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    Okello PE, Van Bortel W, Byaruhanga AM, Correwyn A, Roelants P, Talisuna A, D’Alessandro U, Coosemans M, 2006. Variation in malaria transmission intensity in seven sites throughout Uganda. Am J Trop Med Hyg 75 :219–225.

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  • 2

    Ssekabira U, Bukirwa H, Hopkins H, Namagembe A, Weaver MR, Sebuyira LM, Quick L, Staedke S, Yeka A, Kiggundu M, Schneider G, McAdam K, Wabwire-Mangen F, Dorsey G, 2008. Improved malaria case management after integrated team-based training of health care workers in Uganda. Am J Trop Med Hyg 79 :826–833.

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  • 3

    Briet OJ, Vounatsou P, Gunawardena DM, Galappaththy GN, Amerasinghe PH, 2008. Temporal correlation between malaria and rainfall in Sri Lanka. Malar J 7 :77.

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  • 4

    Kleinschmidt I, Sharp B, Benavente LE, Schwabe C, Torrez M, Kuklinski J, Morris N, Raman J, Carter J, 2006. Reduction in infection with Plasmodium falciparum one year after the introduction of malaria control interventions on Bioko Island, Equatorial Guinea. Am J Trop Med Hyg 74 :972–978.

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    Tseng LF, Chang WC, Ferreira MC, Wu CH, Rampao HS, Lien JC, 2008. Rapid control of malaria by means of indoor residual spraying of alphacypermethrin in the Democratic Republic of Sao Tome and Principe. Am J Trop Med Hyg 78 :248–250.

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  • 6

    Barnes KI, Durrheim DN, Little F, Jackson A, Mehta U, Allen E, Dlamini SS, Tsoka J, Bredenkamp B, Mthembu DJ, White NJ, Sharp BL, 2005. Effect of artemether-lumefantrine policy and improved vector control on malaria burden in KwaZulu-Natal, South Africa. PLoS Med 2 :e330.

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  • 7

    Sharp B, van Wyk P, Sikasote JB, Banda P, Kleinschmidt I, 2002. Malaria control by residual insecticide spraying in Chingola and Chililabombwe, Copperbelt Province, Zambia. Trop Med Int Health 7 :732–736.

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  • 8

    Sharp BL, Kleinschmidt I, Streat E, Maharaj R, Barnes KI, Durrheim DN, Ridl FC, Morris N, Seocharan I, Kunene S, LA Grange JJ, Mthembu JD, Maartens F, Martin CL, Barreto A, 2007. Seven years of regional malaria control collaboration–Mozambique, South Africa, and Swaziland. Am J Trop Med Hyg 76 :42–47.

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  • 9

    Protopopoff N, Van Bortel W, Marcotty T, Van Herp M, Maes P, Baza D, D’Alessandro U, Coosemans M, 2008. Spatial targeted vector control is able to reduce malaria prevalence in the highlands of Burundi. Am J Trop Med Hyg 79 :12–18.

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Assessing the Impact of Indoor Residual Spraying on Malaria Morbidity Using a Sentinel Site Surveillance System in Western Uganda

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  • 1 Uganda Malaria Surveillance Project, Kampala, Uganda; School of Public Health, University of California, Berkeley, California; Centers for Disease Control and Prevention, Atlanta, Georgia; National Malaria Control Programme, Uganda Ministry of Health, Kampala, Uganda; US Agency for International Development, Kampala, Uganda; Makerere University Medical School, Kampala, Uganda; Makerere University School of Public Health, Kampala, Uganda; Department of Medicine, University of California, San Francisco, California

A single round of indoor residual spraying (IRS) using lambda-cyhalothrin was implemented in a district of Uganda with moderate transmission intensity in 2007. Individual patient data were collected from one health facility within the district 8 months before and 16 months after IRS. There was a consistent decrease in the proportion of patients diagnosed with clinical malaria after IRS for patients < 5 and > 5 years of age (52% versus 26%, P < 0.001 and 36% versus 23%, P < 0.001, respectively). There was a large decrease in the proportion of positive blood smears in the first 4 months after IRS for patients < 5 (47% versus 14%, P < 0.001) and > 5 (26% versus 9%, P < 0.001) years of age, but this effect waned over the subsequent 12 months. IRS was effective in reducing malaria morbidity, but this was not sustained beyond 1 year for the proportion of blood smears read as positive.

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