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

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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.

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  1. www.handsofhelp.org.

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Acknowledgements

This work would not have been possible without the tireless work of the Hands of Help volunteers and the enthusiasm and warmth of Bufuula community.

Sources of Funding

Funding was secured from private donations in Australia.

Possible Competing Interests

The first author is the Founder of the organisation (Hands of Help) which conducted the research.

Author information

Authors and Affiliations

  1. St Cross College, St Giles, Oxford, OX1 3LZ, UK

    Phoebe C. M. Williams

  2. School of Economics, Australian National University, Canberra, ACT, 0200, Australia

    Alan Martina

  3. School of Public Health and Centre for Education & Research on Ageing, Concord Hospital, The University of Sydney, Sydney, NSW, 2006, Australia

    Robert G. Cumming

  4. International Public Health, Edward Ford Building, The University of Sydney, Sydney, NSW, 2006, Australia

    John Hall

Authors
  1. Phoebe C. M. Williams
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  2. Alan Martina
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Correspondence to Phoebe C. M. Williams.

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Williams, P.C.M., Martina, A., Cumming, R.G. et al. Malaria Prevention in Sub-Saharan Africa: A Field Study in Rural Uganda. J Community Health 34, 288–294 (2009). https://doi.org/10.1007/s10900-009-9151-y

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  • DOI: https://doi.org/10.1007/s10900-009-9151-y

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