How to end malaria in Nigeria

Despite being preventable and treatable, malaria continues to have a devastating impact on people’s health and livelihoods around the world.

Malaria is caused by parasites of the Plasmodium family and transmitted by female Anopheles mosquitoes.

According to the latest available data by the World Health Organisation (WHO), about 3.2 billion people were at risk of the disease in 97 countries, territories and areas in 2013, and an estimated 198 million cases occurred (range: 124 million–283 million). In the same year, the disease killed about 584 000 people (range: 367 000–755 000), mostly children aged under 5 years in sub-Saharan Africa.

President, Malaria Society of Nigeria Sir Dr Babajide Puddicombe said, “the incidence is declining but Nigeria still remains number one in case fatality. Yearly, we have about 100 million cases of malaria every year out of which about 300,000 people die and pregnant women and children under 5 years are mostly at risk.”

He stated this during the awareness programme organized by the society in collaboration Oyingbo Market Women in commemoration of the World Malaria Day themed-Ending Malaria for Good.

Corroborating, a Lecturer at the Department of Medical Laboratory Science, College of Medicine, University of Lagos (CMUL), Dr Chimere Agomo said, others at risk are visitors from places where they don’t have malaria and yet to be immuned; and those who are immuno-compromised.

“Malaria prevalence in the South is much lower than in the Northern part of the country. Ideally, the prevalence in the South should be higher because of the rainy season but the literacy in the South is higher. The health-seeking behaviour in the South is higher; they are more likely to adhere to healthy instructions.  The cattle rearers in the North are more exposed to mosquito bites than those in the South,” Agomo said.

Between 2001 and 2013, a substantial expansion of malaria interventions contributed to a 47 per cent decline in malaria mortality rates globally, averting an estimated 4.3 million deaths. In the WHO African Region, the malaria mortality rate in children under 5 years of age was reduced by 58 per cent. During the same period, the global incidence of malaria was reduced by 30 per cent.

Despite this progress, the disease remains endemic in all six WHO regions and the burden is heaviest in the African Region, where an estimated 90 per cent of all malaria deaths occur. Two countries – the Democratic Republic of the Congo and Nigeria – account for about 40 per cent of estimated mortality due to malaria worldwide.

Around the world, millions of people remain without access to malaria prevention and treatment, and most cases and deaths go unregistered and unreported. Given the projected growth in the size of the world’s population by 2030, more people will be living in countries where malaria is a risk, putting further strains on health systems and national malaria programme budgets.

According to WHO, for malaria trends to remain on a downward trajectory, unremitting political commitment, substantial and predictable financing, and increased regional collaboration are necessary.

Puddicombe said, “malaria is not the only health issue confronting the government, so the government has cannot effectively fight the war against the scourge of malaria alone. This is where credible non-governmental organisations like MSN comes in to complement government’s efforts. It is not enough o give treated nets, diagnostic kits, artemisin combination therapy and gloves without funds for malaria awareness programmes.  With adequate funding, MSN can execute our programmes in different parts of the country.”

Agomo called for malaria test before treatment, saying, “in countries where they ensured that everybody was tested before treatment, they noticed that the quantities of Artemisinin‐based combination therapies (ACTs) they were buying dropped. Unlike here where everybody who comes to the clinic claims to have malaria gets ACTs but that’s a waste of money.”

To end the scourge of malaria in the country, the lecturer said, there is a need for massive awareness creation for behavioural change and improved health seeking behaviour to increase demand for services.

He added that the government has to be committed to the fight against malaria or else things that are needed will not be provided.

“Government needs to provide diagnostic options in the hospitals, there’s need for light in the hospitals and the laboratory scientists and doctors need to be trained.”

Puddicombe however said, in a country where there are no proper drainage system in most states, most of those that exist are filled with stagnant water, poor power supply, potiholes in most of our roads, poor state of most of our environmentalists, high levels of poverty and as long as credible NGOs are not actively involved in government’s efforts at malaria control, ending malaria for good will remain a mirage.

The Women Market leader, Alhaja Basirat Balogun, who was a beneficiary of the medical check-up and distribution of mosquito treated nets commended the initiative by MSN and called for more “so the market women can benefit from and be health conscious.

“I also want to urge market women especially in Lagos state to take out time for regular medical check-up to live healthy.”