Malaria Prevention in Sub-Saharan Africa: A Field Study in Rural Uganda

Abstract

Malaria, a completely preventable and treatable disease, remains one of the biggest killers in Sub-Saharan Africa today. The objectives of this study were to describe the impact of malaria on a small rural community in Uganda (Bufuula) and to implement and evaluate a malaria prevention program (subsidised insecticide treated nets with an accompanying education session). In January 2006, a survey of 202 households (100% response rate) was conducted, and meetings held with the Village Council, which revealed that malaria was the community's major cause of morbidity and mortality, and showed there was a lack of access to preventative measures. Furthermore, 34% of each household's income was allocated to the burden of malaria. A malaria education and mosquito net distribution session was held in January 2006, which was attended by over 500 villagers who purchased 480 heavily-subsidised long lasting insecticide treated nets (LLINs). Home visits were conducted 1 week later to ensure the LLINs were hung correctly. A follow-up survey was conducted in January 2007. There was a rise in net ownership following the program (18% to 51%, P < 0.0001) and lower rates of childhood malaria prevalence (14%) than reported in Ugandan national statistics (40%). However, only half the nets owned were being used correctly by those most vulnerable to the illness. The findings suggest that mosquito nets must be provided with an effective education program and may be more successful if conducted in whole districts simultaneously rather than on a per-community basis. The evidence for super-targeting strategies for those most vulnerable is also considered. These findings provide important lessons and considerations for other wide-scale malaria prevention programs.

Determinants of bed net use in children under five and household bed net ownership on Bioko Island, Equatorial Guinea

“…It seems reasonable that if caregivers knew how malaria was transmitted and prevented, they were more likely to protect their children with nets. This supports the notion as reported elsewhere [34,35] that health education yields changes in health seeking behaviour related to malaria prevention. Paradoxically, knowing whether fever was a symptom of malaria was not associated with higher ownership.…”

Gendered vulnerabilities to a neglected disease: A comparative investigation of the effect of women’s legal economic rights and social status on malaria rates

“…Bates et al, 2004;Norris, 2004;Sachs and Malaney, 2002;WHO, 2013;Williams et al, 2009), we find that the social environment (with regard to women's standing) is in fact a stronger predictor of crossnational malaria rates than geographical location. In some ways, this finding illustrates that through improvements in gender equality, poor nations can potentially overcome some of their natural or environmental predispositions to this disease, and likely other tropical illnesses as well.…”

Household malaria knowledge and its association with bednet ownership in settings without large–scale distribution programs: Evidence from rural Madagascar

“…Identification of malaria knowledge as a predictor of malaria prevention behaviors suggests a focus on malaria–specific education as a means of increasing bednet coverage even in settings without large scale distribution and subsidization of bednets [28,29]. However, questions remain as to the origins of the malaria knowledge measured in this study which appears correlated with household bednet ownership.…”