According to the experts, some of current interventions that government is currently implementing are not effective in some parts of the country and have instead become a money-making venture for different parties involved in the fight against malaria.
Public health experts have asked the government to change its
approach in malaria prevention strategies.
According to the experts, some of current interventions that
government is currently implementing are not effective in some parts of the
country and have instead become a money-making venture for different parties
involved in the fight against malaria.
The researchers want government to carry out more indoor residual spraying and
develop malaria diagnostic equipment based on Uganda’s malaria patterns instead
of buying insecticide-treated mosquitoes that are often abused.
Malaria is one of the leading causes of death in Uganda is estimated to be
endemic in 95 percent of the country, affecting around 3 million people
annually. Over the years, several campaigns have been developed to eliminate
the disease. Currently, Uganda uses a combination of approaches which includes
use of insecticide-treated mosquitoes, indoor residue spraying, social behaviour
communication, larviciding and the provision of subsidized antimalarial
medicine.
Prof Freddie Sengooba, an associate professor of health and systems management
at Makerere University Public School says that other methods of eradicating
malaria-like indoor residual spraying-IRS should be prioritised just like the distribution
of mosquito nets.
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Prof Sengooba says that government needs to look into increasing
the coverage area since IRS has been proved to be a very effective control
method.
Currently, residual spraying is carried out in around ten
districts in the country with high malaria burdens-Kitgum, Amuru, Adaku, Apac,
Gulu, Kole, Lamwo, Nwoya, Oyam and Pader.
A study carried out by Makerere University School of Public Health
under their SPEED project in 2016 revealed that indoor spraying using Actellic
300 CS in Lira showed a decrease in the number of malaria deaths in the
district. The study revealed that a reduction in the number of outpatients
suffering from Malaria from 18.7 percent to 15.1 percent over a five year
period.
IRS can be carried out using insecticides such as Dichloro Diphenyl
Trichloroethane- DDT, Pyrethroid Alpha-Cypermethrin and Carbamate however
resistance to DDT and Pyrethroid Alpha-Cypermethrin has been reported by the
Ministry of Health.
Prof Sengooba adds that some of the methods that are being used
are not necessarily the most effective but are rather being fronted as a means
of making money.
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Maureen Nantume a Biochemist says that government needs to invest
in technology development instead of using what is sold in the world market and
may not necessarily be effective.
"Currently Rapid Diagnostic kits are used to test for malaria
but so many of these kits give results that cannot be quantified. They are
general. As a result, there are some people who have developed resistance to
anti-malarial. In a year they receive treatment for malaria more than three
times."
In 2015, the health ministry embarked on a five-year malaria strategic plan
aimed at eliminating the disease by 2030. The campaign included mosquito net
distribution, residue spraying, and larviciding and would cost 4 trillion
shillings.
By the end of last year, more than 2 trillion shillings had been
used. As of last year, 27 million mosquito nets had been given out at a cost of
172 billion shillings.
Annually 500 billion shillings is spent on malaria control and according to
data from the health ministry, the number of malaria deaths have been reducing.
In 2015 6,100 people are reported to have died. In 2017 the figure
stood at 5100 from 5700 in 2016. Last year, the figure stood at 1,600.
Dr Jimmy Opigo, the head of the Malaria Control Programme at the Ministry of Health
says that Uganda is on the path to eliminate malaria by 2030. He says
government’s malaria preventive and control measures have been effective.
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According to the Malaria Consortium, IRS is one of the most
effective measures to prevent and control malaria. It controls malaria by
killing mosquitoes every time they enter a house.
It is estimated that at least one mosquito enters a house every
2-3 days for a meal. If all houses are properly sprayed, IRS has the capacity
to reduce on the number of mosquitoes in an area before they can pass on
malaria parasites.
Pamela Mawanda
Freelancer