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Tag: malaria

  • Why war against malaria is failing, by experts

    Why war against malaria is failing, by experts

    The life-threatening disease caused by parasites transmitted to people from the infected female Anopheles mosquito bites is not only preventable but curable with anti-malarial drugs. But many Nigerians still fall sick despite the introduction of a combined therapy – Artesunate Combination Therapy (ACT). OYEYEMI GBENGA-MUSTAPHA examines the factors responsible.

    THE war against malaria has been on for a very long time, but it is far from being won. It remains a life-threatening disease in the developing countries.

    Medical experts have attributed fund paucity, drugs counterfeiting and dearth of research as some of the problems that make the various interventions by governments and donor-agencies ineffective.

    According to a 2015 World Health Organisation (WHO) report, there were more than 200 million cases of malaria and 437 000 deaths. More than 90 per cent of malaria deaths occur in Africa.

    Going by this year’s report, no appreciable progress has been made in malaria control. The report estimated five million more malaria cases in 2016 than in 2015. Malaria deaths stood at around 445 000, a similar number to the previous year.

    Insufficient funding at the domestic and international levels has been identified as a major problem. There have been gaps in the provision of insecticide-treated nets, medicines and other life-saving tools.

    But to WHOs Director-General, Dr. Tedros Adhanom Ghebreyesus, major gains have been made in the anti-malaria battle.

    He said: “In recent years, we have made major gains in the fight against malaria. We are now at a turning point. Without urgent action, we risk going backwards, and missing the global malaria targets for 2020 and beyond.”

    The WHO Global Technical Strategy for Malaria plans to achieve a 40 per cent reduction in malaria case incidence and mortality rates by 2020.

     

    A wake-up call

     

    Reacting to the latest WHO report, the Director, Global Malaria Programme, Dr. Pedro Alonso, said: “We are at a crossroads in the response to malaria. We hope this report serves as a wake-up call for the global health community. Meeting the global malaria targets will only be possible through greater investment and expanded coverage of core tools that prevent, diagnose and treat malaria. Robust financing for the research and development of new tools is equally critical.”

    Many local medics have adopted the new malaria treatment standard – screen for malaria before treating a patient by using the rapid diagnostic malaria kit. Yet, when malaria is diagnosed and treatment initiated, the patient does not get any better. What then could be responsible?

     

    Role of fake drugs

     

    According to the WHO, anti-malarial and antibiotics are amongst the most commonly reported substandard and counterfeited products. Malariariologist and Head of Department, Public Health & Epidemiology, Nigerian Institute of Medical Research (NIMR), Yaba, Lagos, Dr. Sam Awolola, said both generic and innovator medicines can be faked.

    The products, according to him, range from very expensive products for cancer to very inexpensive products for pain treatment. They can be found in illegal street markets, via unregulated websites, pharmaceutical stores, clinics and hospitals.

    According to him, one out of every 10 medical products in low and middle-income countries, including Nigeria is either substandard or counterfeited.

    The substandard and faked medical products contribute to anti-microbial resistance and drug-resistant infections.

    Research has shown that counterfeited products could contain no active ingredient, wrong active ingredient, or the wrong amount of the correct active ingredient.

    The products contain corn starch, potato starch or chalk. Some substandard and falsified medical products have been toxic in nature with either fatal levels of the wrong active ingredient or other toxic chemicals.

    All substandard and adultrated  products are often produced in very poor and unhygienic conditions and by unqualified personnel. They contain unknown impurities and are sometimes, contaminated with bacteria.

    The counterfeited products are by their nature difficult to detect from the original.  But, they fail in treating the disease and often lead to serious health complications, including death.

    A top official at the Nigerian Agency for Food and Drug Administration and Control (NAFDAC), who spoke under the condition of anonymity, urged consumers to assist the agency in tackling the challenge of fake products.

    The official said: “Because we have high technology cutting devices to checkmate these fakers, but should some escape our vigilance, consumes should call our attention to same.”

    He advised consumers to be cautious of spam email advertising medicines; lack of authenticity; no verification logo or certificate; spelling mistakes and poor grammar on the packaging.

    Besides, he said that websites that do not display a physical address or landline and websites offering prescription only medicines without a prescription, and suspiciously low-priced products, must not be patronised.

    According to the WHO, the checklist must be applied for online purchase.

    The organisation listed the questions to which due attention must be paid as: Is it exactly the medicine ordered? Is it the correct dosage? Is the packaging in good condition, clean, with a patient information leaflet and in the language in which it was advertised? Does the medicine look, feel and smell as it should? Are security seals intact with no signs of tampering? Does any customs declaration or postal label declare the contents as medicines? Does the batch number and expiry date on the primary internal packaging match the batch number and expiry date on the secondary (external) packaging?

    By last month, WHO had issued 20 global medical product alerts and numerous regional warnings, and provided technical support in over 100 cases.

    In Borno State, for example, WHO supported the launch of a mass antimalarial drug administration campaign that reached about 1.2 million children aged under-five years in targeted areas.

    The early results have shown a reduction in malaria cases and deaths in the Northeast state.

    Malariologists and other experts in the field of control believe that all hope is not lost on the elimination of the killer-disease.

     

    Prevention

     

    According to the experts, vector control is the best way to prevent and reduce malaria transmission. They said that with a higher coverage of vector control interventions within a specific area, a measure of protection will be achieved across the community.

    WHO recommends protection for all people at risk of malaria with effective malaria vector control and the two forms of control are: insecticide-treated mosquito nets and indoor residual spraying.

     

    Insecticide-treated

    mosquito nets

     

    Long-lasting insecticidal nets (LLINs) are the preferred form of insecticide-treated mosquito nets (ITNs) for public health programmes. In most settings, WHO recommends LLIN coverage for all people at risk of malaria. The most cost-effective way to achieve this is by providing LLINs free of charge, which Nigeria has imbibed, to ensure equal access for all. In parallel, effective behavioural change communication strategies are required to ensure that all people at risk of malaria sleep under a LLIN every night, and that the net is properly maintained.

     

    Indoor spraying with

    residual insecticides

     

    Indoor Residual Spraying (IRS) with insecticides is a powerful way to rapidly reduce malaria transmission. Its potential is realised when at least 80 per cent of houses in targeted areas are sprayed. Indoor spraying is effective for three to six months, depending on the insecticide formulation used and the type of surface on which it is sprayed.

    In some settings, multiple spray rounds are needed to protect the population for the entire malaria season. Lagos is one of the states that have applied the spraying method.

     

     Anti-malarial drugs

     

    Antimalarial drugs can also be used to prevent malaria. For pregnant women living in moderate-to-high transmission areas, WHO recommends intermittent preventive treatment with sulfadoxine-pyrimethamine, at each scheduled antenatal visit after the first trimester.

    Also for infants, three doses of intermittent preventive treatment with sulfadoxine-pyrimethamine are recommended, delivered alongside routine vaccinations.

    In 2012, WHO recommended Seasonal Malaria Chemoprevention as an additional malaria prevention strategy for areas of the Sahel sub-region of Africa. The strategy involves the administration of monthly courses of amodiaquine plus sulfadoxine-pyrimethamine to all children under-five years of age during the high transmission season.

    Dr. Awolola said the best anti-malarial drug the world had ever known: chloroquine was safe, cheap and effective, until the malaria parasites developed resistance to it.

    He said that Sulphadoxine pyrimethamine is a drug combination with a lot of promise which the parasites also became resistant to.

    The malariologist said: “The drawback of drug resistant malaria is a global concern. The main fear is that drug resistance will trigger intense transmission patterns.

    “Over the last century, the use of monotherapies, like quinine, chloroquine, mefloquine, lumefantrine, pyrimethamine and halofantrine, have led to rapid resistance by Plasmodium falciparum.”

    Describing the banning of monotherapies expected, he said what should be of interest is “whether our healthcare practitioners truly believe in the failure of monotherapies is another subject.

    “Chloroquine, though under proscription is still the drug of choice for many physicians today, evidence from our work showed that indeed molecular markers of resistance to this drug is very much in circulation.”

    On the current recommended anti-malarial drugs: Artemisinin-based Combination Therapies (ACTs), Dr Awolola said that ACTs kill the parasites in the blood of the infected person within three day.

    “Arthemether-lumefantrine is presently the mostly favoured ACT use as first or second line treatment in Nigeria and other African countries.However, in 2003, only one years after WHO recommended that ACTs be used everywhere, delayed parasite clearance in P.falciparum, suggesting artemisinin resistance was reported close to the Thailans-Cambodia border in South-East Asia,” he said of the discovery of ACTs as a great hope for malaria treatment.

    In 10 years, Awolola said the spread of artemisinin resistance expanded substantially across the Greater Mekong sub-region from the coast of Vietnam in the East to the border of India in the West.

    He said these resistant parasites have already been shown capable of infecting the main African vector Anopheles gambiae, “signs that artemisinin resistance is developing in Africa is emerging from studies conducted by researchers from London School of Hygiene and Tropical Medicine who discovered a new genetic mutation – ‘ap2mu’ that makes P.falciparum less sensitive to artemisinin, which may mean the beginning of ACTs resistant P.falciparum in Africa.”

    Awolola decried the relatively little contributions of African governments malaria research funding, as he explained: “today, Africa still harbours the burden of the disease. Yet, funding for malaria research is donor-dependent in an era where we all dream of elimination. The statistics of funding malaria research by African governments is precarious and the Nigerian situation is pathetic.

    “An assessment of funding malaria at NIMR from 2007 to 2016 showed shocking statistics with above 80 per cent provided through external support, while Nigerian Government through the Federal Ministry of Health offered less than seven percent. If we ignore the responsibilities of today, we cannot elude the challenges of tomorrow.”

     

    Insecticide resistance

     

    Awolola told those who still believe in the use of ITNs that much of the success recorded malaria control came from vector control. Vector control is highly dependent on the use of pyrethroids, which are the only class of insecticides currently recommended for ITNs or LLINs.

    But mosquito resistance to pyrethroids has been recorded in many countries.  In some areas, resistance to all four classes of insecticides used for public health has been detected. The resistance are rarely associated with decreased efficacy of LLINs, which continue to provide a substantial level of protection in most communities.

    Rotational use of different classes of insecticides for IRS has been recommended as one approach to manage insecticide resistance.

    However, malaria-endemic areas of sub-Saharan Africa and India are posing significant concern due to high levels of malaria transmission and widespread reports of insecticide resistance.

    The use of two different insecticides in a mosquito net offers an opportunity to mitigate the risk of the development and spread of insecticide resistance nets.

     

  • Fed Govt, Osun, NGOs fight malaria with nets

    Fed Govt, Osun, NGOs fight malaria with nets

    Malaria is considered a major health challenge that hinders the development of countries, especially those in African, where over a million lives, including expectant mothers and children under the age of 0-5 years are affected.

    Mindful that the disease remains one of the biggest challenges and which causes 11 per cent of maternal mortality in Nigeria, the Federal Government and key stakeholders are making serious efforts to ensure that the rate at which the disease spreads is reduced maximally.

    In a bid to curb the spread of the disease, the Federal Government and various international organisations have stepped up advocacies to ensure people are adequately sensitised to preventive measures and how to get treated if affected.

    One of the measures through which the spread of malaria can be curbed is the use of Long Lasting Insecticide-Treated Nets (LLIN).

    Lately, the Osun State government, through its Ministry of Health, in collaboration with a number of non-governmental organisations that include the Catholic Relief Services, the National Malaria Elimination Programme, the World Health Organisation and the Society for Family Health, embarked on the replacement of LLIN campaign across the state in furtherance of the 1.6 million nets distributed in 2013.

    The Commissioner for Health, Dr. Rafiu Isamotu, revealed that, in February this year, the team, which comprised officials of the various organisations and the state government envisaged 4,974,662 as the population expected to benefit from the programme.

    He said: “The team toured the entire state with a mandate to distribute for the population about three million nets as part of its mandates.”

    Also, the Manager for the LLIN Replacement Campaign, John Ocholi told Southwest Report that the nets are chemically-treated and endorsed by the World Health Organisation to protect people from mosquito bites that cause malaria.

    Ocholi added that the move was imperative as he said governments globally are interested in curbing the deadly disease. He, therefore, called on people, especially the expectant mothers and children to optimise the opportunity by making use of the material.

    Apart from the micro-planning, sensitisation  and advocacy programme, the team visited the ministries, departments and agencies (MDAs), traditional rulers, traders, the media and other relevant stakeholders to persuade them to key into the initiative and create more awareness on the exercise.

    Also, the Osun State Deputy Governor, Chief (Mrs) Grace Titi Laoye-Tomori, was installed as the state’s Net-Ambassador to rally support for the programme. At the investiture ceremony, the deputy governor promised, on behalf of the state government, to ensure the provision of logistics and other mechanisms to assist in the success of the campaign.

    Other community leaders, traditional rulers and government officials at the local level were also installed as Net-Ambassadors for their respective domains.

    In continuation of the efforts to make more people aware of the exercise, officials were drawn throughout the 322 wards to help with household mobilisation. Houses were reached from August 13 to 17, this year with net cards to ensure the eligibility of each household (i.e. father, mother and two children) have a net card while cases with more children attract an extra net card. The Net Cards were the legal tender for the collection of the nets. During the household mobilisation, about 2,762,110 net cards were distributed out of the 2,763,701 envisaged.

    During the process, two beneficiaries of the LLIN, Mr. Adereti Wasiu and Mrs. Ololade Afolabi, praised the state government and its partners for the initiative. They pledged their readiness to make wise use of the nets.

    Meanwhile, on September 6, this year, Osun State Governor, Ogbeni Rauf Aregbesola, presided over the inauguration of the LLIN Replacement Campaign Distribution.

    At the ceremony, Aregbesola underscored the importance of the nets as protective guards against mosquito bites. He promised to restore healthy living apart from dredging water canals that enhance mosquito breeds. He also supported the all-round sensitisation initiative to ensure compliance and adherence to the campaign.

    The Minister of Health, Prof Isaac Adewole, who was represented by the Chief Medical Director of LAUTECH Teaching Hospital, Osogbo, Prof. Akeem Lasisi, said the Federal Government, in its ongoing efforts to rid the country of malaria, is providing about 13 million nets for the six worst hit states. Adewole explained that the Federal Government is planning to reduce drastically the prevalence of the disease by 2020.

    Representatives of the Society for Family Health, Dr. Jenifer Ayate, the Catholic Relief Services, Dr. I. Adebayo, the National Malaria Elimination Programme, Dr. Audu Mohammed, the World Health Organisation, Dr. Tolu Arowolo and the Osun State Commissioner for Health, Dr. Isamotu, all re-emphasised the need for people to be cautious and to embrace the use of the nets to protect their families.

    After the opening ceremony and the distribution exercise with the sampling of the use as well as onward collection by beneficiaries, from September 6 to 10, this year, about 2,470,472 nets were redeemed with net cards out of the 2,912, 850, representing 89.5 per cent reach. In the process, about 12,008 workers were engaged for the distribution across the 30 local government areas.

    After the distribution, 119 independent monitors moved round Osun State from September 14 to 17, to assess the level of compliance with the campaign.

    Households were visited to know the challenges encountered during the drying, hanging and use of the nets. During the end-process as it was called, residents were assisted to hang the nets and re-orientated on the need to sleep under the nets at bed time to safeguard them from mosquito bites.

    At the debriefing was Dr Isamotu, Special Adviser to the Governor on Health, Dr. Gbenga Oyinlola, Permanent Secretary, Osun State Ministry of Health, Dr. Akinyinka Esho and Dr. Ernest Nwokolo, of the Directorate of Society for Family Health, among others.

     

  • Akeredolu flags off distribution of 2.9million insecticide nets in Ondo

    Akeredolu flags off distribution of 2.9million insecticide nets in Ondo

    Gov. Rotimi Akeredolu of Ondo State on Friday in Akure flagged off the distribution of 2.9 million long lasting  insecticide treated mosquito nets to residents of the state.

    Akeredolu, who was represented by Dr Jibayo Oyewole, the Special Adviser on Health Matters to the governor, noted that malaria still remained a major public health problem in Nigeria despite  preventable measures.

    He said that malaria constituted a major economic burden in the country because about N148 billion  was lost annually in the form of treatment cost and prevention.

    According to him, statistics have shown that more than 60 per cent of hospital attendance was due to malaria and three out of every 10 admission beds were due to malaria.

    The governor said that the critical elements needed to achieve positive change in fight against malaria was the change in behavioural and social norms with regards to sleeping inside treated mosquito nets.

    “The ownership and use of the nets has remained the most cost effective and easily deployed methods for malaria prevention.

    “Significant reduction in malaria related deaths and disability over the years have been attributed to the massive promotion of the ownership and use of the nets,” he said.

    The governor said the distribution of the nets was to ensure universal coverage of the populace in the state.

    Similarly, the governor’s wife, Mrs Betty Ayanwu-Akeredolu, said malaria infection still posed a great threat to health and socio-economic wellbeing of many Nigerians.

    Ayanwu-Akeredolu stressed the need for concerted efforts to fight malaria.

    The governor’s wife, who was honoured as net ambassador in the state by the Catholic Relief Service ( CRS ), encouraged the people to use the nets correctly so that there would be effectiveness of the campaign.

    She said nobody should sell the nets because some organisations and government paid for them.

    “These nets do not come free, but a lot of funds have gone into it; therefore let us use the nets for what they are meant for and not for fishing but sleeping inside them after hanging for 24 hours.

    “I have committed myself for Ondo State that is free of malaria and if we all make concerted efforts, we will create the Ondo State we deserve and history will not forget us,” she said.

    Mrs Rebecca Bassey, the representative of Catholic Relief Services, said that over 16.5 million nets were being distributed in six states in Nigeria,  Ondo State being one of them.

    Bassey noted that the state had demonstrated itself to be a dependable and reliable partner, considering its show of love for giving safe and conducive environment for the campaign.

    She added that the exercise would no doubt contribute immensely to collective efforts towards eliminating malaria from the state and Nigeria in general.

    “National Malaria Elimination Programme (NMEP) of the Federal Ministry of Health and CRS with funding from Global Fund are distributing over 16.5million nets in six states in Nigeria including Ondo State,” she said.

    According to her, CRS has been implementing programme in Nigeria for over 17 years.

    NAN

  • Fed Govt, Osun, NGOs fight malaria with nets

    Fed Govt, Osun, NGOs fight malaria with nets

    Malaria is considered a major health challenge that hinders the development of countries, especially those in African, where over a million lives, including expectant mothers and children under the age of 0-5 years are affected.

    Mindful that the disease remains one of the biggest challenges and which causes 11 per cent of maternal mortality in Nigeria, the Federal Government and key stakeholders are making serious efforts to ensure that the rate at which the disease spreads is reduced maximally.

    In a bid to curb the spread of the disease, the Federal Government and various international organisations have stepped up advocacies to ensure people are adequately sensitised to preventive measures and how to get treated if affected.

    One of the measures through which the spread of malaria can be curbed is the use of Long Lasting Insecticide-Treated Nets (LLIN).

    Lately, the Osun State government, through its Ministry of Health, in collaboration with a number of non-governmental organisations that include the Catholic Relief Services, the National Malaria Elimination Programme, the World Health Organisation and the Society for Family Health, embarked on the replacement of LLIN campaign across the state in furtherance of the 1.6 million nets distributed in 2013.

    The Commissioner for Health, Dr. Rafiu Isamotu, revealed that, in February this year, the team, which comprised officials of the various organisations and the state government envisaged 4,974,662 as the population expected to benefit from the programme.

    He said: “The team toured the entire state with a mandate to distribute for the population about three million nets as part of its mandates.”

    Also, the Manager for the LLIN Replacement Campaign, John Ocholi told Southwest Report that the nets are chemically-treated and endorsed by the World Health Organisation to protect people from mosquito bites that cause malaria.

    Ocholi added that the move was imperative as he said governments globally are interested in curbing the deadly disease. He, therefore, called on people, especially the expectant mothers and children to optimise the opportunity by making use of the material.

    Apart from the micro-planning, sensitisation  and advocacy programme, the team visited the ministries, departments and agencies (MDAs), traditional rulers, traders, the media and other relevant stakeholders to persuade them to key into the initiative and create more awareness on the exercise.

    Also, the Osun State Deputy Governor, Chief (Mrs) Grace Titi Laoye-Tomori, was installed as the state’s Net-Ambassador to rally support for the programme. At the investiture ceremony, the deputy governor promised, on behalf of the state government, to ensure the provision of logistics and other mechanisms to assist in the success of the campaign.

    Other community leaders, traditional rulers and government officials at the local level were also installed as Net-Ambassadors for their respective domains.

    In continuation of the efforts to make more people aware of the exercise, officials were drawn throughout the 322 wards to help with household mobilisation. Houses were reached from August 13 to 17, this year with net cards to ensure the eligibility of each household (i.e. father, mother and two children) have a net card while cases with more children attract an extra net card. The Net Cards were the legal tender for the collection of the nets. During the household mobilisation, about 2,762,110 net cards were distributed out of the 2,763,701 envisaged.

    During the process, two beneficiaries of the LLIN, Mr. Adereti Wasiu and Mrs. Ololade Afolabi, praised the state government and its partners for the initiative. They pledged their readiness to make wise use of the nets.

    Meanwhile, on September 6, this year, Osun State Governor, Ogbeni Rauf Aregbesola, presided over the inauguration of the LLIN Replacement Campaign Distribution.

    At the ceremony, Aregbesola underscored the importance of the nets as protective guards against mosquito bites. He promised to restore healthy living apart from dredging water canals that enhance mosquito breeds. He also supported the all-round sensitisation initiative to ensure compliance and adherence to the campaign.

    The Minister of Health, Prof Isaac Adewole, who was represented by the Chief Medical Director of LAUTECH Teaching Hospital, Osogbo, Prof. Akeem Lasisi, said the Federal Government, in its ongoing efforts to rid the country of malaria, is providing about 13 million nets for the six worst hit states. Adewole explained that the Federal Government is planning to reduce drastically the prevalence of the disease by 2020.

    Representatives of the Society for Family Health, Dr. Jenifer Ayate, the Catholic Relief Services, Dr. I. Adebayo, the National Malaria Elimination Programme, Dr. Audu Mohammed, the World Health Organisation, Dr. Tolu Arowolo and the Osun State Commissioner for Health, Dr. Isamotu, all re-emphasised the need for people to be cautious and to embrace the use of the nets to protect their families.

    After the opening ceremony and the distribution exercise with the sampling of the use as well as onward collection by beneficiaries, from September 6 to 10, this year, about 2,470,472 nets were redeemed with net cards out of the 2,912, 850, representing 89.5 per cent reach. In the process, about 12,008 workers were engaged for the distribution across the 30 local government areas.

    After the distribution, 119 independent monitors moved round Osun State from September 14 to 17, to assess the level of compliance with the campaign.

    Households were visited to know the challenges encountered during the drying, hanging and use of the nets. During the end-process as it was called, residents were assisted to hang the nets and re-orientated on the need to sleep under the nets at bed time to safeguard them from mosquito bites.

    At the debriefing was Dr Isamotu, Special Adviser to the Governor on Health, Dr. Gbenga Oyinlola, Permanent Secretary, Osun State Ministry of Health, Dr. Akinyinka Esho and Dr. Ernest Nwokolo, of the Directorate of Society for Family Health, among others.

     

  • Kano records 98,000 malaria cases

    •Alerts residents to monkey pox virus

    Kano State Commissioner for Health Dr. Kabiru Ibrahim Getso at the weekend said the state recorded about 97,845 cases of malaria this year.

    He added that the campaign against malaria is gaining momentum, compared to the 104,745 cases recorded in 2016.

    Getso, who spoke at the launch of the state malaria quarterly bulletin, designed by AFENET, a non-governmental health organisation promoting a healthy Africa, described malaria as a high-cost disease.

    He added that the government has spent billions in managing patients and providing anti-malaria materials and drugs free.

    “The government has been supporting different organisations with anti-malaria drugs, insecticides and treated nets to conduct community outreaches.”

    AFENET’s Field Director Dr. Amina Abdullahi Umar said the malaria bulletin is to present the current situation of malaria in the state, encourage the use of routine malaria data for decision making, strengthen malaria surveillance and help to measure the impact of malaria morbidity and mortality.

    The government has alerted residents to the dangers of monkey pox virus, urging them to apply personal hygiene and desist from consuming bush meat and half-cooked beef.

    Getso told reporters yesterday that the government carved out a special hospital for monkey pox patients in case of any outbreak.

    He, however, said no case had been recorded.

    “The disease is transmitted from direct contact with the blood, body fluids, or coetaneous or mucosal lesions of infected animals, such as monkeys, Gambian giant rats, squirrels and rodents.

    “Eating inadequately cooked meat of infected animals is a possible risk factor. Human-to-human transmission occurs from contact with body fluids, secretions or skin lesions of an infected person or objects recently contaminated.”

  • Malaria prevention in pregnancy reduces maternal, child mortality

    Malaria during pregnancy reduces birth weight and low weight at birth are major causes of infant mortality. OYEYEMI GBENGA-MUSTAPHA reports that adherence to intermittent preventive treatment in pregnancy can save mother and child.

    Expectant mothers have been urged to always ask for sulfadoxine-pyrimethamine (SP) as intermittent preventive drug against malaria during pregnancy. They should also register at a health facility for their ante-natal once they are confirmed pregnant.

    A World Health Organisation (WHO) official, Dr Tolu Arowolo, who stated this at the collaborative meeting between – The National Malaria Elimination Programme (NMEP) and Health Writers Association of Nigeria (HEWAN), said the importance of early Antenatal Care (ANC) and administration of intermittent preventive treatment in pregnancy (IPTp) are critical in preventing malaria during pregnancy.

    According to him, IPTp is based on the assumption that every pregnant woman residing in high malaria transmission area, has a trace of malaria in her blood stream or placenta, whether she has its symptoms or not. A pregnant woman is supposed to receive a minimum of three doses of SP before delivery. “They should also sleep under LLINs because it is also an intervention against malaria,’’ she said.

    Arowolo said good nutrition is critical during pregnancy as it helps to nourish the mother and foetus, as well as boost the immune system.

    “IPTp reduces maternal malaria episodes, maternal and fetal anaemia, placental parasitaemia, low birth weight, and neonatal mortality. Furthermore, all pregnant women should receive iron and folic acid supplementation as a part of routine antenatal care,”he said.

    He continued:”Falciparum malaria during pregnancy has long been recognised as an important determinant of low birth weight. The reduction in birth weight is usually more marked in primi-gravidae, but can extend to second and third gravidae in areas of low malaria transmission.”

    According to him, WHO recommends “the following package of interventions for the prevention and treatment of malaria during pregnancy,  use of long-lasting insecticidal nets (LLINs) in all areas with moderate to high malaria transmission in Africa, intermittent preventive treatment in pregnancy (IPTp) with sulfadoxine-pyrimethamine (SP), as part of antenatal care services, prompt diagnosis and effective treatment of malaria infections.

    “Malaria during pregnancy increased neonatal mortality by lowering birth weight, whereas fever in the week before birth had a further independent effect in addition to inducing premature birth. The prevention of malaria in pregnancy and, thus, of malaria-attributable low birth weight, should increase the survival of young babies,” she explained.

    A gynaecologist, Dr Bartholomew Odio, urged everyone, especially pregnant women to always request for malaria screening/testing before the treatment of malaria fever.

    Odio, who is the Malaria Technical Advisor with Jhpiego Nigeria, an affiliate of John Hopkins University, U.S, advised expectant mothers to always demand to know the drugs being given to them.

    Mr Timothy Obot, who represented Head, Monitoring and Evaluation in NMEP, said there had been a lot of commendable strategies deployed to prevent, appropriately diagoonise and treat malaria.

    He said there were huge gaps in appropriate knowledge about the causes, diagnosis, treatment and prevention, thereby necessitating the need to bridge the information gap.

    HEWAN President, Mrs Chioma Obinna, assured of her members’ commitment at curbing and eliminating  malaria and its effects in the country,”

  • Killer disease in Kogi diagnosed as gastroenteritis

    Killer disease in Kogi diagnosed as gastroenteritis

    The Kogi State Commissioner for Health, Dr Saka Audu, on Sunday said that the alleged unknown disease has been diagnosed to be gastroenteritis and therefore called for calmness.

    The commissioner told the News Agency of Nigeria in Lokoja that those so far diagnosed were found to be suffering from gastroenteritis and malaria.

    The state Ministry of Health, had in a statement, said that the disease killed many people in Okunran, Okoloke and Isanlu-Esa in Yagba West Local Government Area.

    “The current information available to us is that the disease actually started six weeks ago in Okoloke village in Yagba West, which is a settlement that is predominantly inhabited by Fulani herdsmen.

    “There have been cases of reported deaths following abdominal pain, vomiting and diarrhoea, but the patients who showed signs of illness had since been evacuated and transported to Kogi State Specialist Hospital Lokoja, for better treatment.

    “So far, we have evacuated 39 patients from Okoloke area and only six of them were admitted and have shown significant sign of improvement while others have since been discharged.

    “Out of the six that were admitted, three of them were diagnosed of gastroenteritis and the remaining three were just cases of malaria, and they have shown remarkable signs of improvement,” Audu said.

    He also stressed that the disease was not Lassa fever, saying the result of samples taken from the patients to Irua General Hospital for investigation proved negative.

    On the 62 persons earlier reported to have died, the commissioner said the figure was given by local leaders in the affected areas and was yet to be verified by government.

    “ We will investigate and trace the dead people to the grave yard and come up with the correct figure.

    “We want to assure the general public that government is doing all that is humanly possible to stay on top of the situation and forestall further loss of lives.

    “We will continue to inform the public as the investigation progresses,’’ Audu said.(NAN)

  • Malaria: Treated mosquito nets distributed in Edo

    Malaria: Treated mosquito nets distributed in Edo

    Dr Sunday Yerumoh, Director, Primary Health Care, Akoko-Edo Local Government Area, Edo, said on Monday that 190,000 insecticide-treated mosquito nets had been distributed to fight malaria in the area.

    Yerumoh disclosed this in an interview with the News Agency of Nigeria (NAN) in Igarra, headquarters of the local government area.

    He said that the treated mosquito nets were provided free to enhance the treatment of the disease and encourage quality health care delivery at the grassroots.

    “We have so far distributed no fewer than 190,000 treated mosquito nets to the residents in the local government area.

    “My appeal is for the people to support the fight to eradicate malaria in our homes by sleeping under the treated nets,” he said.

    The director described malaria as a “harbinger of poverty and death,” urging the people to maintain good hygiene by cleaning their environment to keep mosquitoes away.

    He stressed the need for increased public awareness on malaria to enhance behavioural change toward the reduction of its prevalence.

    “There is more to be done to close knowledge gaps around transmission, prevention and diagnosis of malaria,” the physician said.

    He called on stakeholders to embrace the national policy on malaria to reduce its prevalence in the country.

    “There is the need for collaboration between governments and private organisations to bring down malaria scourge to its lowest,” he added.

  • WHO boosts malaria prevention, control in North-East

    The World Health Organization (WHO) says up to 10,000 lives in Nigeria can be saved by November through targeted steps in malaria prevention and control, if more funds are secured.

    Dr. Pedro Alonso, Director of WHO’s Global Malaria Programme, said to manage malaria in Borno, WHO and its partners were strengthening surveillance systems to monitor cases and outbreaks.

    Alonso said they were also increasing people’s access to care in clinics and to health facilities, and spraying insecticides and distributing bed nets as part of vector control.

    According to him, WHO and partners are also administering malaria drugs to children under five every month from July to October.

    Following more than eight years of conflict in Borno, some 3.7 million people need humanitarian assistance, and all are at risk for malaria, WHO said.

    The UN health agency estimates that through October, 8,500 people are infected weekly, with more expected.

    “The most effective way to reduce deaths in emergencies in fragile States, especially those facing malnutrition, is by boosting malaria prevention and control.

    “However, this is often not viewed as the top priority during an emergency response. We are working with our WHO colleagues and many partners to change this,” Alonso said.

    WHO estimates that over half of recorded deaths there are due to malaria, comprising more than all other diseases combined, including cholera, measles and hepatitis E.

    The vulnerable population, consisting of 58.8 per cent children, stands at risk of disease outbreaks, WHO said.

    WHO said with more than 60 per cent of health facilities only partially functioning, many people have not had access for years to regular health services, including vaccinations and basic medicines.

    In addition to security concerns, deadly malnutrition is rising in parts of the state, the UN health agency said.

    Alonso said “malaria, malnutrition, fragile States and civil strife often feed each other.

    “Wherever we have a humanitarian crisis in a malaria endemic country, we can almost always be sure that malaria is the number one killer.

    “However, malaria is preventable and curable, and increased efforts over the last 15 years have drastically reduced related mortality rates by more than 60 per cent, averting six million deaths.”

    He said WHO malaria experts commissioned a modelling exercise that concluded that joint actions could prevent up to 10,000 deaths in Borno alone.

    In early July, the first of four monthly rounds of mass drug administration reached more than 880,000 of the 1.1 million under-age-five children targeted, he said.

    “WHO hopes for 2.5 million dollars to mobilize the emergency intervention and is relying on the existing polio vaccinator infrastructure to carry out the operation, which faces Boko Haram security threats.

    “We will give one curative dose of antimalarial drugs to a defined population, in this case children under-five.

    “In Borno state, we are giving an antimalarial drug to a child, whether they have malaria infection or not, to ensure they are cleared of parasites at that point and to protect them for four weeks.

    “It’s a necessary temporary fix to reduce malaria deaths for the next six months,” the WHO official said.

    The UN statement said WHO has trained community health workers to offer rapid and read diagnostic tests, provide treatment and advise on prevention.

    WHO quoted Dr Wondi Alemu, WHO Representative in Nigeria, as saying: “We will not know the full impact of our efforts until November.

    “But we are confident that taking these steps will go a long way in reducing deaths and suffering of people from malaria so they can get on with their lives”.

  • Let us end malaria for good

    Tawaii-Tawaii” is all you hear from every corner of every bedroom and every compound in my small neigbourhood somewhere in the Southeast of the River Niger. People are trying to get some sleep after a stressful day, but these tiny insects with wings and suckers won’t let them. The very least they can do is slap themselves anywhere they feel a slight movement, especially the ears.

    Hoping to kill these tormentors popularly known as mosquitoes or anwunta in Igbo. Almost every night, it is still the same old story. It has happened so often over the years, so much so that it is slowly becoming a very sad-and-sorry part of our sleep-routine. The mosquito-story is one story I can perfectly relate with, having been an eye and “ear” witness.

    It is a passionate story where a particular tiny creature torments, and in some cases, kills big creatures. It is a sad story, and I don’t like sad stories. Most people don’t, either. Hence, I have decided to stick to the original plan and write a thing or two on ending malaria for good.

    “End Malaria For Good” is one phrase some Nigerians might even laugh over. A phrase seemingly “too good to be true”. But I believe it is feasible. All it requires of us is just a little bit of enlightenment, once we let go of ignorance. There are so many things about mosquitoes and malaria that most Nigerians have little or no idea about, yet they show little or no interest about learning ways to deal with the problem. There’s this common belief that Naija people survive anything. But why settle for “survive” when you can “thrive”. Why? For us to end malaria for good, we have to let the people know exactly what to do and how to do it.

    We know from History how badly malaria dealt with Africans (Nigerians) from time immemorial. History gave us a clear briefing on how Nigerian children usually died mysteriously, albeit looking back; we now understand it was malaria doing the dirty job in most of those sad cases.

    History also gave us a briefing on how these tiny creatures made the earliest batch of Christian missionaries take to their heels, as they couldn’t stand the slaughter. When they ran back, it seemed at that point as though these tiny creatures were invincible. But thanks to the Industrial Revolution in the 19th century, thanks to the discovery of Quinine.

    The white men came back, and this time they brought the antidote with them, with which the mosquitoes could do little or no harm. The white took these drugs for both attack and defence. As time passed, we started using it as well. Now owing to the fact that science and technology kept advancing, Quinine was substituted with similar malarial drugs with much more efficacy.

    Then, these drugs were rare gemstones. Now, they are reasonably affordable (even free in some cases). Thus, just like the story of the Israelites and the snakes, where all who looked up to the bronze snake, lived. In like manner, anybody who takes Artemether-Lumefantrine (or similar malarial drugs) shall live, and not die.

    Now, how do we inform the people and end malaria for good? So far, the media has done a great job I must confess – from radio to television and print media. An average Nigerian knows almost anything on which malarial drugs to buy, and the dose, even without prescriptions. They have also heard of mosquito nets. But the average Nigerian is more concerned with the cure for malaria than he is, with its prevention. It makes me wonder if “prevention is still better than cure”.

    We would rather buy mosquito killers than clean our gutters and clear the environment. We would rather use the bush than use the closet. All these and more are the seemingly-insignificant-but-essentially-crucial things we must do if we must end malaria for good.

    We tend to neglect these crucial duties, and since everybody is doing it, it almost feels right. What the people need is a re-orientation, but this time we need to lay emphasis more on the “prevention” than on the “cure”. Television operas and radio dramas are few of the best tools to drive the point home. And the reason is simple: people connect with them easily. If we can have TV programmes that don’t just show drugs, but also show an environment that has become mosquito-free because of positive change in lifestyle, hence a resultant positive change in the state of the environment.

    Programmes that showcase people clearing up their homes, clearing their gutters, dumping refuse only in the right places, consciously deciding not to litter the streets like everybody else, and generally doing those simple little things that look like they mean nothing, but can make a big difference on the long run. And I’m quite sure that when this good news starts spreading, when the people start getting the point, the positive change becomes automatic.

    Of course, it’s an obvious fact when I say that no one individual has all the sides to the big picture of “ending malaria for good”.  I hopefully believe I just did my humble part by painting a small portion into this big picture. And believe me when I say I’m elated seeing the big-good-work Miral pharm is doing, getting all these pieces together, different views from different students.

    What a beautiful picture it would be when all the pieces are put together. I only hope they keep this fire burning, going beyond making and selling drugs, much more into harnessing ideas and enriching lives in the process. Sooner than later, we hope to sleep safe, without any “Tawaii-Tawaii”, because tiny creatures have gone missing. So help us God. Amen.

     

    Victor won first prize with this article in the 2017 Ravimal Essay Competition.