Assessment of added protection conferred by combined use of indoor residual spraying (IRS) and seasonal malaria chemoprevention (SMC) for malaria prevention in Benin
Paper Details
Assessment of added protection conferred by combined use of indoor residual spraying (IRS) and seasonal malaria chemoprevention (SMC) for malaria prevention in Benin
Abstract
Malaria is endemic in Benin with seasonal and spatial variation in intensity. Insecticide treated Net (ITN) is a major prevention tool which is deployed nationwide. Other malaria prevention interventions such as seasonal malaria chemoprevention (SMC) and indoor residual spraying (IRS) are also being implemented as complementary measures, either alone or in combination in high transmission health zones in northern Benin. This study aims to provide a precursory retrospective analysis of routine health facility data collected for two consecutive years comparing the cumulative malaria incidence in sites that received IRS alone and IRS + SMC with control sites that did not receive IRS or SMC. Three Health Zones (HZs) comprising 9 districts were used in the study analysis. In 2019, the HZs of Djougou-Copargo-Ouaké (DCO) and Kandi-Gogounou-Ségbana (KGS) both received IRS only. In 2020, KGS HZ received SMC in addition to IRS. The control HZ was Natitingou-Toukountouna-Boukoumbé (NTB) which did neither receive IRS nor SMC. Routine monthly malaria cases from the HZ information system were analyzed for incidence trends. The cumulative incidence (new cases/HZ population at-risk/year) was calculated for the 3 HZs. An unadjusted incidence rate ratio (IRR: incidence of IRS+/- SMC HZ over control HZ) was calculated in R using rate ratio test package. In 2019, similar cumulative malaria incidence in both HZs which was 322 cases/1000 in DCO ZS and 339 cases/1000 in KGS HZ against 420 cases/1000 in the control (NTB HZ). Moreover, in 2020, the number of new malaria cases avoided attributable to the various interventions is estimated at 104.62‰ in the IRS HZ (DCO) and 184.13‰ in the IRS + SMC HZ (KGS) which represents a reduction of 24.72% and 43.52% respectively compared to the control. While in this limited analysis, IRS +/- SMC HZ had lower malaria incidence than control HZ, future well-designed prospective multi-country studies in different transmission settings that address the question of whether a combined use of SMC and IRS provides additional protection are needed.
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Cyriaque Affoukou, Rock Aïkpon, Innocent Djègbè, Georgia Damien, Géraud Padonou, Badirou Aguemon (2024), Assessment of added protection conferred by combined use of indoor residual spraying (IRS) and seasonal malaria chemoprevention (SMC) for malaria prevention in Benin; IJB, V24, N6, June, P163-169
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