Impact of Insecticide Treated Nets and Indoor Residual Spraying on prevalence of Malaria Among Women of reproductive age in Ghana: Implication for Malaria Control and Elimination

Abstract BackgroundThe Global Fund alone contributed 56% of all international financing for malaria and has invested more than US$13.5 billion in malaria treatment, prevention, and control programs as of June 2021. However, there is paucity of studies assessing whether these investments in different malaria interventions (use of mosquito nets, indoor residual spraying and preventive treatment for children and pregnant women) have contributed to a reduction in malaria prevalence. This study aims to quantify the impact of household access to insecticide treated nets (ITNs) and the indoor residual spraying (IRS) on malaria prevalence among women of reproductive age in Ghana. .MethodThis study analyzed the 2016 Ghana Malaria Indicator Survey (MIS), a nationwide survey among women aged 15 to 49 years. The study employed the Poisson regression model with inverse probability to treatment weighting to determine the average treatment effect estimate of the two malaria interventions on the prevalence of malaria among women in Ghana. Results A total sample of 4,861 women interviewed from the 2016 Ghana MIS was used for the analysis. The prevalence of malaria in 2016 was 34.4% (95% CI: [32.4%, 36.4%]). Approximately 80.0% of the women lived in households with access to ITNs (Pr=79.9% , (95% CI: [78.0%, 81.7%])), 12.4% (95% CI: [7.5%, 19.8%]) of the households had access to IRS and 11.4% (95% CI: [7.0%, 18.0%]) of the households had access to both ITNs and IRS. Household access to only ITN contributed to 7.1% (95% CI: [-12.0%, -2.1%], p=0.005) reduction in the prevalence of malaria among women whilst IRS at the households contributed to 6.8% (95% CI: [-13.1%, -0.55%], p=0.033) reduction in malaria prevalence. Households with access to both ITNs and IRS contributed to a 27.1% (95% CI: [-34.9%, -19.25%]) reduction in malaria prevalence among women. ConclusionAccess to both ITNs and the application of IRS at the household level contributed to a significant reduction of malaria prevalence among women of reproductive age in Ghana. This finding confirms the call for integrating malaria control interventions to facilitate attainment of malaria elimination in Ghana.