Browsing by Author "Musoke, Miph Boses"

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    Integrated approach to malaria prevention at household level in rural communities in Wakiso district, Uganda: impact evaluation of a pilot project
    (African health sciences, 2018) Musoke, David; Karani, George; Morris, Keith; Ndejjo, Rawlance; Atusingwize, Edwinah; Guwatudde, David; Musoke, Miph Boses
    The integrated approach to malaria prevention, which advocates for the use of several malaria prevention methods at households, is being explored to complement other existing strategies. We implemented a pilot project that promoted the integrated approach to malaria prevention in two rural communities in Wakiso district, Uganda. Objectives: This paper presents the impact evaluation findings of the project carried out 2 years after implementation with a focus on changes in knowledge and practices on malaria prevention. Methods: The project evaluation was cross-sectional in design and employed both quantitative and qualitative data collection methods. The quantitative survey was conducted among 540 households (household heads being participants) while the qualitative component involved 4 focus group discussions among community health workers (CHWs). Chi-square test was used to compare quantitative results from the evaluation with those of the baseline while thematic analysis was employed for qualitative data. Results: There was a statistically significant positive change in malaria prevention practices in the evaluation compared with the baseline regarding indoor residual spraying (χ2 = 7.9, p = 0.019), mosquito screening of windows and ventilators (χ2 = 62.3, p = 0.001), and closing windows of houses before 6:00 pm (χ2 = 60.2, p < 0.001). The CHWs trained during the project were found to be highly knowledgeable on the various malaria prevention methods in the integrated approach, and continued to promote their use in the community. Conclusion: Findings of the impact evaluation give promise that utilisation of integrated malaria prevention can be enhanced if use of multiple methods is promoted in communities.
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    Malaria prevention practices and associated environmental risk factors in a rural community in Wakiso district, Uganda
    (PLoS ONE, 2018) Musoke, David; Miiro, George; Ndejjo, Rawlance; Karani, George; Morris, Keith; Kasasa, Simon; Nakiyingi-Miiro, Jessica; Guwatudde, David; Musoke, Miph Boses
    Besides use of insecticide-treated mosquito nets (ITNs) and indoor residual spraying (IRS), other complimentary measures including suitable housing structures, and environmental management that reduce breeding of malaria vectors, can be implemented at households to prevent the disease. However, most studies on malaria prevention have focused mainly on ITNs and IRS. The aim of this study was therefore to assess malaria prevention practices beyond ITNs and IRS, and associated environmental risk factors including housing structure in rural Wakiso district, Uganda. Methods A clustered cross-sectional survey was conducted among 727 households in Wakiso district. Data were collected using an interviewer-administered questionnaire and observational checklist. The questionnaire assessed participants' household practices on malaria prevention, whereas the checklist recorded environmental risk factors for malaria transmission, and structural condition of houses. Poisson regression modeling was used to identify factors associated with use of mosquito nets by households. Results Of the 727 households, 471 (64.8%) owned at least one mosquito net. Use of mosquito nets by households was higher with increasing education level of participantsÐprimary (aPR = 1.27 [95% CI: 1.00±1.60]), secondary (ordinary level) (aPR = 1.47 [95% CI: 1.16±1.85]) and advanced level / tertiary (aPR = 1.55 [95% CI: 1.19±2.01]), and higher household income (aPR = 1.09 [95% CI: 1.00±1.20]). Additionally, participants who were not employed were less likely to have mosquito nets used in their households (aPR = 0.83 [95% CI: 0.70±0.98]). Houses that had undergone IRS in the previous 12 months were 42 (5.8%), while 220 (43.2%) households closed their windows before 6.00 pm. Environmental risk factors found at households included presence of vessels that could potentially hold water for mosquito breeding 414 (56.9%), and stagnant water in compounds 144 (19.8%). Several structural deficiencies on houses that could promote entry of mosquitoes were found such as lack of screening in ventilators 645 (94.7%), and external doors not fitting perfectly into walls hence potential for mosquito entry 305 (42.0%). Conclusion There is need to increase coverage and utilisation of ITNs and IRS for malaria prevention in Wakiso district, Uganda. In addition, other malaria prevention strategies such as environmental management, and improving structural condition of houses are required to strengthen existing malaria prevention approaches.
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    Promising Perceptions, Divergent Practices and Barriers to Integrated Malaria Prevention in Wakiso District, Uganda: A Mixed Methods Study
    (PLoS ONE, 2015) Musoke, David; Miiro, George; Karani, George; Morris, Keith; Kasasa, Simon; Ndejjo, Rawlance; Nakiyingi-Miiro, Jessica; Guwatudde, David; Musoke, Miph Boses
    The World Health Organization recommends use of multiple approaches to control malaria. The integrated approach to malaria prevention advocates the use of several malaria prevention methods in a holistic manner. This study assessed perceptions and practices on integrated malaria prevention in Wakiso district, Uganda. Methods A clustered cross-sectional survey was conducted among 727 households from 29 villages using both quantitative and qualitative methods. Assessment was done on awareness of various malaria prevention methods, potential for use of the methods in a holistic manner, and reasons for dislike of certain methods. Households were classified as using integrated malaria prevention if they used at least two methods. Logistic regression was used to test for factors associated with the use of integrated malaria prevention while adjusting for clustering within villages. Results Participants knew of the various malaria prevention methods in the integrated approach including use of insecticide treated nets (97.5%), removing mosquito breeding sites (89.1%), clearing overgrown vegetation near houses (97.9%), and closing windows and doors early in the evenings (96.4%). If trained, most participants (68.6%) would use all the suggested malaria prevention methods of the integrated approach. Among those who would not use all methods, the main reasons given were there being too many (70.2%) and cost (32.0%). Only 33.0%households were using the integrated approach to prevent malaria. Use of integrated malaria prevention by households was associated with reading newspapers (AOR 0.34; 95% CI 0.22 –0.53) and ownership of a motorcycle/car (AOR 1.75; 95%CI 1.03 – 2.98). Conclusion Although knowledge of malaria prevention methods was high and perceptions on the integrated approach promising, practices on integrated malaria prevention was relatively low. The use of the integrated approach can be improved by promoting use of multiple malaria prevention methods through various communication channels such as mass media.