Malaria kills between 70,000 and 100,000 children every year in Uganda. In order to apply successful interventions to eradicate malaria, there is a continuous need to understand the epidemiology and risk factors associated with the disease. The Malaria Indicator Survey (MIS) in 2009 was the first nationally representative survey of malaria conducted in Uganda. The aim of the study presented here was to use this MIS to investigate the distribution of malaria infection in children under the age of 5 years old, as well as to investigate the relationship with selected socio-economic, demographic and environmental factors.
UNAIDS has reported that the prevalence of people infected with HIV but who are not on ART, the incidence of HIV, and AIDS related mortality are falling. The Health Metrics Institute recently made their own, semi-independent, assessment of the trends in each of these indicators and reached similar conclusions with small differences arising from the use of somewhat different assumptions. Both analyses suggest that the world is on track to end AIDS by 2030, but this will depend on continued expansion of treatment at about the present rate together with supportive prevention efforts in Sub-Saharan Africa. Unfortunately, the data on which these analyses are based is weak in almost all places and better data on patient monitoring, follow-up and support, including drug procurement, supply and delivery, and better routing surveillance are needed.
The recent HSRC household survey reports that the HIV prevalence among adolescents and young people is declining. Although the decline is important, the focus needs to be on the fact that the reported HIV prevalence levels are still very high, together with alarmingly high levels of HIV incidence. Prevention methods have demonstrated effectiveness in reducing the risk of HIV acquisition among many of the most-at-risk populations. More research is needed, however, into how HIV is spread among the adolescent population and how to decrease this spread.
Individuals across Africa may have changed their sexual behaviour following the visibility of AIDS in the public sphere in the mid to late 1990s. Though each change in behaviour may have been small, the changes affected simultaneously different aspects of individual sexuality, and added up cumulatively into a moderate reduction in sexual behaviour at the individual level. In turn, this change in individual behaviour was translated into massive disruption of sexual networks at the population level. This made it difficult for HIV to propagate in the population leading to large declines in HIV incidence and prevalence.
In most of sub-Saharan Africa, estimates of the burden of disease due to malaria are unreliable as many people with fever do not reach public health facilities, and there are also imperfect health reporting systems in many of the countries with the largest burden. However, many general population studies exist recording the proportion of people with detectable malaria parasites. Researchers at the Malaria Atlas Project (MAP) have collated these datasets and fitted geo-spatial models to them, providing an estimate of parasite prevalence at any location along with the uncertainty in that estimate.