Evolution of Spatial Risk of Malaria Infection after a Pragmatic Chemoprevention Program in Response to Severe Flooding in Rural Western Uganda

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Citation

Xu, Erin; Goel, Varun; Baguma, Emmanuel; Ayebare, Emmanuel; Hollingsworth, Brandon D.; Brown-Marusiak, Amanda; Giandomenico, Dana; Reyes, Raquel; Ntaro, Moses; & Mulogo, Edgar M., et al. (2024). Evolution of Spatial Risk of Malaria Infection after a Pragmatic Chemoprevention Program in Response to Severe Flooding in Rural Western Uganda. Journal of Infectious Diseases, 229(1), 173-182. PMCID: PMC10786254

Abstract

BACKGROUND: Malaria epidemics result from extreme precipitation and flooding, which are increasing with global climate change. Local adaptation and mitigation strategies will be essential to preventing excess morbidity and mortality.
METHODS: We investigated the spatial risk of malaria infection at multiple timepoints after severe flooding in rural western Uganda employing longitudinal household surveys measuring parasite prevalence and leveraging remotely-sensed information to inform spatial models of malaria risk in the three months after flooding.
RESULTS: We identified clusters of malaria riskemerging in areas that (i) showed the greatest changes in NDVI from pre- to post-flood and (ii) residents were displaced for longer periods of time and had lower access to long-lasting insecticidal nets, both of which were associated with a positive malaria rapid diagnostic test result. The disproportionate risk persisted despite a concurrent chemoprevention program that achieved high coverage.
CONCLUSIONS: The findings enhance our understanding not only of the spatial evolution of malaria risk after flooding, but also in the context of an effective intervention. The results provide a "proof-of-concept" for programs aiming to prevent malaria outbreaks after flooding using a combination of interventions. Further study of mitigation strategies - and particularly studies of implementation - is urgently needed.

URL

http://dx.doi.org/10.1093/infdis/jiad348

Reference Type

Journal Article

Year Published

2024

Journal Title

Journal of Infectious Diseases

Author(s)

Xu, Erin
Goel, Varun
Baguma, Emmanuel
Ayebare, Emmanuel
Hollingsworth, Brandon D.
Brown-Marusiak, Amanda
Giandomenico, Dana
Reyes, Raquel
Ntaro, Moses
Mulogo, Edgar M.
Boyce, Ross M.

Article Type

Regular

PMCID

PMC10786254

Continent/Country

Uganda

ORCiD

Goel - 0000-0002-2933-427X
Boyce, R - 0000-0002-9489-6324