Effectiveness of the Smart Home Model for Integrated Malaria Prevention: A Case-Control Study in Oyam District, Uganda.

Abstract

Malaria is the most prevalent vector-borne disease worldwide, with Uganda ranking third for malaria burden in 2023. In resource-limited settings, where access to diagnosis and treatment is often constrained and recent vaccination strategies may face challenges, traditional primary prevention remains essential and cost-effective. This study evaluated the effectiveness of the smart home model-an integrated malaria prevention strategy promoted by the Uganda Ministry of Health-in reducing infections among children aged < 5 years. A case-control study was conducted in Oyam District, Northern Uganda, between October 2023 and February 2024. Data from 3093 households were analyzed. Malaria status was assessed using rapid diagnostic tests. Household adherence to nine vector-control measures defined the smart home score, categorized as low (0-3), intermediate (4-6), or high (7-9). Higher scores were significantly associated with lower malaria prevalence. An inverse association emerged between household score and infection status: households with scores ≥ 7 were associated with a 80% lower presence of infection, as compared to households with scores ≤ 3 (AOR: 0.21; 95% CI: 0.16-0.27). The most protective measures included consistent use of bed nets, closing windows and doors by 6 p.m., eliminating water reservoirs, adopting proper farming practices, and compound cleanliness. These findings may provide further evidence supporting integrated malaria control strategies, alongside vaccines deployment, particularly in low-resource settings.