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'We spray and walk away': wall modifications decrease the impact of indoor residual spray campaigns through

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End-users modifying walls after indoor residual spraying (IRS) reduces malaria control effectiveness. Monitoring IRS acceptability and coverage is crucial for effective malaria programs.

Keywords:
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Area of Science:

  • Public Health
  • Entomology
  • Vector Control

Background:

  • Malaria prevalence has decreased due to interventions like indoor residual spraying (IRS) and long-lasting insecticide-treated nets (LLINs).
  • The effectiveness of these tools depends on the intervention, the mosquito vector, and end-user behavior.
  • While LLIN use is documented, IRS monitoring often lacks data on long-term user behavior and residual efficacy.

Purpose of the Study:

  • To present historical evidence of end-users altering wall surfaces post-IRS spraying.
  • To highlight how this behavior can decrease IRS coverage, effectiveness, and overall impact.
  • To emphasize the urgent need for guidelines to monitor IRS acceptability and coverage throughout the spraying cycle.

Main Methods:

  • Review of historical evidence and existing literature on end-user behavior related to IRS.
  • Analysis of factors influencing intervention effectiveness, vector behavior, and end-user compliance.
  • Identification of monitoring gaps in current malaria control programs.

Main Results:

  • End-users have historically modified treated surfaces after IRS application.
  • Such modifications can significantly reduce the actual protective coverage and efficacy of IRS.
  • Limited monitoring of IRS acceptability and post-application user behavior exists.

Conclusions:

  • End-user modification of sprayed surfaces poses a threat to the effectiveness of IRS campaigns.
  • Improved monitoring of IRS acceptability and coverage, both pre- and post-spraying, is essential.
  • Developing clear monitoring guidelines is critical for optimizing malaria control strategies and ensuring genuine protection.