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The Effectiveness of Indoor Residual Spraying for Malaria Control in Sub-Saharan Africa: A Systematic Protocol Review and Meta-Analysis

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  • Moses Ocan

    (Africa Center for Systematic Reviews and Knowledge Translation, Makerere University College of Health Sciences, Kampala P.O. Box 7072, Uganda
    Department of Pharmacology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda)

  • Kevin Ouma Ojiambo

    (Africa Center for Systematic Reviews and Knowledge Translation, Makerere University College of Health Sciences, Kampala P.O. Box 7072, Uganda
    Clinical Epidemiology Unit, Department of Medicine, College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda)

  • Loyce Nakalembe

    (Africa Center for Systematic Reviews and Knowledge Translation, Makerere University College of Health Sciences, Kampala P.O. Box 7072, Uganda
    Department of Pharmacology, College of Health Sciences, Soroti University, Arapai P.O. Box 211, Uganda)

  • Geofrey Kinalwa

    (Department of Pharmacology, School of Biomedical Sciences, College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda
    Department of Pharmacology, Fins Medical University, Fort Portal P.O. Box 909, Uganda)

  • Alison A. Kinengyere

    (Africa Center for Systematic Reviews and Knowledge Translation, Makerere University College of Health Sciences, Kampala P.O. Box 7072, Uganda
    Albert Cook Library, College of Health Sciences, Makerere University, Kampala P.O. Box 7072, Uganda)

  • Sam Nsobya

    (Infectious Disease Research Collaboration (IDRC), Kampala P.O. Box 7475, Uganda)

  • Emmanuel Arinaitwe

    (Infectious Disease Research Collaboration (IDRC), Kampala P.O. Box 7475, Uganda)

  • Henry Mawejje

    (Infectious Disease Research Collaboration (IDRC), Kampala P.O. Box 7475, Uganda)

Abstract

Background: Indoor residual spraying (IRS) is a core insecticide-based vector control tool employed in most malaria-affected settings globally. However, mosquito vectors have developed resistance to nearly all of the insecticides currently used in IRS. This has necessitated a transition to new classes of insecticides, from mostly using dichlorodiphenyltrichloroethane (DDT) and pyrethroids from 1997 to 2010 to carbamates in 2011 and organophosphates in 2013. In addition, other vector control measures, like the use of long-lasting insecticide-treated bed nets (LLINs), have also been employed for malaria control. Despite the implementation of these mosquito vector control interventions, malaria remains a disease of public health concern, especially in sub-Saharan Africa, which bears over 90% of the disease burden. This review will thus collate evidence on the effectiveness of IRS for malaria control in sub-Saharan Africa. Methods and analysis: The systematic review will be conducted following a priori criteria developed using the PRISMA guidelines. Articles will be obtained through a search of the Web of Science, Google Scholar, Medline via PubMed, Scopus and Embase databases. Mesh terms and Boolean operators (“AND”, “OR”) will be used in the article search. Additionally, websites of malaria research institutions will be searched. The article search will be conducted by two independent librarians (AAK and RS). All identified articles will be transferred to EPPI-reviewer v6.15.1.0 software. Article screening and data abstraction will be performed in duplicate by four reviewers (KOO, LN, GK and MO), and any further disagreements will be resolved through discussion and consensus. We shall extract data on the country, region, study design, insecticide combination, season, susceptibility procedure used, vector control interventions, population, mosquito species, malaria incidence or prevalence, insecticide efficacy, susceptibility, genotypic resistance, vector mortality and knockdown effect. Data analysis will be performed using STATA v 17.0. Effect sizes will be statistically pooled using inverse-variance-weighted random-effects meta-analysis. Heterogeneity and publication bias in the articles will be assessed using the I 2 statistic and a funnel plot, respectively. For the studies that will not be included in the meta-analysis, a narrative synthesis will be written following the Cochrane Consumer and Communication Review Group format. Results: The findings of this review will help generate evidence on the effectiveness of indoor residual spraying using WHO pre-qualified insecticides in malaria control in sub-Saharan Africa. This protocol was registered in PROSPERO, registration number CRD42024517119.

Suggested Citation

  • Moses Ocan & Kevin Ouma Ojiambo & Loyce Nakalembe & Geofrey Kinalwa & Alison A. Kinengyere & Sam Nsobya & Emmanuel Arinaitwe & Henry Mawejje, 2025. "The Effectiveness of Indoor Residual Spraying for Malaria Control in Sub-Saharan Africa: A Systematic Protocol Review and Meta-Analysis," IJERPH, MDPI, vol. 22(6), pages 1-12, May.
    • Handle: RePEc:gam:jijerp:v:22:y:2025:i:6:p:822-:d:1662648
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