Sunday, July 10, 2011


Tuesday, 5th July, 2011
By Raymond Baguma and Gerald Kawemba
INDOOR residual spraying as a strategy to control malaria in Uganda is too costly and has affected the programme countrywide.
According to Dr. Seraphine Adibaku, the head of the Malaria Control Programme, this is why other malaria control strategies such as use of insecticide-treated nets and Artemisinin-based combination therapy are considered to be ahead of indoor residual spraying.
The Government is implementing the indoor residual spraying using pyrethrum-based and carbon-based insecticides in 10 malaria-endemic districts in the northern and eastern regions.
They include Amolatar, Apac, Kitgum, Kumi and Bukedea.
“About three million people in the 10 districts have been covered. We have reached over 90% of the population,” Adibaku said.
She added that under the Presidential Malaria Initiative, the budget for indoor residual spraying is sh4.5b per district each year.
Adibaku said it would be much cheaper if the ministry distributed insecticide-treated mosquito nets.
She, however, said indoor spraying has an advantage of delivering immediate impact compared to treated nets.
Adibaku disclosed that the health ministry is re-evaluating the effectiveness of using DDT for malaria control.
Dr. Joaquim Saweka, the World Health Organisation (WHO) resident representative in Uganda, said indoor residual spraying is highly effective and has been successful in Zanzibar and Rwanda.
He, however, added that it is capital intensive and needs a lot of money for each application done twice a year.
Saweka cited his previous posting in Ghana during which a town of 300,000 inhabitants required $3m for spraying each year.
He said with the high cost of spraying and low financial resources available, Uganda needs to prioritise usage of insecticide-treated mosquito nets.
aweka added that Uganda is on the right path to eradicating malaria with efforts in prevention, diagnosis and treatment as well as universal coverage of insecticide-treated nets.
Health minister Dr. Richard Nduhura yesterday kicked off a nationwide programme to distribute 11,000 bicycles to health volunteers who will diagnose and treat malaria in homes. The programme is supported by the Global Fund.
It is part of the Government’s home-based management of malaria, which is part of a larger national strategy to deliver treatment to children within 24 hours after diagnosis.

Source: The Science Times – May – July 2008

Oyam (Northern Uganda) – At long last, Indoor Residual Spraying (IRS) of dichlorodiphenyltrichloroethane (DDT) to kill mosquitoes and reduce malaria, was officially launched on April 11, 2008 in Oyam district, one of the areas hardest hit by malaria in the world. Oyam was previously part of Apac district in Northern Uganda. It is surrounded by sprawling wetlands - Okole and Arocha, which are part of the swampy Lake Kwania an arm of Lake Kyoga. Until 2005 -2006 most homes in Oyam had been vacated due to the rebel activities by the Lords Resistance Army (LRA) and the would be residents were in Internally Displaced People’s (IDP) Camps.
The swamp and displacement of residents to IDPs led to the overgrowth of bushes around homes and on what used to be farms. The conditions were conducive for the breeding and multiplication of the anopheles mosquitoes; which mosquito feeds on human blood and while it sucks blood, the victim is infected with Plasmodium parasites which cause malaria fever to humans.
While launching the IRS program at Oyam district headquarters on April 11, 2008, the Health Minister Dr. Stephen Malinga said, “The IRS program was to be conducted strictly indoors and that the spraying was not in any way to spill outside houses.” Malinga thanked US President George Bush’s Presidential Malaria Initiative (PMI), which was supporting Uganda’s anti-malarial IRS program.
“Environmental leaders and commercial organic farmers should acknowledge past mistakes in DDT spraying, which we’ve guarded against strictly through IRS,” Malinga said. Malinga said that a pilot indoor spray in kabala district had brought down the prevalence of malaria cases. “Evidence from out-patients’ departments (OPDs) of most hospitals and health centres in the region show level of malaria cases,” said Malinga.
The Science Times carried out an impromptu assessment among residents, local leaders and elders a few days after the DDT IRs Program launch, to capture their feelings, fears, concerns and interests.
A pregnant mother in the village of Piyo Barjonga in Minakulu sub-county, Ms Evelyn Achen was happy that finally a serious fight against mosquitoes was underway. “I removed my property early so that spraying goes on smoothly. I am optimistic this will help us against the deadly malaria. I have seen many children die at my neighbours’ homes and in hospital. Right now, two of my four children are bed ridden with malaria, yet the nearest health center is 13 km away.”
An ex-Police Officer Sergeant (Retired) Francis Okidi, a resident of Bobi village, Atek Parish in Minakulu sub-county, was very happy a few days after his house was sprayed with DDT. “I am now sleeping so well without any mosquitoes biting me.

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