ArticleThe Journal of infectious diseases2025
Impact of Late-Rainy Season Indoor Residual Spraying on Holoendemic Malaria Transmission: A Cohort Study in Northern Zambia.
Article in The Journal of infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Early-evening indoor and outdoor foraging by major malaria vectors in Nchelenge, Zambia.PLOS global public health · 2026Article
- Early-evening indoor and outdoor foraging by major malaria vectors in Nchelenge, Zambia.medRxiv : the preprint server for health sciences · 2025Article
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Authors and funding
17 authors.
Funding
Abstract
backgroundIndoor residual spraying (IRS) is a malaria control strategy implemented before the rainy season. Nchelenge District, Zambia, is a holoendemic setting where IRS has been conducted since 2008 with little impact on malaria incidence or parasite prevalence. Pre-rainy season IRS may not reduce the post-rainy season peak abundance of the major vector Anopheles funestus.
methodsA controlled, pretest-posttest, prospective cohort study assessed the impact of late-rainy season IRS on malaria prevalence, incidence, hazard, and vector abundance. A total of 382 individuals were enrolled across 4 household clusters, of which 2 were sprayed in April 2022 toward the end of the rainy season. Monthly household and individual surveys and indoor overnight vector collections were conducted through August 2022. Multivariate regression and time-to-event analyses estimated the impact of IRS on outcomes measured by rapid diagnostic tests, microscopy, and quantitative polymerase chain reaction.
resultsAmong participants, 72% tested positive by rapid diagnostic test at least once, and incidence by microscopy was 3.4 infections per person-year. Residing in a household in a sprayed area was associated with a 52% reduction in infection hazard (hazards ratio, 0.48; 95% CI, .29-.78) but not with changes in incidence, prevalence, or vector abundance. The study-wide entomologic inoculation rate was 34 infectious bites per person per year.
conclusionsMonthly tracking of incidence and prevalence did not demonstrate meaningful changes in holoendemic transmission intensity. However, hazard of infection, which provides greater power for detecting changes in transmission, demonstrated that late-rainy season IRS reduced malaria risk.
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