Community Acceptance of Indoor Residual Spraying for Malaria Control and Associated Factors

Abstract

Introduction: Malaria remains a major global public health challenge despite substantial progress in control measures. In 2024, an estimated 282 million cases and 610,000 deaths were reported, with nearly 95% occurring in the WHO African Region. In India, malaria burden has declined considerably, although transmission persists in endemic regions. Indoor Residual Spraying (IRS) is an effective WHO-recommended intervention; however, its success depends largely on community acceptance, awareness, and participation.

Method: A community-based cross-sectional analytical study was conducted among 220 randomly selected adult household representatives from malaria-endemic rural villages of Palghar district, Maharashtra (2024–2025). Data were collected using a validated, interviewer-administered questionnaire assessing socio-demographic characteristics, housing conditions, malaria knowledge, perceptions, receipt of IEC messages, and acceptance of Indoor Residual Spraying (IRS). Associations were examined using Chi-square tests and logistic regression to estimate crude and adjusted odds ratios with 95% confidence intervals, considering p<0.05 statistically significant.

Result: The study found 56 (25.5%) households accepted IRS, whereas 164 (74.5%) refused. Acceptance was significantly higher among nuclear families (28.5% vs. 16.4%; p=0.004), residents of kuccha/semi-pucca houses (47.1% vs. 21.5%; p=0.001), lower socioeconomic groups (26.9% vs. 20.8%; p=0.042), and participants receiving malaria IEC messages (30.6% vs. 18.8%; p=0.031). Multivariable analysis identified kuccha/semi-pucca housing (AOR=3.86) and receipt of IEC messages (AOR=2.16) as the strongest independent predictors of IRS acceptance.

Conclusion: The study concluded that acceptance to IRS was very low, with 25.5% of the respondents accepting IRS and 74.5% refusing the intervention.