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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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By Carlton Cofie - UK

The Herculean task of removing the threat of malaria has  become  even  more  daunting  with  reported Tresistance to the world's most effective treatment.

International scientists have spotted a trend in western Cambodia  where  it  is  taking  longer  to  clear  malaria parasites  from  the  blood  even  with  artemisinin-based combination therapies (ACTs) , the world's best defence against the most prevalent and deadly form of malaria.

The efficacious drug usually cleared all malaria parasites from the blood within two or three days, but in recent trials along the Thai-Cambodia border, this took up to four or five days.

Assistant  Director-General  of  the  World  Health Organisation (WHO), Dr Hiroki Nakatani, says this early warning  sign  of  emerging  resistance  is  of  particular concern because previous generations of malaria drugs have been undermined by resistance which started in this way.

Resistance  started  with  chloroquine,  followed  by resistance  to  sulfadoxine-pyrimethamine  and mefloquine, drugs used in malaria control several years ago. And it started around the same region along the Thai- Cambodia border.

Rude Awakening
Now  it  appears  that  if  the  World  Health  Organisation's drive to eliminate artemisinin-tolerant parasites does not succeed  the  worlds  malaria  prevalent  regions  will  be confronted with a full-blown resistance not to mention the ramifications of a global health catastrophe.

It is superfluous to say that the Global Malaria Action Plan to  reduce  malaria  deaths  and  cases  by  70  percent  will then become a fleeting illusion.

The obvious lesson here is simple: prevention is better than cure. But that sounds too simple to many people. It has been agreed that the best fight against the disease which  claims  a  million  lives  annually  is  prevention  of mosquito bites using insecticide treated nets.

However  mankind's  attitude  to  the  problem  is  as unchanging as the spots of a leopard. Yet, quite unlike that perceptive and elusive creature, we have tended to play  the  ostrich  with  heads  buried  in  the  sand  and  our bodies exposed to mosquitoes.

Yet a child is killed every 30 seconds, pregnant women are dying and many more continue to fall victim to malaria. There is the story of a 20 year old Briton, Harry Yirrell, who spent four months in Ghana as a volunteer but died from malaria a week after returning home.

Now,  Mrs  Jo  Yirrell,  mother  of  the  malaria  victim,  has  since  Harry's  death  three  years  ago,  worked  tirelessly with charities to raise awareness about the disease. She has joined forces with a charity, Malaria No More, to get every man, woman and child at risk in Africa a mosquito net by the end of 2010 - a target set by the United Nations in 2008.

The reality in Ghana and Sub-Saharan Africa dictates that malaria  be  attacked  with  urgency  because  it  is  an emergency! This demands a constant march forward, not two steps forward, one step backward.

Having made the case that malaria is an emergency; we must  now  face  the  mighty  task  of  changing  people's attitude towards it. Attitudes of patients, government and even doctors, all come under the microscope.

In  the  case  of  the  unfortunate  British  volunteer,  it  has been seen as a tragic irony because malaria doesn't need to kill anyone. He had the tablets with him - he just didn't take them.

Instead  of  taking  the  tablets  to  protect  him  from  the disease,  Harry  gave  them  to  his  Ghanaian  girlfriend. Another irony!

A tour of the guest house where Harry stayed revealed why he contracted malaria. There was no mosquito net in his bedroom. Even worse, he loved to sleep outside in a hammock.

Considering  the  fact  that  malaria  has  always  had  a reputation  as  a  ruthless  killer,  you  really  wonder  why anyone would want to test his luck in such manner. The unfortunate result here is that though no Ghanaian can be held liable for the loss of Harry's Yirrell's life, the whole country has had to bear a weird feeling of shame for the tragedy.

Even more shameful is the mentality that the African body fears  no  germs  or  bacteria.  It  may  be  true  that  having been born and bred in the malaria region we have some immunity against the disease.

Be that as it may, ignoring bed nets and prescriptions is foolhardy at a time when the WHO is confronted with the recent  drug-resistant  malaria  situation  that  has  been documented around the Thai-Cambodia border. There is genuine fear that this form of malaria could spread rapidly to other susceptible countries. It has happened before.
In some areas where mosquito nets are already widely used,  it  has  been  estimated  that  less  than  5%  are  re- treated  to  achieve  their  expected  impact.  WHO  says  it
has  worked  with  mosquito  net  and  insecticide manufacturers  to  make  re-treatment  as  simple  as possible.

However, the best hope lies with newly developed, long- lasting  treated  nets  which  may  retain  their  insecticidal properties for four to five years, the life span of the net, thus making re-treatment unnecessary.

On  the  government's  side,  the  blame  is  simply  not providing enough insecticide bed nets. These bed nets which  have  been  known  to  be  the  most  effective prevention against malaria, has been subsidized though, but  it  needs  to  be  in  every  household  to  serve  the purpose.

The other big issue are fake drugs. Counterfeit medicines have been identified as one of the obstacles to malaria control.

Government may claim to be cash-strapped but there is so  much  more  it  can  do  through  communication, community  mobilization  and  advocacy  to  engender comprehensive behaviour change.

When it comes to blaming doctors, it is true to say that those  who  know  the  right  thing,  must  be  more accountable.

Dr Constance Bart-Plange, Programme Manager of the National  Malaria  Control  Programme  (NMCP)  has revealed  that  only  22.4  per  cent  of  malaria  cases  are confirmed  before  treatment.  Clinicians,  sometimes, under the pressure of work or in the absence of laboratory facilities,  in  diagnosing  malaria,  have  to  base  their diagnosis  on  only  clinical  suspicion  depending  on symptoms  the  patient  presents.  This  has  often  led  to wrong diagnosis and wrong treatment.

There is a mission to reduce malaria deaths and cases by 70 per cent in line with the Global Malaria Action Plan. The health  professionals  know  how  much  complications  do arise  when  they  fail  to  thoroughly  diagnose  patients  to confirm their status before treatment.

Yet they blame everything on the failure of government to provide  facilities  and  motivate  personnel  in  order  to reduce long queues at hospitals. One  wonders  what  happened  to  the  malaria  rapid diagnostic test made up of a simple kit, the adherence to which could reduce wrong diagnosis and treatment.

Ghana, now in the malaria control phase, has set to reach the elimination stage by 2015 where the pandemic would no  longer  remain  a  public  health  concern.  But  the  one
thing lacking here is a sustained effort by all.
There are promising signs that malaria will one day cease to pose a threat to life. That day will come when trial vaccines lead to the real final solution- protective inoculation.

Some  charities  have  set  themselves  the  mission  to ensure that leaders of G8 and EU countries deliver their goal to provide 100 million bed nets to sub-Saharan Africa by the end of 2010.

But  as  future  promises  do  not  always  materialise,  we have to make a focused effort at making current malaria- fighting strategies work. That way, when future realities derail the malaria eradication agenda, we can still be on top.

Third Edition