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In the dimly lit confines of her hut in Hoima, Namulagwa Hajira watches over her feverish daughter, who lies motionless beneath a worn mosquito net. The air is thick with the buzzing of mosquitoes, a constant reminder of the silent threat to their lives.

Each night, Namulagwa faces a haunting reality where a single mosquito bite can mean the difference between life and death. For her and countless other families in Hoima, malaria is not just a health concern; it is a daily battle that drains their strength and hope.

Namulagwa’s story is emblematic of the broader struggle in Hoima. She has experienced the devastating loss of several children to malaria. "When my child falls ill, I feel a crushing fear," Namulagwa says, her voice trembling. "I know that my resources are limited, and that every delay in treatment could be fatal." The emotional and financial strain of dealing with malaria is evident in her weary eyes. 

“We all sleep under a mosquito net, even the children sleep under the net but I don’t know where malaria is coming from because I make sure that I tuck it under the mattress.”

The situation is compounded for many families, including Nantongo Grace, who also faces the relentless grip of malaria. "Every time my child gets malaria, it's as if our whole world collapses," Nantongo explains. "The cost of medicine and the days lost at work are unbearable. But we sleep under the mosquito net maybe mosquitoes bite us while outside because we can’t stay under nets even during day.”

At this Azur health center IV, the statistics show that in the past months alone, over 180 cases of malaria were registered with children under five and pregnant women being the most affected. And the numbers are alarming says Ignatius Byakutaga, a clinician at the facility. 

“Our clients here especially the parents have to take care of a lot at home and confining them in the ward is costly unless they’re very sick children. Most of our patients want to be treated as outpatients so what we do is agree with them but those who are very sick, we don’t negotiate with them because of the risks involved.”

The disease is a burden for these poor families and this is making management of patients difficult. Byakutaga explains that, “we are very careful, we agree with them that they are able to come back for the second dose at the time of appointment. Those who are not able to come back, we link the to health centers nearest to their homes.”

Child suffering from Malaria resting on the floor of Kigorobya Health Centre IV in Hoima district. (Photo by Ambrose Niwagaba Katoto)

Experts emphasize use of treated mosquito nets, clearing bushes around homes and drain stagnant water and “immediately they fall sick, they must go to health facilities that are recognized to be properly diagnosed and treated so that we don’t have reservoir stocks in the community.”

Today, Uganda joins the global community in marking World Mosquito Day, a day that emphasizes the importance of mosquito control and malaria prevention. As the country grapples with the burden of malaria, the need for innovative strategies and increased efforts in mosquito control has never been more urgent.

Krystal Mwesiga Birungi, field entomology coordinator at Target Malaria Uganda, highlights the critical importance of continued research and development in this field. "Progress towards eliminating malaria has stagnated in recent years, necessitating the exploration of new mosquito control strategies to complement the existing tools," Birungi emphasizes.

Uganda faces one of the highest malaria incidence rates globally, with the World Malaria Report 2023 indicating 12.7 million cases and 17,556 deaths in 2022 alone. This makes malaria not only a health crisis but also an economic one, costing the country over $500 million annually. "By intensifying our efforts to control the vector of the disease, we can redirect these resources toward crucial investments in public health," Birungi suggests, pointing to the potential for significant economic benefits if malaria can be brought under control.

The fight against malaria in Uganda is complicated by several factors, including the development of resistance among mosquitoes to commonly used insecticides and the inadequate coverage of preventive measures like insecticide-treated nets. Birungi notes, "The disparities in the health care system in many areas of Uganda also make it difficult for patients ill with malaria to seek medical attention to access malaria treatment."

As Uganda reflects on World Mosquito Day, "generating support for these transformative approaches to mosquito control initiatives is key if Uganda is to achieve great strides in reducing malaria cases," Birungi asserts, calling for a united effort in the ongoing battle against malaria.