1
|
DeBoer KR, Vaz LM, Ondo Mfumu TA, Nlang JAM, Ondo L, Riloha Rivas M, Incardona S, Pollock J, von Fricken ME, Mba Eyono JN, Donfack OT, Guerra CA, García GA. Assessing IRS performance in a gender-integrated vector control programme on Bioko Island, Equatorial Guinea, 2010-2021. Malar J 2023; 22:323. [PMID: 37880774 PMCID: PMC10599007 DOI: 10.1186/s12936-023-04755-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 10/13/2023] [Indexed: 10/27/2023] Open
Abstract
BACKGROUND Indoor residual spraying (IRS) is a common vector control strategy in countries with high malaria burden. Historically, social norms have prevented women from working in IRS programmes. The Bioko Island Malaria Elimination Project has actively sought to reduce gender inequality in malaria control operations for many years by promoting women's participation in IRS. METHODS This study investigated the progress of female engagement and compared spray productivity by gender from 2010 to 2021, using inferential tests and multivariable regression. Spray productivity was measured by rooms sprayed by spray operator per day (RSOD), houses sprayed by spray operator per day (HSOD), and the daily productivity ratio (DPR), defined as the ratio of RSOD to HSOD, which standardized productivity by house size. RESULTS The percentage of women participating in IRS has increased over time. The difference in DPR comparing male and female spray operators was only statistically significant (p < 0.05) for two rounds, where the value was higher for women compared to men. Regression analyses showed marginal, significant differences in DPR between men and women, but beta coefficients were extremely small and thus not indicative of a measurable effect of gender on operational performance. CONCLUSIONS The quantitative analyses of spray productivity are counter to stigmatizing beliefs that women are less capable than male counterparts during IRS spray rounds. The findings from this research support the participation of women in IRS campaigns, and a renewed effort to implement equitable policies and practices that intentionally engage women in vector control activities.
Collapse
Affiliation(s)
| | | | - Teresa Ayingono Ondo Mfumu
- MCD Global Health, Malabo, Equatorial Guinea
- Ministry of Health and Social Welfare, National Malaria Control Programme, Malabo, Equatorial Guinea
| | | | - Lucas Ondo
- MCD Global Health, Malabo, Equatorial Guinea
| | - Matilde Riloha Rivas
- Ministry of Health and Social Welfare, National Malaria Control Programme, Malabo, Equatorial Guinea
| | | | | | - Michael E von Fricken
- Department of Environmental and Global Health, University of Florida, Gainesville, FL, USA
| | | | | | | | | |
Collapse
|
2
|
García GA, Atkinson B, Donfack OT, Hilton ER, Smith JM, Eyono JNM, Iyanga MM, Vaz LM, Mba Nguema Avue R, Pollock J, Ratsirarson J, Aldrich EM, Phiri WP, Smith DL, Schwabe C, Guerra CA. Real-time, spatial decision support to optimize malaria vector control: The case of indoor residual spraying on Bioko Island, Equatorial Guinea. PLOS Digit Health 2022; 1:e0000025. [PMID: 36812503 PMCID: PMC9931250 DOI: 10.1371/journal.pdig.0000025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 03/15/2022] [Indexed: 06/18/2023]
Abstract
Public health interventions require evidence-based decision-making to maximize impact. Spatial decision support systems (SDSS) are designed to collect, store, process and analyze data to generate knowledge and inform decisions. This paper discusses how the use of a SDSS, the Campaign Information Management System (CIMS), to support malaria control operations on Bioko Island has impacted key process indicators of indoor residual spraying (IRS): coverage, operational efficiency and productivity. We used data from the last five annual IRS rounds (2017 to 2021) to estimate these indicators. IRS coverage was calculated as the percentage of houses sprayed per unit area, represented by 100x100 m map-sectors. Optimal coverage was defined as between 80% and 85%, and under and overspraying as coverage below 80% and above 85%, respectively. Operational efficiency was defined as the fraction of map-sectors that achieved optimal coverage. Daily productivity was expressed as the number of houses sprayed per sprayer per day (h/s/d). These indicators were compared across the five rounds. Overall IRS coverage (i.e. percent of total houses sprayed against the overall denominator by round) was highest in 2017 (80.2%), yet this round showed the largest proportion of oversprayed map-sectors (36.0%). Conversely, despite producing a lower overall coverage (77.5%), the 2021 round showed the highest operational efficiency (37.7%) and the lowest proportion of oversprayed map-sectors (18.7%). In 2021, higher operational efficiency was also accompanied by marginally higher productivity. Productivity ranged from 3.3 h/s/d in 2020 to 3.9 h/s/d in 2021 (median 3.6 h/s/d). Our findings showed that the novel approach to data collection and processing proposed by the CIMS has significantly improved the operational efficiency of IRS on Bioko. High spatial granularity during planning and deployment together with closer follow-up of field teams using real-time data supported more homogeneous delivery of optimal coverage while sustaining high productivity.
Collapse
Affiliation(s)
- Guillermo A. García
- Medical Care Development International, Silver Spring, MD, United States of America
| | - Brent Atkinson
- Medical Care Development International, Silver Spring, MD, United States of America
| | | | - Emily R. Hilton
- Institute for Health Metrics and Evaluation, Univeristy of Washington, Seattle, WA, United States of America
| | - Jordan M. Smith
- Medical Care Development International, Malabo, Equatorial Guinea
| | | | | | | | | | - John Pollock
- Medical Care Development, Augusta, ME, United States of America
| | - Josea Ratsirarson
- Medical Care Development International, Silver Spring, MD, United States of America
| | | | - Wonder P. Phiri
- Medical Care Development International, Malabo, Equatorial Guinea
| | - David L. Smith
- Institute for Health Metrics and Evaluation, Univeristy of Washington, Seattle, WA, United States of America
| | | | - Carlos A. Guerra
- Medical Care Development International, Silver Spring, MD, United States of America
| |
Collapse
|
3
|
Guerra CA, Tresor Donfack O, Motobe Vaz L, Mba Nlang JA, Nze Nchama LO, Mba Eyono JN, Riloha Rivas M, Phiri WP, Schwabe C, Aldrich E, Ratsirarson J, Fuseini G, García GA. Malaria vector control in sub-Saharan Africa in the time of COVID-19: no room for complacency. BMJ Glob Health 2020; 5:bmjgh-2020-003880. [PMID: 32938611 PMCID: PMC7496565 DOI: 10.1136/bmjgh-2020-003880] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/05/2020] [Accepted: 09/07/2020] [Indexed: 01/15/2023] Open
Affiliation(s)
- Carlos A Guerra
- International Division, Medical Care Development, Silver Spring, Maryland, USA
| | | | | | - José A Mba Nlang
- International Division, Medical Care Development, Malabo, Equatorial Guinea
| | - Lucas O Nze Nchama
- International Division, Medical Care Development, Malabo, Equatorial Guinea
| | | | - Matilde Riloha Rivas
- National Malaria Control Programme, Ministry of Health and Social Welfare, Malabo, Equatorial Guinea
| | - Wonder P Phiri
- International Division, Medical Care Development, Malabo, Equatorial Guinea
| | | | - Edward Aldrich
- International Division, Medical Care Development, Silver Spring, Maryland, USA
| | - Josea Ratsirarson
- International Division, Medical Care Development, Silver Spring, Maryland, USA
| | - Godwin Fuseini
- International Division, Medical Care Development, Malabo, Equatorial Guinea
| | - Guillermo A García
- International Division, Medical Care Development, Silver Spring, Maryland, USA
| |
Collapse
|
4
|
Guerra CA, Fuseini G, Donfack OT, Smith JM, Ondo Mifumu TA, Akadiri G, Eyang DEM, Eburi CO, Motobe Vaz L, Micha VM, Okenve LA, Janes CR, Andeme RM, Rivas MR, Phiri WP, Slotman MA, Smith DL, García GA. Malaria outbreak in Riaba district, Bioko Island: lessons learned. Malar J 2020; 19:277. [PMID: 32746919 PMCID: PMC7398070 DOI: 10.1186/s12936-020-03347-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 07/25/2020] [Indexed: 11/18/2022] Open
Abstract
At the beginning of 2019, a sudden surge of malaria cases was observed in the district of Riaba, Bioko Island. Between January and April, confirmed malaria cases increased 3.8-fold compared to the same period in 2018. Concurrently, anopheline human biting rate (HBR) increased 2.1-fold. During the outbreak, 82.2% of the district population was tested for malaria with a rapid diagnostic test; 37.2% of those tested had a detectable infection and were treated according to national guidelines. Vector control interventions, including indoor residual spraying and larval source management were scaled-up. After the interventions, the number of confirmed cases decreased by 70% and the overall parasite prevalence in the communities by 43.8%. Observed prevalence in a follow up malaria indicator survey, however, was significantly higher than elsewhere on the island, and higher than in previous years. There was no significant reduction in HBR, which remained high for the rest of the year. The surge was attributed to various factors, chiefly increased rainfall and a large number of anthropogenic anopheline breeding sites created by construction works. This case study highlights the need for sustained vector control interventions and multi-sector participation, particularly in malaria control and elimination settings with persistently high local malaria receptivity.
Collapse
Affiliation(s)
- Carlos A Guerra
- Medical Care Development International, 8401 Colesville Road, Suite 425, Silver Spring, MD, 20910, USA
| | - Godwin Fuseini
- MedicalCare Development International, Av. Parques de Africa, Malabo, Equatorial Guinea
| | | | - Jordan M Smith
- MedicalCare Development International, Av. Parques de Africa, Malabo, Equatorial Guinea
| | - Teresa Ayingono Ondo Mifumu
- MedicalCare Development International, Av. Parques de Africa, Malabo, Equatorial Guinea.,National Malaria Control Programme, Ministry of Health and Social Welfare, Malabo, Equatorial Guinea
| | - Gninoussa Akadiri
- MedicalCare Development International, Av. Parques de Africa, Malabo, Equatorial Guinea
| | - Delicias Esono Mba Eyang
- MedicalCare Development International, Av. Parques de Africa, Malabo, Equatorial Guinea.,National Malaria Control Programme, Ministry of Health and Social Welfare, Malabo, Equatorial Guinea
| | - Consuelo Oki Eburi
- MedicalCare Development International, Av. Parques de Africa, Malabo, Equatorial Guinea.,National Malaria Control Programme, Ministry of Health and Social Welfare, Malabo, Equatorial Guinea
| | - Liberato Motobe Vaz
- MedicalCare Development International, Av. Parques de Africa, Malabo, Equatorial Guinea
| | - Victor Mba Micha
- MedicalCare Development International, Av. Parques de Africa, Malabo, Equatorial Guinea
| | - Leonor Ada Okenve
- MedicalCare Development International, Av. Parques de Africa, Malabo, Equatorial Guinea.,National Malaria Control Programme, Ministry of Health and Social Welfare, Malabo, Equatorial Guinea
| | - Christopher R Janes
- Department of Entomology, Texas A&M University, TAMU 2475, College Station, TX, 77843, USA
| | - Ramona Mba Andeme
- National Malaria Control Programme, Ministry of Health and Social Welfare, Malabo, Equatorial Guinea
| | - Matilde Riloha Rivas
- National Malaria Control Programme, Ministry of Health and Social Welfare, Malabo, Equatorial Guinea
| | - Wonder P Phiri
- MedicalCare Development International, Av. Parques de Africa, Malabo, Equatorial Guinea
| | - Michel A Slotman
- Department of Entomology, Texas A&M University, TAMU 2475, College Station, TX, 77843, USA
| | - David L Smith
- Institute for Health Metrics and Evaluation, University of Washington, 2301 Fifth Avenue, Seattle, WA, 98121, USA
| | - Guillermo A García
- Medical Care Development International, 8401 Colesville Road, Suite 425, Silver Spring, MD, 20910, USA.
| |
Collapse
|