Malaria prevention practices and associated environmental risk factors in a rural community in Wakiso district, Uganda
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Date
2018
Journal Title
Journal ISSN
Volume Title
Publisher
PLoS ONE
Abstract
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.
Description
Keywords
Malaria prevention, Environmental risk factors, Rural community, Wakiso district, Uganda
Citation
Musoke D, Miiro G, Ndejjo R, Karani G, Morris K, Kasasa S, et al. (2018) Malaria prevention practices and associated environmental risk factors in a rural community in Wakiso district, Uganda. PLoS ONE 13(10): e0205210. https://doi. org/10.1371/journal.pone.0205210