In Ghana, IRS is a core vector control intervention and a component of the current National Malaria Control Strategy and Ghana Strategic Plan for Malaria Control 2014-2020. PMI support for IRS started in 2008. In the ensuing 12 years, PMI has targeted between five and nine districts in the Northern region (recently divided into three regions: Northern, North East, and Savannah) per year, with the highest number of structures sprayed (383,142 structures) and population protected (941,240 people) in 2012. AngloGold Ashanti Malaria Control Ltd (AGAMal) has been conducting IRS since 2006 in the Obuasi district of the Ashanti region with its own funds. Since 2008, AGAMal has received financial support from the Global Fund to expand its IRS activities to the entire Upper West and three districts in the Upper East regions.
In 2019, under the PMI VectorLink (VL) Ghana project, IRS was conducted in eight districts, targeting 324,704 structures using Actellic (pirimiphos-methyl) and SumiShield (clothianidin) insecticides, from April 2 to May 9, 2019, for the main operation and from May 16 to 26, 2019 for a partial spray pilot as part of an operational research study. A total of 298,385 structures were sprayed out of 316,285 structures that spray operators (SOPs) found in the targeted districts, accounting for a coverage rate of 94.3%. VL Ghana planned to spray the Chereponi district, which would have brought a total number of PMI IRS districts to nine. However, protracted ethnic conflict forced the project to cancel 2019 IRS operations in Chereponi. For the 2020 IRS campaign, after extensive research and assessment, the project identified a new district for IRS expansion, Tatale-Sangul District (TSD).
The table below provides an overview of the number of sprayed structures and population protected from 2016 through 2019, including targets for 2020.
Number of Districts, Structures Sprayed, and Population Protected, 2016‒2020
|Year||Number of Districts||Structures Sprayed||Population Protected||Insecticide|
|2020 (Target)||9||346,285||990,579||Pirimiphos-methyl; clothianidin and deltamethrin mixture|
To date, the project has supported NMCP with entomological surveillance including annual insecticide resistance monitoring and monthly vector bionomics monitoring at established sites within PMI IRS districts. The project has also supported National Insecticides Resistance Monitoring Partnership (NIRMOP) through a subcontract to Noguchi Memorial Institute for Medical Research (NMIMR), which collected and reported on insecticide resistance data in 20 established sentinel sites throughout the country. In addition, the project regularly monitored spray quality and residual efficacy of IRS insecticides.
In mid-2019, VL Ghana began implementing ITN technical assistance activities following the VectorWorks project closeout. Major tasks completed during the period were 12-month ITN durability monitoring data collection, the inclusion of ITN-related questions into outreach training and supportive supervision (OTSS+), an ITN prototype design workshop, and initiation of monthly planning sessions with the NMCP vector control team for 2020 school-based distribution campaign.
In its third year, VectorLink Ghana will conduct IRS in nine districts: Bunkpurugu-Nakpanduri (BND), East Mamprusi (EMD), Gushegu (GUD), Karaga (KAD), Kumbungu (KUD), Mamprugu Moaduri (MMD), Tatale-Sanguli (TSD), West Mamprusi (WMD), and Yunyoo-Nasuan (YND), from on/about March 24 through May 1, 2020. The project will continue building the capacity of the government to plan and implement quality IRS in the future. Figure 1 highlights the target districts for IRS in 2020.
In 2020, the PMI VectorLink Ghana project will work with the NMCP, Ghana Health Service (GHS) Regional and District Health Directorates, District Assemblies, and community and religious leaders to spray 346,285 targeted structures in nine districts using Actellic (in MMD), SumiShield (in BND, KAD, WMD, and YND), and Fludora Fusion (clothianidin + deltamethrin mixture) (in EMD, GUD, KUD, and TSD). The project’s primary objective is to reach a minimum coverage of 85% of the structures found in each district by implementing high-quality IRS operations (and at least 90% of eligible structures per NMCP target).
In addition to spraying, the project will carry out the following activities:
- Introduce mobile data collection in two operations sites in two districts (GUD and TSD).
- Pilot IRS self-mobilization (at no cost) in the new district by engaging and encouraging community leadership to assume full responsibility for community mobilization.
- Roll out the use of VectorLink Collect in Ghana to manage IRS data and entomology data.
- Prepare a new nationwide supplemental environmental assessment (SEA) for 2020‒2025 because the current one expires in March 2020.
- Conduct monthly vector bionomics monitoring in 12 sentinel sites nationwide including 8 in PMI-supported IRS districts.
- Monitor insecticide resistance in 17 sites (10 PMI IRS, 3 non-sprayed and 4 new national sites)
- Provide technical support for strategic decision making and deployment of interventions for malaria control to the Malaria Vector Control Oversight Committee (MaVCOC).
- Continue building the capacity of GHS at all levels on vector control to ensure proper monitoring, implementation, and sustainability of IRS.
- Continue to support the National Insecticides Resistance Monitoring Partnership (NIRMOP) to collect annual insecticide resistance data at 15 sentinel sites.
- Monitor the residual efficacy of three insecticide formulations that will be sprayed in 2020.
- Conduct 24-month ITN durability monitoring data collection.
- Provide technical support to the NMCP with annual school-based distribution and routine distribution of ITNs.
- Build social and behavior change skills and expertise of district education officers to support effective ITN campaigns in schools.
- Support planning for 2021 ITN point mass distribution campaign.
Click here to see how PMI VectorLink Ghana recycles and repurposes materials from their indoor residual spraying campaign.