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To assess malaria-related prevention and treatment strategies in an urban parish of Kampala, Uganda, a questionnaire was administered to 339 randomly selected primary caregivers of children 1–10 years of age. Our study population was relatively stable and well educated, with better access to health services than many in Africa. Ownership of an insecticide-treated net (ITN) was reported by 11% of households and was predicted only by greater household wealth (highest quartile versus lowest quartile: odds ratio [OR] 21.8; 95% confidence interval [CI], 2.74–173). Among women, 5% reported use of an ITN and 11% used intermittent preventive therapy (IPT) during their last pregnancy. Use of appropriate IPT during pregnancy was predicted only by completion of secondary education or higher (OR, 2.87; 95% CI, 1.13–7.21). Children of 123 (36%) caregivers had experienced an episode of fever in the past 2 weeks. Of these, 22% received an anti-malarial that could be considered "adequate" (combination therapy or quinine). Only 1% of febrile children received adequate treatment at the correct dose within 24 hours of onset of fever. The only independent predictor of treatment with an adequate anti-malarial was accessing a clinic or hospital as the first source of care. In this urban area, use of appropriate malaria control measures occurs uncommonly.
Received December 22, 2005. Accepted for publication February 2, 2006.
Acknowledgments: We thank the clinical study team of Charles Ocan, Arthur Mpimbaza, Bridget Nzarubara, Catherine Maiteki, Moses Musinguzi, John Patrick Mpindi, Basaliza M. Karakire, Naome Kilama, and Norah Asaba. We also thank Marx Dongo, William Musoke, and Caroline Bako for work in the community; Peter Padilla, Sara Kibirango, and Kenneth Mwebaze for administrative support; and Samuel Shillcut for helping us to develop the portion of our questionnaire related to household assets.
Financial support: This study was supported by the National Institutes of Allergy and Infectious Disease (AI052142) and Fogarty International Center/National Institutes of Health (TW00007). Financial support to individual authors was provided from the UCSF Dean’s Office Medical Student Research Program (S.K. and J.D.) and an Alpha Omega Alpha Carolyn L. Kuckein Student Research Fellowship (S.K.).
* Address correspondence to Sarah G. Staedke, San Francisco General Hospital, 1001 Potrero, Building 30, Room 408, San Francisco, CA 94110. E-mail: sstaedke{at}medsfgh.ucsf.edu
Authors’ addresses: Sarah K. Kemble, Jennifer C. Davis, Heidi Hopkins, Grant Dorsey, and Sarah G. Staedke, University of California, San Francisco, Box 0811, San Francisco, CA 94143, E-mails: Sarah.Kemble{at}ucsf.edu, Jennifer.Davis{at}ucsf.edu, hhopkins{at}medsfgh.ucsf.edu, gdorsey{at}medsfgh.ucsf.edu, and sstaedke{at}medsfgh.ucsf.edu. Nalugwa Talemwa, and Denise Njama-Meya, Makerere University Medical School, Mulago Hospital, PO Box 7475 or Department of Medicine, PO Box 7072, Kampala, Uganda, E-mails: talemwan{at}yahoo.co.uk and denise.meya{at}gmail.com.
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