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. 2022 May 18;2(5):e0000285. doi: 10.1371/journal.pgph.0000285

Fig 1. The IRS intervention and the Bongo study design.

Fig 1

A. Distribution of IRS across the Upper East, Upper West, and Northern Regions of Ghana, West Africa between 2012 to 2016. Highlighted in light red are the IRS programmes funded by the Global Fund in partnership with the AGAMal (Upper East and Upper West Regions) and in dark red are those funded by PMI/AIRS (Northern Region). Districts where no shading is indicated, denote no ongoing IRS programmes during the study time period. Bongo District, where the current study took place, is denoted by the black hashed lines. The thick black lines are used to signify borders between Ghana and Burkina Faso (light grey) to the north, and Ghana and Togo (light grey) to the west. This map was drawn in R using the rnaturalearth package (https://github.com/ropensci/rnaturalearth) and data from Natural Earth (http://www.naturalearthdata.com/) under a CC0 license, with district-level data from the Malaria Atlas (https://github.com/malaria-atlas-project/malariaAtlas) available in an open-access repository. B. Four age-stratified cross-sectional surveys (N = ~2,000) were conducted in Bongo at the end of the wet (blue circles) and the end of the dry seasons (gold circles) between October 2012—June 2016. The study design can be broken down into two study phases: (1) Pre-IRS: two surveys prior to the introduction of IRS (Survey 1 October 2012 (S1); Survey 2 May/June 2013(S2)); and (2) Post-IRS: two surveys following three-rounds of IRS (Survey 3 October 2015 (S3); Survey 4 May/June 2016 (S4)). The three-rounds of IRS were implemented between 2013–2015 as indicated with grey shading: Round 1 (R1: October 2013 –January 2014, Vectoguard 40WP), Round 2 (R2: May–July 2014, Actellic 50EC), and Round 3 (R3: December 2014 –February 2015, Actellic 300C). LLINs were mass distributed in Bongo District using universal coverage campaigns between 2010–2012 and again in 2016 as indicated. The mosquitos are used to denote when the monthly entomology surveys were undertaken (February 2013 and September 2015).