Additional impact of indoor residual spraying in combination with mass drug administration on malaria burden in a high transmission setting in Uganda if IRS is implemented: "testing acceleration to zero transmission"
Project Summary
Elimination of malaria is the only option that avoids the continuous evolution of resistant parasites and vectors. In order to achieve substantial and sustained parasite clearance from the human population, simultanoeasly with vector pressure relief afforded by indoor residual spraying (IRS), targeted curative and preventive strategies amongst different populations than pregnant women and infants are needed. Both children and adults with high immunity are reservoirs of asymptomatic infection and therefore of ongoing transmission. In order to effectively interrupt malaria transmission and rapidly change transmission environments from high to low transmission, and from low transmission to pre elimination, and to elimination, both the environmental and human reservoirs of the malaria parasite need to be targeted. Vector control and preventive chemotherapy interventions must be used concurrently. While the advantages of elimination are widely supported, strategic approaches for navigating from program scale-up to pre-elimination to elimination need to be defined in medium-high burden Sub-Saharan Africa countries based on actual country program experience. We performed a quasi-experimental study to provide data on mass drug administration (MDA) delivery, coverage and its additional impact on IRS in a high transmission setting in Uganda to guide program action and facilitate continual progress toward elimination goals.