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Journal articles on the topic 'Malaria – Treatment – Uganda'

Author: Grafiati

Published: 4 June 2021

Last updated: 4 February 2022

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1

Nanyunja, Miriam, Juliet Nabyonga Orem, Frederick Kato, Mugagga Kaggwa, Charles Katureebe, and Joaquim Saweka. "Malaria Treatment Policy Change and Implementation: The Case of Uganda." Malaria Research and Treatment 2011 (September 19, 2011): 1–14. http://dx.doi.org/10.4061/2011/683167.

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Malaria due to P. falciparum is the number one cause of morbidity and mortality in Uganda where it is highly endemic in 95% of the country. The use of efficacious and effective antimalarial medicines is one of the key strategies for malaria control. Until 2000, Chloroquine (CQ) was the first-line drug for treatment of uncomplicated malaria in Uganda. Due to progressive resistance to CQ and to a combination of CQ with Sulfadoxine-Pyrimethamine, Uganda in 2004 adopted the use of ACTs as first-line drug for treating uncomplicated malaria. A review of the drug policy change process and postimplementation reports highlight the importance of managing the policy change process, generating evidence for policy decisions and availability of adequate and predictable funding for effective policy roll-out. These and other lessons learnt can be used to guide countries that are considering anti-malarial drug change in future.

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2

Okello, Denis, and Youngmin Kang. "Exploring Antimalarial Herbal Plants across Communities in Uganda Based on Electronic Data." Evidence-Based Complementary and Alternative Medicine 2019 (September 15, 2019): 1–27. http://dx.doi.org/10.1155/2019/3057180.

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Malaria is one of the most rampant diseases today not only in Uganda but also throughout Africa. Hence, it needs very close attention as it can be severe, causing many deaths, especially due to the rising prevalence of pathogenic resistance to current antimalarial drugs. The majority of the Ugandan population relies on traditional herbal medicines for various health issues. Thus, herein, we review various plant resources used to treat malaria across communities in Uganda so as to provide comprehensive and valuable ethnobotanical data about these plants. Approximately 182 plant species from 63 different plant families are used for malaria treatment across several communities in Uganda, of which 112 plant species have been investigated for antimalarial activities and 96% of the plant species showing positive results. Some plants showed very strong antimalarial activities and could be investigated further for the identification and validation of potentially therapeutic antimalarial compounds. There is no record of an investigation of antimalarial activity for approximately 39% of the plant species used for malaria treatment, yet these plants could be potential sources for potent antimalarial remedies. Thus, the review provides guidance for areas of further research on potential plant resources that could be sources of compounds with therapeutic properties for the treatment of malaria. Some of the plants were investigated for antimalarial activities, and their efficacy, toxicity, and safety aspects still need to be studied.

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3

MBONYE, A. K., I. C. BYGBJERG, and P. MAGNUSSEN. "PREVENTION AND TREATMENT PRACTICES AND IMPLICATIONS FOR MALARIA CONTROL IN MUKONO DISTRICT UGANDA." Journal of Biosocial Science 40, no. 2 (March 2008): 283–96. http://dx.doi.org/10.1017/s0021932007002398.

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SummaryAvailable data in Uganda indicate a resurgence of malaria morbidity and mortality countrywide. This study assessed the burden of malaria, treatment and prevention practices in order initiate a policy debate on the scaling-up of current interventions. A triangulation of methods using a cross-sectional survey and key informant interviews was used to assess self-reported malaria at a household level in Mukono District, Uganda. A total of 5583 households were surveyed, and a high proportion (2897, 51·9%) reported a person with malaria two weeks prior to the survey. Only 546 households (9·8%) owned and used insecticide-treated nets (ITNs) for malaria prevention. Similarly, only a few households (86, 1·5%) used indoor residual spraying. Self-treatment with home-stocked drugs was high, yet there was low awareness of the effectiveness of expired drugs on malaria treatment. Self-reported malaria was associated with socioeconomic, behavioural and environmental factors, but more especially with household ownership of ITNs. These results will contribute to the current debate on identifying new approaches for scaling-up prevention interventions and effective case management, as well as selection of priority interventions for malaria control in Uganda.

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4

Frank, Ahimbisibwe B., Matagi Leon, Senkumba Mohamed, and Atuhaire Privah. "Personal Orientation: The Silent Player in Efforts to Improve Treatment Seeking-Behavior Regarding Malaria in Uganda." International Journal of Innovative Science and Research Technology 5, no. 5 (May 16, 2020): 61–66. http://dx.doi.org/10.38124/ijisrt20may021.

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Uganda government and development partners have engaged in various communication activities and programs with a view to change people’s behaviors regarding malaria, mobilize communities and create an enabling environment for sound health practices. However, malaria has remained one of the leading causes of mortality and morbidity in Uganda. All players in the communications effort against malaria had a goal of reducing malaria-related mortality and morbidity by 70% by 2015. It was not clear whether this was achieved since another strategic objective proposed in 2015 was that at least 85% of the population should undertake correct practices in malaria prevention and treatment by 2017.

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5

Bitawha, Nyine, O. Tumwesigye, P. Kabariime, Abert K. M. Tayebwa, S. Tumwesigye, and J. W. Ogwal-Okeng. "Herbal Treatment of Malaria — Four Case Reports from the Rukararwe Partnership Workshop for Rural Development (Uganda)." Tropical Doctor 27, no. 1_suppl (January 1997): 17–19. http://dx.doi.org/10.1177/00494755970270s107.

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We present a small study of four cases of malaria treated using a traditional herbal remedy at Rukararwe, Uganda. Our results demonstrate that this remedy has the potential to cure malaria clinically and parasitologically.

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6

Blanchard-Horan, Christina. "Health Microinsurance in Uganda: Affecting Malaria Treatment Seeking Behavior." International Journal of Public Administration 30, no. 8-9 (July 4, 2007): 765–89. http://dx.doi.org/10.1080/01900690701226646.

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7

Katuura, E., P. Waako, J. Ogwal-Okeng, and R. Bukenya-Ziraba. "Traditional treatment of malaria in Mbarara District, western Uganda." African Journal of Ecology 45, s1 (March 2007): 48–51. http://dx.doi.org/10.1111/j.1365-2028.2007.00737.x.

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8

Baluku, Joseph Baruch, Sylvia Nassozi, Brian Gyagenda, Margret Namanda, Irene Andia-Biraro, William Worodria, and Pauline Byakika-Kibwika. "Prevalence of Malaria and TB Coinfection at a National Tuberculosis Treatment Centre in Uganda." Journal of Tropical Medicine 2019 (July 25, 2019): 1–7. http://dx.doi.org/10.1155/2019/3741294.

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The prevalence of malaria and tuberculosis (TB) coinfection is not well established in countries that are highly burdened for both diseases. Malaria could impair TB containment and increase mortality of TB patients. The objective of this study was to determine the prevalence of malaria/TB coinfection among bacteriologically confirmed adult TB patients at a national TB treatment centre in Uganda. Using a cross-sectional study design we enrolled 363 bacteriologically confirmed adult TB patients, and data on demographics and medical history was collected. Blood samples were tested for malaria blood smear, rapid malaria diagnostic test (RDT), complete blood count, haematological film analysis, HIV serology, and CD4+ and CD8+ cell counts. Malaria was defined as either a positive blood smear or RDT. The study participants were mostly male (61.4%), with a median age of 31 (interquartile range, IQR: 25-39) years, and 35.8% were HIV positive. The prevalence of malaria was 2.2% (8/363) on the overall and 5% (3/58) among participants with rifampicin resistance. A triple infection of HIV, malaria, and rifampicin resistant TB was observed in 3 participants. The prevalence of malaria among TB patients is low, and further evaluation of the epidemiological, clinical, and immunological interaction of the two diseases is warranted.

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9

Natukunda, Agnes, Gyaviira Nkurunungi, Ludoviko Zirimenya, Jacent Nassuuna, Gloria Oduru, Rebecca Amongin, Prossy N. Kabuubi, et al. "Effect of intermittent preventive treatment for malaria with dihydroartemisinin-piperaquine on immune responses to vaccines among rural Ugandan adolescents: randomised controlled trial protocol B for the ‘POPulation differences in VACcine responses’ (POPVAC) programme." BMJ Open 11, no. 2 (December 2020): e040427. http://dx.doi.org/10.1136/bmjopen-2020-040427.

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IntroductionDrivers of lower vaccine efficacy and impaired vaccine-specific immune responses in low-income versus high-income countries, and in rural compared with urban settings, are not fully elucidated. Repeated exposure to and immunomodulation by parasite infections may be important. We focus on Plasmodium falciparum malaria, aiming to determine whether there are reversible effects of malaria infection on vaccine responses.Methods and analysisWe have designed a randomised, double-blind, placebo-controlled, parallel group trial of intermittent preventive malaria treatment versus placebo, to determine effects on vaccine response outcomes among school-going adolescents (9 to 17 years) from malaria-endemic rural areas of Jinja district (Uganda). Vaccines to be studied comprise BCG vaccine on day ‘zero’; yellow fever, oral typhoid and human papilloma virus vaccines at week 4; and tetanus/diphtheria booster vaccine at week 28. Participants in the intermittent preventive malaria treatment arm will receive dihydroartemisinin/piperaquine (DP) dosed by weight, 1 month apart, prior to the first immunisation, followed by monthly treatment thereafter. We expect to enrol 640 adolescents. Primary outcomes are BCG-specific interferon-γ ELISpot responses 8 weeks after BCG immunisation and for other vaccines, antibody responses to key vaccine antigens at 4 weeks after immunisation. In secondary analyses, we will determine effects of monthly DP treatment (versus placebo) on correlates of protective immunity, on vaccine response waning, on whether there are differential effects on priming versus boosting immunisations, and on malaria infection prevalence. We will also conduct exploratory immunology assays among subsets of participants to further characterise effects of the intervention on vaccine responses.Ethics and disseminationEthics approval has been obtained from relevant Ugandan and UK ethics committees. Results will be shared with Uganda Ministry of Health, relevant district councils, community leaders and study participants. Further dissemination will be done through conference proceedings and publications.Trial registration numberCurrent Controlled Trials identifier: ISRCTN62041885.

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MBONYE, ANTHONY K., STELLA NEEMA, and PASCAL MAGNUSSEN. "TREATMENT-SEEKING PRACTICES FOR MALARIA IN PREGNANCY AMONG RURAL WOMEN IN MUKONO DISTRICT, UGANDA." Journal of Biosocial Science 38, no. 2 (January 25, 2005): 221–37. http://dx.doi.org/10.1017/s0021932005007108.

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Understanding treatment-seeking practices for malaria in pregnancy is necessary in designing effective programmes to address the high malaria morbidity in pregnancy. This study assessed women’s perceptions on malaria in pregnancy, recognition of early signs of pregnancy and of malaria, and the cultural context in which treatment seeking takes place in Mukono District. Focus group discussions (FGD) and key informant interviews were conducted among pregnant women, non-pregnant women, adolescents and men. The results showed that malaria, locally known as omusujja, was perceived as the most common cause of ill health among pregnant women. Although malaria commonly presents with fever, some pregnant women feel hot in the womb with or without signs of fever and this illness, locally known as nabuguma, may lead to progressive weakness and occasionally to miscarriage and few respondents associated it with malaria. Primigravidae, adolescents and men were not considered at risk of omusujja or nabuguma. Similarly anaemia and low birth weight were not associated with malaria; in fact paleness was described as a normal sign of pregnancy. There are cultural and social pressures on married women to get pregnant and this forces them to conceal symptoms like feeling feverishness, backache, nausea, general weakness, loss of appetite and vomiting until they are sure these are due to pregnancy. Most women, however, could not differentiate symptoms of malaria from those of early pregnancy. There is a belief that omusujja is a normal sign of pregnancy and this is coupled with a strong cultural practice of using herbs and clays as a first resort to treat pregnancy ailments including malaria. The cultural beliefs and practices regarding delivery of twin and first births, coupled with the high cost of care, prevent women from delivering and using other services at health units.

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11

James Henry, Obol, Kitara David Lagoro, and Christopher Garimoi Orach. "Prevalence of Malaria and Treatment Seeking Behaviours among Pregnant Women in Postconflict Internally Displaced Persons' Camps in Gulu District." ISRN Public Health 2012 (December 26, 2012): 1–5. http://dx.doi.org/10.5402/2012/164935.

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Background. Malaria is a serious health problem that contributes greatly to morbidity and mortality in Uganda. It mainly affects pregnant women and children under 5 years of age. Malaria accounts for 9–14% of inpatient deaths in public and private not-for-profit health facilities in Uganda. Methods. A cross-sectional study using quantitative data collection technique was carried out in Gulu district IDP camps. Proportion to size cluster sampling method was used to determine the numbers of pregnant women to be interviewed per IDP camp. We interviewed 769 pregnant women from 20 IDP camps using consecutive sampling methods by moving to the next nearest household. Results. 372(49%) of respondents indicated that they had suffered from malaria in the past two months. 348(94%) respondents got treatment for malaria. 299(86%) sought treatment from a health facility, 35 (10%) sought treatment from clinic, and 14(4%) sought treatment from drug shops. Factors associated with treatment seeking were experience of miscarriage (, value ) and antenatal visit (, value ). Conclusion. The prevalence of malaria was high among the respondents at about half. Majority of the respondents sought treatment from health facilities while a few of them sought treatment for malaria from clinic and drug shop. Pregnant women should be advised to seek treatment whenever they have malaria from health facility to ensure that the treatment given is appropriate.

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12

Bukirwa, Hasifa, Adoke Yeka, Moses R. Kamya, Ambrose Talisuna, Kristin Banek, Nathan Bakyaita, John Bosco Rwakimari, et al. "Artemisinin Combination Therapies for Treatment of Uncomplicated Malaria in Uganda." PLoS Clinical Trials 1, no. 1 (May 19, 2006): e7. http://dx.doi.org/10.1371/journal.pctr.0010007.

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13

Adia, Madina Mohamed, Godwin Anywar, Robert Byamukama, Maud Kamatenesi-Mugisha, Yahaya Sekagya, Esezah K. Kakudidi, and Bernard T. Kiremire. "Medicinal plants used in malaria treatment by Prometra herbalists in Uganda." Journal of Ethnopharmacology 155, no. 1 (August 2014): 580–88. http://dx.doi.org/10.1016/j.jep.2014.05.060.

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14

Nsungwa-Sabiiti, Jesca, Stefan Peterson, George Pariyo, Jasper Ogwal-Okeng, Max G. Petzold, and Goran Tomson. "Home-based management of fever and malaria treatment practices in Uganda." Transactions of the Royal Society of Tropical Medicine and Hygiene 101, no. 12 (December 2007): 1199–207. http://dx.doi.org/10.1016/j.trstmh.2007.08.005.

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15

Nabudere, Harriet, Gabriel L. Upunda, and Malick Juma. "Policy brief on improving access to artemisinin-based combination therapies for malaria in the East African community." International Journal of Technology Assessment in Health Care 26, no. 2 (April 2010): 255–59. http://dx.doi.org/10.1017/s026646231000019x.

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The World Health Organization (WHO) since June 1998 has advocated for the use of artemisinin-based combination therapies (ACTs) in countries where Plasmodium falciparum malaria is resistant to traditional antimalarial therapies such as chloroquine, sulfadoxine-pyrimethamine, and amodiaquine (19;22). In 2006, WHO released evidence-based guidelines for the treatment of malaria backed by findings from various scientific studies (21). During the period between 2002 and 2006, all the five East African states Tanzania, Kenya, Uganda, Rwanda, and Burundi changed their national antimalarial treatment policies to use ACTs as first-line treatments for uncomplicated falciparum malaria and commenced with deployment of the drugs in the state-managed health facilities (12–15). To scale up the use of ACTs in the East African region to combat malaria and speed up progress toward the sixth Millennium Development Goal, a combination of delivery, financial, and governance arrangements tailored to national or subnational contexts needs to be considered.

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16

Tabuti, John R. S. "Herbal medicines used in the treatment of malaria in Budiope county, Uganda." Journal of Ethnopharmacology 116, no. 1 (February 2008): 33–42. http://dx.doi.org/10.1016/j.jep.2007.10.036.

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17

Nsobya, Samuel L., Christian Dokomajilar, Moses Joloba, Grant Dorsey, and Philip J. Rosenthal. "Resistance-Mediating Plasmodium falciparum pfcrt and pfmdr1 Alleles after Treatment with Artesunate-Amodiaquine in Uganda." Antimicrobial Agents and Chemotherapy 51, no. 8 (June 11, 2007): 3023–25. http://dx.doi.org/10.1128/aac.00012-07.

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ABSTRACT Key parasite polymorphisms were assessed in subjects treated for malaria with artesunate-amodiaquine in Tororo, Uganda. For pfcrt, all of the isolates tested had the CVIET haplotype. For pfmdr1, 86Y and 1246Y were common at baseline and their prevalences were significantly higher in new isolates after therapy, indicating that treatment selected for mutations associated with a decreased response to amodiaquine.

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18

Ategeka, John, Abel Kakuru, Richard Kajubi, Razack Wasswa, Harriet Ochokoru, Emmanuel Arinaitwe, Adoke Yeka, et al. "Relationships Between Measures of Malaria at Delivery and Adverse Birth Outcomes in a High-Transmission Area of Uganda." Journal of Infectious Diseases 222, no. 5 (April 2, 2020): 863–70. http://dx.doi.org/10.1093/infdis/jiaa156.

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Abstract Background Clinical trials of interventions for preventing malaria in pregnancy often use measures of malaria at delivery as their primary outcome. Although the objective of these interventions is to improve birth outcomes, data on associations between different measures of malaria at delivery and adverse birth outcomes are limited. Methods Data came from 637 Ugandan women enrolled in a randomized controlled trial of intermittent preventive treatment of malaria in pregnancy. Malaria at delivery was detected using peripheral and placental blood microscopy, placental blood loop-mediated isothermal amplification (LAMP), and placental histopathology. Multivariate analyses were used to estimate associations between measures of malaria at delivery and risks of low birth weight (LBW), small for gestational age (SGA), and preterm birth (PTB). Results Detection of malaria parasites by microscopy or LAMP was not associated with adverse birth outcomes. Presence of malaria pigment detected by histopathology in ≥30% of high-powered fields was strongly associated with LBW (adjusted risk ratio [aRR] = 3.42, P = .02) and SGA (aRR = 4.24, P < .001) but not PTB (aRR = 0.88, P = .87). Conclusions A semiquantitative classification system based on histopathologically detected malaria pigment provided the best surrogate measure of adverse birth outcomes in a high-transmission setting and should be considered for use in malaria in pregnancy intervention studies.

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Ellis, Jayne, Prosperity C. Eneh, Kenneth Ssebambulidde, Morris K. Rutakingirwa, Mohammed Lamorde, Joshua Rhein, Fiona V. Cresswell, David R. Boulware, and Melanie R. Nicol. "Case Report: Three's a crowd: a case report examining the diagnostic and pharmacokinetic challenges in HIV-tuberculous meningitis-malaria co-infection." Wellcome Open Research 3 (September 6, 2018): 111. http://dx.doi.org/10.12688/wellcomeopenres.14726.1.

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In 2016, 10.4 million cases of tuberculosis (TB) were reported globally. Malaria also continues to be a global public health threat. Due to marked epidemiological overlap in the global burden of TB and malaria, co-infection does occur. An HIV-infected, 32-year-old male presented with a two-week history of headache with fevers to Mulago National Referral Hospital, Uganda. Five months prior, he was diagnosed with pulmonary TB. He endorsed poor adherence to anti-tuberculous medications. Mycobacterium tuberculosis in CSF was confirmed on Xpert MTB/RIF Ultra. On day 2, he was initiated on dexamethasone at 0.4mg/kg/day and induction TB-medications were re-commenced (rifampicin, isoniazid, ethambutol, pyrazinamide) for TBM. He continued to spike high-grade fevers, a peripheral blood smear showed P. falciparum parasites despite a negative malaria rapid diagnostic test (RDT). He received three doses of IV artesunate and then completed 3 days of oral artemether/lumefantrine. To our knowledge this is the first published case of HIV-TBM-malaria co-infection. TBM/malaria co-infection poses a number of management challenges. Due to potential overlap in symptoms between TBM and malaria, it is important to remain vigilant for co-infection. Access to accurate parasitological diagnostics is essential, as RDT use continues to expand, it is essential that clinicians are aware of the potential for false negative results. Anti-malarial therapeutic options are limited due to important drug-drug interactions (DDIs). Rifampicin is a potent enzyme inducer of several hepatic cytochrome P450 enzymes, this induction results in reduced plasma concentrations of several anti-malarial medications. Despite recognition of potential DDIs between rifampicin and artemisinin compounds, and rifampicin and quinine, no treatment guidelines currently exist for managing patients with co-infection. There is both an urgent need for the development of new anti-malarial drugs which do not interact with rifampicin and for pharmacokinetic studies to guide dose modification of existing anti-malarial drugs to inform clinical practice guidelines.

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Ellis, Jayne, Prosperity C. Eneh, Kenneth Ssebambulidde, Morris K. Rutakingirwa, Mohammed Lamorde, Joshua Rhein, Fiona V. Cresswell, David R. Boulware, and Melanie R. Nicol. "Case Report: Three's a crowd: a case report examining the diagnostic and pharmacokinetic challenges in HIV-tuberculous meningitis-malaria co-infection." Wellcome Open Research 3 (January 15, 2019): 111. http://dx.doi.org/10.12688/wellcomeopenres.14726.2.

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In 2016, 10.4 million cases of tuberculosis (TB) were reported globally. Malaria also continues to be a global public health threat. Due to marked epidemiological overlap in the global burden of TB and malaria, co-infection does occur. An HIV-infected, 32-year-old male presented with a two-week history of headache with fevers to Mulago National Referral Hospital, Uganda. Five months prior, he was diagnosed with pulmonary TB. He endorsed poor adherence to anti-tuberculous medications. Mycobacterium tuberculosis in CSF was confirmed on Xpert MTB/RIF Ultra. On day 2, he was initiated on dexamethasone at 0.4mg/kg/day and induction TB-medications were re-commenced (rifampicin, isoniazid, ethambutol, pyrazinamide) for TBM. He continued to spike high-grade fevers, a peripheral blood smear showed P. falciparum parasites despite a negative malaria rapid diagnostic test (RDT). He received three doses of IV artesunate and then completed 3 days of oral artemether/lumefantrine. To our knowledge this is the first published case of HIV-TBM-malaria co-infection. TBM/malaria co-infection poses a number of management challenges. Due to potential overlap in symptoms between TBM and malaria, it is important to remain vigilant for co-infection. Access to accurate parasitological diagnostics is essential, as RDT use continues to expand, it is essential that clinicians are aware of the potential for false negative results. Anti-malarial therapeutic options are limited due to important drug-drug interactions (DDIs). Rifampicin is a potent enzyme inducer of several hepatic cytochrome P450 enzymes, this induction results in reduced plasma concentrations of several anti-malarial medications. Despite recognition of potential DDIs between rifampicin and artemisinin compounds, and rifampicin and quinine, no treatment guidelines currently exist for managing patients with co-infection. There is both an urgent need for the development of new anti-malarial drugs which do not interact with rifampicin and for pharmacokinetic studies to guide dose modification of existing anti-malarial drugs to inform clinical practice guidelines.

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21

Waiswa, Peter, Flavia Mpanga, Danstan Bagenda, Rornald Muhumuza Kananura, Thomas O’Connell, Dorcus Kiwanuka Henriksson, Theresa Diaz, et al. "Child health and the implementation of Community and District-management Empowerment for Scale-up (CODES) in Uganda: a randomised controlled trial." BMJ Global Health 6, no. 6 (June 2021): e006084. http://dx.doi.org/10.1136/bmjgh-2021-006084.

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IntroductionUganda’s district-level administrative units buttress the public healthcare system. In many districts, however, local capacity is incommensurate with that required to plan and implement quality health interventions. This study investigates how a district management strategy informed by local data and community dialogue influences health services.MethodsA 3-year randomised controlled trial (RCT) comprised of 16 Ugandan districts tested a management approach, Community and District-management Empowerment for Scale-up (CODES). Eight districts were randomly selected for each of the intervention and comparison areas. The approach relies on a customised set of data-driven diagnostic tools to identify and resolve health system bottlenecks. Using a difference-in-differences approach, the authors performed an intention-to-treat analysis of protective, preventive and curative practices for malaria, pneumonia and diarrhoea among children aged 5 and younger.ResultsIntervention districts reported significant net increases in the treatment of malaria (+23%), pneumonia (+19%) and diarrhoea (+13%) and improved stool disposal (+10%). Coverage rates for immunisation and vitamin A consumption saw similar improvements. By engaging communities and district managers in a common quest to solve local bottlenecks, CODES fostered demand for health services. However, limited fiscal space-constrained district managers’ ability to implement solutions identified through CODES.ConclusionData-driven district management interventions can positively impact child health outcomes, with clinically significant improvements in the treatment of malaria, pneumonia and diarrhoea as well as stool disposal. The findings recommend the model’s suitability for health systems strengthening in Uganda and other decentralised contexts.Trial registration numberISRCTN15705788.

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Ahimbisibwe, Frank B., Leon Matagi, Mohamed Senkumba, and Privah Atuhaire. "Knowledge of Health Communications Management and Treatment Seeking-Behavior Regarding Malaria in Uganda." Open Journal of Epidemiology 10, no. 03 (2020): 203–19. http://dx.doi.org/10.4236/ojepi.2020.103019.

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23

SSEGAWA, PAUL, and JOHN M. KASENENE. "PLANTS FOR MALARIA TREATMENT IN SOUTHERN UGANDA: TRADITIONAL USE, PREFERENCE AND ECOLOGICAL VIABILITY." Journal of Ethnobiology 27, no. 1 (March 2007): 110–31. http://dx.doi.org/10.2993/0278-0771(2007)27[110:pfmtis]2.0.co;2.

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24

Sangaré, Laura R., Andy Stergachis, Paula E. Brentlinger, Barbra A. Richardson, Sarah G. Staedke, Mpungu S. Kiwuwa, and Noel S. Weiss. "Determinants of Use of Intermittent Preventive Treatment of Malaria in Pregnancy: Jinja, Uganda." PLoS ONE 5, no. 11 (November 29, 2010): e15066. http://dx.doi.org/10.1371/journal.pone.0015066.

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25

Nsungwa-Sabiiti, Jesca, Göran Tomson, George Pariyo, Jasper Ogwal-Okeng, and Stefan Peterson. "Community effectiveness of malaria treatment in Uganda—a long way to Abuja targets." Annals of Tropical Paediatrics 25, no. 2 (June 2005): 91–100. http://dx.doi.org/10.1179/146532805x45683.

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Menon, Manoj P. "Prevalence of Anemia Among Children Under 5 Years of Age – Uganda, 2009." Blood 120, no. 21 (November 16, 2012): 4262. http://dx.doi.org/10.1182/blood.v120.21.4262.4262.

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Abstract Abstract 4262 Anemia in children under 5 years of age, defined by the World Health Organization as a hemoglobin (hb) level < 11g/L, is a global public health problem, affecting a significant percentage of the world's children. In addition to its contribution to childhood mortality, the role of anemia in cognitive impairment and educational attainment is also well recognized. According to the 2000-01 Demographic Health Survey (DHS), the prevalence of anemia in Uganda was 64% among children <5, similar to other countries in the region. A subsequent 2006 DHS noted that the prevalence of anemia had increased to 72% in Uganda. Although it is estimated that nearly half of all cases of anemia are due to iron deficiency, the causes of anemia, which disproportionately affect children and pregnant woman, are multifactorial and include nutritional deficiencies and parasitic infections. In endemic regions, the causative role of malaria is particularly important. The 2009 Uganda Malaria Indicator Survey (UMIS) is a nationally representative household survey which collects demographic data and measurements of hemoglobin and testing for malaria in addition to coverage estimates of malaria prevention and control activities. Hemoglobin measurements were collected via the HemoCue®, a point of use test. Malaria was detected both by peripheral blood smear and via the rapid diagnostic test, Paracheck-Pf®, which detects the presence of histidine rich protein 2 (HRP2). For this analysis, we utilized the results of the rapid diagnostic test, which is characterized by high sensitivity but lower specificity as the tests detect HRP2 which persists in the bloodstream after clearance of the parasite. The UMIS collected data on household assets. Using principal component analysis, a wealth index was created and households were stratified into wealth quintiles. We analyzed data on hemoglobin levels (adjusted for altitude) among children under 5 years. We assessed various risk factors and performed both univariate and bivariate analyses. Those variable which were significantly associated with anemia (p <0.05) were included in the multivariate analysis. The UMIS utilized a two-stage sample design; 4,421 households were randomly selected (response rate 97.5%) from 170 clusters. Half (51%) of the sampled children were female and over 80% were between 12 and 59 months. Of the 4,065 children under 5 in the sample, hemoglobin measurements were obtained on 3,878 children (95%). Of these, 61% of children <5 had a hb level less than 11 g/L; nearly 10% were severely anemic with a hb less than 8 g/L. On bivariate analysis, anemia was more common in children between 12–59 months (p =.001), living in rural areas (p=.001), in households in the poorest wealth quintiles (p<.001), in those households having problems in satisfying their food needs (p<.001) and among those with concomitant malaria infection (p <.001). The prevalence of anemia among children who tested negative for malaria was 45% (versus 77% among those who tested positive). Maternal education was inversely associated with anemia (p=.009). Neither household size nor distance to the nearest health facility were associated with anemia. The sex of the child was also not associated with anemia. Using a logistic regression model, only simultaneous malaria infection (p <.001) and living in poorer households (p <.001) were associated with anemia. While the prevalence of anemia has decreased in Uganda since the most recent national household survey in 2006, the burden of anemia remains unacceptably high. In this analysis, the detection of malaria via Paracheck-Pf® was significantly associated with anemia. Clearly, malaria prevention and effective treatment measures have expanded and as such have reduced the prevalence of malaria during this interim. While these control efforts are likely responsible for the observed downward trend in anemia prevalence, such public health endeavors are unlikely to be sufficient to reduce the burden of anemia. Although the UMIS did not collect data on nutritional deficiencies, previous studies have documented the high percentage of anemia attributed to iron deficiency globally. Therefore, prevention of anemia via iron supplementation and antihelmintics, in conjunction with malaria prevention and treatment strategies, will likely be necessary to halt the global toll of anemia. Disclosures: No relevant conflicts of interest to declare.

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Lee, Yang Jae, Gautam Adusumilli, Rauben Kazungu, Godwin Anywar, Francis Kyakulaga, Esther Katuura, Shanti Parikh, and Merlin Willcox. "Treatment-seeking behavior and practices among caregivers of children aged ≤5 y with presumed malaria in rural Uganda." Transactions of The Royal Society of Tropical Medicine and Hygiene 113, no. 9 (May 29, 2019): 525–33. http://dx.doi.org/10.1093/trstmh/trz039.

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Abstract Background We aimed to determine the rate of herbal medicine usage and the treatment-seeking patterns of children aged ≤5 y with presumed or confirmed malaria in an endemic area of Uganda. Methods We interviewed guardians of 722 children aged 6 months to 5 y, who had experienced an episode of presumed malaria in the previous 3 months, about the illness history. Results Overall, 36.1% of patients took herbal medicines but most also sought modern medical care; 79.2% received Artemether-Lumefantrine (AL), but only 42.7% received the correct AL dose. Of the 36.6% of patients treated in drug shops, 9.8% had a diagnostic test and 30.2% received the correct dose of AL. Antibiotics were frequently provided with AL at drug shops (62%) and formal health centers (45%). There were no significant differences in the self-reported outcomes associated with different treatments. Conclusion Almost all of the patients who took herbal medicine also took modern antimalarials, so further research is needed to explore potential interactions between them. Although formal health facilities provided the correct diagnosis and dose of AL to a majority of children with malaria, many children still received inappropriate antibiotics. Quality of care was worse in drug shops than in formal health facilities.

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Hansen, Kristian S., Richard Ndyomugyenyi, Pascal Magnussen, Sham Lal, and Siân E. Clarke. "Cost-effectiveness analysis of malaria rapid diagnostic tests for appropriate treatment of malaria at the community level in Uganda." Health Policy and Planning 32, no. 5 (February 15, 2017): 676–89. http://dx.doi.org/10.1093/heapol/czw171.

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Namusoke, Fatuma, Niloofar Rasti, Fred Kironde, Mats Wahlgren, and Florence Mirembe. "Malaria Burden in Pregnancy at Mulago National Referral Hospital in Kampala, Uganda." Malaria Research and Treatment 2010 (November 7, 2010): 1–10. http://dx.doi.org/10.4061/2010/913857.

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Pregnancy-associated malaria is a major global health concern. To assess the Plasmodium falciparum burden in pregnancy we conducted a cross-sectional study at Mulago Hospital in Kampala, Uganda. Malaria prevalence by each of three measures—peripheral smear, placental smear, and placental histology was 9% (35/391), 11.3% (44/389), and 13.9% (53/382) respectively. Together, smear and histology data yielded an infection rate of 15.5% (59/380) of active infections and 4.5% (17/380) of past infections; hence 20% had been or were infected when giving birth. A crude parity dependency was observed with main burden being concentrated in gravidae 1 through gravidae 3. Twenty-two percent were afflicted by anaemia and 12.2% delivered low birthweight babies. Active placental infection and anaemia showed strong association (OR=2.8) whereas parity and placental infection had an interactive effect on mean birthweight (P=.036). Primigravidae with active infection and multigravidae with past infection delivered on average lighter babies. Use of bednet protected significantly against infection (OR=0.56) whilst increased haemoglobin level protected against low birthweight (OR=0.83) irrespective of infection status. Albeit a high attendance at antenatal clinics (96.8%), there was a poor coverage of insecticide-treated nets (32%) and intermittent preventive antimalarial treatment (41.5%).Erratum to Malaria Burden in Pregnancy at Mulago National Referral Hospital in Kampala, Uganda

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Lubanga, Rosalind G. N., Sandra Norman, Douglas Ewbank, and Charles Karamagi. "Maternal diagnosis and treatment of children's fever in an endemic malaria zone of Uganda: implications for the malaria control programme." Acta Tropica 68, no. 1 (October 1997): 53–64. http://dx.doi.org/10.1016/s0001-706x(97)00071-5.

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Lubanga, Rosalind G., S. Norman, D. Ewbank, and C. Karamagi. "Mothers' ‘diagnosis’ and treatment of children's fever in a malaria endemic area of Uganda: Implications for the malaria control program." Journal of Clinical Epidemiology 50 (January 1997): S42. http://dx.doi.org/10.1016/s0895-4356(97)87307-6.

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Lubanga, Rosalind, S. Norman, D. Ewbank, and C. Karamagi. "Mothers' ‘iagnosis’ and treatment of children's fever in a malaria endemic area of Uganda: Implications for the malaria control program." Journal of Clinical Epidemiology 49 (January 1996): S10. http://dx.doi.org/10.1016/0895-4356(96)89189-x.

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Mbonye, A. K., K. Schultz Hansen, I. C. Bygbjerg, and P. Magnussen. "Effect of a community-based delivery of intermittent preventive treatment of malaria in pregnancy on treatment seeking for malaria at health units in Uganda." Public Health 122, no. 5 (May 2008): 516–25. http://dx.doi.org/10.1016/j.puhe.2007.07.024.

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Mwanga-Amumpaire, Juliet, Tobias Alfvén, Celestino Obua, Karin Källander, Richard Migisha, Cecilia Stålsby Lundborg, Grace Ndeezi, and Joan Nakayaga Kalyango. "Appropriateness of Care for Common Childhood Infections at Low-Level Private Health Facilities in a Rural District in Western Uganda." International Journal of Environmental Research and Public Health 18, no. 15 (July 21, 2021): 7742. http://dx.doi.org/10.3390/ijerph18157742.

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In Uganda, >50% of sick children receive treatment from primary level-private health facilities (HF). We assessed the appropriateness of care for common infections in under-five-year-old children and explored perspectives of healthcare workers (HCW) and policymakers on the quality of healthcare at low-level private health facilities (LLPHF) in western Uganda. This was a mixed-methods parallel convergent study. Employing multistage consecutive sampling, we selected 110 HF and observed HCW conduct 777 consultations of children with pneumonia, malaria, diarrhea or neonatal infections. We purposively selected 30 HCW and 8 policymakers for in-depth interviews. Care was considered appropriate if assessment, diagnosis, and treatment were correct. We used univariable and multivariable logistic regression analyses for quantitative data and deductive thematic analysis for qualitative data. The proportion of appropriate care was 11% for pneumonia, 14% for malaria, 8% for diarrhea, and 0% for neonatal infections. Children with danger signs were more likely to receive appropriate care. Children with diarrhea or ability to feed orally were likely to receive inappropriate care. Qualitative data confirmed care given as often inappropriate, due to failure to follow guidelines. Overall, sick children with common infections were inappropriately managed at LLPHF. Technical support and provision of clinical guidelines should be increased to LLPHF.

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Opoka, Robert, Christopher Ndugwa, Teresa S. Latham, Adam Lane, Heather Ann Hume, Philip Kasirye, James L. Hodges, Russell E. Ware, and Chandy C. John. "Novel Use of Hydroxyurea in an African Region with Malaria (NOHARM): A Randomized Controlled Trial." Blood 130, Suppl_1 (December 7, 2017): 759. http://dx.doi.org/10.1182/blood.v130.suppl_1.759.759.

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Abstract Background. Hydroxyurea treatment is recommended for children with sickle cell anemia (SCA) living in high-resource malaria-free regions, but its safety and efficacy in malaria-endemic settings such as sub-Saharan Africa, where the greatest sickle cell burden exists, remain unknown. In vitro studies suggest hydroxyurea could increase malaria severity, through upregulation of intracellular adhesion molecule 1 (ICAM-1) that facilitates parasite adhesion to endothelium. In addition, hydroxyurea-associated neutropenia could worsen infections that occur in low-resource settings. Methods. NOHARM (NCT01976416) was a randomized, double-blinded, placebo-controlled trial conducted in malaria-endemic Uganda. Children between the ages of 1.00-3.99 years were enrolled, and then received 12-months of blinded treatment with either hydroxyurea or placebo at 20 ± 2.5 mg/kg/day, with dose adjustments in both arms for weight gain and hematological toxicities. All participants received standard care for SCA including folic acid, penicillin prophylaxis, and pneumococcal vaccination. For malaria prophylaxis, children received insecticide-treated mosquito nets and monthly sulphadoxine-pyrimethamine. The primary outcome was incidence of clinical malaria. Secondary outcomes included SCA-related adverse events, clinical and laboratory effects, and hematological toxicities. After completing the blinded treatment phase, all participants were offered open-label hydroxyurea, as per local Ethics Committee recommendations. Results. Study participants (median age 2.2 years) received either hydroxyurea (N=104) or placebo (N=103) for 12-months. Malaria occurred at a low rate throughout the study. The malaria incidence did not differ between children on hydroxyurea [0.05 episodes/child/year, 95% CI (0.02, 0.13)] versus placebo [0.07 episodes/child/year (0.03, 0.16)]. The hydroxyurea/placebo malaria incidence rate ratio was 0.7 [(0.2, 2.7), p=0.61], and time to infection did not differ significantly between treatment arms. A composite SCA-related clinical outcome (vaso-occlusive painful crisis, dactylitis, acute chest syndrome, splenic sequestration, or blood transfusion) was less frequent with hydroxyurea (45%) than placebo (69%, p=0.001). For individual clinical events, vaso-occlusive pain and hospitalizations were significantly less frequent with hydroxyurea than placebo; the number needed to treat to prevent one hospitalization was 6.4, while the number needed to treat to prevent a SCA-related event was 2.5. Serious adverse events, sepsis episodes, and dose-limiting toxicities were similar between treatment arms. Specifically, low hemoglobin (<6.0 g/dL) occurred more frequently in children receiving placebo than hydroxyurea, while the frequencies of neutropenia, thrombocytopenia and reticulocytopenia did not differ significantly between treatment arms. Three deaths occurred (two hydroxyurea, one placebo, none from malaria). Children receiving hydroxyurea had significantly increased hemoglobin concentration and fetal hemoglobin, along with decreased leukocytes, neutrophils, and reticulocytes. Conclusions. In this prospective randomized double-blinded placebo-controlled trial of young children with SCA living in Uganda, hydroxyurea therapy was both safe and efficacious. Based on these NOHARM data, hydroxyurea treatment appears safe for children with SCA living in malaria-endemic sub-Saharan Africa, without increased risk for severe malaria, infections, or adverse events. Hydroxyurea provides predicted SCA-related laboratory and clinical efficacy, but the optimal dosing and monitoring regimens for affected children in Africa remain undefined. Disclosures Ware: Agios: Membership on an entity's Board of Directors or advisory committees; Bristol Myers Squibb: Research Funding; Addmedica: Research Funding; Nova Laboratories: Consultancy; Global Blood Therapeutics: Consultancy.

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Nagitta Oluka, Pross, Marcia Mkansi, and George William Kajjumba. "The Relationship Between Market Environment Dimensions and Availability of Malaria Pills in Uganda." Global Advances in Health and Medicine 10 (January 2021): 216495612110021. http://dx.doi.org/10.1177/21649561211002126.

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Introduction This study sought to examine the contribution of relationship building (in terms of collaboration, information sharing and supply chain interdependence) on the availability of malaria treatment pills in public hospitals in Sub-Saharan Africa using data from Uganda. Methods By means of a cross-sectional survey research design, the study used a questionnaire strategy to collect quantitative data. Out of the 320 questionnaires that were distributed in 40 public hospitals, 283 were answered and returned, which yielded an 88% response rate. Structural equation modelling (SEM) was used to establish the relationship between measured variables and latent constructs. Results Drawing on the survey results, the confirmatory factor analysist and the Structural Equation Modelling clearly demonstrate that relationship building (in terms of collaboration, information sharing and supply chain interdependence) significantly influences the availability of Artemisinin-based combination therapies in public general hospitals in Uganda. Conclusion Policy-makers should focus on developing cheaper information technology tools to exchange information regarding stock levels, forecasting, quantification, orders, and dispensing. This study developed a measurement model for an inter-hospital relationship, using relational view theory, and it employs dimensions in terms of information sharing and supply chain interdependence to predict and explain the availability of malaria pills in government hospitals.

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Dorsey, G., C. R. Phares, J. N. Babirye, G. Ndeezi, M. R. Kamya, P. J. Rosenthal, E. T. Katabira, and J. E. Olson. "Predictors of chloroquine treatment failure in children and adults with falciparum malaria in Kampala, Uganda." American Journal of Tropical Medicine and Hygiene 62, no. 6 (June 1, 2000): 686–92. http://dx.doi.org/10.4269/ajtmh.2000.62.686.

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Baliraine, Frederick N., and Philip J. Rosenthal. "Prolonged Selection of pfmdr1 Polymorphisms After Treatment of Falciparum Malaria With Artemether-Lumefantrine in Uganda." Journal of Infectious Diseases 204, no. 7 (October 1, 2011): 1120–24. http://dx.doi.org/10.1093/infdis/jir486.

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Kilian, A. H. D., D. Tindyebwa, T. Gulck, W. Byamukama, T. Rubaale, G. Kabagambe, and R. Korte. "Attitude of women in western Uganda towards pre-packed, unit-dosed malaria treatment for children." Tropical Medicine and International Health 8, no. 5 (May 2003): 431–38. http://dx.doi.org/10.1046/j.1365-3156.2003.01044.x.

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Kengeya-Kayondo, Jane F., Janet A. Seeley, Ellen Kajura-Bajenja, Elizabeth Kabunga, Eva Mubiru, Fatuma Sembajja, and Daan W. Mulder. "Recognition, treatment seeking behaviour and perception of cause of malaria among rural women in Uganda." Acta Tropica 58, no. 3-4 (December 1994): 267–73. http://dx.doi.org/10.1016/0001-706x(94)90020-5.

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Tumwebaze, Patrick, Melissa D. Conrad, Andrew Walakira, Norbert LeClair, Oswald Byaruhanga, Christine Nakazibwe, Benjamin Kozak, et al. "Impact of Antimalarial Treatment and Chemoprevention on the Drug Sensitivity of Malaria Parasites Isolated from Ugandan Children." Antimicrobial Agents and Chemotherapy 59, no. 6 (March 9, 2015): 3018–30. http://dx.doi.org/10.1128/aac.05141-14.

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ABSTRACTChanging treatment practices may be selecting for changes in the drug sensitivity of malaria parasites. We characterizedex vivodrug sensitivity and parasite polymorphisms associated with sensitivity in 459Plasmodium falciparumsamples obtained from subjects enrolled in two clinical trials in Tororo, Uganda, from 2010 to 2013. Sensitivities to chloroquine and monodesethylamodiaquine varied widely; sensitivities to quinine, dihydroartemisinin, lumefantrine, and piperaquine were generally good. Associations betweenex vivodrug sensitivity and parasite polymorphisms included decreased chloroquine and monodesethylamodiaquine sensitivity and increased lumefantrine and piperaquine sensitivity withpfcrt76T, as well as increased lumefantrine sensitivity withpfmdr186Y, Y184, and 1246Y. Over time,ex vivosensitivity decreased for lumefantrine and piperaquine and increased for chloroquine, the prevalences ofpfcrtK76 andpfmdr1N86 and D1246 increased, and the prevalences ofpfdhfrandpfdhpspolymorphisms associated with antifolate resistance were unchanged. In recurrent infections, recent prior treatment with artemether-lumefantrine was associated with decreasedex vivolumefantrine sensitivity and increased prevalence ofpfcrtK76 andpfmdr1N86, 184F, and D1246. In children assigned chemoprevention with monthly dihydroartemisinin-piperaquine with documented circulating piperaquine, breakthrough infections had increased the prevalence ofpfmdr186Y and 1246Y compared to untreated controls. The noted impacts of therapy and chemoprevention on parasite polymorphisms remained significant in multivariate analysis correcting for calendar time. Overall, changes in parasite sensitivity were consistent with altered selective pressures due to changing treatment practices in Uganda. These changes may threaten the antimalarial treatment and preventive efficacies of artemether-lumefantrine and dihydroartemisinin-piperaquine, respectively.

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Ndyomugyenyi, Richard, Pascal Magnussen, and Siân Clarke. "Diagnosis and treatment of malaria in peripheral health facilities in Uganda: findings from an area of low transmission in south-western Uganda." Malaria Journal 6, no. 1 (2007): 39. http://dx.doi.org/10.1186/1475-2875-6-39.

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Liow, Eric, Rosemin Kassam, and Richard Sekiwunga. "Understanding Unlicensed Drug Vendor Practices Related to Childhood Malaria in One Rural District of Uganda: An Exploratory Study." Journal of Tropical Medicine 2018 (2018): 1–11. http://dx.doi.org/10.1155/2018/6987435.

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This study investigated unlicensed drug outlets’ practices for the management of malaria in the rural district of Butaleja, Uganda. A qualitative design using semistructured interviews was used. Interviews were recorded, translated, transcribed, and analyzed using thematic analysis. A total of 75 vendors, representing 85% of the outlets in the study area, were interviewed. Most of the vendors were associated with a drug shop type of outfit. About three-quarters reported having completed some level of postsecondary education, but just one-tenth of the vendors had qualifications that made them eligible to apply for a license to operate a drug shop. While most outlets stocked at least one type of antimalarial, only about one-quarter stocked an artemisinin-based combination therapy (ACT), one-quarter expressed a preference for ACTs, and less than one-tenth attested to firmly adhering to the national malaria treatment guidelines on dispensing ACTs as the first-line option. In contrast, nine out of 10 vendors stocked quinine and well over a third stocked antimalarials no longer recommended, such as chloroquine and sulphadoxine-pyrimethamine. Given the ongoing gap between the national malaria policy and unlicensed drug outlet practices, this study calls for greater engagement of unlicensed vendors to improve the management of childhood malaria.

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Matovu, Fred, Aisha Nanyiti, and Elizeus Rutebemberwa. "TREATMENT COSTS FOR COMMUNITY-BASED MANAGEMENT OF MALARIA AND PNEUMONIA VERSUS MALARIA ALONE IN CHILDREN AGED 4-59 MONTHS IN EASTERN UGANDA." African Journal of Health Economics 02, no. 02 (2013): 01–10. http://dx.doi.org/10.35202/ajhe.2013.2205.

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Mbonye, Anthony K., Ib Bygbjerg, and Pascal Magnussen. "Intermittent preventive treatment of malaria in pregnancy: Evaluation of a new delivery approach and the policy implications for malaria control in Uganda." Health Policy 81, no. 2-3 (May 2007): 228–41. http://dx.doi.org/10.1016/j.healthpol.2006.05.018.

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GASASIRA, ANNE F., ANNETTE NASSALI, BRIDGET NZARUBARA, GRANT DORSEY, MOSES R. KAMYA, PHILIP J. ROSENTHAL, and SARAH G. STAEDKE. "COMPARATIVE EFFICACY OF AMINOQUINOLINE-ANTIFOLATE COMBINATIONS FOR THE TREATMENT OF UNCOMPLICATED FALCIPARUM MALARIA IN KAMPALA, UGANDA." American Journal of Tropical Medicine and Hygiene 68, no. 2 (February 1, 2003): 127–32. http://dx.doi.org/10.4269/ajtmh.2003.68.127.

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Anywar, Godwin, Charlotte I. E. A. van’t Klooster, Robert Byamukama, Merlin Willcox, Patricia A. Nalumansi, Joop de Jong, Protase Rwaburindori, and Bernard T. Kiremire. "Medicinal Plants Used in the Treatment and Prevention of Malaria in Cegere Sub-County, Northern Uganda." Ethnobotany Research and Applications 14 (January 10, 2016): 505–16. http://dx.doi.org/10.17348/era.14.0.505-516.

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Waako, P. J., J. Ogwal-Oken, R. Kiguba, D. Ross-Degna, and O. Aupont. "Immediate Responses by Private and Public Hospitals to National Malaria Treatment Policy Change Pronouncements in Uganda." International Journal of Tropical Medicine 5, no. 1 (January 1, 2010): 1–5. http://dx.doi.org/10.3923/ijtmed.2010.1.5.

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Yeka, Adoke, Ruth Kigozi, Melissa D. Conrad, Myers Lugemwa, Peter Okui, Charles Katureebe, Kassahun Belay, et al. "Artesunate/Amodiaquine Versus Artemether/Lumefantrine for the Treatment of Uncomplicated Malaria in Uganda: A Randomized Trial." Journal of Infectious Diseases 213, no. 7 (November 23, 2015): 1134–42. http://dx.doi.org/10.1093/infdis/jiv551.

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Lindblade, Kim A., Devin B. O'neill, Don P. Mathanga, Justus Katungu, and Mark L. Wilson. "Treatment for clinical malaria is sought promptly during an epidemic in a highland region of Uganda." Tropical Medicine and International Health 5, no. 12 (December 2000): 865–75. http://dx.doi.org/10.1046/j.1365-3156.2000.00651.x.

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