Student Dissertation

Agency : Qualitative Assessment, Indoor Residual Spray, Kala-Azar

Background : In 1953 and 1970, insecticidal DDT spray under national malaria eradication program resulted in marked decline in disease incidence. Forty eight percent teams started the spray after 10 am and completed the spray till 5 pm which lead on to less number of coverage of sprayed households. Eight percent squad teams were not found to have all team members. Personal protective equipment was not being used by 84 percent teams which may lead to harmful effect on field teams. Twenty eight percent teams were working with single stirrup pump while two pumps are required for effective spray. Buckets availability was also found less in 87 percent teams. Eight percent teams did not have awareness about quantity of DDT to be mixed while making paste and 15 percent of teams did not have information about quantity of water used in a mixture preparation. Seventeen percent squad teams were found practicing more or less than range of 23- 28 strokes per minute and were not aware about correct plunger movement of 10-15 cm in each time. Speed of spray was found more or less than 10-20 seconds in 57 percent teams. All squad teams were aware about spraying height inside households. Only eighty one percent teams were practicing to maintain the distance of spraying lance about one hand/one and half feet from the wall. Ninety seven percent teams were making vertical spray swaths and only 64 percent of all squad teams were found practicing successive swaths overlapping of length of middle finger. Thirty two percent teams were not having awareness about breadth of the spray swath.

Recommendations : Quality of indoor residual spray was found compromised due to following important identified factors: Insufficient number of team members, PPE equipment, stirrup pumps, buckets, plastic sheets was directly affecting the per day covered households due to involvement of less workforce at field level. Non-awareness among squad teams about uniform distribution, strokes per minute, plunger movement length, width of spray swath, overlapping of successive swaths, speed of spray and height of spray distance. Approximately 80 to 90 percent squad teams at block level have enough knowledge about DDT mixture preparation, plunger movement distance, spraying lance distance from wall surface and spraying height inside households but teams have partial knowledge about frequency of strokes per minute, speed of spray and breadth of spray swath. So training of squad teams needs to be done to make indoor residual spray effective to eliminate Kala-azar from Darbhanga district of Bihar. Training without effective implementation plans will not result in long term skill retention.