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Benin Launches Second President's Malaria Initiative (PMI) Indoor Residual Spraying Campaign.

Operator spraying the walls of a house with insecticide. (Photo USAID)

On March 9, 2009, as part of the President’s Malaria Initiative (PMI), Benin launched its second Indoor Residual Spraying (IRS) campaign. IRS is a component of the country’s strategy to combat malaria. A joint USAID-Centers of Disease Control and Prevention (CDC) team visited communities in Ouémé department to witness the progress of the IRS campaign.

Indoor Residual Spraying in Action.

The USAID team included Nathan Miller, Benin/PMI Advisor, and Michael Lynch, a medical epidemiologist with CDC / Atlanta. PMI funds IRS operations in the Ouémé department only.

The visit started at the Porto Novo IRS warehouse where Research Triangle Institute (IRS) National Coordinator, Eugene Kiti, and Damien Kodjo, Environmental Consultant, met the visitors. Travelling to Awonou, a hamlet 15 km north of the town of Adjohoun, the team observed the spraying of two houses. As one team of operators was spraying the houses, others reminded villagers on safety procedures they must observe before and after their houses have been sprayed to avoid direct contact with the insecticide. For IRS to succeed, communities must accept and cooperate with spray operators.

An older woman admitted that, when IRS field coordinators and operators first came to announce the IRS operation in her community, she refused to let them operate, arguing that she was alone and too old and weak to move her belongings out of her house. When the IRS operators returned the following day, Philomène Kouégninou, a younger women who appears to act as a leader of the group, welcomed them and convinced the villagers to let the IRS team operate.

In the end, for Awonou villagers, like for the most vulnerable Beninese, success of the global Rolling Back Malaria effort will depend on the commitment of the health system of Benin to increase and facilitate access in public and private community health centers to malaria treatment and prevention products donated to the Government of Benin by the international community, like mosquito bednets and ACT medication.

Operators provide villagers with safety instructions after spraying their house with insecticide. (Photo USAID))

Indoor Residual Spraying Basics IRS is a commonly used malaria vector control method that has been particularly effective. It is implemented by applying long-acting chemical insecticides on the walls and roofs of all houses and domestic animal shelters in a given area, in order to kill the adult vector mosquitoes that land and rest on these surfaces. The insecticide remains on the treated surfaces upon which the mosquitoes will rest before or after taking a blood meal. The lasting effect of the insecticide is sufficient to kill resting mosquitoes for a period ranging from 3 to 12 months depending on the insecticide, the surface on which it is applied, and local conditions. The objective of IRS programs is to reduce the life span of the female mosquito population so as to reduce the population’s ability to sustain malaria transmission.

IRS is most effective in areas with seasonal malaria transmission and is typically implemented by teams of spray operators who spray houses in at-risk localities prior to the rainy season, before heavy rains prompt increases in the mosquito (Anopheles) vector population.

Critical to its effectiveness, IRS must attain coverage rates of at least 85 percent of the houses in a target area and spraying must be timed correctly. IRS requires effective leadership and management for planning, organization and implementation.

PMI in Benin

In December 2006, Benin was selected by the U.S. Government as one of 15 countries to receive funding from the PMI. The program is designed to reduce malaria deaths by 50% by achieving 85% coverage of the most vulnerable groups - principally pregnant women and children under five years of age - with key preventive and therapeutic interventions.

In support of Benin’s national malaria control program, PMI focuses on four highly effective interventions recommended by the World Health Organization to combat malaria: treatment with lifesaving anti-malarial drugs; insecticide-treated mosquito nets; preventive treatment for malaria during pregnancy; and indoor spraying of homes with insecticides (IRS) before the rainy season.

Since October 2007, PMI has made available 1.1 million artemisinine-based combination treatments (ACT), 2.3 million tablets of sulfadoxine-pyrimethamine (SP) for the preventive treatment of pregnant women, 650,000 mosquito bed nets impregnated with long-acting insecticides (ITNs), and 30 kits of microscopes and laboratory consumables for the accurate and rapid diagnosis of malaria.

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