Testing indoor residual spraying coverage targets for malaria control, Bioko, Equatorial Guinea.

IF 8.4 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Bulletin of the World Health Organization Pub Date : 2025-06-01 Epub Date: 2025-05-03 DOI:10.2471/BLT.24.292505
Guillermo A García, Dianna E B Hergott, David S Galick, Olivier Tresor Donfack, Liberato Motobe Vaz, Lucas O Nze Nchama, Jeremías N Mba Eyono, Restituto M Nguema Avue, Matilde Riloha Rivas, Marcos M Iyanga, Faustino E Ebang Bikie, Teresa A Ondo Mifumu, Wonder P Phiri, Michael E von Fricken, Robert C Reiner, David L Smith, Carlos A Guerra
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引用次数: 0

Abstract

Objective: To test 50% indoor residual spraying coverage (percentage of households sprayed) for non-inferiority against the recommended 80% coverage for malaria control.

Methods: Indoor residual spraying was done in 2021 and 2022 on Bioko, Equatorial Guinea, in a control arm (80% coverage) and intervention arm (50% coverage) with 37 clusters each. We assessed malaria infection in a representative sample of the population during annual surveys using rapid diagnostic tests. We compared the change in the odds of Plasmodium falciparum infection between baseline and post-intervention using difference-in-differences analysis within a survey-weighted binomial generalized linear model. Given differences between the arms at baseline, we adjusted the model for indoor residual spraying coverage at baseline.

Findings: Relative to baseline, the odds of malaria infection post-intervention were 1.11 (95% confidence interval, CI: 0.81-1.52) in the 80% arm and 0.97 (95% CI: 0.72-1.29) in the 50% arm. In the adjusted model, the change in the odds of P. falciparum infection was no greater in the intervention arm than in the control arm (odds ratio: 0.89; 95% CI: 0.58-1.36), with the upper CI being lower than the non-inferiority margin of 1.43.

Conclusion: There was no evidence that 50% coverage was inferior in preventing malaria, which supports the use of this target in settings where this level makes indoor residual spraying feasible by increasing the cost-effectiveness and equity of the intervention.

赤道几内亚比奥科,检测疟疾控制的室内滞留喷洒覆盖目标。
目的:比较50%的室内滞留喷洒覆盖率(家庭喷洒百分比)与建议的80%的疟疾控制覆盖率。方法:于2021年和2022年在赤道几内亚的比奥科市进行室内残留喷洒,分为对照组(80%覆盖率)和干预组(50%覆盖率),每组37组。我们在年度调查期间使用快速诊断测试评估了人口中代表性样本的疟疾感染情况。我们在调查加权二项广义线性模型中使用差中差分析比较了基线和干预后恶性疟原虫感染几率的变化。考虑到武器在基线上的差异,我们根据室内残留喷洒覆盖率在基线上调整了模型。结果:相对于基线,干预后疟疾感染的几率在80%组为1.11(95%可信区间,CI: 0.81-1.52),在50%组为0.97(95%可信区间:0.72-1.29)。在调整后的模型中,干预组的恶性疟原虫感染几率变化并不大于对照组(优势比:0.89;95% CI: 0.58-1.36),上CI低于非劣效性边际1.43。结论:没有证据表明50%的覆盖率在预防疟疾方面较差,这支持在这样的环境中使用这一目标,在这种情况下,通过提高干预的成本效益和公平性,室内残留喷洒是可行的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Bulletin of the World Health Organization
Bulletin of the World Health Organization 医学-公共卫生、环境卫生与职业卫生
CiteScore
11.50
自引率
0.90%
发文量
317
审稿时长
3 months
期刊介绍: The Bulletin of the World Health Organization Journal Overview: Leading public health journal Peer-reviewed monthly journal Special focus on developing countries Global scope and authority Top public and environmental health journal Impact factor of 6.818 (2018), according to Web of Science ranking Audience: Essential reading for public health decision-makers and researchers Provides blend of research, well-informed opinion, and news
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