Malaria control methods used by the community in peri-urban area (Ndeeba Parish)
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A thesis submitted in partial fulfillment of the requirements for the award of the Post Graduate Diploma Degree in Public Health of Makerere University.
Malaria threatens 2200 million people worldwide every year. The disease undermines the health and welfare of mainly women and children. Malaria is the leading cause of morbidity and mortality in Uganda. Close to 50% of the population suffers an average of two attacks per year. Currently almost all the anti-malarial activities are in a fragmentary state and grossly uncoordinated. The study was cross-sectional and descriptive, designed to identify malaria control methods used by the community in Ndeeba Parish (a peri-urban area). The general objective was to reduce the incidence and effects of malaria in the Kampala City community. Specific objectives were, to determine mosquito control methods used by the community in Ndeeba; to find out the community’s knowledge and perceptions about malaria in the study area; and to find out health seeking behaviour regarding malaria attack amongst the people in the study population. Data collection involved use of both qualitative and quantitative methods. The multi-stage cluster sampling method was used to sample the study units (households). Qualitative data was collected through Focus group discussions where participants were sampled purposively with guidance of the local leaders. Data analysis was done using a computer (EPI INFO Program) Mosquitoes were found to be a big health problem in Ndeeba parish. This was mentioned in 90% of the respondents. Both qualitative and quantitative results showed that there was a high level of knowledge about the cause of malaria. Forty eight of the respondents showed they knew some traditional methods of mosquito control. Traditional methods that were mentioned included: burning (smoking) of green leaves in 43%, environmental sanitation in 34% and burning (smoldering) of cow dung in 23 %. However these methods were not being used amongst the people as they were mentioned to be inconveniencing because of the smoke and soot that they produce. Mosquito coils were mentioned as the commonest method of mosquito- control being used in Ndeeba in 56% of the respondents. Bednets were indicated to be used in 34% of the cases. While indoor spraying was commonly used in combination with other methods in 10% of the cases. There was an association between education level and the use of a protective method (p value 0.0017). It was mentioned that bednets were used by few people because they were expensive in 75 % of the respondents, and that the bednets were uncomfortable to use. From the results, mosquito screens in the windows were found not to be protective against presence of mosquitoes in the house, Odds ratio 0.6. Similarly screened ventilators were found not be protective against presence of mosquitoes in the house Odds ratio 0.73 . This was attributable to the high mosquito density in the area as indicated by 90% of the respondents. There was poor communal effort in malaria control. Members mentioned that residents were uncooperative in maintaining their compounds. And that people were dumping refuse in the drains which leads to clogging and water stagnation hence increasing the mosquito breeding sites in the area. Members blamed Kampala city council for the failure to provide adequate refuse disposal bins. There should be improved effort in environmental sanitation as to reduce the mosquito breeding sites.
Malaria threatens 2200 million people worldwide every year. The disease undermines the health and welfare of mainly women and children. Malaria is the leading cause of morbidity and mortality in Uganda. Close to 50% of the population suffers an average of two attacks per year. Currently almost all the anti-malarial activities are in a fragmentary state and grossly uncoordinated. The study was cross-sectional and descriptive, designed to identify malaria control methods used by the community in Ndeeba Parish (a peri-urban area). The general objective was to reduce the incidence and effects of malaria in the Kampala City community. Specific objectives were, to determine mosquito control methods used by the community in Ndeeba; to find out the community’s knowledge and perceptions about malaria in the study area; and to find out health seeking behaviour regarding malaria attack amongst the people in the study population. Data collection involved use of both qualitative and quantitative methods. The multi-stage cluster sampling method was used to sample the study units (households). Qualitative data was collected through Focus group discussions where participants were sampled purposively with guidance of the local leaders. Data analysis was done using a computer (EPI INFO Program) Mosquitoes were found to be a big health problem in Ndeeba parish. This was mentioned in 90% of the respondents. Both qualitative and quantitative results showed that there was a high level of knowledge about the cause of malaria. Forty eight of the respondents showed they knew some traditional methods of mosquito control. Traditional methods that were mentioned included: burning (smoking) of green leaves in 43%, environmental sanitation in 34% and burning (smoldering) of cow dung in 23 %. However these methods were not being used amongst the people as they were mentioned to be inconveniencing because of the smoke and soot that they produce. Mosquito coils were mentioned as the commonest method of mosquito- control being used in Ndeeba in 56% of the respondents. Bednets were indicated to be used in 34% of the cases. While indoor spraying was commonly used in combination with other methods in 10% of the cases. There was an association between education level and the use of a protective method (p value 0.0017). It was mentioned that bednets were used by few people because they were expensive in 75 % of the respondents, and that the bednets were uncomfortable to use. From the results, mosquito screens in the windows were found not to be protective against presence of mosquitoes in the house, Odds ratio 0.6. Similarly screened ventilators were found not be protective against presence of mosquitoes in the house Odds ratio 0.73 . This was attributable to the high mosquito density in the area as indicated by 90% of the respondents. There was poor communal effort in malaria control. Members mentioned that residents were uncooperative in maintaining their compounds. And that people were dumping refuse in the drains which leads to clogging and water stagnation hence increasing the mosquito breeding sites in the area. Members blamed Kampala city council for the failure to provide adequate refuse disposal bins. There should be improved effort in environmental sanitation as to reduce the mosquito breeding sites.
Keywords
Malaria, Peri-urban, Antimalarial treatment, Ndeeba Parish, Mosquito control, Mosquito nets, Environmental sanitation