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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 Malaria diary: A story of the past and the present

By Rebecca Kwei, Ghana

Having written a “few stories” on malaria over the years I have witnessed the  strides made in the fight against malaria and  cannot reviewing my notes to track the success story and its relevance to the 2011 World Malaria Day theme , “Achieving Progress and Impact.” 

The Roll Back Malaria partnership chose the theme to highlight the progress made to eliminate malaria and make the lives of every man, woman and child count”.

The Malaria story
The malaria story starts from 1955 on a 15-year campaign costing more than one-third of the World Health Organisation’s (WHO) total expenditure. It was under a universal effort known as the Global Malaria Eradication Programme (GMEP). Acting on the realization that spraying homes with DDT was a cheap and effective way of controlling malaria, the WHO resolved at the time to eradicate malaria completely.

The DDT campaign led to the elimination of malaria from most developed countries and some sub-tropical developing countries in Latin America, parts of Asia and Europe, including parts of former the Soviet Union.

Prof Don de Savigny
I recall an interview with Prof Don de Savigny of the Swiss Tropical Institute on what we termed the “malaria story”. Prof de Savigny said the global effort to tackle malaria had the political backing of political leaders who pumped billions of dollars into the project. Every country issued malaria eradication postage stamps to support the world-wide campaign under the theme “The World United Against Malaria.”

    Prof Don de Savigny

The US government issued initial 100 million postage stamps to raise funds for the world-wide drive against malaria and between 1958 -1960, contributed over 140 million dollars to the malaria eradication campaign.

        A malaria postage  stamp

When in the early 1970s it was realized that malaria eradication from Africa was impossible with the existing tools the effort was abandoned. As Prof de Savigny puts it, “malaria fell off the political and development agenda” of the WHO.

Thus, Africa was excluded from the GMEP until more effective and economical methods could be found to eradicate malaria in such settings.

Malaria was put back on the international health agenda in the late 1980s when it became clear that the increasing cases of malaria deaths could no longer be ignored. 

Current tools for the final “war”
With the renewed interest in malaria came efforts over the past decade to develop several malaria interventions, although they remain unavailable in many places.

Conferences held in the late 80s and 90s to refocus attention on malaria led to the renewal of interest in the disease, culminating in the birth of a new technology in 1996 - the Insecticide Treated Nets (ITNs). 

Long Lasting Insecticidal Net (LLIN)
The Long Lasting Insecticidal Net (LLIN) is an improvement on the normal Insecticide Treated Nets (ITNs), which needed to be re-treated regularly. The LLINs are designed to repel, disable, or kill malaria-bearing mosquitoes and are effective without re-treatment for about 4 years.

Prevention, they say, is better than cure and sleeping under mosquito nets prevents mosquito bites. The nets have been known to reduce mortality in children under five by about 20 per cent and malarial illnesses among children under five and pregnant women by up to 50 per cent. Sadly, most people are reluctant to sleep under the net due to the hot African weather. In Ghana for example, although many people know about bed nets, its usage is low.

 

Local Ghanaian drama to encourage the use of bed nets

Rapid Diagnostic Test (RDT)
It is important that any fever presented at the hospital be confirmed through microscopy or the rapid diagnostic test (RDT) to be malaria. RDTs assist in the diagnosis of malaria by detecting evidence of malaria parasites in human blood. They are best deployed at levels of care where microscopy is not available due to the lack of laboratory facilities, power source and/or skilled personnel.

                   Rapid Diagnostic Test kit

Advantages of RDTs
• They are rapid and relatively easier to perform, thus enabling the use of confirmatory diagnosis to in poor and peripheral health facilities and the community.

• Result is available within a short time

• None-requirement of high skills, laboratory sophistication, electricity etc

• Can fill diagnostic gaps at health facilities where microscopy is not available.

Affordable Medicines Facility-Malaria (AMFm)
Perhaps the latest progress recorded in the fight against malaria is the launch of the AMFm, an initiative to ensure that people suffering from malaria have access to inexpensive, effective anti-malaria treatment in the form of Artemisinin-based Combination Therapy (ACT).

                              ACT drug

ACTs were too costly for many people but under the AMFm it is now going for the affordable price of $1.00. It is available in most health facilities and is expected to discourage people from using chloroquine and other monotherapies which are no longer effective treatment for malaria. 

Malaria Vaccine
A vaccine is an essential tool in stopping malaria because malaria routinely develops resistance to drugs. Mosquitoes routinely develop resistance to insecticides. A malaria vaccine will provide the all-important prevention to the disease and also close the gap left by other interventions.

In October this year the first results of the RTS,S candidate vaccine against malaria will be released.

RTS,S is the first malaria vaccine to reach phase III clinical trials and is world’s most clinically-advanced malaria vaccine candidate.

About 16,000 children in two age groups – six to 10 weeks and five to 17 months were selected from seven African countries namely Ghana, Burkina Faso, Gabon, Kenya, Malawi, Mozambique and Tanzania to take part in the 3-year trial.

 The vaccine could be available for targeted use as early as 2013 among young children aged 5 to 17 months. 

Intermittent Preventive Treatment (IPT)
Intermittent Preventive Treatment (IPT) in pregnancy provides ante-natal malaria treatment to pregnant women, who are particularly vulnerable to the disease. A total of 33 out of 43 endemic countries in the African Region have adopted intermittent preventive treatment for pregnant women (IPTp) as national policy. 

Intermittent Preventive Treatment of malaria in infants (IPTi)
IPTi is the administration of an antimalarial drug at the time of childhood vaccinations in the first year of life and delivered alongside the WHO’s Expanded Programme for Immunisation (EPI). WHO is considering recommending IPTi for children under-five in high-risk areas.
 
Hope for the future
If the renewed interest in malaria is sustained, Africa may not have to wait too long for a solution to the malaria menace. From all indications, these are exciting times for Africa. 2011 has seen a renewal of global commitment for Universal Access to essential malaria interventions.

There is the need however to take the campaign further through national budgetary support for research driven by African scientists to guide evidence-based policies for malaria control.

Editions: 
Seventh Edition