Malaria remains one of the leading health problems of the developing world, and Uganda
bears a particularly large burden from the disease. Our understanding is limited by
a lack of reliable data, but it is clear that the prevalence of malaria infection,
incidence of disease, and mortality from severe malaria all remain very high. Uganda
has made progress in implementing key malaria control measures, in particular distribution
of insecticide-impregnated bednets, indoor residual spraying of insecticides, utilization
of artemisinin-based combination therapy to treat uncomplicated malaria, and provision
of intermittent preventive therapy for pregnant women. However, despite enthusiasm
regarding the potential for the elimination of malaria in other areas, there is no
convincing evidence that the burden of malaria has decreased in Uganda in recent years.
Major challenges to malaria control in Uganda include very high malaria transmission
intensity, inadequate health care resources, a weak health system, inadequate understanding
of malaria epidemiology and the impact of control interventions, increasing resistance
of parasites to drugs and of mosquitoes to insecticides, inappropriate case management,
inadequate utilization of drugs to prevent malaria, and inadequate epidemic preparedness
and response. Despite these challenges, prospects for the control of malaria have
improved, and with attention to underlying challenges, progress toward the control
of malaria in Uganda can be expected.
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