It is with great pleasure that we announce the completion of the Katakwi Rotary Malaria Project (KRMP) Phase II endline survey, and with it the operational research phase of this incredible project!

This project has been a remarkable collaboration between the National Malaria Control Division (NMCD), Malaria Partners International (MPI), Rotary International (RI), including multiple clubs in the US and in Uganda headed by Soroti Central Rotary Club and Seattle #4, President’s Malaria Initiative (PMI), the Bill and Melinda Gates Foundation (BMGF) and Pilgrim Africa. We are so grateful to all the partners.

Over the last two years our Village Health Teams (VHTs) have accomplished wonders:

  • Children under 5 seen for suspected malaria: 33,982 
  • Children and adults over 5 seen for suspected malaria: 47,233 
  • Total children under 5 treated for malaria: 23,816
  • Total children and adults over 5 treated for malaria: 27,721

On average, VHTs treated approximately 1.8 cases of malaria per person over this two year period,

This August, the Pilgrim Africa field research team assessed the comparative effectiveness of two different types of community case management: integrated community case management (iCCM) vs proactive community case management (ProCCM) on malaria burden. VHTs in the ProCCM arm tested and treated at least 8x as many individuals as VHTs in the iCCM arm. Did this level of testing and treating have any transmission suppressing impact?

To answer this question, the field researchers braved the rainy season, the risks of Covid, and violent unrest in the study area to survey 4,146 community residents. They asked questions about household characteristics, malaria care and treatment practices, and the coverage of prevention tools, and simultaneously measured malaria infection levels. Results were compared with baseline and midline surveys conducted in 2020 and 2019. 

The findings were presented and discussed with all partners and independent scientists working in East Africa and internationally during a successful Project Advisory Committee meeting on September 24, 2021. 

The results, which were somewhat surprising, showed that ProCCM had no transmission suppressing effect relative to iCCM. However, ProCCM relieved the outpatient burden in catchment area health facilities relative to iCCM, which is critical in light of severe understaffing. ProCCM also caught more severe malaria in the community, which helps to prevent malaria related mortality and the debilitating aftereffects of severe malaria. ProCCM also improved antenatal uptake of preventive care, crucial to protect newborns and mothers. 

These outcomes highlight the lifesaving impact VHTs have on their communities. Community case management, coupled with vector control to prevent malaria, effectively addresses the outsize risk of malaria mortality in children under 5. As a result, NMCD, RI, MPI, World Vision (WV) and Pilgrim Africa are planning iCCM scale-up in Katakwi District for 2022. 

Enormous thanks and gratitude to all those who supported the lifesaving work and research executed during KRMP. You supported VHTs to deliver lifesaving care to over 51,000 people, generated important evidence for policy, and provided impetus to scale up this important intervention to an entire district.