Sustainability of Malaria Elimination Strategies in Uganda and Zimbabwe: A Systematic Literature Review.

Abstract

Malaria is a parasitic infectious disease spread through the bite of an infected female Anopheles mosquito. Preventive and control measures have been put in place to eliminate this menace, but the efforts are proving futile as the number of cases continue to increase annually. Presently two, vector control strategies play a pivotal role in the control of malaria – Indoor Residual Spraying and treated bed nets. The sustainability of these control strategies entails the ability of the various program components and activities to continue achieving malaria elimination over time. A systematic review was conducted according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta Analyses. A literature search based on Patient, Intervention, Comparison and Outcomes was used on the Web of Science, EBSCO host and Science Direct databases for best relevant results. Thirty-six full text articles passed to the systematic review. Factors that were evaluated include vector resistance to insecticides; the reported extent of community involvement; sustainability prospects and the impact of IRS and LLINS in malaria elimination. The available literature suggests that the sustainability of malaria control initiatives in Uganda and Zimbabwe may possibly be unachievable. The communities are mere recipients of the control measures, without adequate involvement, hence their sustainability is not being realized. Policy adjustments for both countries therefore becomes inevitable.