Communicable Disease- Malaria in Uganda


Millenium Development Goals

Target 6C: Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases

  • Between 2000 and 2015, the substansial expansion of malaria interventions led to a 58% decline in malaria mortality rates globally
  • Since 2000, over 6.2 million deaths from malaria were averted, primarily in children under 5 years of age in sub-saharan africa
  • Due to increased funding, more children are sleeping under insectiside-treated nets in sub-saharan africa.
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Why Uganda?

  • Infant mortality rate = 57.6/1000 = 1st highest
  • Life expectancy = 55.4 = 13th lowest
  • Sanitation (unimproved) 80.9%
  • Malaria is the leading cause of death among ugandans accounting for over 27% of deaths
  • Endemic across 95% of the country
  • Uganda has the sixth highest number of annual deaths from malaria in Africa.
  • Approximately 16 million cases and 10,500 deaths annually
  • A single episode of malaria costs a family of average 9 US dollars or 3% of their annual income.
  • Accounts for 30-50% of outpatient visits at health facilities, 15-20% of all hospital admissions and up to 20% of all hospital deaths
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Environmental and Human Causes

  • In tropics and subtropics, vector-borne diseases, transmitted by mosquitos, flies, ticks, fleas and worms, often reach a peak during the rainy season
  • Mosquitos bite between dusk and dawn
  • Anopheles mosquitos lay their eggs in water, which hatch into larvae, eventually emerging as adult mosquitos
  • The long lifespan and strong human-biting habit of the African vector species is the main reason why nearly 90% of the world's malaria cases are in Africa
  • Transmission also depends on climatic conditions that may affect the number and survival of mosquitos, such as rainfall patterns, temperature and humidity. In many places, transmission is seasonal, with the peak during and just after rainy seasons
  • Across uganda, at least 13.8 million people use unsanitary or shared toilets. More than 3.2 million people have no toilet at all.
  • Swampy fields of sugarcane are ideal for breeding mosquitos.
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Prevalence, Incidence and Patterns of Infection

  • Endemic across 95% of the country
  • Upganda has the sith highest number of annual deaths from malaria in Africa
  • Approx. 16 milliomn cases and 10,500 deaths annually
  • Malaria is the lading cause of death among Ugandans accounting for over 25% of deaths
  • Most malaria casea and deaths occur in Sub-Saharan Africa.
  • Partial immunity to malaria is developed over years of exposure, and while it never provides complete protection, it does reduce the risk that malaria infection will cause severe disease. For this reason, malaria deaths in Africa mainly occur in young children, whereas in areas with less transmission and low immunity, all age groups are at risk
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Socio-Economic Impacts

  • Nearly 25% of households spend more than 10% of their total household income on healthcare. About 4.3% of Ugandans are impovertised by out-of-pocket payments
  • Less than 1% of Upgandans have insurance cover
  • Parliament is due to debate a bill to pave the way for legislation to introduce national social health insurance, as a first step towards universal healthcare.
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Ugandan Government and International Responses

  • As a result of its successes in reducing malaria cases, the ICCM (integrated community case management) program has also been prioritised as one of the key interventions of the Uganda Malaria Reduction Strategic Programme 2014-2020
  • Unprecedented money and global attention has saved 4.3 million lives since 2001 (as of May 2015)
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