PMI AIRS Returns to Ghana’s Karaga District

In the northern region of Ghana, the U.S. President’s Malaria Initiative’s (PMI) Africa Indoor Residual Spraying (AIRS) Project returned to Karaga District in 2017 after four years. The main reason for the return was a drop in the price of the insecticide used for indoor residual spraying (IRS). Unitaid is investing in the Innovative Vector Control Consortium (IVCC) through the NgenIRS project to make new insecticides for indoor residual spraying more affordable to African malaria programs and their partners.

IRS involves spraying an insecticide on the ceilings and walls of homes, where the malaria-carrying mosquitoes rest after feeding. The insecticide kills the mosquitoes, preventing the further spread of the disease. Ensuring insecticide is effective is essential to a successful IRS program. As the PMI AIRS Project began to detect a high level of insecticide resistance through its entomological monitoring and surveillance activities, the project switched to a more effective though more expensive insecticide. As a result, fewer districts were able to be sprayed. With a population of more than 108,000 people (Source: Ghana Health Services ITN distribution data, 2016), Karaga’s Health Management Information System reported an average annual malaria prevalence rate of 26%, and a rate of malaria case fatality for children under five years at 19% in 2016.

“When IRS was withdrawn from my community about four years ago, my siblings started getting malaria,” said Osman Salamatu, a 25-year-old mother, whose household was the first to be sprayed in the 2017 campaign. Women are impacted most by the burden of malaria because they are the primary caregivers when children and other adults contract malaria. While caring for others, women are often unable to work, which leads to a loss of income. Salamatu said she is excited because she knows that her children will be protected from malaria now and she will have more time to do income-earning work.

Osman Salamatu was the first beneficiary to receive IRS in the 2017 campaign in Karaga District in Northern Ghana. Photo: Lena Kolyada.

After her house was sprayed, Salamatu said, “I saw (that) many insects in my room were killed and I am sure that the mosquitoes will die also.” She encouraged other people in the community to work with the PMI AIRS Project to ensure that their houses are sprayed as well. The efficacy of IRS depends on a high acceptance rate by the communities to have their homes sprayed. PMI has set a target of 85 percent IRS coverage in communities to kill the mosquitoes that transmit malaria and ensure protection.

Salamatu learned about the benefits of IRS from the PMI AIRS Project’s community mobilization activities. Before spraying, the PMI AIRS Project conducts advocacy and sensitization meetings with various stakeholders – from district government officials to residents – to ensure the community understands how IRS will help prevent malaria in their homes and the necessary safety precautions to follow to keep their families safe and healthy during spraying.

Karaga had one of the highest burdens of malaria in Ghana before the 2017 spray. With the re-introduction of IRS and spray coverage of 92.4%, the project is expected to significantly reduce the incidence of malaria in the district in 2017.