This paper describes the challenges faced by elderly persons (50 years and above) in Uganda, as parents and/or relatives of persons infected by HIV and as caregivers of the infected relatives and their uninfected children. Little is known regarding these indirect impacts of HIV/AIDS on the elderly in sub-Saharan Africa. Yet, the elderly are most often the main caregivers of HIV-infected persons and their families. Data used in this study were obtained from focus group discussions and in-depth interviews conducted among elderly respondents in 10 rural and urban communities within two Ugandan districts, Luwero and Kamuli. Findings indicate that the elderly do provide care to patients with AIDS at the terminal stage of the illness-when patients most need constant care. In most cases, the challenge of caring for the sick patients is compounded by the responsibility to care for the children affected by HIV/AIDS, which also starts when their parents are still living, not when the children become orphans. This demanding work was reported to negatively affect the elderly in various dimensions (economic, emotional, physical, and nutritional), all of which impacts their health and well-being. The responsibility for day-to-day patient care is borne primarily by elderly females, who reported a higher rate of physical ailments than male respondents-perhaps an indication of their disproportionate contribution to the care responsibilities. Most of the elderly respondents interviewed have a lot of anxiety about their future health and well-being, which they attributed in most part to the HIV/AIDS epidemic. These challenges do appear to exacerbate the aging process of the elderly whose health and well-being are already affected by the poor resource base and weak health infrastructure in this setting.

As the HIV/AIDS epidemic continues to devastate the sub-Saharan Africa region, the demand for care and support services to persons infected and affected by the disease is proliferating. Currently providing the bulk of this much-needed care and support are elderly persons. However, limited work has been done to examine how such care and support impacts the well-being of elderly caregivers. Using qualitative data from elderly respondents in two Ugandan districts, Kamuli and Luwero, this article examines changes in the household structure and living arrangements of older persons (50 years and above) after they take on caregiving responsibilities for persons suffering from AIDS-related illnesses and orphans and vulnerable children (OVC) affected by HIV/AIDS. The findings show that elderly caregivers face drastic disruptions of living arrangements, including prolonged travels and absences from their homes to care for the sick. There is also a sharp increase in their household size as they take on more OVC. The implications of such changes on the older persons' health and well-being are discussed.

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We examine whether a concerted malaria prevention education effort is associated with reduced malaria disease burden among children under the age of 5 years residing in conflict-affected settings in Northern Uganda. Two camps for internally displaced persons were identified in the Lira District of Northern Uganda. All residents in both camps were given free insecticide treated nets (ITNs), along with basic information on installation and use. In one camp, Ogur, an intense malaria prevention education intervention through community meetings, household visits, and posters was administered to camp residents for a 6-month period by trained community health care workers who were also camp residents. The residents of Ogur camp also received assistance in hanging their ITNs as needed from the resident community health workers. In the other camp, Abia, no additional health education intervention was provided after the ITN distribution. After 6 months, a survey was conducted among a cross-section of respondents from each camp. The results from this survey show significantly lower rates of reported malaria among children under 5 years in the intervention camp (Ogur) compared with children in the reference camp (adj. RR = 0.68; 95% CI: 0.50, 0.91). This suggests that including enhanced malaria prevention education as an integral component of ITN distribution programs could help promote the use of malaria prevention methods and help stem malaria infections.

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