Indian Council of Medical Research - National Institute of Research in Tribal Health (ICMR- NIRTH), Jabalpur, Madhya Pradesh, India.
Malaria Elimination Demonstration Project (MEDP), Mandla, Madhya Pradesh, India.
Malar J. 2021 Feb 18;20(1):101. doi: 10.1186/s12936-021-03639-9.
The Government of Madhya Pradesh employed Indoor Residual Spraying (IRS) with alpha-cypermethrin synthetic pyrethroids in sub-centres with Annual Parasite Incidence (API) from 2 to 4.99. In sub-centres with API more than 5, Long-Lasting Insecticidal Nets (LLINs) were distributed. At the request of the State Government, the Malaria Elimination Demonstration Project (MEDP) staff observed and provided support to both IRS and LLINs campaigns. In the year 2017, the study team monitored only the IRS campaigns, however, in the year 2018, the supportive supervision was provided to the IRS campaign teams along with post-distribution monitoring of the LLINs.
The study was carried out during IRS spraying using a pre-tested, closed-ended monitoring checklist which consisted of two parts- observations of spraying team and observation of sprayed houses. For LLINs, a sample of the households that received the bed nets was taken for the study. For IRS, the spraying teams were monitored for quality and technique for a total of 159 times in 2017 and 183 times in the year 2018, respectively. For post spraying observations, a total of 1261 and 1791 households were observed in the years 2017 and 2018, respectively. The use of LLINs was observed in 5 % of the households in 2018 and 2020, which is about 2,000 houses in each survey where each house received about 2.5 LLINs per household. The results of surveys were compared to assess impact of supportive supervision and monitoring.
Significant improvement was noted after supportive supervision in year 2018 in various aspects of spraying. Preparedness of spraying, such as advance information to villagers, presence of equipment and records improved by up to 70 %. The methodology of spraying preparation improved from 50 to 90 %, spraying technique improved from 54 to 80 %, and proper use equipment during spraying improved from 51 to 92 %. After eight months post distribution of the LLINs in 2019, improvement was seen in regular usage of LLINs by 28 %. It was found that on-spot demonstrations during distribution and carrying of LLINs when sleeping outside homes increased by 56 %. Results of IEC campaigns revealed the reduction in adverse effects by 64 % and increase in awareness by 97 %.
Effective supervision improved the quality of IRS and usage of LLINs in the study area. Based on these results, continued training and monitoring of staff that is deployed to spraying houses and distribute bed nets was suggested. The study also revealed that proper IEC/BCC drives help increase community acceptance of vector control measures and their rational usage.
中央邦政府在寄生虫发病率（API）为 2 至 4.99 的基层医疗中心使用了含α-氯氰菊酯的拟除虫菊酯室内滞留喷洒（IRS）。在 API 超过 5 的基层医疗中心，分发了长效驱虫蚊帐（LLINs）。应邦政府的要求，消除疟疾示范项目（MEDP）工作人员观察并为 IRS 和 LLINs 运动提供支持。在 2017 年，研究小组仅监测 IRS 运动，但在 2018 年，向 IRS 运动团队提供了支持性监督，并对 LLINs 的分发后监测提供了支持。
在 IRS 喷洒期间使用了经过预先测试的封闭式监测检查表进行了这项研究，该检查表由两部分组成-喷洒团队的观察和喷洒房屋的观察。对于 LLINs，对收到蚊帐的家庭进行了抽样研究。对于 IRS，分别在 2017 年和 2018 年对喷洒团队进行了总计 159 次和 183 次的质量和技术监测。在喷洒后观察中，2017 年和 2018 年分别观察了 1261 户和 1791 户家庭。2018 年和 2020 年，5%的家庭观察到使用了 LLINs，这大约是每个调查中 2000 户家庭，每个家庭收到大约 2.5 张 LLINs。对调查结果进行了比较，以评估支持性监督和监测的影响。
2018 年，在支持性监督后，喷洒的各个方面都有了显著的改善。喷洒的准备工作，例如提前向村民提供信息、设备和记录的存在，提高了 70%。喷洒准备方法从 50%提高到 90%，喷洒技术从 54%提高到 80%，以及在喷洒过程中正确使用设备的比例从 51%提高到 92%。2019 年 LLINs 分发八个月后，定期使用 LLINs 的比例提高了 28%。发现分发和携带 LLINs 时的现场演示增加了 56%。IEC 运动的结果显示，不良反应减少了 64%，意识提高了 97%。
有效的监督提高了 IRS 的质量和 LLINs 在研究区域的使用。基于这些结果，建议对部署到喷洒房屋和分发蚊帐的工作人员进行持续培训和监测。该研究还表明，适当的信息、教育和宣传（IEC）/社区参与（BCC）活动有助于增加社区对病媒控制措施的接受程度和合理使用。
