Echodu Richard, Ajolorwot Sandra, Aryemo Frida, Nyeko Christopher, Okot Jacob, Iwiru Tereza, Nakiwu Vivian, Bei Amy K, DeBlasio Melody, Turyasingura Natasha, Zhang Elizabeth, Parikh Sunil
Department of Biology, Faculty of Science, Gulu University, P.O. Box 166, Gulu, Uganda.
Gulu University Multifunctional Research Laboratories, P.O. Box 166, Gulu, Uganda.
Malar J. 2025 Jun 8;24(1):181. doi: 10.1186/s12936-025-05288-8.
It remains unclear how household structure and practices can contribute to Uganda's goal of becoming a malaria-free nation by 2040. Effective malaria prevention and control require the implementation of measures such as long-lasting insecticidal nets, indoor residual spraying (IRS), treatment with artemisinin-based combination therapy (ACT), maintaining suitable housing structures, and practicing environmental management at the household level. This study examines household structure and practices related to malaria prevalence in children under five years old, as well as prevention and control efforts across five districts in Northern Uganda.
A cross-sectional survey was conducted in five districts (Gulu, Omoro, Amuru, Pader, and Lamwo) from November 2022 to March 2023 to assess malaria prevalence, prevention practices, and health-seeking behaviours. Data were collected using rapid diagnostic tests for Plasmodium falciparum, observational checklists, and pre-tested questionnaires, with analysis performed using IBM SPSS Statistics.
The survey included 597 households and 4524 individuals, with 25.6% being children under five years of age. Of 1157 children under five, 597 (51.6%) were tested, revealing RDT positive prevalence of 44.1%. Most households had over seven members, with an average of 3.69 people per bed net. While 77.6% of households owned mosquito nets, visual inspection revealed 70.2% were torn, and only 48.7% of individuals slept under a net the night before the survey. IRS coverage was low, with 97.7% of households not sprayed in the last three months. Health-seeking behaviour predominantly involved government health centers. Housing structures, particularly mud/clay walls and grass-thatched roofs, were significantly associated with higher malaria prevalence (p < 0.001). Were their enough untreated nets?
A high prevalence of malaria was observed in children under five years old. This was closely linked to the poor use of bed nets, low coverage of IRS, and inadequate housing structures, which primarily consisted of grass-thatched roofs and mud or clay walls. The study highlights the urgent need for improved housing, IRS, and consistent use of insecticide-treated nets to reduce malaria prevalence.
目前尚不清楚家庭结构和做法如何有助于乌干达实现到2040年成为无疟疾国家的目标。有效的疟疾预防和控制需要实施诸如长效驱虫蚊帐、室内滞留喷洒（IRS）、青蒿素联合疗法（ACT）治疗、维持合适的住房结构以及在家庭层面开展环境管理等措施。本研究调查了乌干达北部五个地区与五岁以下儿童疟疾流行率相关的家庭结构和做法，以及预防和控制措施。
2022年11月至2023年3月在五个地区（古卢、奥莫罗、阿穆鲁、帕德和拉姆沃）进行了一项横断面调查，以评估疟疾流行率、预防措施和就医行为。使用恶性疟原虫快速诊断检测、观察清单和预先测试的问卷收集数据，并使用IBM SPSS Statistics进行分析。
该调查包括597户家庭和4524人，其中25.6%为五岁以下儿童。在1157名五岁以下儿童中，597名（51.6%）接受了检测，快速诊断检测阳性率为44.1%。大多数家庭有七名以上成员，平均每顶蚊帐可供3.69人使用。虽然77.6%的家庭拥有蚊帐，但目视检查显示70.2%的蚊帐有破损，在调查前一晚只有48.7%的人睡在蚊帐下。室内滞留喷洒覆盖率很低，97.7%的家庭在过去三个月内未进行喷洒。就医行为主要涉及政府卫生中心。住房结构，特别是泥/土墙和茅草屋顶，与较高的疟疾流行率显著相关（p < 0.001）。是否有足够的未处理蚊帐？
五岁以下儿童疟疾流行率很高。这与蚊帐使用不当、室内滞留喷洒覆盖率低以及住房结构不足密切相关，住房结构主要是茅草屋顶和泥墙或土墙。该研究强调迫切需要改善住房、室内滞留喷洒，并持续使用经杀虫剂处理的蚊帐以降低疟疾流行率。
