Integrated approach to malaria prevention at household level in rural communities in Uganda: experiences from a pilot project

Abstract

BackgroundMalaria is a major public health challenge in sub-Saharan Africa. In Uganda, malaria is the leading cause of morbidity and mortality especially among children under five years of age. This pilot project promoted prevention of malaria at household level using an integrated approach in two rural communities in Wakiso District, Uganda. This involved advocating and implementing several strategies in a holistic manner geared towards reduction in the occurrence of malaria. The specific strategies involved can be classified as: 1) personal protection – use of insecticide-treated bed nets and insecticide sprays; 2) reducing mosquito breeding sites – draining pools of water, larviciding and clearing unnecessary vegetation around homes; and 3) reducing entry of mosquitoes into houses – installing mosquito proofing in windows, ventilators and open eaves, and closing windows and doors early in the evenings.Case descriptionThe objectives of the project were to: carry out a baseline survey on malaria prevention; train community health workers and increase awareness among the community on the integrated approach to malaria prevention; and, establish demonstration sites using the integrated approach. A baseline survey among 376 households was conducted which generated information on the knowledge, attitudes and practices of the community in relation to malaria prevention. The project trained 25 community health workers and over 200 community members were sensitized on the integrated approach to malaria prevention. In addition, 40 demonstration households using the integrated approach were established.Discussion and evaluationThe use of multiple methods in the prevention of malaria was appreciated by the community particularly the demonstration households using the integrated approach. Initial project evaluation showed that the community had become more knowledgeable about the various malaria prevention methods that were advocated in the integrated approach. In addition, some of the methods that were not being used before project implementation, such as early closing of windows, had been adopted. The presence of mosquitoes in the demonstration households had also reduced.ConclusionThe integrated approach to malaria prevention at household level was well perceived by the project community, which could be scaled up to other areas. More rigorous studies such as randomized controlled trials are also recommended to further explore the public health impact of the integrated approach to malaria prevention.

Health-Seeking Behaviour towards Poverty-Related Disease (PRDs): A Qualitative Study of People Living in Camps and on Campuses in Cameroon

“…As in other developing countries, malaria was perceived as a common disease in both settings [16–18]. Its presence was attributed to poverty, poor hygiene and tropical climatic conditions conducive to mosquitoes.…”

Low prevalence of laboratory-confirmed malaria in clinically diagnosed adult women from the Wakiso district of Uganda

“…Historically, Entebbe has been classified as a malaria hyper-endemic area [20, 21] with an estimated malaria prevalence of 13% in young children [6]. Most studies of malaria rates in adults in the region have focused on pregnant women or HIV-infected persons [22–24] and as a result the effectiveness of recent interventions in reducing malaria prevalence in the general population is unknown.…”

Knowledge and practices on malaria prevention in two rural communities in Wakiso District, Uganda

“…In addition to promotion of use of ITNs and IRS, advocating the use of other malaria prevention methods is important in reducing the burden of the disease in endemic countries. Indeed, the integrated approach to malaria prevention promoted in the study community after conducting this survey had immediate benefits such as reduced presence of mosquitoes in houses 15 . It is planned that the long term public health impact of the integrated approach in the study community will be assessed more than 2 years after implementing the project.…”

“…This study assessed the knowledge and practices on malaria prevention in two rural communities in Wakiso district, Uganda with emphasis on the various prevention strategies that can be used. The study was carried out as a baseline survey before implementation of a pilot project that promoted the integrated approach to malaria prevention which advocates the use of several malaria prevention methods in a holistic manner at households 15 .…”