In spite of several years of research and rigorous efforts at control, attainment of a malaria-free world remains a vision. Statistics reveal that an estimated two billion people (more than 40 percent of the world population) live in areas with malaria risk. The global annual incidence of malaria is estimated to be between 300-500 million clinical cases, with a death toll of between two to three million. About one million deaths among children under five years are attributable to malaria, with sub-Saharan Africa having more than 90 percent of the total malaria incidence and mortality.
Malaria is endemic throughout Nigeria and has continued to be a major challenge to our healthcare delivery system. The problem is compounded with misdiagnosis and empirical treatment. Of deep concern to discerning minds is the effect of this disease on maternal and child health as well as a bi-directional link between malaria and economic development. It is a fact that high prevalence of malaria impairs health and consequently restraints economic development. It leads to loss of productive hours, money and labour force.
The question here is: since malaria is a preventable disease, why is it so endemic in our country? The answers are simple and straightforward. In Nigeria, people don’t protect themselves sufficiently from mosquito bites. Two, most illnesses, including malaria, are treated at home or in the community before or without seeking care at a formal health facility. Added to these are our coastal environment and improper diagnoses. In many places, hospitals don’t do a proper check. If someone has even a few of the symptoms of malaria, they just give them treatment without proper diagnosis. The consequence of this is that while a growing number of countries have recorded decrease in the number of confirmed cases of malaria, the disease has remained a scourge here.
One of the essential family practices that most Nigerians are found wanting in is sufficient protection from mosquito bites. You can’t contract malaria if you aren’t bitten by mosquitoes, and the type of mosquitoes that transmit malaria usually bite at night. As such, it is crucial to sleep every night under a long-lasting insecticide-treated bed net. Also, people should make sure all windows and doors are properly screened to prevent mosquitoes from coming in. Many people also do something called “indoor residual spraying” where they spray insecticide on the walls inside their house to kill any mosquitoes which might come in. It is equally advisable for those that frequently have malaria attack to wear long-sleeved clothing in the evenings and at night to stop mosquitoes from biting them. Furthermore, it is important to make sure that one is diagnosed properly. Our people need to be aware that having symptoms of fatigue, weakness, nausea and cold which are very typical of malaria is not enough to conclude it is malaria, thereby resorting to self-medication without visiting a health facility for proper diagnosis and treatment.
The World Health Organisation (WHO) recommends that anyone suspected of having malaria should receive diagnosis and treatment with an effective drug within 24 hours of the onset of symptoms. It is only when a sick person cannot have access to a health care provider within that timeframe that home treatment is acceptable as first aid.
Moreover, in Nigeria, you should NOT be given chloroquine to treat malaria, unless your case is confirmed as not being caused by plasmodium falciparum. Virtually all the plasmodium falciparum in Africa are resistant to chloroquine, and so it is no longer an effective treatment. Instead, first-line treatment for malaria is recommended as an artemisinin-based combination therapy.
However, the truth is that whether the malaria map will keep shrinking, as it has in the past decade, or be reclaimed by the malaria parasites depends, to a great extent, on the resources that will be invested in control efforts over the next few years. Yes, the landmark 2015 goal of near zero deaths from malaria can be achieved with sustained investment.
In the effort to reduce malaria in our country, everyone is a stakeholder. Just as government at all levels has the responsibility to strengthen the health system, the citizens, individually and as a group, also have a big stake. We have the responsibility of protecting our children and family from malaria by using insecticide-treated nets (ITNs), draining of stagnant water or water collection points, and keeping our environment clean. Insecticide-treated nets have the benefits of reducing man-mosquito contact thereby helping people to sleep well and stopping transmission. The ITN usage is also effective against other insects including bedbugs, cockroaches and lice.
Complete elimination of the malaria parasite (and thus the disease) would constitute eradication. While eradication is more desirable, it is not currently a realistic goal for most of the countries where malaria is endemic, but we can all play a role in reducing it.
RASAK MUSBAU
Musbau is of the Features Unit, Ministry of Information and Strategy, Alausa, Ikej
