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Prevention, proper management of malaria will reduce deaths, say experts

By Paul Adunwoke
14 November 2021   |   4:15 am
Recently, the National Malaria Elimination Programme (NMEP) revealed that over 90,000 malaria-related deaths are recorded in Nigeria every year.

Recently, the National Malaria Elimination Programme (NMEP) revealed that over 90,000 malaria-related deaths are recorded in Nigeria every year.

The agency stated that Nigeria accounts for about a quarter of global burden of malaria, with nine to 10 persons dying of malaria or malaria related causes every hour.

To tackle the issue, health experts proffered diverse solutions, which range from prevention and proper management to treatment with effective antimalarial.

Dr. Obinna Ebirim, a Public Health Physician and Health Promotion Specialist, said the process of reducing malaria deaths involve preventing malaria transmission and proper management of malaria cases. “This is what we attempt to achieve in malaria control programmes. The activities used in prevention include use of insecticide-treated nets (ITN), indoor residual spraying (IRS) of insecticides on surfaces, since mosquitoes usually rest on surfaces inside the house after a blood meal, intermittent preventive treatment of malaria in pregnant women (IPTp) in which curative antimalarial is given to pregnant women during antenatal visits, and intermittent preventative treatment of malaria in infancy (IPTi) in which therapeutic antimalarial is given to infants during routine immunisation visits,” he said.

He explained that proper management of malaria cases entails laboratory diagnosis or diagnosis based on symptoms, when there is no laboratory and index of suspicion is high. There is also quick treatment of malaria with the appropriate antimalarial, depending on many factors.

Ebirim listed some of the factors limiting these control activities to include high prevalence of the deadly mosquito species that cause malaria, the supporting climate in this part of the world, poor infrastructure to address malaria and the inability to bear the cost of control activities, which brought about reliance on donors.

On the role government can play to help in the fight against the disease, he said there is need to ensure continued support of the malaria control activities, through expressing the political will, as evidenced by adequate resource commitment and efficient programme implementation.

“Also, there is need to improve social amenities and infrastructure related to water and sanitation to support preventive approaches. Full implementation of the National Health Law (NHA 2014) by government will ensure that quality services are delivered in our health facilities, including management of malaria,” he explained.

Ebirim stated that Health institutions must continue to build health workers’ capacity, through training and retraining on malaria case management, IPTp and IPTi, while ensuring that these are actually practised and not mere training rhetoric. It is equally imperative that that the drugs and tools required for management and prevention of malaria are available and accessible.

He said: “A new announcement this week that has warmed our hearts as Malaria Control advocates is the approval of a malaria vaccine by the World Health Organisation. This is one of the surest means of ending malaria in Africa because we know that vaccines work. Its use is very cost-effective and it was instrumental in the global eradication and near-eradication of smallpox and polio. It is important for the public to acknowledge the strictness of WHO approval in order to trust the safety of this vaccine.

“In 2015, I attended the Strategic Advisory Group of Experts (SAGE) on immunisation meeting, where this vaccine was presented for WHO’s approval. But the experts were not comfortable with the safety profile then and asked the manufacturers to go back and ensure it is safer. I am happy that this has now been achieved and the vaccine is now available for use in ending malaria and saving lives”.

Dr. Modupe Akinyinka, a Senior lecturer and Consultant Public Health Physician at the Department of Community Health and Primary Health Care Lagos State University College of Medicine (LASUCOM), said the current standard treatment for malaria, once diagnosis is made, is the artemisinin combination therapy (ACT)

She explained that malaria is spread by the bite of an infected Anopheles mosquito that transmit a parasite called plasmodium, while typhoid is caused by the bacteria called salmonella typhi, which is spread through contaminated food and drinking water. Both have similar signs and symptoms and can be fatal, if not treated.

She said urgent action is needed to get the global response to malaria back on track and that ownership of the challenge lies in the hands of countries most affected by malaria, such as Nigeria. “It is a grassroots campaign that aims to keep malaria high on the political agenda, mobilise additional resources, and empower communities to take ownership of malaria prevention and care.”

She urged Nigerians to ensure good environmental sanitation to prevent the breeding of the mosquitoes that transmit malaria.

“Making preventive tablets and mosquito nets available to pregnant women, under-five children and their mothers will also go a long way in preventing the disease. Testing kits should be made available at all health facilities, so that people can get tested before treatment to prevent drug resistance to current drugs for treatment,” she said.

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