%D %0 ARTICLE %T Determining areas that require indoor insecticide spraying using Multi Criteria Evaluation , a decision-support tool for malaria vector control programmes in the Central Highlands of Madagascar . %J %V 6 ( ) %P 2 %A Rakotomanana F %A Randremanana RV %A Rabarijaona LP %A Duchemin JB %A Ratovonjato J %A Ariey F %A Rudant JP %A Jeanne I %M pub17261177 %X BACKGROUND : The highlands of Madagascar present an unstable transmission pattern of malaria . The population has no immunity , and the central highlands have been the sites of epidemics with particularly high fatality . The most recent epidemic occurred in the 1980s , and caused about 30 , 000 deaths . The fight against malaria epidemics in the highlands has been based on indoor insecticide spraying to control malaria vectors . Any preventive programme involving generalised cover in the highlands will require very substantial logistical support . We used multicriteria evaluation , by the method of weighted linear combination , as basis for improved targeting of actions by determining priority zones for intervention . RESULTS : Image analysis and field validation showed the accuracy of mapping rice fields to be between 82 . 3% and 100% , and the Kappa coefficient was 0 . 86 to 0 . 99 . A significant positive correlation was observed between the abundance of the vector Anopheles funestus and temperature ; the correlation coefficient was 0 . 599 ( p < 0 . 001 ) . A significant negative correlation was observed between vector abundance and human population density : the correlation coefficient was -0 . 551 ( p < 0 . 003 ) . Factor weights were determined by pair-wise comparison and the consistency ratio was 0 . 04 . Risk maps of the six study zones were obtained according to a gradient of risk . Nine of thirteen results of alert confirmed by the Epidemiological Surveillance Post were in concordance with the risk map . CONCLUSION : This study is particularly valuable for the management of vector control programmes , and particularly the reduction of the vector population with a view to preventing disease . The risk map obtained can be used to identify priority zones for the management of resources , and also help avoid systematic and generalised spraying throughout the highlands : such spraying is particularly difficult and expensive . The accuracy of the mapping , both as concerns time and space , is dependent on the availability of data . Continuous monitoring of malaria transmission factors must be undertaken to detect any changes . A regular case notification allows risk map to be verified . These actions should therefore be implemented so that risk maps can be satisfactorily assessed .