This study compared the mortality responses and residual activity of two third generation indoor residual spray (3GIRS) products: a microencapsulated suspension (CS) of pirimiphos-methyl (Actellic 300CS – ACS)) and a polymer-enhanced suspension concentrate (SC-PE) of deltamethrin (K-Othrine Polyzone – KOPZ) when applied to various inert surfaces using conventional hand-compression application equipment and techniques. The study was divided in two observational formats. The semi-field component used sets of four specially constructed surfaces of approximately 0.5m2 surface size, each simulating common wall surfaces used to construct homes in southern DRC. Surfaces included painted cement, exposed cement, baked, and unbaked clay, each sprayed with either one of the two insecticides or water only serving as a matching blank control. The second format used the same insecticides applied inside two houses with either painted cement and baked clay walls. An untreated wall surface in each house served as the blank control. Using contact cone bioassays and an An. arabiensis insecticide-susceptible colony, comparisons were made between the different surfaces and two insecticides. In houses, on each wall, separate bioassays were conducted in 3 locations (top, center and bottom) to determine if insecticide residual activity and/or contact availability differed. Lastly, a comparison was made between matching semi-field and house wall surfaces (painted cement and baked clay).
In this study, under semi-field and house conditions, both insecticides produced effect significant mortality in mosquitoes, indicating either are suitable for use in IRS to reduce mosquito densities and indoor transmission of malaria. The effect of wall material is significant, showing insecticidal residual action varies differently. Both in semi-field and natural house conditions, painted cement walls provided the longest residual efficacy although the difference was relatively small compared with cement walls in the semi-field experiments. Unbaked clay surfaces resulted in the shortest residual life based on an 80% mortality cut-off. Cement and painted cement walls sprayed with either chemical have shown a long residual life in other studies [26, 40,41,42]. On smooth, non-absorbent surfaces such as painted brick, less spray volume of insecticide is required while applied dose of active ingredient remains constant between surface types [1]. Desalegn and colleagues [43] recommend community awareness of the importance of painting houses to enhance the residual effect of insecticide be included in health education programmes while indicating the relatively poor response on mud or unbaked clay walls. More crude wall surfaces reduce the effectiveness of insecticide limiting contact between active ingredient and mosquito tarsi because of greater chemical absorption compared to less pervious materials like cement, plastered and/or painted surfaces, baked clay, and wood substrates [32,44,45]. For instance, in India, KOPZ mortality decreased faster on mud surfaces compared to others [46]. The inferior results seen on clay-based walls in this study may reflect differences in formulation wherein wettable powders (WP) and water dispersible granules (WG) are best suited to more porous surfaces such as unbaked clay, while suspension and emulsifiable concentrates are generally more effective on finished cement, wood and painted surfaces (especially oil-based paints). Although the formulation can influence residual action, so can the active ingredient. A previous study in the same TFM area recorded long residual activity of a clothianidin-based product on the same type of unbaked clay walls using a wettable granule formulation [24]. Addressing IRS issues with unbaked clay is important as it remains a common building material in many rural areas of Africa [32] and accounts for nearly 40% of structures inside the TFM concession [TFM Malaria Control Programme 2018, unpublished report].
When using 80% kill as a cut-off value for ‘acceptable’ mortality for operational control programs, both formats showed KOPZ provided a longer residual life compared to ACS along with a higher relative risk of mosquitoes being killed with KOPZ. These findings correspond to two studies done in the same area and period in Tanzania also showing the residual performance of KOPZ was superior to ACS [32, 33]. Considering high temporal variability in response, in general, this investigation indicated estimations of ACS lasting between 4-6 months (~17-26 weeks) on sprayed walls and KOPZ lasting at least 6 months (26 weeks) hold true [27]. Both products under semi-field and house conditions showed strong insecticidal effect on susceptible mosquitoes indicating suitable use in IRS programs to reduce indoor anopheline densities and the transmission of malaria in southern DRC.
In sprayed houses with painted cement walls, KOPZ provided a residual life of at least 25 weeks (~ 6 months) near the bottom of the wall and a maximum of 47 weeks (11 months) in the middle portion of the wall. The house constructed with baked clay had a bio-efficacy between 15 and 21 weeks; whereas the semi-field observations varied between 7 and 14 weeks.
In north central Florida (USA), experimental hut trials with KOPZ gave a residual life of 6 months with a mean 80% final mortality on wood panels and at least 1 year with a minimum 98% mortality on metal and cement surfaces [26].
In Tanzania, KOPZ performed well up to 8.3 months on mud, 15.5 months on concrete and 16 months on plywood in laboratory conditions [33]. In a simple hut design, KOPZ gave 8, 12 and 14 months of control on concrete, plywood, and palm thatch, respectively; whereas mortality was below 80% within the first week after spraying on a mud surface [33]. In experimental huts, acceptable mortality lasted to 11.4 months on concrete and the mud surface recorded <80% mortality at the beginning of the trial [33]. In India, the residual life for KOPZ for IRS was 150 days (5 months) on mud and wood surfaces and 157 days (5.2 months) on cement [46]. KOPZ was also trialed as an outdoor residual treatment on painted cement walls of homes in Malaysia against Aedes mosquitoes where it provided residual control activity of 17 weeks although sprayed surfaces shielded by roofing could occasionally be subjected to rain and sunlight exposure that would potentially reduce insecticide effectiveness more quickly [47].
The present research findings are consistent with previous published observations in terms of the variability of mortality over time depending on various factors including the type of wall material and the environmental setting [43,48,49,50].
ACS gave a residual life under the 80% threshold from the beginning of the tests on unbaked clay walls, and a lower residual life between 3 and 7.5 weeks was than recorded on the other experimental walls. In the house with baked clay walls, residual life was between 7 and 17 weeks. Some studies have also recorded low residual life of ACS on sprayed surfaces. For example, in Tanzania, laboratory bioassays showed residual activity of 4.4 and 4.9 months on mud surfaces, 5.0 and 6.4 on concrete, and 12 months on plywood. However, in experimental huts using 60-min cone bioassays, the same study recorded 0.9 and 4.8 months on two mud walls, respectively, followed by concrete walls at 6.6 and 7.0 months, and 8.4 and 10.8 months on hut thatch ceilings [32]. In Ethiopia, a high target dose (1.854 g/m2) of ACS gave a residual life of 5 months on “rough” mud surface, 6 months on smooth mud, and between 4 and 5 months on dung and painted surfaces, respectively [4]. Two studies in Benin gave conflicting results: in northern Benin a duration of 4-5 months was recorded on mud and cement walls [51], while experimental huts showed residual activity between 9 and 12 months on cement and 6 months with mud surfaces [40]. In Central Côte d’Ivoire the residual activity of ACS was between 20 and 30 weeks on cement and 15 to 20 weeks on mud walls [41]. In the Lake Victoria Basin in Tanzania, the residual efficacy was different between the five districts monitored. Residual life was between 21 and 29 weeks on mud, 26 and 43 weeks on painted walls, and between 32 and 43 weeks on cement surfaces [42]. In Zanzibar, ACS was effective up to 8 months on mud, cement and water-based painted walls, and at least 9 months on oil-based painted walls [52]. Finally, in Brazil, at least 8 months of residual activity was recorded on both exposed and plastered cement [53].
Although our study recorded a relatively low residual life for ACS, during a 5-year period of community IRS using ACS, routine monitoring using cone bioassays recorded residual performance (based on ≥80% mortality) varying from 4 to 7.5 months on unbaked clay walls, and 6 to 8 months on cement, painted cement and baked clay [TFM Malaria Control Programme 2018, unpublished report]. IRS with ACS has shown benefits in different countries. In Lira District, Uganda and in Mutasa District, Zimbabwe, it was associated with a reduction in malaria morbidity 6 months after intervention [54,55]. In a high pyrethroid and carbamate resistant region of Zambia, ACS was effective for 5-8 months after spraying [56] and in Benin, for up to 10 months [40].
Though the mortality rates of experimental unbaked clay wall were under the 80% threshold from the beginning of the trial, the mean mortality recorded for this surface throughout the study period (38 weeks) was 56%. The basis or rationale for the 80% WHO operational threshold is unclear and appears arbitrarily. The importance and merit of a set or universal cut-off for residual effectiveness is questionable (other than for comparison purposes) and would be relative and dependent to the operational and epidemiological circumstances of a specific area [57,58]. Other studies have analyzed lower cut-off values together with the WHO recommended threshold [24,33].
Comparing the results recorded on experimental walls and those in houses, we noted that the houses gave generally better residual activities despite normal human presence which could be a factor affecting insecticide efficacy and bioavailability over time. For both insecticides and two different sprayed surfaces, the area near the bottom of the walls recorded reduced residual efficacy compared to the middle and top sections of the same sprayed wall. Although these findings might reflect differences in spray application (i.e., technique), it is also possibly the effect of human and animal (e.g., domestic pets) activity reducing the availability of insecticide closer to the bottom of the wall (subject to contact and abrasion) than the upper wall locations.
This study underlines the importance of doing site-specific assessments under field conditions for making evidence-based decisions in operational control settings [53,59]. The development of newer generation formulations that extend the contact residual activities of active ingredients allows greater operational flexibility to a control program. Added effective life potentially allows a single spray round to provide protection over an entire high transmission period, contributing tremendously to the cost-effectiveness of IRS. KOPZ is a polymer-enhanced suspension concentrate of deltamethrin specifically designed as a long-lasting formulation for residual application. The addition of the polymer potentiates insecticidal efficacy helping to protect deltamethrin from degradation and allowing the slow release of the insecticide over a longer period [47,60]. Similarly, ACS employs polymer micro-encapsulation of pirimiphos-methyl that allows the delivery of smaller quantities of insecticide over a longer period of time compared to other formulations (e.g., emulsifiable concentrate [1]. As shown in this study and others, both insecticidal products have greater residual life in some settings than others. Therefore, the classification of the types of materials to be sprayed can be very important in estimating the effectiveness of a formulation in IRS operations [1] while guided by local epidemiological and entomological considerations [61]. It is advisable to carefully consider each particular location regards environmental conditions and the variety of wall surfaces available in a community to monitor carefully the residual effectiveness of an insecticide product and its appropriateness for use in a program [43,53,59,62]. Decisions for implementing programs based on findings from other regions could be misleading and result in an overestimation of the effectiveness of IRS.