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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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WHY is malaria still killing us?

Asks Rebecca Kwei from Ghana

I was  recently  down  with malaria.  My  friends  kept making fun of me about how I   have  allowed  ‘a  small  insect, mosquito’  to  knock  me  out. Malaria  has  been  with  us  since time immemorial and yet is still a major  health  challenge.  Many factors  account  for  this  state  of affairs.  Poor  environmental c o n d i t i o n s ,   i n a p p r o p r i a t e  
medication and lack of adequate medical care to manage cases, are many  of  the  challenges  that continue  to  confront  African countries.

According  to  health  experts, malaria,  which  has  remained  a major  health  problem  in  Ghana just like many African countries, is a complex health problem that demand  a  combination  various interventions to eliminate it.

The  basic  knowledge  most Ghanaians have is that the female a n o p h e l e s   m o s q u i t o   w h i c h   causes  malaria,  breeds  in  dirty s u r r o u n d i n g   a n d   s t a g n a n t  waters.  Hence,  most  preventive measures in Ghana are aimed at educating  the  populace  to  keep their surroundings clean and get rid  of  stagnant  waters.  But  the anopheles mosquito prefers clean w a t e r   s a i d   t h e   a n o p h e l e s   m o s q u i t o   w h i c h   t r a n s m i t s   malaria  to  humans  preferred relatively clean water.

"The anopheles is choosy in terms of  where  it  breeds,"  says  the Manager of the National Malaria Control  Programme(NMCP), Mrs. Constance Bart-Plange. She explains  that  the  anopheles mosquito  lays  its  eggs  in  areas where  it  can  get  clean  stagnant water  such  as  in  flower  pots, ponds,  pot  holes,  dugout  pits, hoof  prints,  puddles,  rice  fields and streams.

A  number  of  interventions  have been introduced over the years to bring  the  disease  under  control. O n e   i n t e r v e n t i o n   t h a t   h a s   received  a  lot  of  promotion  and  patronage is the use of Insecticide Treated  Nets  (ITNs).The  World Health Organisation and Ghana’s Ministry  of  Health  (MOH)  have stated  that  ITNs  are  the  most effective,  efficient  and  cost- effective  tool  in  controlling mosquitoes and reducing malaria transmission.

Since  Ghana  started  promoting the  use  of  ITNs,  the  results  has been  encouraging.  A  research conducted  by  the  Navrongo Health  Research  Centre  in  the Kasena  Nankana  District  of  the Upper  East  Region  of  Ghana showed  that  using  permethrin
insecticide  to  treat  the  nets achieved  an  18-33  per  cent reduction  in  all-cause  mortality in children under  five.

Furthermore,  3.5  million  nets  were  distributed  in  Ghana  from  1998  to  2007  while  households  with bed  nets  increased  from  48.3  per  cent  in  2005  to 51.1 per cent in 2006. But  there  is  more  room  for  improvement  as  the  country  has  a  long  way  to  go  to  achieve  extensive coverage  and  use  of  ITNs  nation-wide.  Dr  Constance  Bart-Plange  says  the  government  has highly subsidized the nets, reducing the price from about 3 dollars to 20 cents   to encourage people to  use  it.  The  nets  can  be  purchased  at  designated centre throughout the country. While all these efforts are in the right direction, it is important for Ghana’s   Health Ministry to find out why people are not using the ITNs .

Until a vaccine is discovered, it is important that  political  and  financial  commitments are  strengthened,  clear  and  timely  policy guidelines drawn and implemented.

Another   major step in Ghana’s efforts to control malaria  was  in  2005  when  she  reviewed  the antimalarial drug policy and switched to the use of Artemisin-based  Combination  Therapy  (ACT), Artesunate+Amodiaquine, as the first line drug for  the treatment of uncomplicated malaria due to the increasing resistance to chloroquine.

The use of ACT in Ghana came with some problems initially,  as  some  patients  were  said  to  have  had adverse  reactions  to  the  Artesunate-amodaiquine combination.

That  came  with  its  problems  initially,  as  some patients were said to have had adverse reactions to the  Artesunate-amodiaquine  combination.  In 2005, two brands of artesunate-amodiaquine were recalled  following  safety  concerns.  Following  the  recall, the government put in place a task force to examine what went wrong. The Ministry of Health has  since introduced coartem as a second line drug for malaria treatment.

Worthy  of  mention  is  the  new  strategy  for  the treatment  of  malaria  in  infants  known  as Intermittent  Preventive  Treatment  of  Malaria  in Infants (IPTi).This involves giving infants a single dose of fansidar two or three times in the first year of  the  infant  at  the  same  time  as  routine immunisation,  regardless  of  whether  they  have malaria or not.

This  strategy  which  is  being  implemented  by UNICEF  in  Ghana  and  some  other  African countries has been found to be safe, efficacious and affordable and is expected to be rolled out in Ghana soon.  Pregnant  women  are  also  being  given,sulphadoxine-pyrimethamine  as  intermittent preventive  treatment  during  their  ante-natal  care visits  in  addition  to  being  encouraged  to    sleep under ITNs.

It  is  evident  that  a  lot  of  interventions  are  taking place to eradicate malaria but despite the progress, Ghana  still  falls  short  of  global  malaria  goals. Perhaps the icing on the cake would the discovery of  a vaccine for malaria hopefully in 2011.

One major boost in this direction is the pioneering efforts  of  INDEPTH  Network,  an  international NGO,  of  which  Ghana  is  at  the  forefront  in  the establishment  of  the  Malaria  Clinical  Trials Alliance (MCTA) with a $17 million grant from the Bill and Melinda Gates Foundation. Currently there are  16  MCTA  trial  sites  in  10  African  countries; Burkina  Faso,  Gabon,  Ghana,  Kenya,  Nigeria, Malawi, Mozambique, Senegal, Tanzania and The Gambia.

Until  a  vaccine  is  discovered,  it  is  important  that political and financial commitments are   strengthened,  clear  and  timely  policy  guidelines drawn and implemented.

Second Edition