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A combined effect: using indoor residual spraying and insecticide-treated nets together for additional impact

Global efforts to fight malaria have proven tremendously successful in the last decade, especially in sub-Saharan Africa. Much of this success has resulted from the scale-up and widespread deployment of vector control interventions, such as indoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs). In recent years, progress toward malaria elimination has stagnated, and increasing resistance to pyrethroids, the class of insecticides most commonly used for vector control, threatens current progress. For many national malaria control and elimination programmes, decisions about how to deploy specific interventions are becoming increasingly complex.

Most national programmes align activities with WHO guidance on achieving and maintaining universal access to core interventions, but questions remain about the best methods for layering new tools on top of existing ones to maximize programme impact across transmission settings. Decisions about when, where, and how to use each strategy, including whether to use them simultaneously in the same communities, will depend on national programmes’ goals and should be tailored to local context. This requires, among other things, an evolving evidence-base built upon impact evaluations from various disease ecologies and transmission intensities.

This thematic series will present data analysed as part of the Next-Generation Indoor Residual Spraying Project. Results from five partner countries, including Ghana, Mali, Mozambique, Uganda, and Zambia, collectively show that, in areas of moderate to high transmission with pyrethroid-resistant vectors, adding IRS with non-pyrethroid insecticides to standard LLINs provides additional cost-effective to highly cost-effective protection from malaria in a variety of settings across sub-Saharan Africa.


  1. As malaria cases increase in some of the highest burden countries, more strategic deployment of new and proven interventions must be evaluated to meet global malaria reduction goals.

    Authors: Sergi Alonso, Carlos J. Chaccour, Joseph Wagman, Baltazar Candrinho, Rodaly Muthoni, Abuchahama Saifodine, Francisco Saute, Molly Robertson and Rose Zulliger

    Citation: Malaria Journal 2021 20:143

    Content type: Research

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  2. Attaining the goal of reducing the global malaria burden is threatened by recent setbacks in maintaining the effectiveness of vector control interventions partly due to the emergence of pyrethroid resistant ve...

    Authors: Carlos Chaccour, Rose Zulliger, Joe Wagman, Aina Casellas, Amilcar Nacima, Eldo Elobolobo, Binete Savaio, Abuchahama Saifodine, Christen Fornadel, Jason Richardson, Baltazar Candrinho, Molly Robertson and Francisco Saute

    Citation: Malaria Journal 2021 20:84

    Content type: Research

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  3. The need to develop new products and novel approaches for malaria vector control is recognized as a global health priority. One approach to meeting this need has been the development of new products for indoor...

    Authors: Joseph M. Wagman, Kenyssony Varela, Rose Zulliger, Abuchahama Saifodine, Rodaly Muthoni, Stephen Magesa, Carlos Chaccour, Christelle Gogue, Kenzie Tynuv, Aklilu Seyoum, Dereje Dengela, Francisco Saúte, Jason H. Richardson, Christen Fornadel, Yvonne-Marie Linton, Laurence Slutsker…

    Citation: Malaria Journal 2021 20:54

    Content type: Research

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  4. The National Malaria Control Programme (NMCP) of Mali has had recent success decreasing malaria transmission using 3rd generation indoor residual spraying (IRS) products in areas with pyrethroid resistance, pr...

    Authors: Joseph Wagman, Idrissa Cissé, Diakalkia Kone, Seydou Fomba, Erin Eckert, Jules Mihigo, Elie Bankineza, Mamadou Bah, Diadier Diallo, Christelle Gogue, Kenzie Tynuv, Andrew Saibu, Jason H. Richardson, Christen Fornadel, Laurence Slutsker and Molly Robertson

    Citation: Malaria Journal 2020 19:340

    Content type: Research

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  5. Ségou Region in central Mali is an area of high malaria burden with seasonal transmission. The region reports high access to and use of long-lasting insecticidal nets (LLINs), though the principal vector, Anophel...

    Authors: Joseph Wagman, Idrissa Cissé, Diakalkia Kone, Seydou Fomba, Erin Eckert, Jules Mihigo, Elie Bankineza, Mamadou Bah, Diadier Diallo, Christelle Gogue, Kenzie Tynuv, Andrew Saibu, Jason H. Richardson, Christen Fornadel, Laurence Slutsker and Molly Robertson

    Citation: Malaria Journal 2020 19:293

    Content type: Research

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  6. Ghana has been implementing the indoor residual spraying (IRS) of insecticides since 2006, focusing operations in the north. Insecticide resistance concerns prompted a switch from pyrethroids to organophosphat...

    Authors: Christelle Gogue, Joseph Wagman, Kenzie Tynuv, Andrew Saibu, Yemane Yihdego, Keziah Malm, Wahjib Mohamed, Welbeck Akplu, Titus Tagoe, Anthony Ofosu, Ignatius Williams, Samuel Asiedu, Jason Richardson, Christen Fornadel, Laurence Slutsker and Molly Robertson

    Citation: Malaria Journal 2020 19:242

    Content type: Research

    Published on:

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