A5016730184- Malaria Research and Control
- Mosquito-borne diseases and control
- Global Maternal and Child Health
- Parasites and Host Interactions
- Viral Infections and Vectors
- Hemoglobinopathies and Related Disorders
- Insect Pest Control Strategies
- Healthcare Systems and Reforms
- Insect Resistance and Genetics
- Drug Transport and Resistance Mechanisms
- Health Policy Implementation Science
- Iron Metabolism and Disorders
- Neonatal Health and Biochemistry
- COVID-19 epidemiological studies
- Diverse Scientific Research Studies
- Vaccine Coverage and Hesitancy
- Child Nutrition and Water Access
- Community Health and Development
- Viral Infections and Outbreaks Research
- Methemoglobinemia and Tumor Lysis Syndrome
- Computational Drug Discovery Methods
- Digital Imaging for Blood Diseases
- Hepatitis C virus research
- Pharmacological Effects and Toxicity Studies
- HIV/AIDS Impact and Responses
Infectious Diseases Research Collaboration
2016-2025
Ministry of Health
2019-2025
Kenya Medical Research Institute
2023
Liverpool School of Tropical Medicine
2023
University of London
2014
Makerere University
2008-2012
BackgroundLong-lasting insecticidal nets (LLINs) are the primary malaria prevention tool, but their effectiveness is threatened by pyrethroid resistance. We embedded a pragmatic cluster-randomised trial into Uganda's national LLIN campaign to compare conventional LLINs with those containing piperonyl butoxide (PBO), synergist that can partially restore susceptibility in mosquito vectors.Methods104 health sub-districts, from 48 districts Uganda, were randomly assigned PBO (PermaNet 3.0 and...
ContextCombination therapy is now widely advocated as first-line treatment for uncomplicated malaria in Africa. However, it not clear which regimens are optimal or how to best assess comparative efficacies highly endemic areas.ObjectiveTo compare the efficacy and safety of 3 leading combination therapies malaria.Design, Setting, ParticipantsSingle-blind randomized clinical trial, conducted between November 2004 June 2006, all episodes children an urban community Kampala, Uganda. A total 601...
Background. Malaria risk may be heterogeneous in urban areas of Africa. Identifying those at highest for malaria lead to more targeted approaches control.
Abstract The scale-up of malaria control efforts has led to marked reductions in burden over the past twenty years, but progress slowed. Implementation indoor residual spraying (IRS) insecticide, a proven vector intervention, been limited and difficult sustain partly because questions remain on its added impact widely accepted interventions such as bed nets. Using data from 14 enhanced surveillance health facilities Uganda, country with high net coverage yet burden, we estimate starting...
Five years of sustained indoor residual spraying (IRS) insecticide from 2014 to 2019, first using a carbamate followed by an organophosphate, was associated with marked reduction in the incidence malaria five districts Uganda. We assessed changes over additional 21 months, corresponding change IRS formulations clothianidin and without deltamethrin. Using enhanced health facility surveillance data, our objectives were 1) estimate impact on monthly case counts at sites 6.75 year period, 2)...
Long-lasting insecticidal nets (LLINs) are the cornerstone of malaria control, but their effectiveness is threatened by pyrethroid resistance. We embedded a pragmatic, cluster-randomised trial into Uganda’s national LLIN distribution campaign in 2020–2021, comparing pyrethroid-piperonyl butoxide (PBO) LLINs to pyrethroid-pyriproxyfen LLINs. Target communities surrounding public health facilities (clusters, n=64), covering 32 districts were included. Clusters randomised 1:1 blocks two...
Abstract Background Malaria rapid diagnostic tests (mRDTs) that target histidine-rich protein 2 (HRP2) are important tools for Plasmodium falciparum diagnosis. Parasites with pfhrp2/3 gene deletions threaten the use of these mRDTs and have been reported in Africa, Asia, South America. We studied blood samples from 3 African countries to determine if were present. Methods analyzed 911 dried spots Ghana (n = 165), Tanzania 176), Uganda 570). infection was confirmed by 18S rDNA polymerase chain...
The High Burden Impact (HBHI) strategy for malaria encourages countries to use multiple sources of available data define the sub-national vulnerabilities risk, including parasite prevalence. Here, a modelled estimate Plasmodium falciparum from an updated assembly community survey in Kenya, mainland Tanzania, and Uganda is presented used provide more contemporary understanding prevalence stratification across sub-region 2019. Malaria surveys undertaken between January 2010 June 2020 were...
Long-lasting insecticidal nets (LLINs) supplemented with the synergist piperonyl butoxide have been developed in response to growing pyrethroid resistance; however, their durability field remains poorly described. A pragmatic cluster-randomised trial was embedded into Uganda's 2017–2018 LLIN distribution compare of LLINs and without PBO. total 104 clusters (health sub-districts) were included each receiving one four products, two + PBO (Olyset Plus PermaNet 3.0) pyrethroid-only Net 2.0)....
Long-lasting insecticidal nets (LLINs) are the foundation of malaria control but resistance mosquito vectors to pyrethroids threatens their effectiveness. We embedded a cluster-randomised trial into Uganda's 2017-18 campaign distribute LLINs. LLINs with piperonyl butoxide (PBO) reduced parasite prevalence more effectively than conventional (without PBO) for 18 months. Here, we report final 25-month survey results.LLINEUP was conducted in 48 districts eastern and western Uganda. 104 health...
Abstract Background Long-lasting insecticidal nets (LLINs) are a key malaria control intervention. To investigate factors associated with ownership and use of LLINs in Uganda, cross-sectional community survey was conducted March–June 2017, approximately 3 years after national Universal Coverage Campaign (UCC). Methods Households from 104 clusters (health sub-districts) 48 districts were randomly selected using two-staged cluster sampling; 50 households enrolled per cluster. Outcomes...
Intermittent preventive treatment (IPT) is a well established malaria control intervention. Evidence that delivering IPT to schoolchildren could provide community-level benefits limited. We did cluster-randomised controlled trial assess the effect of primary with dihydroartemisinin-piperaquine (DP) on indicators transmission in community, Jinja, Uganda.We included 84 clusters, each comprising one school and 100 closest available households. The clusters were randomly assigned 1:1 receive DP...
Abstract Background Long-lasting insecticidal nets (LLINs) are the principal tool for malaria control in Africa and presently treated with a single class of insecticide; however, increasing levels insecticide resistance threaten their success. In response to this threat have been developed that incorporate synergist, piperonyl butoxide (PBO), which inhibits activity cytochrome P450s is one main mechanisms resistance, allowing pyrethroids be reversed. However, data on value cost effectiveness...
Tororo District, Uganda experienced a dramatic decrease in malaria burden from 2015-19 during 5 years of indoor residual spraying (IRS) with carbamate (Bendiocarb) and then organophosphate (Actellic) insecticides. However, marked resurgence occurred 2020, which coincided change to clothianidin-based IRS formulations (Fludora Fusion/SumiShield). To quantify the magnitude resurgence, investigate causes, evaluate impact shift back Actellic 2023, we assessed changes metrics regions within near...
Background In Uganda, community services for febrile children are expanding from presumptive treatment of fever with anti-malarials through the home-based management (HBMF) programme, to include malaria, diarrhoea and pneumonia Integrated Community Case Management (ICCM). To understand level support available, capacity motivation health workers deliver these expanded services, we interviewed medicine distributors (CMDs), who had been involved in HBMF programme Tororo district, shortly before...
Abstract Pyrethroid bednets treated with the synergist piperonyl butoxide (PBO) offer possibility of improved vector control in mosquito populations metabolic resistance. In 2017–2019, we conducted a large-scale, cluster-randomised trial (LLINEUP) to evaluate long-lasting insecticidal nets (LLINs) pyrethroid insecticide plus PBO (PBO LLINs), as compared conventional, pyrethroid-only LLINs across 104 health sub-districts (HSDs) Uganda. LLINEUP, and similar trials Tanzania, were found provide...
Long-lasting insecticidal nets (LLINs) are a key malaria control intervention, but their effectiveness is threatened by resistance to pyrethroid insecticides. Some new LLINs combine pyrethroids with piperonyl butoxide (PBO), synergist that can overcome P450-based metabolic in mosquitoes. In 2017–2018, the Ugandan Ministry of Health distributed and without PBO through national mass-distribution campaign, providing unique opportunity rigorously evaluate across different epidemiological...
Recent reductions in malaria burden have been attributed largely to long-lasting insecticidal nets (LLINs). In March-June 2017, approximately 3 years after a national LLIN distribution campaign, cross-sectional community survey was conducted investigate factors associated with parasitaemia and anaemia, advance of Uganda's 2017-2018 campaign.Households from 104 clusters 48 districts were randomly selected using two-staged cluster sampling; 50 households enrolled per cluster. Eligible children...
Insecticide resistance threatens recent progress on malaria control in Africa. To characterize pyrethroid Uganda, Anopheles gambiae (s.s.) and arabiensis were analyzed from 11 sites with varied vector strategies. Mosquito larvae collected between May 2018 December 2020. Sites categorized as receiving no indoor-residual spraying ('no IRS', n = 3); where IRS was delivered 2009 to 2014 2017 then discontinued ('IRS stopped', 4); had been sustained since active', 4). included bendiocarb,...
<title>Abstract</title> Background: Histidine Rich Protein 2 (HRP2)/pan-Lactate Dehydrogenase (pLDH) combination Rapid Diagnostic Tests (RDTs) may address the shortcomings of RDTs that detect HRP2 alone. However, relative contribution possible causes discordant results (RDT-negative and microscopy-positive) performance in field settings are poorly quantified. Methods: This study utilized samples from two cross-sectional surveys conducted 32 districts at 64 sites across Uganda between...
Introduction Malaria remains a significant public health challenge globally, particularly in sub-Saharan Africa, where progress has stalled recent years. Long-lasting insecticidal nets (LLINs) are critical preventive tool against malaria. This study investigated the effectiveness of newer-generation LLINs following universal coverage campaign Uganda. Methods Health facility data collected 36 months prior to LLIN distribution and 24 after were used from 64 sites that took part...
Malaria, a febrile disease caused by the Plasmodium parasites and transmitted mosquitoes, is leading cause of mortality in children under 5 endemic countries. The widespread deployment insecticide-treated bed nets (ITNs) has significantly reduced malaria transmission, but rising levels insecticide resistance threatens to halt progress. Monitoring vital for effective vector control, particularly when deploying new tools. Understanding mosquito population responses these interventions crucial...