Sustainability of Malaria Prevention Strategies in Uganda and Zimbabwe: A Systematic Review

Abstract

Background- Malaria is a parasitic infectious disease spread through the bite of an infected female Anopheles mosquito. Presently two  vector control strategies play a pivotal role in the control of malaria – Indoor Residual Spraying and treated bed nets. Preventive and  control measures have been put in place in Zimbabwe and Uganda to eliminate this menace. However, the efforts are proving futile as  the number of cases continues to increase annually. 

Objective- The review was aimed at determining the ability of indoor residual  spraying and long-lasting insecticidal nets to continue achieving malaria elimination over time in Zimbabwe and Uganda. 

Methods- A  systematic review was conducted according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta- Analyses. A literature search based on Patient, Intervention, Comparison, and Outcomes was used on the Web of Science, EBSCO host  and Science Direct databases for the best relevant results. Thirty-six full-text articles were passed to the systematic review. Factors that  were evaluated include vector resistance to insecticides, the reported extent of community involvement, sustainability prospects, and the impact of indoor residual spraying and long-lasting insecticidal nets in malaria elimination. 

Results- The available literature suggests that  the sustainability of malaria control initiatives in Uganda and Zimbabwe may be unachievable. There seems to be a gap in all the  reviewed literature concerning the assessment of the level of participation of the communities in which these strategies are being  implemented. The communities are mere recipients of the control measures without adequate involvement. Hence, their sustainability is  not being realized. 

Conclusion- Zimbabwe and Uganda may continue to face challenges in the fight against malaria if they do not incorporate sustainability concepts into their malaria elimination efforts. Their continued overreliance on international aid and Non- Governmental Organizations will remain their major pitfall.