Opiyo Mercy, Sherrard-Smith Ellie, Malheia Arlindo, Nhacolo Arsenio, Sacoor Charfudin, Nhacolo Ariel, Máquina Mara, Jamu Luis, Cuamba Nelson, Bassat Quique, Saúte Francisco, Paaijmans Krijn
Barcelona Institute for Global Health (ISGlobal), Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.
Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.
PLOS Glob Public Health. 2022 Apr 20;2(4):e0000227. doi: 10.1371/journal.pgph.0000227. eCollection 2022.
Indoor residual spraying of insecticides (IRS) is a key malaria vector control strategy. Whilst human attitude towards IRS is monitored before or shortly after implementation, human activities leading to the modification of insecticide-treated walls post-IRS are not. This could inadvertently reduce the protective effects of IRS. We monitored the extent of modifications to the sprayed indoor wall surfaces by household owners for six months post-IRS campaigns in two districts targeted for malaria elimination in southern Mozambique. In parallel, we assessed building of any additional rooms onto compounds, and mosquito net use. We quantified the contribution of wall modifications, added rooms, prolonged spray campaigns, and product residual efficacies on actual IRS coverage and relative mosquito bite reduction, using a mechanistic approach. Household owners continually modified insecticide-treated walls and added rooms onto compounds. Household surveys in southern Mozambique showed frequent modification of indoor walls (0-17.2% of households modified rooms monthly) and/or added rooms (0-16.2% of households added rooms monthly). Actual IRS coverage reduced from an assumed 97% to just 39% in Matutuine, but only from 96% to 91% in Boane, translating to 43% and 5.8% estimated increases in relative daily mosquito bites per person. Integrating post-IRS knowledge, attitude, and practice (KAP) surveys into programmatic evaluations to capture these modification and construction trends can help improve IRS program efficiency and product assessment.
室内滞留喷洒杀虫剂（IRS）是一项关键的疟疾媒介控制策略。虽然在实施前或实施后不久会监测人们对IRS的态度，但在IRS实施后导致经杀虫剂处理的墙壁发生改变的人类活动却未被监测。这可能会无意中降低IRS的保护效果。在莫桑比克南部两个目标为消除疟疾的地区，我们在IRS活动结束后的六个月里监测了家庭住户对室内喷洒墙面的改动程度。同时，我们评估了在住宅区内新建额外房间的情况以及蚊帐的使用情况。我们采用一种机制方法，量化了墙面改动、新增房间、延长喷洒活动以及产品残留效力对实际IRS覆盖率和相对减少蚊虫叮咬的贡献。家庭住户持续对经杀虫剂处理的墙壁进行改动，并在住宅区内增加房间。莫桑比克南部的家庭调查显示，室内墙面经常被改动（每月有0 - 17.2%的家庭对房间进行改动）和/或增加房间（每月有0 - 16.2%的家庭增加房间）。在马图廷，实际IRS覆盖率从假定的97%降至仅39%，但在博阿内仅从96%降至91%，这意味着每人相对每日蚊虫叮咬估计增加了43%和5.8%。将IRS实施后的知识、态度和行为（KAP）调查纳入项目评估，以捕捉这些改动和建设趋势，有助于提高IRS项目效率和产品评估。
