Abstract:

Study aimed at establishing efficacy of Indoor Residual Household Spraying (IRHS) program in controlling malaria among children under-five in Ndola, Zambia.

Methods: A comparative study conducted at Nkwazi (intervention) and Masala (non- intervention) compound, over a period of six months from October 2017 to April 2018. Sample size; 410 caretakers and 6 key informants. Sampling: Cluster, systematic and purposive, from, 6^th to 30^th April 2018 and 28^th May to 26^th August 2019 respectively. Interview guide, Semi-structured questionnaire and checklist used. Content analysis, univariate and bivariate, SPSS version 20 Chi-square determined association of variables: Demographic, morbidity, knowledge, acceptability, compliance, and outcome efficacy of IRHS.

Results: Malaria incidence was 25.4% among children under five at IRHS intervention area after six months and non-intervention areas accounted 2.1%. 83.3% had positive results and most affected aged 0-1year 46.1%, and 74 were positive, P >0.225. 96.1% and 74.1% of caretakers in Nkwazi and Masala were knowledgeable about malaria, while 43.4% in Nkwazi lacked knowledge on danger signs. IRHS coverage was average n=4. 83.8% of the caretakers said IRHS was useful P< 0.000. 70% had homes sprayed P<0.000. 68.2% in Nkwazi slept in sprayed houses P<0.000. Acceptability of IRHS was average 56% p<0.000. Community sensitization influences sleeping under mosquito net p<0.000. Program officers n=5 reported spraying done at the same time yearly. Refusals accounted 90.2% and 66.3% in Nkwazi and Masala P<0.000.

Conclusion: Malaria morbidity among children under-five continued to increase in the intervention area despite IRHS.

Keywords: Indoor Residual Household Spraying Malaria Comparative.

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