Malaria Patterns in the Afromontane Ecotone in Uganda

Abstract

Background : Malaria remains a major tropical vector-borne disease of immense public health concern owing to its debilitating effects in sub-Saharan Africa. In the recent past, the Afromontane ecotones in Eastern Africa have been reported to experience dramatic cases of malaria. However, its epidemiology remains widely unexplored in these regions. Methods: This study analysed malaria patterns in the Afromontane ecotone of Mount Elgon, Uganda. Times series data of malaria cases from five local health centers was utilised to determine malaria incidences within attitudinally stratified ecotones. Inverse Distance Weighted (IDW) interpolation regression was utilised to determine the spatio-temporal patterns of malaria. Findings: On average 66.3±69.2 suffered from malaria on a monthly basis. This was more pronounced in the months of May-August 89.3±87.6 compared to the months of November-February 39.7±33.2. Individuals of the age groups 0- 28 days and 29 days-4 years were more affected by malaria with 98.9±145 and 86.1±141 respectively compared to individuals of the age groups 5-59, 60 and above with malaria incidence of 47.7±27.2 and 9.9±4.2 respectively. Malaria incidences were more concentrated in the lower altitude 586.5±749.8 compared to mid and high altitude areas; 345.1±320.5 and 338.2±350.6 respectively. Spatial patterns reveal that malaria incidences have relatively increased in the high altitude ecotones from low in 2012 to moderately high incidence in 2017 but with the lower altitude remaining with a higher incidences 586.5±749.8. In addition, malaria incidence varied with gender groups with males having incidences of 66.5±89.4 (0-28 days), 160.1±170.6 (29 days-4 years), 55.1±30.3 (5-59 years) and 9.3±3.7 (60 years and above) while males had 131.2±180.7 (0-28 days), 86.1±141 (29 days-4 years), 40.3±21.7 (5-59 years) and 10.5±4.6 (60 years and above). Interpretation: In this regard, malaria control interventions ought to strategically respond to prepare the inhabitants to the high altitude ecotones to cope and adapt with malaria whilst supporting the lower altitude ecotones withstand the malaria burden. Funding Statement: This study was funded privately by the corresponding author (Siya Aggrey). Declaration of Interests: The authors declare that they have no competing interest. Ethics Approval Statement: The study was approved by the Research Ethics Committee of Makerere University College of Veterinary Medicine, Animal Resources and Biosecurity (Reference number SBLS.SA.2018).