6 June 2018

Uganda: Indoor Spraying Keeps Away Malaria

Authorities in Dokolo and Apac districts have made great strides in fighting malaria using indoor residual spraying (IRS).

IRS is the application of insecticide to the inside of dwellings, on walls and other surfaces that serve as a resting place for malaria-infected mosquitoes. IRS kills mosquitoes when they come in contact with treated surfaces, preventing disease transmission.

The districts has been using IRS since 2013.

Dr Samuel Ojok, the Dokolo district health officer, says five years ago, malaria contributed to 53 per cent of all the cases received at the out patient departments, with children the most affected.

Malaria was also a leading cause of miscarriages. Malaria cases reported weekly in Dokolo reduced from an average of 3,500 cases per week in 2014 to less than 300 cases per week at the end of 2017, according to 2017 Health Monitoring Information System report.

Implementation

The Dokolo District information officer, Mr Suwed Musafiri, says the IRS intervention was conceived in 2012 following a council resolution.

"That time, Dokolo was almost having the highest prevalence of malaria in the whole country," he says.

"We were not doing well; we had lots of issues; children dropping out of school, children dying and mothers having miscarriages," he adds.

The IRS is funded by USAID, UKAID, President's Malaria Initiative and Centre for Disease Control (CDC) and Prevention.

Mr Musafiri says IRS will continue until 2022.

Today, the total IRS coverage in Dokolo District stands at 86 per cent.

The Dokolo District chairman, Mr Frederick Odongo, said they have been successful in the fight against malaria because everybody is involved.

"Before we started implementing IRS, we mobilised and sensitised the community and we set target of what we expect from the pump operators. Where there is resistance, we normally go there and dialogue with the community and they understand and allow their houses to be sprayed," Mr Odongo says.

By the end of the programme, the district expects 90 per cent coverage.

School enrolment boosted

The inspector of schools, Mr Patrick Okae, says enrolment in the 60 government-aided primary schools in Dokolo has gone up due to the successful battle against malaria.

Mr Cons Okabo-Opio, the head teacher of Angwecibange Primary School, who is also the chairperson of all head teachers in Dokolo, acknowledges an increase in the number of pupils at Angwecibange in recent years.

"In 2016, we had 1,457 pupils; in 2017, we had 1,581 and the total enrolment for this year is 1,685 pupils," Mr Okabo-Opio says.

Apac's success story

According to the etymological infective rate conducted in 2004, Apac District was found to have the highest number of mosquito bites in the world standing at 1,564 bites.

Dr Myers Lugemwa, the deputy manager of malaria control programme at the Ministry of Health, said then that when 1,564 is divided by the number of days in a year, an individual living in the district would suffer about five mosquito bites every night.

The officer in charge of Akororo Health Centre III in Apac District, Mr James Opio, said before several interventions aimed at eliminating malaria were in place, the district registered upsurge in malaria cases. For instance, on average, 150 cases of malaria were registered on a weekly basis at Akokoro health centre alone, in 2015/2016.

Today, the incidence of malarial has drastically reduced because of a number of interventions including the use of IRS, long lasting insecticide treated net and intermittent preventive treatment (IPT).

IPT is a public health intervention aimed at treating and preventing malaria episodes in infants.

"We currently receive only 23 cases of malaria on a weekly basis," Mr Opio said.

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