Experiences of households using integrated malaria prevention in two rural communities in Wakiso district, Uganda: a qualitative study

Abstract

BackgroundThe integrated approach to malaria prevention which advocates use of several methods in a holistic manner is being explored to complement existing strategies. A pilot project that promoted integrated malaria prevention established 40 demonstration households using the approach. As part of impact evaluation of the project 2 years after implementation, the experiences of these households using integrated malaria prevention were assessed.MethodsA qualitative cross-sectional survey was carried out in Wakiso district, Uganda which involved 40 in-depth interviews among households implementing integrated malaria prevention. The study assessed practices on malaria prevention, benefits and challenges of using integrated malaria prevention, preference of malaria prevention methods, and impact of the demonstration households on the community. Thematic analysis was employed using Atlas ti software.ResultsThe households continued to use many of the malaria prevention methods in the integrated approach including sleeping under long-lasting insecticidal nets, screening in windows and ventilators, removing mosquito breeding sites, and closing of doors early in the evenings. The major benefits reported from using integrated malaria prevention were reduction in mosquito populations in their houses and less occurrence of malaria particularly among children. Although several community members learnt about and admired various malaria prevention methods from the demonstration households especially screening in windows and ventilators, the majority could not afford to implement some of them due to lack of resources. The main challenge established in using integrated malaria prevention was the much time required to implement the several methods some of which had to be done regularly such as early closing of windows. In addition, complacency had led to some households not utilizing a number of methods in the integrated approach because of using others.ConclusionUse of the integrated approach to malaria prevention benefited the demonstration households mainly through observed reduction in mosquitoes indoors and malaria occurrence hence could be promoted in other areas. Other studies to quantify the protective effect of integrated malaria prevention particularly regarding malaria prevalence and contribution of each of the methods are required.

Malaria Outbreak Facilitated by Appearance of Vector-Breeding Sites after Heavy Rainfall and Inadequate Preventive Measures: Nwoya District, Northern Uganda, February–May 2018

“…ese approaches supplement WHO-recommended Integrated Vector Management (IVM) strategies in the fight against malaria [39]. Personal protection to prevent human-vector contact is effective where vectors feed on only humans but may become ineffective where mosquitoes feed on both human and animal populations [40].…”

Integrated approach to malaria prevention at household level in rural communities in Wakiso district, Uganda: impact evaluation of a pilot project

“…Therefore, the improvement in knowledge and practices on malaria prevention in this research cannot be solely attributed to the interventions implemented during the project. Nevertheless, as the demonstration households using the integrated approach to malaria prevention that were established during the project reported benefits such as reduction in number of mosquitoes in their houses and less occurrence of malaria as presented in our earlier paper26, the interventions should have had a considerable positive impact in the community. Improvement in knowledge and practices on malaria prevention attributable to the interventions was also established during the endline evaluation conducted at the end of the project9.…”

Householders’ perception about sustaining the useful life of long-lasting insecticide-treated nets in Ghana

“…Householders’ perceptions of the effectiveness of alternative mosquito prevention, particularly alternatives that are socio-culturally accepted (including burning herbs and reliance on orange peels and dried palm nuts), affect efforts to promote effective and optimum use of LLINs—and the end of the useful life of a net. 19 , 20 Often this stems from a historically integrated use of both conventional and unconventional mosquito control methods that introduces householders to various modalities, as observed in Ethiopia, Ghana and Uganda. 18–21 Relating to the use of alternative methods of malaria control is access and capacity to acquire new nets.…”