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TIPS ON MALARIA

  • HOW CAN MOSQUITOES BE CONTROLLED?

    Mosquitoes around the home can be reduced significantly by minimizing the amount of standing water available for mosquito breeding. Residents are urged to reduce standing water around the home in a variety of ways.

  • HOW CAN I PROTECT MYSELF FROM MOSQUITO-BORN DISEASES?

    The best way is to avoid being bitten by mosquitoes.This can be accomplished using personal protecting  while outdoors when mosquitoes are present. Treated bed nets should be used sleeping. Mosquito repellent should be used when outdoor.

  • WHO ARE AT RISK?


    Nearly half of the world’s population is at risk of getting malaria. Pregnant women are particularly at risk of malaria. Children under 5 years are at high risk of malaria.
     

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The army operation against malaria

The AngloGold Ashanti Malaria Control Limited (AGAMal) activity has been under a technical advisory committee of three eminent Ghanaian scientists who direct the indoor residual spraying (IRS) in the Obuasi Municipality and nine districts in the Upper West Region. The advisory team is chaired by the universally-acclaimed public health physician, Professor Fred Binka, Vice Chancellor of the University of Health and Allied Sciences, in Ho,Volta Region. In an interview with Salifu Abdul-Rahaman of Eyes on Malaria, he gave the history and effectiveness of IRS as a malaria prevention tool.

Prof, what is the history behind the use of IRS as a malaria prevention and control tool?
Indoor residual spraying has been used as a malaria prevention control tool for a very long time especially when the focus was on vector control. It was primarily used during the Global Malaria Eradication campaign (1955-69).It has been effectively used in eliminating malaria from several areas, including United States of America and all parts of Europe. It is very clear that IRS has been effective in malaria prevention, especially when we need to bring down transmission rate in the population.

What is the background to the project in Obuasi?
As you may be aware the Obuasi project started as Obuasi Malaria Control Programme following a response from the management of the mines to help reduce the incidence of malaria in its concessionary area to boost productivity.

After a huge success, management set up AGAMal as a subsidiary of the mining company to scale up the project to other parts of the country. Consequently, they applied to the Ministry of Health to partner with the National Malaria Control Programme to scale up the intervention to 40 other district across the country. But there has been a change in the funding mechanism of the Global Fund. So the intervention has been scaled down to ten districts. This is where we are now.

What is the work of the Technical Advisory Committee?
We deal with the technical aspect of the intervention; we offer technical advice to the project management so that we deliver the intervention appropriately and not expose the people to the mosquitoes. That will negate the objective of the intervention. We advise on the timing of the IRS, the kinds of insecticide to use and how often to spray the intervention area, in order to avoid resistance to the insecticide.

What has changed since the programme began?
We used to spray twice in a year, but having discovered a long lasting insecticide, the spraying is now done once in a year.
We monitor to ensure that the intervention is making progress in terms of reducing the incidence of malaria in the population. The Kintampo Health Research Centre in the Brong-Ahafo region has been engaged to conduct a study on the malaria prevalence rate in the target area for more empirical evidence on the prevalence of malaria in the target population.

What impact has the intervention made in your opinion?
We have seen a steady reduction in malaria prevalence in the target areas. Except for some few areas that we did not make more progress due to technical changes in the deployment of logistics. It is a huge intervention which comes with huge costs in procuring the insect icide and getting the cooperation of deployed spray operators. It is an army operation. Generally, we are happy with the progress. Unfortunately, we are not getting to do more because of the change in the funding mechanism which has led to the scaling down of the target areas.

How do we sustain this laudable intervention?
The government has to step in due to the crisis in the health sector. The National Health Insurance does not cover preventive measures. There is no budget lined up for preventive measures. Even funding to support the expanded programme for immunization has become problematic. The government needs to commit more resources to preventive medicine for the population to stay healthy. The Obuasi story is an example of how Public-Private–Partnerships can be very efficient in malaria control in the country. It is a laudable initiative.

Some people question the use of IRS as an effective malaria control tool, claiming that some mosquitoes bite outside for their meal and not indoors. What is your comment?
I do not agree with that view. The malaria vector is endophilic (tends to live or rest indoors). The mosquitoes bite indoors for their blood meal, after resting on the walls. Those that bite outdoor are not critical, they do not transmit malaria. We have different kinds of mosqui toes; those that bite outside do not transmit malaria.

What is your reaction to the saying that the aerial dispensing technique is a good approach to malaria control?
We have gone past that approach. It was a bad use of insecticide. The target is the indoor walls where the mosquitoes are known to take a rest before they bite at night for their blood meal.

What do you say to complaints about the smell of the insecticide?
The smell is not harmful, it is temporary. It is not a major issue because it is not harmful. Just a few hours after spray and the smell will be gone.

The Permethrin insecticide was used in the bednet study in Navrongo in the Upper East Region of Ghana in the 90s. Why is it no longer recommended for IRS?

That was done to reduce pressure on the Permethrin to avoid the development of res i stance. Besides, the Permethrin insecticide has been used more extensively in agriculture than in public
health.
 

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