Indoor Residual Spraying

IRS

Many malaria vectors are considered “endophilic”; that is, the mosquito vectors rest inside houses after taking a blood meal. These mosquitoes are particularly susceptible to control through indoor residual spraying (IRS).IRS involves coating the walls and other surfaces of a house with a residual insecticide. For several months, the insecticide will kill mosquitoes and other insects that come in contact with these surfaces.

History of IRS

RS with DDT was the primary malaria control method used during the Global Malaria Eradication Campaign (1955-1969). The campaign did eliminate malaria from several areas and sharply reduced the burden of malaria disease in others. It is proven to be an effective malaria prevention tool. Primary malaria prevention on a large scale depends on two vector control interventions: indoor residual spraying (IRS) and insecticide-treated mosquito nets (ITNs). Historically, IRS has reduced malaria transmission in many settings in the world. The evidence from randomized comparisons of IRS versus no IRS confirms that IRS reduces malaria incidence in unstable malaria settings.

The IRS Campaign

AGAMal received its first Global Fund Grant in 2008 as the first private sector principal recipient of the Grant. This Grant was an amount of US$133M. After an initial delay, AGAMal implemented its first Global Fund Grant and took IRS to 11 districts across the country in 2011. This number was made up of 4 districts in Ashanti, 1 district in Central, 3 districts in Western, and 3 districts in Upper West Regions. The number of districts was supposed to have been scaled up to a total of 40 districts in 6 regions in Ghana for over 5 years.
AGAMal received its first Global Fund Grant in 2008 as the first private sector principal recipient of the Grant. This Grant was an amount of US$133M. After an initial delay, AGAMal implemented its first Global Fund Grant and took IRS to 11 districts across the country in 2011. This number was made up of 4 districts in Ashanti, 1 district in Central, 3 districts in Western, and 3 districts in Upper West Regions. The number of districts was supposed to have been scaled up to a total of 40 districts in 6 regions in Ghana for over 5 years.

Historical Perspectives

The IRS process starts with notification of beneficiary communities and the recruitment of operational staff. This is followed by the SBCC campaign. The SBCC activities are organized into three sub-activities: Pre-Operational, Operational and Post Intervention Activities These activities are geared towards addressing concerns, misconceptions, and fatigue from previous operations and to give general education on Malaria and Indoor Residual Spraying. It is also a means to sustain gains, improve, and collaborate with stakeholders to achieve the maximum program impact.

The Pre-Operational Activities include

Community entry in new and already existing communities

With the benefit of already documented information about the community, key opinion leaders/influential people are identified and their support is sought for successful program implementation. These include the traditional authorities, religious leaders, heads of regulatory and partnering institutions, the District Chief Executive, and heads of other institutions.

Recruitment & capacity building for staff

There is training for the entire operational staff. The recruits get a longer training period than staff who were engaged in the previous season. While these pieces of training are going on, the SBCC team starts with targeted SBCC in communities that recorded a lot of refusals from previous spray season’s records.

Media Campaign To Support Spraying Initiative

The contracted stations transmit jingles, announcements and do Live Presenter Mentions (LPM) daily and hold weekly panel discussions to educate the communities and get the necessary feedback for program improvement. Community announcements (gong-gong beating, mosques & churches) mass announcements (using Public Address systems fixed on vehicles) are also used at the community level for information dissemination and education.

Data Management

This department is primarily responsible for collecting, validating, processing and storing all IRS and related data in manner that is reliable, accessible and timely to facilitate effective decision making and track progress towards program objectives.

Entomology

The Entomology provides data on vector transmission dynamics, insecticide resistance profiles, insecticide batch potencies, effectiveness of spray applications, efficacy of insecticides used for the IRS operations on sprayed surfaces and the elucidation of mechanisms of insecticide resistance and its impact on the vector control.

Monitoring & Evaluation

The primary aim of the Monitoring and Evaluation department of is to monitor progress towards the attainment of the goals and objectives and evaluate the outcomes and impact of the Indoor Residual Spraying. This is achieved through the systematic collation of information on the input, process, output, outcome and impact indicators and by tracking progress towards set targets. The molecular laboratory has a state-of-the-art equipment for undertaking a wide range of analysis on mosquitoes collected from the field. The entomology team is adequately equipped with a range of requisite analytical skills to undertake morphological identification and molecular assays to differentiate sibling species of Anopheles gambiae s.l and also determine kdr and Ace-1 mutations in insecticide resistant vectors. There is also the capacity to carry out enzyme-linked immunosorbent assays (ELISAs) to detect sporozoite infections in the vectors of malaria, among others.