IMMC Inc.
The IMM Consortium
Integrated
Malaria
Management

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The cost and effectiveness of different interventions ...more
Interior residual spraying (IRS)
Spraying the interior vertical surfaces of homes with a pesticide reduces malaria transmission by both toxicity and by repellant action. DDT is the most effective pesticide because it lasts a long time and has the strongest repellant action.



Image credit: Seeking permission








Image credit: Seeking permission











Image credit: Seeking permission




Image credit: Seeking permission

Interior Residual Spraying
Interior residual spraying (IRS) is a malaria control intervention where the interior walls of a dwelling are sprayed with an insecticide. The sparying needs to be done by trained staff who understand the precautions that need to be taken in order for the procedures to be safe.

In general terms the insecticides used are toxic to mosquitoes, but safe for animals and humans in the manner used.

IRS works in two ways: (1) by killing mosquitoes when they land on the surfaces to rest; and, (2) by a repellent effect that discourages the mosquito from coming into the space in the first place.

Training staff and being safe Being safe when working for prolonged periods with insecticides requires use of the correct procedures and good safety practices. All staff should therefore be well trained in the handling and use of pesticides.

The IMM Consortium has experience in the management of insecticides, the training and certification of staff in the use and handling of chemicals and insecticides.

Cost effectiveness
IRS has been reported to be 3 times more cost effective than bednets ... but cost comparison is not easy because of the many variables involved. Programs that make use of IRS seem to get more tangible results than programs involving bednets, or programs that treat malaria with addressing the problem of malaria transmission and reinfection.

The data depicted in the image to the left relates to the malaria control program on Bioko Island, Equatorial Guinea operated by Marathon Oil. In the graphic the left hand data refers to the reduction in the malaria parasite in the mosquito population: down by 94% in three years. The right hand data refers to the reduction of the malaria parasite in children: down by 44% in three years.

Spray plans
The best results are achieved when a high proportion of the structures are treated. This is a challenge because of people's unwillingness for the teams to enter their homes, and the logistics of the work in areas where the layout is complex.

Increasingly, spray programs are being implemented using GPS devices to record what is being done.

The issue of DDT
DDT is the most cost effective insecticide ... it is a low cost insecticide, it lasts much longer than any other insecticide and it acts both to kill mosquitoes and to repell mosquitoes. Depending on the detailed circumstances, use of DDT is probably 4 times more cost effective than any other IRS insecticide.

DDT has been totally banned in many countries due to its persistance in the food chain. This was an issue of some significance when DDT was being used in vast quantities for agricultural pest control, but is not a meaningful issue when used in low volumes in connection with mosquito pest control in malaria endemic areas. This is a very emotional matter - the consensus of the IMM Consortium is that DDT's value in malaria control is very high relative to the potential risks that it is immoral not to make appropriate use of DDT.

IMM
About Integrated Malaria Management ...Go

Surveillance, data collection and analysis ... ...Go
Environmental clean-up ... ...Go
Source control ... ...Go
Interior residual spraying ... ...Go
Ultra Low Volume (ULV) spraying ... ...Go
Personal protection ... insecticide treated bednets ... ...Go
The medical dimension ... ...Go


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