title: The effect of indoor residual spraying on malaria and anemia in a high-transmission area of northern Uganda.
abstract: Indoor residual spraying (IRS) with insecticide is now recommended for malaria control in high-transmission settings. However, concerns about insecticide resistance have increased. We conducted a cross-sectional household survey in high-transmission northern Uganda in two districts previously sprayed with pyrethroids before documentation of pyrethroid resistance and at least one round of carbamates and in one contiguous district that was not sprayed. Parasitemia prevalence among children < 5 years of age was lower in the two IRS districts compared with the non-sprayed district: 37.0% and 16.7% versus 49.8%, P < 0.001. Anemia prevalence was also significantly lower in the two IRS districts: 38.8% and 36.8% versus 53.0%, P < 0.001. Multivariable Poisson regression models indicated that a child living in a sprayed district had a 46% and 32% lower risk of parasitemia and anemia, respectively, than a child in a non-sprayed district (P < 0.001). Carefully managed IRS can significantly reduce malaria burden in high-transmission settings.
authors: Malaria Branch, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA. LSteinhardt@cdc.gov
authors: Laura C
authors: LC
authors: Steinhardt
authors: Adoke
authors: A
authors: Yeka
authors: Sussann
authors: S
authors: Nasr
authors: Ryan E
authors: RE
authors: Wiegand
authors: Denis
authors: D
authors: Rubahika
authors: Asadu
authors: A
authors: Sserwanga
authors: Humphrey
authors: H
authors: Wanzira
authors: Geoff
authors: G
authors: Lavoy
authors: Moses
authors: M
authors: Kamya
authors: Grant
authors: G
authors: Dorsey
authors: Scott
authors: S
authors: Filler
mesh_terms: D000740:Anemia / Q000453:epidemiology*; D002219:Carbamates / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005191:Family Characteristics; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007305:Insecticide Resistance / Q000187:drug effects; D007306:Insecticides / Q000494:pharmacology*; D008288:Malaria / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D008297:Male; D009032:Mosquito Control / Q000379:methods*; D018512:Parasitemia / Q000453:epidemiology; D011722:Pyrethrins / Q000494:pharmacology*; D014454:Uganda / Q000453:epidemiology
chemical_list: D002219:Carbamates; D007306:Insecticides; D011722:Pyrethrins