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Some expectant mother receiving treatment for malaria in Adjumani hospital



The ministry of health has set aside $26million (about sh93b) to start indoor residual spraying in the west Nile sub-region this month.

According to records from the Ministry of Health, West Nile has a high malaria transmission with 80% of people with fever testing positive.

The ministry says 50% of all outpatient attendees, 25% of all in-patients and 15% of all deaths in the region are due to malaria.

Dr Jimmy Opigo, the commissioner for the Malaria control program at the ministry of health, said West Nile has a unique type of mosquito which can breed even in the dry season and bites when outside the house hence the high rate of malaria transmission even in December and January dry seasons.

“I request and advise that we embrace the indoor residual spraying. IRS is coming to our region for the first time, the community demanded and we have struggled to get over USD$26m to invest in the intervention for two years as we see how to continue with it,” Opigo explained.

Dr Jimmy Opigo in-charge Malaria Control Programme Ministry of Health

He said that it has taken the health ministry more than three years of concerted efforts to get the program funded for West Nile.

He attributed the delay to the widespread use of Dichlodiphenltrichloroethane (DDT) for cotton growing and Tobacco in West Nile especially parts of the Arua, Terego, Maracha, and Yumbe.

Opigo warned that mosquitoes in West Nile have developed resistance to pyrethroids and also the chemicals in mosquito nets are not killing them.

He revealed that the Ministry of Health is working with National Environmental Management Authority (NEMA) on an Environmental Impact Assessment (EIA) for DDT spraying, an exercise which has just been concluded.

NEMA & National Drugs Authority have also supersized the placement of stores and soak pits for waste disposal.

“In the district, we work with the environment officer for all the detailed safety and environmental compliance and the IRS is indoors strictly. We stopped aerial spraying and outdoor applications,” Opigo said.

IRS and mosquito control are covered by the public health Act and even in the one just amended pending assent by President Yoweri Museveni, meaning that the option of enforcement is there though it is not being encouraged.

“The activity apart from fighting malaria will boost the micro economy as it will employ close to 5,000 seasonal workers and put money in allowances directly to them. That is almost half of what Parish Development Model makes available because we have sent over sh700m to the big districts, let alone what will be brought in cash and materials by central government participants,” Opigo underlined.

According to the district health officer of Adjumani District, Dr Dominic Drametu, Malaria still was among the top ten causes of Mortality during the financial year 2021-2022 with a total of 70 death- 41 males and 29 females.

“The proportion of pregnant mothers with malaria from January 2022 to March 2022 increased from 23% to 32% from April to June 2022 which is a dangerous trend that necessitates indoor Residual Spraying,” Drametu said.

Drametu highlighted that the high malaria burden registered in the district was due to the misuse of insecticide treated mosquito nets by some households, inadequate supply nets during routine distribution and wastage of malaria commodities, especial in treating negative cases based on presumed clinical signs.

Uganda has relied on indoor residual spraying as a tool for fighting malaria, beginning in the Kigezi region in 1960s and 1970s. It was repeated in Kigezi  in 2006 and moved to Acholi and parts of Lango in 2009 and later to eastern Uganda in 2014.

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