Malaria is a protozoan disease and one of the leading causes of illness and deaths in the world. Malaria is predominant in the tropics and subtropics, and it is reported that malaria kills a child every minute. In Tanzania at least 40% of outpatient attendances are attributable to malaria. This study assessed the impact of Insecticidetreated nets (ITNs) + indoor residual spraying (IRS) in Geita district, IRS alone in Nyangâ€™hwale district and compared the two interventions between the two districts of Tanzania. In a retrospective cross-sectional study, district malaria surveillance data for five years (2011- 2015) and two years (2013-2014) were collected and analyzed for Geita and Nyangâ€™hwale districts respectively. A total of 1,387,805 ITNs were distributed and 435,719 households sprayed between 2011 and 2015, however IRS coverage was uneven. There was evidence of malaria prevalence reduction from 53% to 12% in Geita district within the five years of intervention. The ITNs coverage was associated with a reduction in malaria prevalence while IRS was not. In Nyangâ€™hwale district malaria cases increased from 103,788 to 123,337 cases in 2013 and 2014 respectively, and were accompanied by decreased households sprayed from 49,554 to 41,632. Furthermore, only ITNs had a significant effect in the combination. However, even at 100% ITNs coverage, the estimated probability of finding malaria cases would not be zero. Therefore, based on this study, the use of the two interventions that both use pyrethroids in combination has insignificant benefits and should be avoided unless IRS insecticide is not a pyrethroid.
Geita and Nyangâ€™hwale districts, Insecticide-treated nets, Indoor residual spraying, Tanzania
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