title: Targeting indoor residual spraying for malaria using epidemiological data: a case study of the Zambia experience.
abstract: BACKGROUND
  In Zambia and other sub-Saharan African countries affected by ongoing malaria transmission, indoor residual spraying (IRS) for malaria prevention has typically been implemented over large areas, e.g., district-wide, and targeted to peri-urban areas. However, there is a recent shift in some countries, including Zambia, towards the adoption of a more strategic and targeted IRS approach, in coordination with increased emphasis on universal coverage of long-lasting insecticidal nets (LLINs) and effective insecticide resistance management. A true targeted approach would deliver IRS to sub-district areas identified as high-risk, with the goal of maximizing the prevention of malaria cases and deaths.
  
  
  RESULTS
  Together with the Government of the Republic of Zambia, a new methodology was developed applying geographic information systems and satellite imagery to support a targeted IRS campaign during the 2014 spray season using health management information system data.
  
  
  CONCLUSIONS
  This case study focuses on the developed methodology while also highlighting the significant research gaps which must be filled to guide countries on the most effective strategy for IRS targeting in the context of universal LLIN coverage and evolving insecticide resistance.
authors.affiliation: John Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. jpinchoff@gmail.com.
authors.forename: Jessie
authors.initials: J
authors.lastname: Pinchoff
authors.affiliation: Akros, Cresta Golfview Grounds, Great East Road, Unit 5, Lusaka, Zambia. dlarsen@akros.com.|Department of Public Health, Food Studies and Nutrition, Syracuse University, Syracuse, NY, USA. dlarsen@akros.com.
authors.forename: David A
authors.initials: DA
authors.lastname: Larsen
authors.affiliation: Akros, Cresta Golfview Grounds, Great East Road, Unit 5, Lusaka, Zambia. silvia.renn@gmail.com.
authors.forename: Silvia
authors.initials: S
authors.lastname: Renn
authors.affiliation: Akros, Cresta Golfview Grounds, Great East Road, Unit 5, Lusaka, Zambia. dpollard@akros.com.
authors.forename: Derek
authors.initials: D
authors.lastname: Pollard
authors.affiliation: US President's Malaria Initiative, Washington, DC, USA. cfornadel@usaid.gov.
authors.forename: Christen
authors.initials: C
authors.lastname: Fornadel
authors.affiliation: Division of Parasitic Diseases and Malaria, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, USA. mmaire@cdc.gov.
authors.forename: Mark
authors.initials: M
authors.lastname: Maire
authors.affiliation: National Malaria Control Centre, Ministry of Health, Government of the Republic of Zambia, Lusaka, Zambia. chsikaala@yahoo.com.
authors.forename: Chadwick
authors.initials: C
authors.lastname: Sikaala
authors.affiliation: US President's Malaria Initiative, Washington, DC, USA. csinyangwe@usaid.gov.
authors.forename: Chomba
authors.initials: C
authors.lastname: Sinyangwe
authors.affiliation: Akros, Cresta Golfview Grounds, Great East Road, Unit 5, Lusaka, Zambia. bwinters@akros.com.|University of Montana School of Public and Community Health Sciences, Missoula, MT, USA. bwinters@akros.com.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Winters
authors.affiliation: Akros, Cresta Golfview Grounds, Great East Road, Unit 5, Lusaka, Zambia. dbridges@akros.com.
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Bridges
authors.affiliation: Akros, Cresta Golfview Grounds, Great East Road, Unit 5, Lusaka, Zambia. awinters@akros.com.|University of Montana School of Public and Community Health Sciences, Missoula, MT, USA. awinters@akros.com.
authors.forename: Anna M
authors.initials: AM
authors.lastname: Winters
mesh_terms: D000818:Animals; D000852:Anopheles / Q000187:drug effects / Q000472:pathogenicity; D040362:Geographic Information Systems; D006801:Humans; D007303:Insect Vectors / Q000187:drug effects / Q000472:pathogenicity; D057148:Insecticide-Treated Bednets; D007306:Insecticides / Q000008:administration & dosage*; D008288:Malaria / Q000517:prevention & control*; D009032:Mosquito Control / Q000379:methods*; D015024:Zambia
chemical_list: D007306:Insecticides