Indoor residual spraying or IRS is the process of spraying the inside of dwellings with an insecticide to kill mosquitoes that spread malaria. A dilute solution of insecticide is sprayed on the inside walls of certain types of dwellings—those with walls made from porous materials such as mud or wood but not plaster as in city dwellings. Mosquitoes are killed or repelled by the spray, preventing the transmission of the disease. In 2008, 44 countries employed IRS as a malaria control strategy. Several pesticides have historically been used for IRS, the first and most well-known being DDT.
The World Health Organization (WHO) recommends IRS as one of three primary means of malaria control, the others being use of insecticide treated bednets (ITNs) and prompt treatment of confirmed cases with artemisinin-based combination therapies (ACTs). While previously the WHO had recommended IRS only in areas of sporadic malaria transmission, in 2006 it began recommending IRS in areas of endemic, stable transmission as well.
According to the WHO:
[N]ational governments should:
Introduce and/or scale up coverage of targeted IRS as a primary malaria control intervention in countries where available data indicates that it can be effective towards achieving malaria targets.
Take all necessary steps to ensure effective implementation of IRS interventions, including selecting the appropriate insecticide, spraying where and when necessary and sustaining a high level of coverage, and to prevent unauthorized or un-recommended use of public health insecticides.
Strengthen the managerial capacity of national malaria control programmes and improve human, technical and financial resources for the timely delivery and high coverage of effective interventions including IRS, with adequate monitoring and evaluation.
Furthermore, for IRS to be effective:
There must be a high percentage of sprayable surfaces within each dwelling.
The vector (mosquitos) must feed or rest indoors.
The targeted vectors must be susceptible (i.e. not resistant) to the insecticide being sprayed.
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