Analysis of the effect of community sensitization on the outcome of indoor residual spraying program against mosquitoes in Mpika Districts, Zambia

Abstract

This study sought to analyze the effect of community sensitization on the outcome of indoor residual spraying program against mosquitoes in Mpika district of Zambia.

Indoor residual spray using carbamate insecticide was carried out in two phases: phase one march to April, phase two October to November 2012 in Mpika district. Two catchment areas were selected based on community sensitization on the IRS program. Boma area where sensitization took place was considered as cluster A and Mpumba area where community sensitization did not take place was considered as cluster B. The objectives of the study were comparing IRS outcome between cluster A and B, identify the best way to sensitize local community on IRS and identify perceived benefits of IRS by households exposed to IRS in the study areas. A retrospective cohort study design was used in this study which involved collection of 2012 data of households planned for IRS program, sample size of 369 and 345 households were randomly selected from cluster A and cluster B respectively. In order to achieve some of the objectives of the study such as the best way to sensitize local community in IRS and identify perceived benefits of IRS by households exposed to IRS, the focus group discussions were also conducted in the two study sites. However IRS program outcome was defined as a total number of households who had their structures sprayed.The annual proportion of households who had their structured sprayed per phase were 74.6% and 40.8% in Cluster A (n= 369) and B (n= 345) respectively. The chances of improving IRS program outcome were 4.23 times higher for cluster A than cluster B with statistical significance of 95% C.I. (3.08, 5.81). Furthermore the results revealed that there was a statistically significant association between community sensitization and IRS program outcome (χ2 = 83.05, df = 1, ρ <0.0001). The results also revealed that the chance of getting positive responses to IRS program from case cluster A was 5 times larger than the chance of getting positive responses in cluster B. [ 95% C.I. (0.17, 0.33)]. Discussions revealed that the best way to sensitize community is to involve them in all stages of IRS program. Reduction of malaria incidence was seen as a benefit of IRS program. This study revealed a higher proportion of households who had their structures sprayed where local people had been sensitized on the IRS program than where sensitization was not done. Community sensitization was the only factor associated with IRS program outcome. The responsiveness to IRS program was high in the area where sensitization was done; hence, local people need to be sensitized on all stages of IRS program.