Factors influencing indoor residual spraying in Lusaka district's Mtendere, Kanyama and Matero Compounds

Abstract

Monitoring and evaluation assessments of the IRS programmes reveal an inability to meet set IRS coverage targets. The purpose of this was to determine the factors that influence the low IRS coverage. A cross sectional household study was carried out in Lusaka District’s Mtendere, Kanyama and Matero Compounds. Data was collected from heads of households by an interactive method using a scheduled questionnaire.295 households were randomly selected. The sample size was calculated for the coverage rate of 78% plus or minus 5% and at 95% confidence interval. The 78% was derived from the IRS coverage of the 2006/2007 season during which 85% of eligible structures in Lusaka District were targeted Using Epi Info Version 6.0 the Yates corrected P values were calculated using chi square and used to determine relationships and associations between variables. The study established that IRS Coverage was 48.6% which was less than the targeted 85%. There was 36% coverage in Kanyama, 52.2% in Matero and 62% in Mtendere Compounds. Most of the houses (60%) were sprayed during the peak malaria season which is also the rainy season and that Willingness to have IRS had influence on IRS Coverage while community participation in IRS was nonexistent. Significant relationships were found between IRS Coverage and study area (P value<0.001), knowledge of the institution that carried out IRS (P value <0.001) and access to IRS related IEC (P value 0.042). The study found a significant relationship between the respondent’s willingness to have IRS: ability to remember what was heard and/or seen during IRS related IEC (P value 0.040), knowledge of the institution which sprayed (P value <0.001) and benefits anticipated from IRS (<0.001). 66.3% of the respondents own and use mosquito nets of which 45% were untreated, 20% were long lasting nets and 35% were locally treated nets. 62.3% of the respondents whose houses were not sprayed indicated that the sprayers did not come to their houses. Of the 143 houses that were sprayed 2.1% altered the walls after IRS, 34.3% reacted negatively to IRS, sprayers left pesticides on the floor in 7% of the houses there houses. The Ministry of Health (MOH) and National Malaria Control Centre (NMCC) shall find these results useful in planning for the IRS as it highlights areas that need attention. The policy makers ought to continue informing the communities regarding IRS and involving them in IRS activities as well as to monitor the activities of the sprayers whilst carrying out IRS