ArticleHealth science reports2026
Malaria Morbidity and Its Association With Indoor Residual Spraying in Amolatar District, Uganda: A Retrospective Ecological Study Using Routine DHIS2 Data.
Article in Health science reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background and Aims: Despite sustained investments in malaria control, Uganda continues to experience recurrent malaria morbidity. Indoor residual spraying (IRS) is a key vector control intervention; however, evidence regarding its short-term effectiveness under routine district-level data remains limited. This study assessed malaria morbidity and its association with IRS in Amolatar district using routine district health information system 2 data (DHIS2). Methods: A retrospective ecological observational study was conducted using monthly aggregated malaria surveillance data from all 13 public health facilities in Amolatar District between December 2024 and November 2025. Malaria data were extracted from the District Health Information System together with outpatient, laboratory, and indoor residual spraying operational records. The 12-month dataset was used to describe annual malaria trends, while the pre-post analysis evaluated changes in malaria indicators before and after IRS implementation. The pre-IRS period was defined as May-August 2025 ( Results: A total of 167,123 OPD visits were recorded during the study period, of which 123,994 individuals were tested for malaria and 44,378 were confirmed positive. Malaria transmission peaked between May and August 2025. Following IRS implementation, the mean monthly TPR declined significantly from 36% before IRS to 31.7%, representing an 11.1% relative reduction (mean difference-4.0 percentage points; 95% CI -8.4 to - 0.1; Conclusion: IRS implementation was associated with a short-term reduction in malaria test positivity rate. Continued implementation and longer-term analyzes using robust longitudinal analytical approaches are recommended to better understand sustained impact of indoor residual spraying on malaria morbidity.
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