Eradicating malaria or reducing its burden in most tropical countries, including Nigeria, has remained a major concern to governments in Africa and the international community because of high mortality rate caused by the disease. The World Health Organisation (WHO) has set aside the 25th of April annually to create awareness on the disease as part of its strategies to reduce the disease burden.
Speaking in a forum tagged, “Malaria: The Nigeria Challenge,” sponsored by Novo Health Africa, Managing Director/Chief Executive Officer, Dr Dorothy Jeff-Nnamani described malaria as a major public health problem in Nigeria contributing directly to poverty, low productivity, reduced school attendance and accounts for more cases of deaths than any other country in the world.
She said the Federal Ministry of Health estimates financial loss from malaria in the form of treatment costs, prevention, loss of man-hour etc as roughly 132billion naira annually and attributes 30% of childhood deaths and 11% of maternal deaths to malaria. According to her, malaria is a disease that has been around with us and because of that people most times forget how deadly it is. “It is a major contributor to mortality in children under 5, pregnant women and the elderly.
“For many years, Nigeria and the rest of the world have committed huge resources to the fight against malaria. No doubt we have recorded measurable significant success. However the desired ultimate goal will be the total elimination and finally global eradication of malaria.
“Unquestionably, that calls for action from every stakeholder from fundamentals such as education, adequate creation of awareness, proper identification of signs and symptoms, recording of cases, accurate diagnosis, correct treatment regime, practical prevention and control initiatives to the more specialized areas of research and technology,” she said.
She raised the alarm that though malaria is a global disease, it is endemic in Nigeria. “This affects the gross domestic product (GDP) of the entire nation.”
Dr Tolu Arowolo, National Professional Officer for Malaria, WHO Nigeria, said Nigeria is in the era of malaria control and it is a journey.“ Malaria vector control and personal protection is core intervention with the introduction of long lasting insecticidal nets and malaria vaccine which was very recently recommended by WHO. Though Nigeria is yet to implement single dose premquine as a gametocytocide in plasmodium falciparum (PF) malaria.”
She said it is important to for all to protect against mosquito bites, which is the number one malaria carrier.
“The net is the biggest thing used for the resistance of malaria. It is a better mosquito/malaria prevention. Net should be the weapon against mosquitoes. Pregnant women as well as children should sleep under the net. Parents should introduce the net in early stage of a child’s life and as a family, they should use net, which is cost effective,” she stated. Contributing, Dr Wellington Oyibo, Consultant Microbiologist and Parasitologist, Lagos University Teaching Hospital (LUTH), said there was 198 million cases of malaria globally in 2013; 584,000 deaths and 216 million clinical cases globally in 2012, 650,000 deaths, mostly in children less than 5years old according to WHO.
Oyibo said malaria is a disease caused by the obligate intracellular protozoa of the genus plasmodium. According to him, early detection and prompt effective treatment to cure the infection can prevent progression to severe disease while with proper management of severe disease, it can prevent death. The objective of malaria treatment is to ensure rapid and long lasting clinical cure and reduction of morbidity including malaria-related anemia. He went further to encourage health practitioners to prevent progression of uncomplicated malaria to severe and potentially fatal disease as well as minimize the chance and rate of development of drug resistance.
He recommended the 3Ts which is test, treat and track, though the testing before treatment is still very low, recognising malaria may no longer be as easy as ‘looking and touching’. “Every suspected malaria case should be confirmed by microscopy prior to treatment and all diagnostic tools must be quality assured across all levels of the health system.”
While institutions should research and innovate on malaria diagnostics, drugs and vaccines, malaria surveillance, capacity building for health workers and other support for malaria control should be intensified. Above all, “sleeping under long lasting insecticidal nets can prevent malaria,” he concluded.
Meanwhile, Lagos State Government utilizes a multi-pronged strategy; which include vector control interventions, preventive therapies, diagnostic testing, treatment with quality-assured Artemisinin-based Combination Therapies (ACTs), and strong malaria surveillance to control and eliminate malaria, the State Commissioner for Health, Dr. Jide Idris has said.
Idris who made this known over the weekend during a community sensitization campaign to commemorate this year’s World Malaria Day at the Amu Market in Mushin Local Government Area noted that various integrated preventive measures that have been put in place by the State government is geared towards combating malaria.
Highlighting the various integrated preventive measures, the Commissioner explained that Long Lasting Insecticide Nets (LLINs) have been deployed to communities stressing that nets are also distributed in public health facilities to children who had completed their immunization schedule and also to pregnant women who booked for antenatal care adding also that pregnant women are freely and routinely given in the prescribed manner Sulphadoxine Pyrimethamine (SP) for Intermittent Preventive Treatment of malaria during Ante Natal Clinics.
“Another preventive strategy being deployed in the State is the Indoor Residual Spraying (IRS) which is the application of long-acting chemical insecticides on the walls and roofs of houses for the effect of curtailing malaria transmission. The 6th round in the series of IRS activities was implemented in seven LGAs namely Ojo, Ikorodu, Badagry, Amuwo-Odofin, Kosofe, Epe and Ibeju-Lekki LGAs in 2014 and approximately 650,000 rooms were sprayed,” Idris said.
The Commissioner who was represented at the event by the Deputy Director in charge of Disease Control in the State Ministry of Health, Dr. Rotimi Agbolagorite added that the State Ministry of Health has also implemented Larviciding; which is the application of larvicides to bodies of water to attack mosquito larvae and prevent the development of the larvae to adult mosquitoes in Ikosi-Isheri and Agboyi Ketu local council development areas both within the Kosofe Local Government Area.
Idris stated that the State government has also made available in all public health facilities in the State, Malaria case management which entails the compulsory diagnosis of malaria either by the use of the Rapid Diagnostic Test kits or microscopy and effective treatment with the use of Artemisinin Combination Therapies (ACTs) antimalarials adding that all patients can access the service at no cost.
“It is important that the citizens in the State are equipped with the right information to enable them take appropriate actions regarding malaria control. To this end, information dissemination is carried out through jingles on the radio, community sensitization and mobilizations activities where information leaflets and fliers are distributed to the citizens”, the Commissioner said.
He posited that the fight against malaria is a collaborative one amongst all relevant stakeholders that requires the commitment of everyone stressing that all residents must all be active in ensuring that their environment is clean and free of any collection of water that can serve as a breeding site for mosquitoes.
“Everyone should sleep inside a Long Lasting Insecticide net every night. Pregnant women should receive Sulphadoxine Pyrimethamine (SP) for Intermittent Preventive Treatment of malaria during ANC clinics. You should also visit the nearest health facility when ill and demand for laboratory testing prior to the administration of antimalarial,” Idris stated.
The Commissioner noted that despite the huge investments in malaria control and the significant impact in the decline in malaria morbidity and mortality, an estimated 198 million cases of malaria occurred globally in 2013 and 584,000 associated deaths were recorded stressing that the statistics were according to the year 2014 World Malaria Report.
He stated that tragically, most cases occurred in Africa while most deaths affects children under five years of age adding that the cosmopolitan nature of Lagos and the abundant distribution of coastal areas encourage the availability of stagnant water resulting in breeding sites for the anopheles mosquito.
Also, while speaking at the event, the Executive Secretary of Mushin Local Government Area, Hon. Babajide Bello noted that keeping a healthy environment devoid of breeding sites for mosquitoes is one of the ways Malaria scourge can be fought.
He charged residents of local government as well as market men and women of Amu Market to key into various preventive interventions being put in place by the State government in fighting malaria.
(Doris Obinna)
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