / Q000379:methods*; D009073:Mozambique
chemical_list: D007306:Insecticides
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