Integrated approach to malaria prevention in rural communities in Uganda: experiences, perceptions and practices
Cardiff Metropolitan University
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Background: Despite immense global malaria prevention efforts, the disease remains a major cause of morbidity and mortality in sub-Saharan Africa. An integrated approach to malaria prevention, which advocates the use of several malaria prevention measures holistically, is being explored to reduce the occurrence of the disease. Aim: The aim of the thesis was to assess experiences, perceptions and practices on the integrated approach to malaria prevention in Wakiso district, Uganda. Methods: Study I was a pilot project that promoted the integrated approach and involved 3 phases. Phase 1 (baseline) was cross-sectional, and determined knowledge and practices on malaria prevention. Phase 2 (intervention) implemented an intervention on the integrated approach. Phase 3 (evaluation) was a cross-sectional impact evaluation of using the integrated approach. Study II was a clustered cross-sectional survey that assessed perceptions, utilisation and barriers of integrated malaria prevention. Results: The majority of participants (64.6%) had low knowledge on malaria prevention methods, with mosquito nets (81.7%) most known. Insecticide-treated nets were the most used method with 45.5% of households owning at least one net (Study I phase 1). The pilot project trained 25 community volunteers, sensitised over 200 community members, and established 40 demonstration households (Study I phase 2). There was improvement in knowledge on removal of mosquito breeding sites (51% versus 7%) in the evaluation in comparison with the baseline respectively. Improvement in practices in the evaluation compared with the baseline included mosquito screening in windows and ventilators (χ2 = 62.3; p < 0.001). The benefits reported by the demonstration households included reduction in mosquito populations and occurrence of malaria (Study I phase 3). If trained, most participants (68.6%) would use all methods in the integrated approach. Only 33.0% households were using the integrated approach, which was associated with reading newspapers (AOR 0.34; 95% CI 0.22 – 0.53) (Study II). Conclusion: Stakeholders involved in malaria control should intensify efforts of promoting multiple malaria prevention methods.
PhD Thesis Cardiff School of Health Sciences
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