Abstract:
Malaria burden remains one of the major public health challenges in sub-Saharan Africa, Uganda inclusive.
Uganda has the 3 rd highest global disease cases estimated to be 225 million and the 8 th highest level of
deaths equivalent to 781,000 per year. Malaria remains a leading cause of morbidity and mortality in Uganda,
accounting for 30-50% of outpatient visits at health facilities, 15-20% of all hospital admissions, and up to
20% of all hospital deaths with at least 27.2% of inpatient deaths among children under five years of age.
Widely recommended Plasmodium vector control approaches include utilization of long-lasting insecticidal
nets and indoor residual sprays which are insecticide-based. This study assessed a nine-year period malaria
cases data (2012-2020) obtained from the health management database to depict malaria spatial and
temporal patterns in Busia and Tororo districts pre and post-vector control interventions. The routine malaria
surveillance data reported passively through public and high-volume private health facilities were entered and
manipulated into MS Excel. This was done separately for each of the 9 years. Considering the malaria cases
registered on annual basis, Mann- Kendal test revealed a drastic decline of malaria cases over the nine-year
period (2012 -2020) in Tororo district with Sen’s slope of -22, while for Busia district it revealed an increase of
malaria cases (Sen’s slope +28). Equally, these trends reveal varied spatial patterns over the two districts.
Both Busia and Tororo revealed a high prevalence of malaria between May-November in respect to bimodal
rainfall pattern, matching with the perennial transmission setting of Uganda. This study has shown that, for
further epidemiological characterization, vector behavior, biology and physiology need consistent monitoring
and surveillance while implementing new vector control interventions targeting outdoor biting Plasmodium
vectors.