Investing in the defeat of malaria

ESTABLISHED in May 2007 by the 60th session of the World Health Assembly, the decision-making body of the World Health Organisation, (WHO), World Malaria Day is commemorated on every 25th April. It recognizes worldwide efforts to control malaria, which global statistics have shown that 3.3 billion people in 106 countries stand the risk of contracting the disease. The day was established to provide education and understanding of malaria and spread information on year-long intensified implementation of national malaria-control strategies, including community-based activities for malaria prevention and treatment in endemic areas.

There are an estimated 300 million acute cases of malaria every year around the world, resulting in more than one million deaths. Approximately 90 per cent of deaths from the scourge occur in Africa, mostly in young children. Malaria in Nigeria, according to the Federal Ministry of Health (MoH), is responsible for 60 per cent of outpatient visits to health facilities; 30 per cent of childhood deaths; 25per cent of deaths in children under one year; and 11 per cent of maternal deaths.

Nigeria accounts for one-quarter of malaria cases in Africa and there are more deaths caused by malaria in Nigeria than in any other country. Furthermore, the Federal Ministry of Health estimates a financial loss from malaria (in the form of treatment costs, prevention, loss of man-hours, etc.) to be roughly 132 billion Naira per year (approximately $838,564,000 USD).

With these staggering statistics, it is clear that health is a prerequisite for economic prosperity and the disease is directly contributing to poverty, low productivity, and reduced school attendance in Nigeria. Malaria is a deadly parasitic disease transmitted by the Anopheles mosquito, which infects the host with a one-cell parasite called Plasmodium. It is transmitted from person to person through the bite of female specie of the anopheles mosquito, which needs blood for her eggs. The female anopheles mosquito transmits the malaria parasite to a human being when it bites after having previously bitten an infected person. It carries the parasite in its saliva and in the process of biting the host, it deposits the plasmodium in the blood stream. Malaria can also be transmitted from mother to her baby during delivery, through organ transplant, sharing of needles and syringes and during the process of blood transfusion.

Depending on the type of malaria attack, the sufferer’s level of immunity and the condition of the host’s spleen, malaria can present with a number of symptoms. These include high temperature, chills, headache, sweats, tiredness, nausea and vomiting. Other common symptoms are dry cough, back pain and muscle ache. It can also present with rare symptoms like impairment of brain and spinal cord functions, seizures and loss of consciousness among others. The disease is endemic throughout Nigeria and it has continued to pose a major challenge to our healthcare delivery system, as a large number of outpatient hospital attendances are people suffering from malaria.

Of deep concern is the effect on maternal and child health as well as bi-directional link between malaria and economic development. Malaria is preventable and treatable and history shows that it can be eliminated because less than a century ago, it was prevalent across the world, including Europe and North America. But by the mid-1930s, it was eliminated in most of West Europe, while the United States achieved elimination of the disease in 1951.

In its bid to control and consequently eliminate malaria, WHO recommends a multi-pronged strategy. This encompasses vector control interventions, preventive therapies, diagnostic testing, treatment with quality assured Artemisin-based Combination Therapies (ACTs) and strong surveillance. Using Lagos State as a case study due to its cosmopolitan nature, the abundant distribution of coastal areas and the behaviour of many of its inhabitants, which encourage the availability of stagnant water resulting in breeding sites for the anopheles mosquito, transmission of malaria in the state is stable and all-year round. Therefore, the state government, under the auspices of the Lagos State Malaria Research, Technical and Advisory Committee (LASMARTAC) – with members drawn from Teaching Hospitals, Research Institutions, College of Medicine, Ministries, Parastatals and Development Partners – has employed this recommended multi-pronged approach for malaria elimination.

The strategies are in line with the newly developed National Malaria Strategic Plan for 2014-2020. This comprises the use of Long Lasting Insecticide Nets (LLINs), Indoor Residual Spraying (IRS), Larviciding – the application of chemicals to mosquito breeding sites in communities for larva control and the use of intermittent preventive therapy (IPT) among pregnant women. Also, in collaboration with its partners, it has equipped health facilities with Rapid Diagnostic Test (RDT) kits for diagnosis; while Artemisin in Combination Therapy (ACTs) anti-malarias are provided free for treatment in all its health facilities.

As Nigeria joins the rest of the global community to celebrate the World Malaria Day with the theme, “Invest in the future: Defeat malaria” which had been adopted since 2013, it is essential that investment in malaria control continues and wooing of new donors to join in a global partnership against the disease so that the gains made so far would be consolidated towards preventing further deaths from the disease. In the effort towards defeating malaria in the country, everyone is a stakeholder.

Just as the government at all levels has the responsibility to strengthen the health system, individually and as a group, the citizens also have a big stake. We have the responsibility of protecting ourselves and our children from malaria by using insecticide-treated nets, draining of stagnant water and keeping our environment clean.

And in the long run, complete eradication which is the ultimate goal, can be attained.

•Bakare is of the Features Unit, Ministry of Information and Strategy, Alausa, Ikeja.