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    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.


    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.


    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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  • Volume 1

Killing the African Hippopotamus Malaria

Malaria is in many ways like the hippopotamus, depending on what one thinks is the  cause of the disease. There is hardly anybody in Ghana who has not suffered from the  disease, yet knowing about what causes it remains elusive to many who live in the rural  areas. Although, there is widespread knowledge that mosquitoes cause malaria, many  African societies have traditional perceptions about the causes and management of the  disease.

It is, therefore, not surprising that everybody in Africa can treat malaria. Right from the  household level, where self-medication is common, to witchdoctors and herbalists, who prepare concoctions to treat the disease, there are various medications and preparations  to treat malaria. Some people believe in Ghana that they suffer from malaria because they  exert themselves too much while working under the hot sun. To others, eating 
s w e e t a n d o i l y f o o d s , p o o r e n v i ro n m e n t a l s a n i t a t i o n a n d
consumption of unripe fruits can cause malaria.

But Ghana is not alone. In Banjul for example, some rural dwellers believe that if you drink lots of sour milk during the rainy season you would get malaria. In some parts of Togo, it is believed that one suffers from malaria from eating too much palm oil.

The deep cultural belief in witchcraft, has also greatly impacted on the prevention and treatment of malaria across Africa. It is not surprising therefore that the treatment for the disease greatly varies, particularly in the rural areas where interventions are greatly influenced by the perceptions about the disease. These include drinking coconut juice, applying regular enema, drinking liquid from boiled pineapple peels and boiled neem tree

The truth about the causes, diagnosis and treatment of malaria across the Continent is largely surrounded by myths an d conceptio ns j ust like the hippopotamus, which lives largely submerged by water with only the ears sticking out.

Perceptions and myths about the causes and treatment of malaria, which has hindered the effective management of the disease, largely within the communities, could be likened to the hippopotamus, which has a large part of its body submerged in water. ”Malaria is unique because its roots lie in human communities," says Dr Margaret Gyapong, a Malaria Expert at the Dodowa Health Research Centre in the Greater Accra region of Ghana.

Early work on malaria, she said, focused  on vector control without reference to human behaviour and belief system. “Too often behavioural and socio- cultural aspects were an afterthought. Lack of attention to these aspects is some reason for the failure of early attempts at malaria control.", she notes.

Dr Gyapong points out that said perceptions about the causes of the disease has influenced the decisions individuals make in seeking treatment for the disease.

She laments that as a result of such myths, decisions to seek treatment for malaria at health facilities are often the last resort. The relatively few patients, who have any contact with the health services, represent the 'ears of the hippopotamus,'" Dr Gyapong said.

Studies have shown that usually, victims of malaria seek medical examination and treatment from health facilities when the initial attempts have failed resulting in late presentation. Very often treatment of malaria in Ghana occurs at home with only a few of such home- based treatments being correct and complete. Clearly, there is an urgent need for health education to deal with the perception about the disease. Health education is needed at this point to help Malaria, no doubt, is a common but complex disease. There have been studies to determine the proportion of fevers actually due to malaria. However fever remains the most recognized symptom of malaria. This situation sometimes leads to the practice of presumptive diagnosis and treatment on the part of both health professionals and people within the communities.

For those within the communities, presumptive diagnosis and treatment reduces cost in time and money for the patient or guardian, who may find it difficult to attend a formal health outlet. Prof. Kwadwo Koram of the Nugochi Memorial Institute for Medical Research
, however, said there were drawbacks in presumptive diagnosis because of over- exposure of population to risk of drug toxicity.

He said there was also the "likelihood of  inaccurate dosing, including the use of sub-therapeutic treatments that may favour the evolution or spread of drug- resistance".

Studies on health-seeking behaviour, perceptions of malaria, treatments, and decision-making for health care at the household, community and health facility levels, are crucial to malaria control. Malaria is an important social, economic and developmental problem affecting individuals, families and communities. The best chance for combating the disease is a collaborative control has led to studies on perceptions about the disease. Some of these studies have recently informed policy development.

For instance, one intervention by the Ghana Health Service (GHS) is to bring malaria treatment closer to the communities, especially to help save the lives of children through the promotion of early and appropriate home management of malaria.

This is because the majority of children who die from malaria do so within 48  hours of onset of illness. The early use of  effective anti-malaria medicines at home, therefore, can help reduce the burden of the disease
The GHS was distributing chloroquine at the community level through trained people. However, with the introduction of the new malaria drug, artesunate amodiaquine,

It is time to “kill” the African Hippopotamus malaria!

Studies are being conducted to see if this drug, complex in administrating, could be distributed in the communities. Malaria control is everybody's business and everyone should contribute. It requires the partnership of community members and the involvement of those engaged in health care delivery.

Indeed malaria is of major concern to households. It can be detrimental to livelihoods and if not protected these costs can push households towards poverty. In Ghana, the disease is the leading cause of workdays lost due to illness. The condition, with the general malaise it brings on, reduces output by increasing absenteeism from work and school.

WHO records indicate that there are 300 to 500 million clinical cases a year and up to 2.7 million deaths occurs globally. Certainly malaria is not only a public health problems but also a  developmental problem that must be addressed.

Eunice Menka, Ghana

First Edition