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. 2018 Nov 2;11(11):CD012689.
doi: 10.1002/14651858.CD012689.pub2.

Insecticide space spraying for preventing malaria transmission

Joseph Pryce  1 , Leslie Choi, Marty Richardson, David Malone
Affiliations

Insecticide space spraying for preventing malaria transmission

Joseph Pryce et al. Cochrane Database Syst Rev. .

Abstract

Background: Space spraying is the dispersal of a liquid fog of insecticide into an outdoor area to kill adult insects. It has been regularly used in public health and pest control programmes, including use as an emergency response to malaria epidemics. This Cochrane Review aims to assist the decision-making of malaria vector control programmes by summarizing the evidence of the impact of space spraying on malaria transmission.

Objectives: The review's primary objective was to evaluate the impact of space spraying on malaria transmission, or the incremental impact when applied in combination with other malaria control methods, in comparison to equivalent conditions with no space spraying intervention.To guide future evaluations of space spraying, a secondary objective was to identify and summarize the range of space spraying strategies that have been trialled, those which were promising and warrant further evaluation, and those which appear unlikely to warrant further evaluation (for example, if they were not feasible to implement, or were unacceptable to the population).

Search methods: We searched the Cochrane Infectious Diseases Group Specialized Register; the Cochrane Central Register of Controlled Trials (CENTRAL), published in the Cochrane Library; PubMed (MEDLINE); Embase (OVID), CAB Abstracts (Web of Science), LILACS (BIREME), the World Health Organization (WHO) International Clinical Trials Registry Platform, and ClinicalTrials.gov up to 18 April 2018. We contacted organizations for ongoing and unpublished trials, and checked the reference lists of all included studies for relevant studies.

Selection criteria: We included cluster-randomized controlled trials, interrupted time series (ITS) studies, randomized cross-over studies, and controlled before-and-after (CBA) studies comparing space spraying with no space spraying that met the inclusion criteria for the review.

Data collection and analysis: Two review authors independently assessed trials for eligibility and risk of bias, and extracted the data. For ITS studies, we present findings graphically, and estimated the effect of space spraying on the step change and the slope change. We assessed the certainty of evidence using the GRADE approach.

Main results: Two ITS studies, conducted between 1972 and 1984, met our inclusion criteria for the primary objective, and one study contributed to the quantitative analysis. This study was conducted in India, reported the incidence of malaria in four separate sites, and covered a total population of 18,460 people. In the pooled analysis across sites, there was no step effect for the incidence of uncomplicated malaria (step rate ratio 1.00, 95% confidence interval (CI) 0.51 to 1.92). There was an effect on the slope: the number of cases was reduced by 15% per month (slope rate ratio 0.85, 95% CI 0.79 to 0.91). Using these ratios, we estimated the effect of 12 months of space spraying on malaria incidence to be a reduction from 6 cases to 1 case per month per 1000 population (95% CI 0 to 2 cases, very low-certainty evidence). The second study reported the impact of space spraying on malaria incidence and adult mosquito density in a population of 15,106 in Haiti, but it did not provide data from previous years. Thus, we could not estimate an effect of space spraying that was independent from temporal trends.For the review's secondary objective, we identified a further two studies in addition to the two ITS studies; both used a CBA design and were conducted between 1973 and 2000. The four studies used a range of delivery methods including handheld, vehicle-mounted, and aircraft-mounted spraying equipment. A variety of insecticides, doses, and spraying times were also used, with methods typically determined based on environmental factors and vector profiles.

Authors' conclusions: Evidence from one state in India conducted over 30 years ago suggests an effect of space spraying on the incidence of malaria, but the certainty of the evidence is very low. Reliable research in a variety of settings will help establish whether and when this intervention may be worthwhile.

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Conflict of interest statement

JP has no known conflicts of interest. LC has no known conflicts of interest. MR has no known conflicts of interest. During the completion of the review, DM was employed by the Innovative Vector Control Consortium (IVCC). The title of the review is related to the use of insecticide applications for malaria vector control. The IVCC as an organization has a programme of working with industry on the development of novel insecticides and other vector control tools. The IVCC has no current programmes specifically related to the development of space spray insecticides, but one project relates to their use in a malaria transmission setting. Since completing the review, DM has joined Sumitomo Chemicals, a manufacturer of vector control products.

Figures

1
1
Space spraying with hand‐held equipment to control the mosquito population in Thailand
2
2
PRISMA diagram
3
3
‘Risk of bias' summary: review authors' judgements about each risk of bias item for each included study. We did not assess the risk of bias for Hobbs 1976 or Seleena 2004, as the evidence of the effectiveness of space spraying in these studies has not been presented in this review or included in the analysis.
4
4
Incidence of clinical malaria per 1000 population in the Miragoane Valley of Haiti, March 1972 to February 1973. Incidence in the sprayed zone of the study site is shown in blue; the incidence in the surrounding untreated area is shown in red. The vertical red lines indicate the start and end of the space spraying intervention.
5
5
Number of cases of clinical malaria in Pudupettai, India, reported monthly between 1979 and 1982. The vertical red line indicates the start of the space spraying intervention.
6
6
Number of cases of clinical malaria in Vanapuram, India, reported monthly between 1980 and 1984. The vertical red line indicates the start of the space spraying intervention.
7
7
Number of cases of clinical malaria in Melpallipattu, India, reported monthly between 1980 and 1984. The vertical red line indicates the start of the space spraying intervention.
8
8
Number of cases of clinical malaria in Sathanur Dam, India, reported monthly between 1980 and 1984. The vertical red line indicates the start of the space spraying intervention.
9
9
Mosquito density measured in the sprayed region in Haiti using updraft UV light‐traps, March 1972 to February 1973. The initial implementation and end of the space spraying intervention are illustrated by vertical red lines.
10
10
Mosquito density measured as a human biting rate in the sprayed region in Haiti, March 1972 to February 1973. The initial implementation and end of the space spraying intervention are illustrated by vertical red lines.
See this image and copyright information in PMC

Update of

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Publication types