Burden of malaria and its negative impact on Nigeria

Malaria is a major public health problem, with high global burden. However, large regional disparities exist in malaria burden. In 2015, Sub-Saharan Africa alone accounted for 90% of the malaria cases and 92% of the malaria deaths worldwide.

According to the 2018 World Malaria Report, about 70 percent of all malaria cases and deaths recorded in 2017 occurred in Nigeria and 10 other countries.

The annual report which was produced by the World Health Organisation (WHO) and launched on Monday in Maputo, Mozambique revealed that malaria hit hardest in India and 10 African countries in 2017 with Nigeria taking the lead.

The 10 African countries affected are Nigeria, Burkina Faso, Cameroon, Democratic Republic of the Congo, Ghana, Mali, Mozambique, Niger, Uganda and United Republic of Tanzania.

Malaria remains the most important public health parasitic disease and a major global health problem with the greatest burden in sub-Saharan Africa.

Malaria is so widespread that it is virtually impossible to come across any Nigerian who has never had malaria or had a family who developed it.

This large burden has led to the development and setting of several strategies and targets aimed at malaria control, and where possible its elimination.

The Global Strategy for Malaria, 2016 to 2030 targets a 90% reduction in the incidence and mortality rates of malaria, as well as an elimination of malaria in 35 of its endemic countries by 2030.

According to the WHO, an estimated 445,000 people out of 216 million cases died from malaria in 2016; 90% of this is accounted for by Africa.

The report further revealed that Malaria kills over half a million children less than 5 years of age each year out of which Nigeria accounts for 25 percent of the world’s malaria burden.

WHO Director-General Dr Tedros Adhanom Ghebreyesus had said that even though nobody is expected to die from malaria, the world faces a new reality.

According to him, as progress stagnates, ‘’we are at risk of Squandering years of toil, investment and success in reducing the number of people suffering from the disease.

“We recognise we have to do something different now. So today we are launching a country-focused and -led plan to take comprehensive action against malaria by making our work more effective where it counts most – at local level.

When countries prioritize action on malaria, we see the results in lives saved and cases reduced’’, he added.

The common symptoms of malaria headache, chills, and fever are mild and are not just specific to malaria, this sometimes makes it difficult to recognize as malaria.

These symptoms can however become dreadful leading to the severe or complicated form of malaria, Prompt diagnosis and treatment of malaria are necessary to prevent a mild case of malaria from progressing to the severe form.

Although anyone can be affected, children under five and pregnant women are the most vulnerable; and because of this, preventive treatment in pregnancy with the antimalarial drug sulfadoxine pyrimethamine is recommended by WHO to protect pregnant women. This drug is administered during routine ante natal visits.

As huge as the malaria burden is, there is poor awareness of its magnitude. The high cost of health care also impacts this, as having to go to the clinic often may become a financial burden.

The WHO had said that despite marginal increase in recent years in the distribution and use of insecticide-treated bed nets in sub-Saharan Africa, indices for malaria remain unimpressive.

“In 2017, an estimated half of at-risk people in Africa did not sleep under a treated net. Also, fewer homes were protected by indoor residual spraying than before, and access to preventive therapies that protect pregnant women and children from malaria remains too low.”

The WHO however said that in 2017, no local transmission of malaria was reported in China and El Salvador where malaria had long been endemic, stressing that it was a proof on the efficacy of the intensive, country-led control efforts.

It further disclosed that it recently certified Paraguay was the first country in the Americas to be certified malaria free in 45 years. Three other countries, it added was Algeria, Argentina and Uzbekistan that requested official malaria-free certification from WHO.

Similarly, India, a country that represents four percent of global malaria burden recorded a 24 percent reduction in cases in 2017, compared to 2016.

Also in Rwanda, 436 000 fewer cases were recorded in 2017 compared to 2016. Ethiopia and Pakistan both reported marked decreases of more than 240 000 in the same period.

Ghebreyesus, however asked countries with high malaria cases to prioritize action on malaria so they could save more lives of its citizens.

He suggested that they take advantage of newly launched country-led malaria response to scale up prevention and treatment, and increase investment, to protect vulnerable people from the deadly disease.

Even though malaria is wide spread, it is preventable; one of the key strategies to prevent malaria is vector (mosquito) control.

Mosquitoes breed on stagnant water, and so by removing stagnant water from the immediate environment, vectors are effectively controlled.

Discarded tyres, untended pools, and any container that could hold stagnant water are possible breeding grounds for mosquito. Bushes and weeds near the home are resting sites for mosquitoes.

General sanitary practices such as maintaining a hygienic drainage system, clean environments, proper waste disposal, removal of stagnant water, are effective ways of controlling the vector, mosquito.

The use of insecticide treated nets and indoor spraying with insecticides are popular measures for vector control.

The major problems in the control of malaria are: resistance of malaria parasites to drugs and insecticides, proliferation of counterfeit drugs; self-management, inadequate health facilities, inadequate local research efforts and poor health practices by individuals and communities.