Reduction of malaria prevalence by indoor residual spraying: a meta-regression analysis.
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Indoor residual spraying (IRS) has become an increasingly popular method of insecticide use for malaria control, and many recent studies have reported on its effectiveness in reducing malaria burden in a single community or region. There is a need for systematic review and integration of the published literature on IRS and the contextual determining factors of its success in controlling malaria. This study reports the findings of a meta-regression analysis based on 13 published studies, which were chosen from more than 400 articles through a systematic search and selection process. The summary relative risk for reducing malaria prevalence was 0.38 (95% confidence interval = 0.31-0.46), which indicated a risk reduction of 62%. However, an excessive degree of heterogeneity was found between the studies. The meta-regression analysis indicates that IRS is more effective with high initial prevalence, multiple rounds of spraying, use of DDT, and in regions with a combination of Plasmodium falciparum and P. vivax malaria.
Published Version (Please cite this version)10.4269/ajtmh.2012.11-0620
Publication InfoFedak, K; Kim, D; & Kramer, Randall A (2012). Reduction of malaria prevalence by indoor residual spraying: a meta-regression analysis. Am J Trop Med Hyg, 87(1). pp. 117-124. 10.4269/ajtmh.2012.11-0620. Retrieved from http://hdl.handle.net/10161/6472.
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Juli Plant Grainger Professor of Global Environmental Health
Randall Kramer is the Juli Plant Grainger Professor of Global Environmental Health in the Nicholas School of the Environment and deputy director of the Duke Global Health Institute. Before coming to Duke in 1988, he was on the faculty at Virginia Polytechnic Institute and State University. He has held visiting positions at IUCN--The World Conservation Union, the Economic Growth Center at Yale University, and the Indonesian Ministry of Forestry. He has served as a consultant to t