Malaria Consortium Uganda Country Office, Kampala, Uganda.
Nwoya District Local Government, Nwoya, Uganda.
Malar J. 2022 Feb 19;21(1):55. doi: 10.1186/s12936-022-04066-0.
Malaria remains the number one cause of morbidity and mortality in Uganda. In 2009, the United States President's Malaria Initiative (PMI) funded an indoor residual spraying (IRS) project in 10 mid-northern districts, resulting in marked reductions in malaria prevalence over 5 years, from 62.5 percent to 7.2 percent. When the project ended and IRS withdrawn, malaria prevalence increased exponentially to pre-IRS level of 63 percent in 2016 and was characterized by frequent life-threatening upsurges that were exacerbated by a weak national led malaria surveillance system with delayed and piece meal responses. Malaria Consortium, in collaboration with Nwoya district local government implemented a district led malaria surveillance and response system. This study was conducted to compare the impact of District led and national led surveillance and response systems on overall malaria burden in two sub-counties in Nwoya district, Northern Uganda.
The assessment was conducted between week 41 of 2018 and week 10 of 2019 in Anaka and Alero sub counties following the shift from the national to district led malaria surveillance and response system. A district multi-sectoral malaria response taskforce team, known as the District Malaria Surveillance and Response Team (DMSRT), was formed by the Nwoya District Health Team (DHT). The DMSRT was trained and equipped with new surveillance tools for early detection of and response to malaria upsurges within the district, and were mandated to develop a costed district specific malaria response plan.
All (18) targeted health facilities provided weekly malaria reports and continuously updated the malaria normal channel graphs. There was an overall reduction in weekly new malaria cases from 12.9 in week 41 of 2018 to 6.2 cases in week 10 of 2019. Malaria positivity rates (TPR) for Alero and Anaka sub-counties reduced from 76.0 percent and 69.3 percent at week 42 of 2018 to 28 percent and 30.3 percent, respectively at week 10 of 2019.
Malaria surveillance and response, with precisely targeted multipronged activities, when led and implemented by local district health authorities is an effective, efficient, and sustainable approach to prevent malaria upsurges and associated morbidity and mortality.
疟疾仍然是乌干达发病率和死亡率的首要原因。2009 年，美国总统疟疾倡议（PMI）在 10 个中北部地区资助了一项室内滞留喷洒（IRS）项目，该项目导致疟疾发病率在 5 年内显著下降，从 62.5%降至 7.2%。当项目结束和 IRS 停止时，疟疾发病率呈指数级增长，到 2016 年达到之前 IRS 水平的 63%，并且经常出现危及生命的激增，国家主导的疟疾监测系统薄弱，反应迟缓且零碎，使情况恶化。疟疾联盟与努瓦亚区地方政府合作，实施了一个由区主导的疟疾监测和应对系统。本研究旨在比较由区主导和国家主导的监测和应对系统对乌干达北部努瓦亚区两个分区的整体疟疾负担的影响。
评估于 2018 年第 41 周至 2019 年第 10 周在阿纳卡和阿莱罗分区进行，此后国家主导的疟疾监测和应对系统转变为区主导的疟疾监测和应对系统。由努瓦亚区卫生队组成的区多部门疟疾应对工作队，称为区疟疾监测和应对小组（DMSRT）。DMSRT 接受了培训，并配备了新的监测工具，以便在区内及早发现和应对疟疾激增，并被授权制定具体的区疟疾应对计划。
所有（18）个目标保健设施每周都提供疟疾报告，并不断更新疟疾正常渠道图表。每周新疟疾病例总数从 2018 年第 41 周的 12.9 例降至 2019 年第 10 周的 6.2 例。阿莱罗和阿纳卡分区的疟疾阳性率（TPR）从 2018 年第 42 周的 76.0%和 69.3%降至 2019 年第 10 周的 28.0%和 30.3%。
由当地区卫生当局领导和实施的疟疾监测和应对措施，采取有针对性的多管齐下的活动，是预防疟疾激增及相关发病率和死亡率的有效、高效和可持续方法。
