Resurgence of malaria after discontinuation of indoor residual spraying of insecticide in a previously high transmission intensity area of Uganda

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dc.contributor.authorRaouf, Saned
dc.contributor.authorMpimbaza, Arthur
dc.contributor.authorKigozi, Ruth
dc.contributor.authorSserwanga, Asadu
dc.contributor.authorRubahika, Denis
dc.contributor.authorKatamba, Henry
dc.contributor.authorLindsay, Steve W.
dc.contributor.authorKapella, Bryan K.
dc.contributor.authorBelay, Kassahun A.
dc.contributor.authorKamya, Moses R.
dc.contributor.authorStaedke, Sarah G.
dc.contributor.authorDorsey, Grant
dc.date.accessioned2022-12-18T16:49:18Z
dc.date.available2022-12-18T16:49:18Z
dc.date.issued2016
dc.description.abstractIndoor residual spraying (IRS) and long-lasting insecticidal nets (LLINs) are the primary tools for malaria prevention in Africa. It is not known whether reductions in malaria can be sustained after IRS is discontinued. Our aim in this study was to assess changes in malaria morbidity in an area of Uganda with historically high transmission where IRS was discontinued after a 4-year period followed by universal LLIN distribution. Methods. Individual-level malaria surveillance data were collected from 1 outpatient department and 1 inpatient setting in Apac District, Uganda, from July 2009 through November 2015. Rounds of IRS were delivered approximately every 6 months from February 2010 through May 2014 followed by universal LLIN distribution in June 2014. Temporal changes in the malaria test positivity rate (TPR) were estimated during and after IRS using interrupted time series analyses, controlling for age, rainfall, and autocorrelation. Results. Data include 65 421 outpatient visits and 13 955 pediatric inpatient admissions for which a diagnostic test for malaria was performed. In outpatients aged <5 years, baseline TPR was 60%–80% followed by a rapid and then sustained decrease to 15%– 30%. During the 4–18 months following discontinuation of IRS, absolute TPR values increased by an average of 3.29% per month (95% confidence interval, 2.01%–4.57%), returning to baseline levels. Similar trends were seen in outpatients aged ≥5 years and pediatric admissions. Conclusions. Discontinuation of IRS in an area with historically high transmission intensity was associated with a rapid increase in malaria morbidity to pre-IRS levels.en_US
dc.identifier.citationRaouf, S., Mpimbaza, A., Kigozi, R., Sserwanga, A., & Dorsey, G. (2016). Resurgence of malaria after discontinuation of indoor residual spraying of insecticide in a previously high transmission intensity area of Uganda. The Lancet Global Health, 4, S9. DOI: 10.1093/cid/cix251en_US
dc.identifier.other10.1093/cid/cix251
dc.identifier.urihttps://nru.uncst.go.ug/handle/123456789/6422
dc.language.isoenen_US
dc.publisherThe Lancet Global Healthen_US
dc.subjectIRSen_US
dc.subjectMalariaen_US
dc.subjectResurgenceen_US
dc.subjectLLINen_US
dc.subjectUgandaen_US
dc.titleResurgence of malaria after discontinuation of indoor residual spraying of insecticide in a previously high transmission intensity area of Ugandaen_US
dc.typeArticleen_US
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