Improving the performance of spray operators through monitoring and evaluation of insecticide concentrationsof pirimiphos-methyl during indoor residual spraying for malaria control on Bioko Island

Background: Quality control of indoor residual spraying (IRS) is necessary to ensure that spray operators (SOs) deposit the correct concentration of insecticide on sprayed structures, while also confrming that spray records are not being falsifed. Methods: Using high-performance liquid chromatography (HPLC), this study conducted quality control of the organophosphate insecticide pirimiphos-methyl (Actellic 300CS), during the 2018 IRS round on Bioko Island, Equatorial Guinea. Approximately 60 SOs sprayed a total of 67,721 structures in 16,653 houses during the round. Houses that were reportedly sprayed were randomly selected for quality control testing. The SOs were monitored twice in 2018, an initial screening in March followed by sharing of results with the IRS management team and identifcation of SOs to be re-trained, and a second screening in June to monitor the efectiveness of training. Insecticide samples were adhesive-lifted from wooden and cement structures and analysed using HPLC. Results: The study suggests that with adequate quality control measures and refresher training, suboptimal spraying was curtailed, with a signifcant increased concentration delivered to the bedroom (diference=0.36, P