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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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Subsidised tests kits: the way to go

In a tiny village known as Emusenjeli in Western Kenya, Gideon Amuchuku walks to the nearby shopping centre (Emahanga) to buy anti-malarial drugs for his sick daughter, Lynn. Though she has not been diagnosed, he says that Lynn has fever and complaining of headache.

“I know. This is likely to be malaria. That is why I have to buy her the drugs,” he says. He is confident because the anti-malarial drugs are sold in Kenya across the counter.

This is not the first time Amuchuku is going to give his daughter malaria medicine without diagnosis. He says he has done it many times not only to his daughter, but to all his family members, including himself.

However, a recently published report in the PLOS ONE open-assess journal indicates that dispensing antimalarial medicines without diagnosis jeopardises the effort made to subsidise the drugs, while other studies say that it could lead to drug resistance, as has been witnessed in the past.

“In poor countries where malaria is prevalent but access to health care is limited, many people mistakenly treat the common cold or other serious illnesses such as pneu¬monia with medications for the mosquito-borne disease,” says the study led by William Dickens, a University Distinguished Professor of Economics and Social Policy and a non-resident senior fellow at the Brookings Institution in the US.

According to Amuchuku, it is expensive to test for malaria before buying the drugs. “I have always taken or asked my family members to take malaria drugs based on symptoms because testing is costly,” says the father of two.

Following the Global Fund’s programme to subsidise anti-malarial drugs through the  Affordable Medicines Facility-malaria (AMFm) whose pilot ended in 2012, millions of Kenyans could access the life-saving medicines for half a dollar, making it easily affordable.

However, people had to foot the cost of diagnosis, hence, causing many to opt to take the drugs without diagnosis.

Amuchuku reckons that diagnosis costs one hundred Kenyan shillings (roughly $1.20 cents), which is the cheapest price at any healthcare outlet in Kenya. “This is expensive considering that it is a day’s wage for casual labour in the villages,” he says.

To bridge the gap, the researchers suggest that governments and the international community should consider investing in subsidy of the diagnostic kits as part of the drug subsidy package.

“Providing subsidies and education can influence more people in poor countries like Uganda to get tested for malaria,” says the research.

According to the findings, subsiding malaria tests kits and making them easily available, increases the likelihood that infected people would take the appropriate medication and decrease the patronage of unnecessary, costly, and potentially harmful medications, which are often sold at drug stores without a prescription.

“In my life as a medic, I have come across several patients who have developed serious complications simply because they took wrong medications, when they were actually suffering from different diseases. Some of the diseases that cause fever and are often mistaken for malaria include typhoid, pneumonia, and many other serious bacterial infections,” said Moses Makokha, a clinical officer at Alupe District Hospital in Busia, Western Kenya.

Such diseases, he says, can cause death or lifetime complications if not treated in time. Yet by applying anti-malarial drugs ignorantly, it automatically delays their treatment forcing the patients to seek professional intervention when it is too late.

Makokha notes that even those medicines that are perceived to be ‘simple’ can have devastating effects on human health, if used inappropriately. “By all standards, it amounts to drug abuse,” he says.

A few years ago, the World Health Organisation recommended that all fever cases particularly in children under the age of five be treated using malaria drugs. This was after studies strongly suggested that such a move would reduce mortality rate among children due to malaria.

However, several other studies were later conducted, and results indicated that all fevers were not necessarily as a result of malaria, forcing the WHO to change the policy, and call for diagnosis before treatment.

Furthermore, studies indicated that overexposing anti-malarial drugs to people including those that are not suffering from the disease could lead to drug resistance.

One of the studies conducted in Tanzania, and published in the Bio Med Journal found that among children with fever, just a handful of them could be suffering from malaria.

“Only a small proportion of the children under the age of five with fever had malaria, with a proportion of children having non-malaria fever,” said the study led by Dr Humphrey Mazigo, a communicable disease and environmental health expert. “Improvement of malaria diagnostic and other causes of febrile illness may provide effective measures in the management of febrile illness in malaria endemic areas,” noted the researchers.

Subsidising of the malaria diagnostic kits was part of the Global Fund recommendations of the December 2012 Board Meeting. However, it will depend on every country’s choice, since the AMFm may be run depending on countries’ priority.

- By Isaiah Esipisu

Tenth Edition