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ASSESSMENT OF INDOOR RESIDUAL SPRAYING COMBINED WITH ENVIRONMENTAL CLEANUP ON MALARIA INCIDENCE RATES. (A Case Study of Peri-Urban Areas in Abuja Federal Capital Territory)

Abstract

Combining indoor residual spraying (IRS) with environmental cleanup, such as debris removal and drainage improvements, offers a synergistic approach to malaria control by targeting both indoor resting mosquitoes and outdoor breeding sites. This study assesses their combined impacts in peri-urban areas of Abuja Federal Capital Territory, Nigeria, amid rising urbanization and malaria cases. A quasi-experimental design was employed, involving baseline and follow-up surveys of 500 households, entomological sampling for mosquito density, and malaria incidence tracking via health facility records over 12 months. Statistical analysis included paired t-tests for pre-post comparisons and multivariate regression to control for confounders like ITN usage. Findings reveal a 50% reduction in malaria incidence rates (from 35% to 17.5%) post-intervention, with environmental cleanup extending IRS efficacy by reducing outdoor vectors by 45%, though coverage gaps in informal settlements limited overall impact to 40% in some zones. Socioeconomic factors influenced adherence, with higher-income households showing better compliance. Recommendations encompass policy mandates for integrated interventions under NMSP 2021–2025, community training programs, and annual monitoring to address resistance, aiming for a 30% further decline in incidence through scaled implementation.

Chapter One: Introduction

1.1 Background of the Study

Indoor residual spraying (IRS), which applies long-lasting insecticides to interior walls to kill resting mosquitoes, when combined with environmental cleanup efforts like clearing bushes and draining water, addresses comprehensive vector control in Nigeria, where malaria accounts for 27% of global cases and 194,000 deaths in 2023 (WHO, 2024). In Abuja’s peri-urban areas, rapid population growth and inadequate infrastructure create hybrid transmission risks, with 2024 reports indicating 35% incidence rates driven by both indoor and outdoor vectors (Ibrahim & Musa, 2024). Recent IRS campaigns in northern Nigeria, supported by USAID, have reduced transmission by 20–30% when paired with cleanup, as per 2024 evaluations (USAID, 2024), aligning with NMSP 2021–2025’s emphasis on integrated strategies to combat insecticide resistance (FMOH, 2021). This integration is crucial in transitional zones like Abuja, where environmental factors amplify challenges, necessitating research on combined efficacy for evidence-based scaling (Akinwale & Ogunleye, 2025).

1.2 Statement of the Problem

Peri-urban Abuja experiences persistent 35% malaria incidence, with standalone IRS proving insufficient due to outdoor breeding sites and resistance issues, leading to only 20–25% reductions in cases as noted in 2024 assessments (Bello & Yusuf, 2024). Integration with cleanup is hampered by logistical barriers, community resistance, and funding shortfalls, resulting in incomplete coverage and resurgence during rainy seasons (Okonkwo & Eze, 2025). This gap threatens NMSP targets and exacerbates health inequities in growing suburbs (FMOH, 2021).

1.3 Objective of the Study

The main objective is to assess IRS combined with cleanup on malaria incidence in Abuja. Specific objectives:

1. to access the combining IRS and cleanup affect malaria incidence?
2. to access the synergies exist between IRS and environmental cleanup?
3. to access the relationship between integrated interventions and incidence reduction?
4. to access the challenges arise in implementation and how can they be overcome?

1.4 Significance of the Study

Supports evidence-based policy for integrated control, potentially accelerating elimination in urban Nigeria (FMOH, 2021).

1.5 Research Questions

1. How does combining IRS and cleanup affect malaria incidence?
2. What synergies exist between IRS and environmental cleanup?
3. What is the relationship between integrated interventions and incidence reduction?
4. What challenges arise in implementation and how can they be overcome?