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Socioeconomic determinants of malaria prevalence in Mitooma District. A longitudinal study
This mixed methods longitudinal study aimed to comprehensively investigate changing malaria prevalence patterns
in relation to socioeconomic determinants within Mitooma District, Uganda between January 2020 and December
2022. A sequential exploratory research design was employed incorporating retrospective quantitative analysis of
routinely collected malaria case surveillance records from all 22 public health facilities during the 3-year period to
examine fluctuations and distribution of diagnosed cases according to demographic characteristics, locality, poverty
levels and other exposure variables. Concurrently, qualitative interviews and focus group discussions were conducted
with purposefully selected community caregivers and frontline workers to provide explanatory contextual insights
into transmission dynamics from grassroots perspectives. SPSS software facilitated statistical analyses of surveillance
trends and associations while NVivo aided qualitative thematic synthesis. Robust triangulation of obtained quantitative
and qualitative findings facilitated a well-rounded evidence-based situational understanding with targeted
recommendations for accelerating locally tailored malaria control through multi-sectoral coordination and empowered
community participation going forward. The findings indicated that the unstandardized beta coefficient for household
wealth index representing the expected change in malaria prevalence associated with a one-unit increase in the
measure of socioeconomic position had a value of 0.578, and a standard error of 0.078, furthermore, the standardized
beta coefficient quantifying the predictor's relative importance in the model was 0.686, indicating household wealth
index made a strong unique contribution to explaining variations in disease endemicity, and the t-statistics and
significance levels reveal household wealth index reliably predicted malaria prevalence rates beyond chance.
Institutionalize malaria surveillance focal persons at parish level to strengthen timely reporting, active case finding,
defaulter tracing and immediate response to localized outbreak risks.
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