BACKGROUND Indoor residual spraying (IRS) is widely used as a vector control measure, although there are conflicting findings of its effectiveness in reducing malaria incidence. The objective of this study was to estimate the effect of multiple IRS rounds on malaria incidence and hemoglobin levels in a cohort of children in rural southeastern Uganda. METHODS The study was based upon a dynamic cohort of children aged 0.5-10 years enrolled from August 2011 to June 2017 in Nagongera Subcounty. Confirmed malaria infections and hemoglobin levels were recorded over time for each participant. After each of 4 rounds of IRS, malaria incidence, hemoglobin levels, and parasite density were evaluated and compared with pre-IRS levels. Analyses were carried out at the participant level while accounting for repeated measures and clustering by household. RESULTS Incidence rate ratios comparing post-IRS to pre-IRS incidence rates for age groups 0-3, 3-5, and 5-11 were 0.108 (95% confidence interval [CI], .078-.149), 0.173 (95% CI, .136-.222), and 0.226 (95% CI, .187-.274), respectively. The mean hemoglobin levels significantly increased from 11.01 (pre-IRS) to 12.18 g/dL (post-IRS). CONCLUSIONS Our study supports the policy recommendation of IRS usage in a stable and perennial transmission area to rapidly reduce malaria transmission.

中文翻译：

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在高传播环境中，多轮室内残留喷雾对疟疾发病率和血红蛋白水平的影响。

背景技术室内残留喷雾（IRS）被广泛地用作矢量控制措施，尽管在减少疟疾发病率方面其有效性存在矛盾的发现。这项研究的目的是评估多轮IRS对乌干达东南部农村地区一群儿童的疟疾发病率和血红蛋白水平的影响。方法该研究基于2011年8月至2017年6月在Nagongera Subcounty的0.5-10岁儿童的动态队列研究。随着时间的推移，每位参与者都记录了确诊的疟疾感染和血红蛋白水平。在四轮IRS之后，评估疟疾发病率，血红蛋白水平和寄生虫密度，并将其与IRS前水平进行比较。在参与者级别进行分析，同时考虑重复措施和家庭聚类。结果0-3、3-5和5-11岁年龄组的IRS后与IRS前发生率的发生率比分别为0.108（95％置信区间[CI] 、. 078-.149），0.173（95） ％CI，.136-.222）和0.226（95％CI，.187-.274）。平均血红蛋白水平从11.01（IRS前）显着增加到12.18g / dL（IRS后）。结论我们的研究支持在一个稳定且多年生的传播地区使用IRS的政策建议，以迅速减少疟疾的传播。