Apart from the struggle with the COVID-19 pandemic, other diseases, malaria inclusive, have been occurring and posing a double threat in the livelihoods of the people across the different regions of Uganda.
The Malaria Annual Report (2017/2018) by the Ministry of Health’s National Malaria Control Division noted that Uganda is one of the 10 countries in the sub-Saharan Africa that account for approximately 70% of global malaria cases and deaths.
The country is a malaria endemic country with active transmission at 99%.
In a bid to mitigate malaria cases in Uganda, the government has over the years, been distributing free Long Lasting Insecticidal Treated mosquito nets to the people.
The Long Lasting Insecticidal Nets (LLNS)
It should be noted that through the integrated vector management, over the years, the Ministry of Health has provided mechanisms that protect the common man from mosquito bites.
Some of these mechanisms are the use of Long Lasting Insecticidal Nets (LLINs) and Indoor Residual Spraying (IRS) and others.
Comparing the Conventionally Treated Nets and the LLINs, LLINs are considered “far more effective as they are infused with a WHO-recommended insecticide during production using netting material that is insecticide bound within or around the fibres at the factory, resulting in nets that retain their efficacy for much longer than conventionally treated nets” as disclosed by the March 2020 Long-lasting Insecticidal Nets ‘Supply Update’ Report by UNICEF.
As such, the LLINs with Pyrethroid, are the current standard of care across most malaria-endemic countries.
Due to the substantial investments in the key interventions like distribution of LLINs, indoor residual spraying (IRS), and antimalarial therapies, experts note, Uganda has made tremendous progress in malaria control with parasitemia in children under five years reduced from 42% in 2009 to 19% in 2014, while mortality due to malaria reduced from 20,000 persons in 2005 to about 5,000 in 2016.
Studies and research on LLINs
The World Health Organisation (WHO) recommends the use of vector control mechanisms in preventing malaria. Vector control mechanisms are able to stop mosquitoes from biting a person as well as providing drugs that suppress these infections.
LLINs, according to WHO, are the predominant type of Insecticide Treated Nets distributed by countries and are estimated to have an effective lifespan of 3 years.
According to the May 2014 Uganda Malaria Reduction Strategic Plan (UMRSP), the use of long lasting insecticidal nets (LLINs) is one of the ways of preventing malaria.
The Plan indicates that “these LLINs provide protection against mosquito bites and the transmission of parasites and also kill mosquitoes or repel them.”
The use of LLINs for protection against human-vector contact during sleep is widely accepted as effective and largely embraced in Uganda.
The provision of LLIN to all members of the population ensures optimal protection against human vector contact during sleep when utilized correctly and consistently according to a research done on “Malaria Outbreak Facilitated by Appearance of Vector-Breeding Sites after Heavy Rainfall and Inadequate Preventive Measures in Nwoya District, Northern Uganda from February to May 2018.”
Research results from Nwoya district, which had experienced malaria outbreaks in the last decade, concluded that increased vector-breeding sites after heavy rainfall, together with inadequate malaria preventive measures, contributed to this outbreak.
The Uganda Malaria Annual Report of July 2017-June 2018 notes that by the end of 2017, the Ministry of Health had achieved over 88% coverage by LLIN through its routine distribution and LLIN mass campaign.
In the districts where distributions have taken place, operational coverage was estimated to be over 98%.
The ‘Under the Net’ Campaign
In order to promote mosquito net usage, the government embarked on distributing LLINs to the population.
Through the “Under the Net” campaign, the Ministry of Health has been distributing LLINs to the masses in a wave format.
Two waves, covering Eastern and Western regions were completed and Wave 3 is soon commencing, targeting districts which have recently had heavy rains and as such, are at a big risk of having malaria outbreaks soon.