ArticlePloS one2022
Measures of malaria transmission, infection, and disease in an area bordering two districts with and without sustained indoor residual spraying of insecticide in Uganda.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers.
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Who cites it
26 citing papers in PubMed, 32 citations in OpenAlex.
- Persistent and multiclonal malaria parasite dynamics despite extended artemether-lumefantrine treatment in children.Nature communications · 2024Trial
- Assessing the Effect of Malaria Exposure History on Tetanus Antibody Waning Rates Among Children in Jinja and Tororo Districts, Uganda.The Journal of infectious diseases · 2026Article
- CXCR6+ CD127- Tr1 cells balance immunity and persistence in Plasmodium falciparum infection.The Journal of clinical investigation · 2026Article
- Estimating malaria attributable fraction using quantitative PCR in a longitudinal cohort in Eastern Uganda.medRxiv : the preprint server for health sciences · 2026Article
- "After a long day of play, I get tired and forget to unfurl my bed net": a qualitative study exploring factors affecting insecticide-treated bed net use among school-aged children in eastern Uganda.Malaria journal · 2025Article
- CXCR6bioRxiv : the preprint server for biology · 2025Article
- Anopheles mosquito exposure is associated with age, gender and bed net use in areas in Uganda experiencing varying malaria transmission intensity.The Journal of infection · 2025Article
- Sibling species composition and feeding pattern of malaria vectors in indoor-sprayed and non-sprayed districts of Lira and Kole, northern Uganda.Malaria journal · 2025Article
- Adjusting vector surveillance for human behaviors reveals Anopheles funestus drove a resurgence in malaria despite IRS with clothianidin in Uganda.Scientific reports · 2025Article
- Clone tracking through repeated malaria identifies high-fidelity memory CD4 T cell responses.Science immunology · 2025Article
- Effect of the second and third COVID-19 pandemic waves on routine outpatient malaria indicators and case management practices in Uganda: an interrupted time series analysis.Malaria journal · 2024Article
- The Uganda housing modification study - association between housing characteristics and malaria burden in a moderate to high transmission setting in Uganda.Malaria journal · 2024Article
- Seroprevalence of SARS-CoV-2 and risk factors for infection among children in Uganda: a serial cross-sectional study.medRxiv : the preprint server for health sciences · 2024Article
- Dramatic resurgence of malaria after 7 years of intensive vector control interventions in Eastern Uganda.medRxiv : the preprint server for health sciences · 2024Article
- Susceptibility of Anopheles gambiae to Natural Plasmodium falciparum Infection: A Comparison between the Well-Established Anopheles gambiae s.s Line and a Newly Established Ugandan Anopheles gambiae s.s. Line.The American journal of tropical medicine and hygiene · 2024Article
- Seroprevalence of SARS-CoV-2 and risk factors for infection among children in Uganda: A serial cross-sectional study.PloS one · 2024Article
- Dramatic resurgence of malaria after 7 years of intensive vector control interventions in Eastern Uganda.PLOS global public health · 2024Article
- Experience of healthcare personnel on Co-payment mechanism and the implications on its use in private drug outlets in Uganda.PloS one · 2024Article
- Article
- Natural killer cell antibody-dependent cellular cytotoxicity toClinical & translational immunology · 2024Article
Corrections and comments
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Authors and funding
10 authors at 5 institutions in 4 countries.
Funding
Abstract
Tororo District, in Eastern Uganda, experienced a dramatic decline in malaria burden starting in 2014 following the implementation of indoor residual spraying of insecticide (IRS) in the setting of repeated long-lasting insecticide treated nets (LLINs) distribution campaigns. However, in 2020 malaria began to resurge in Tororo following a change in the active ingredient used for IRS. In this study, epidemiological measures of malaria were compared shortly after the resurgence between two parishes in Tororo District (Kayoro and Osukuru) and one contiguous parish in Busia District (Buteba), where IRS has never been implemented. A cohort of 483 residents from 80 randomly selected households were followed from August 2020 to January 2021. Mosquitoes were collected every 2 weeks using CDC light traps in rooms where participants slept; parasitemia and gametoctyemia measured every 4 weeks by microscopy and PCR; and symptomatic malaria measured by passive surveillance. The annual entomological inoculation rate was significantly higher in Buteba (108.2 infective bites/person/year), compared to Osukuru (59.0, p = 0.001) and Kayoro (27.4, p<0.001). Overall, parasite prevalence was 19.5% by microscopy and 50.7% by PCR, with no significant differences between the three parishes. Among infected individuals, gametocyte prevalence by PCR was 45.5% and similar between sites. The incidence of malaria was significantly higher in Osukuru (2.46 episodes PPY) compared to Buteba (1.47, p = 0.005) and Kayoro (1.09, p<0.001). For participants over 15 years of age, the risk of symptomatic malaria if microscopic parasitemia was present was higher in Osukuru (relative risk [RR] = 2.99, p = 0.03) compared to Buteba. These findings highlight the complex relationships between measures of malaria transmission, infection, and disease, and the potential for excess disease burden, possibly due to waning immunity, in areas where vector control interventions begin to fail after a sustained period of highly effective control.
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