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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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Move with the Times

The heavy-reliance on verbal autopsy data in estimating global malaria mortality has been criticized by the WHO Evidence Review Group on Malaria Burden Estimation Methodology.

Dr Seth Owusu-Agyei, Director of the Kintampo Health Research Centre (KHRC), disclosed this in an interview after presenting a paper titled “Malaria attributable mortality” at the just-ended 12th INDEPTH Scientific Conference in Johannesburg, South Africa.

According to Dr Seth Owusu-Agyei, Co-ordinator of the WHO project on behalf of INDEPTH Network, the group has called for better methods to be developed to collect data on illnesses.

Verbal autopsy is the method by which the likely cause of death in populations where vital registrations of death is incomplete and unreliable is ascertained. In other words, a verbal
autopsy is a method of finding out the cause of a death based on an interview with next of kin or other caregivers.

The global health body WHO acknowledges that in recent years, verbal autopsies have been used more widely to provide information on cause of death in areas where civil registration and death certification systems are weak, and where most people die at home without having had contact with the health system.

In such circumstances this type of interview is often the only way to find out about the cause of death.

Dr Owusu-Agyei said the experts at the meeting proposed an approach based on analyses of the prospective risk of all-cause mortality in relation to cross-sectional parasitological survey data.

He admitted though that not all malaria cases end up in hospitals. “Some patients seek help at home and others at the drug stores and as such the data generated tend to be inaccurate,” he pointed out.

Dr Owusu-Agyei suggested the need for the National Malaria Control Programme (NMCP) for example, to team up with the malaria research centres so as to have harmonised data on mortality that is attributable to malaria.

He said figures on malaria at community levels could be combined with data from the hospitals, to create a reliable data base.

The KHRC director praised the INDEPTH Network on data management affirming its sites have more accurate data on malaria and maternal mortality, through verbal autopsy.

He explained that to ascertain the cause of a death several factors come to play so “if you do not use accurate measures, you cannot ascertain the truth.” In the light of this both verbal and physician autopsy should be used to ascertain the trends of malaria as the cause of death. He revealed that the INDEPTH Board has approved the WHO Malaria Burden Estimation Methodology, as a priority project.

The WHO itself has identified a statistician who can work intensively on the project over the ensuing months with supervisory inputs from Professor Tom Smith of the Swiss Tropical and Public Health Institute in Basel, Switzerland, and former member of t he INDEPTH Scientific Advisory Committee.

After this, the data to be included in the analyses would be assembled and followed with a workshop. Dr Owusu-Agyei said the cross-site data set would subsequently be shared with the WHO.

The INDEPTH Network founded in 1998 has contributed to a vast body of knowledge on the changing patterns in malaria transmission incidence and clinical disease in some sites in sub-Saharan Africa.

Others include studies on malaria control interventions such as treated bed nets (ITNs) and artemisinin combination therapies (Acts).

In recent times it has conducted landmark studies in malaria prevention such as the INDEPTH Effectiveness and Safety Studies of Anti-malarials in Africa (INESS) which is being conducted in 7 HDSS centres.

Again, under the INDEPTH Malaria Clinical Trials Alliance (MCTA), a number of health researchers have been trained and facilities and infrastructure have been improved for clinical and malaria vaccine and therapeutic trials in 10 countries in Africa.

According to the WHO, very little scientifically-based information is available on cause-specific mortality rates for many develping countries. What information does exist is often out of date, applicable only to major urban areas, and not sufficiently disaggregated to differentiate between important sub-groups of populations.

“Yet such information is needed for targeting of scarce health resources, especially as high mortality tends to be clustered in particular geographical locations and segments of the population,” says the global health body.

James Addy reports from South Africa

Eleventh Edition