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Promising perceptions, divergent practices and barriers to integrated malaria prevention in Wakiso District, Uganda: A mixed methods study

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posted on 2022-05-19, 14:41 authored by David Musoke, George Miiro, George Karani, Keith Morris, Simon Kasasa, Rawlance Ndejjo, Jessica Nakiyingi-Miiro, David Guwatudde, Miph Boses Musoke



The World Health Organization recommends use of multiple approaches to control malaria. The integrated approach to malaria prevention advocates the use of several malaria prevention methods in a holistic manner. This study assessed perceptions and practices on integrated malaria prevention in Wakiso district, Uganda.


A clustered cross-sectional survey was conducted among 727 households from 29 villages using both quantitative and qualitative methods. Assessment was done on awareness of various malaria prevention methods, potential for use of the methods in a holistic manner, and reasons for dislike of certain methods. Households were classified as using integrated malaria prevention if they used at least two methods. Logistic regression was used to test for factors associated with the use of integrated malaria prevention while adjusting for clustering within villages.


Participants knew of the various malaria prevention methods in the integrated approach including use of insecticide treated nets (97.5%), removing mosquito breeding sites (89.1%), clearing overgrown vegetation near houses (97.9%), and closing windows and doors early in the evenings (96.4%). If trained, most participants (68.6%) would use all the suggested malaria prevention methods of the integrated approach. Among those who would not use all methods, the main reasons given were there being too many (70.2%) and cost (32.0%). Only 33.0% households were using the integrated approach to prevent malaria. Use of integrated malaria prevention by households was associated with reading newspapers (AOR 0.34; 95% CI 0.22 –0.53) and ownership of a motorcycle/car (AOR 1.75; 95% CI 1.03 – 2.98).


Although knowledge of malaria prevention methods was high and perceptions on the integrated approach promising, practices on integrated malaria prevention was relatively low. The use of the integrated approach can be improved by promoting use of multiple malaria prevention methods through various communication channels such as mass media.


The work was supported by Training Health Researchers into Vocational Excellence (THRiVE) in East Africa, grant number 087540, funded by Wellcome Trust. This investigation also received financial support from TDR, the Special Programme for Research and Training in Tropical Diseases, co-sponsored by UNICEF, UNDP, the World Bank and WHO. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript


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PloS one


Public Library of Science


  • VoR (Version of Record)


Musoke, D., Miiro, G., Karani, G., Morris, K., Kasasa, S., Ndejjo, R., Nakiyingi-Miiro, J., Guwatudde, D. and Musoke, M.B. (2015) 'Promising perceptions, divergent practices and barriers to integrated Malaria prevention in Wakiso District, Uganda: a mixed methods study', PloS one, 10(4), p.e0122699

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Cardiff Met Affiliation

  • Cardiff School of Sport and Health Sciences

Cardiff Met Authors

George Karani Keith Morris

Cardiff Met Research Centre/Group

  • Occupational and Environmental Public Health

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  • © The Authors


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