Willingness to accept use of dichlorodiphenyltrichloroethane (DDT) for indoor residual spraying in Rakai District, Uganda

Objective: To identify factors associated with willingness to accept use ofdichlorodiphenyltrichloroethane (DDT ) for indoor residual household-spraying (IRS ) in malaria control in Rakai district Uganda.Design: A household survey using multistage sampling.Setting: Rakai, rural district in south central Uganda.Subjects: household heads or their spouses.Main outcome measures: Proportion of those that were willing to accept use of DDT for IRS and factors associated with willingness to accept use of DDT.Results: Almost all (90%) study participants were willing to have IRS in their homes, however only 31% of them were willing to have DDT used for that purpose. The factors influencing willingness to accept use of DDT for IRS ranged from reports of having heard of other chemicals used in IRS other than DDT (AOR= 2.9, 95% CI= 1.3-6.5), reports of malaria in the month prior to interview (AOR= 3.6, 95% CI= 1.6-7.9), if they believed that treated bed nets prevent malaria (AOR= 2.9, 95% CI= 1.3-6.4) and DDT controls mosquitoes (AOR= 2.7, 95% CI= 1.1-6.6). They were unwilling to accept use of DDT if they reported that they had heard that DDT is poisonous/harmful to health (AOR=13.9, 95% CI=5.2-37.0).Conclusions: To improve the willingness to accept use of DDT at the  community level there is need to increase awareness of the high risk of malaria acquisition among the population and address the fears of the risks posed to human health by DDT and how these can be minimised

Knowledge and practices on malaria prevention in two rural communities in Wakiso District, Uganda

Background: Malaria is the leading cause of morbidity and mortality in Uganda particularly among children under 5 years of age.Objectives: The study assessed the knowledge and practices on malaria prevention in 2 rural communities in Wakiso District, Uganda with emphasis on the various prevention methods.Methods: The study was a cross-sectional survey carried out among 376 households using both quantitative and qualitative methods. Log-binomial regression, chi square and Spearman's rank order correlation were used to test for associations.Results: The majority of participants (64.6%) had low knowledge on malaria prevention methods, with untreated mosquito nets (81.7%), mosquito coils (36.9%) and insecticide treated nets (29.6%) being the most known methods. Knowledge on malaria prevention methods was associated with age (χ2 = 32.1; p < 0.01), employment status (χ2 = 18.1; p < 0.01), education (χ2 = 20.3; p = 0.01), income (χ2 = 14.5; p = 0.01) and having heard a malaria message in the previous 12 months (χ2 = 92.3; p < 0.01). Households that had at least one mosquito net were 45.5% and net ownership increased with household income. Only 0.5% of the houses had undergone indoor residual spraying in the previous 12 months, while 2.1% had complete mosquito proofing in windows and ventilators to prevent mosquito entry.Conclusion: There is potential to improve practices on malaria prevention by targeting other methods beyond mosquito nets such as installing proofing in windows and ventilators. The integrated approach to malaria prevention which advocates the use of several malaria prevention methods in a holistic manner should be explored for this purpose.Keywords: Malaria, prevention, knowledge, practices, integrated approach, Ugand