By Azoma Chikwe
Malaria is a disease that is easily preventable, treatable and curable but remains a major public health problem. About One hundred million clinical cases of malaria are reported yearly in the country. This situation is due primarily to inadequate and incorrect information for the appropriate use of malaria commodities.
The disease adversely affects all age group in rural and urban commodities in Nigeria. Successful control of malaria will reduce poverty, increase productivity, improve health, reduce school absenteeism and facilitate the attainment of the SDGs.
Malaria elimination strategies require lots of compliance and adaptation of behaviours for appropriate use of malaria commodities. However, lack of appropriate information for the correct use of these commodities have hindered attainment of the optimal desired outcome towards the elimination of malaria. As a result, the uptake and utilisation of malaria commodities have remained low. Persistent poor uptake and use of malaria commodities due to inadequate information is a threat towards elimination of malaria in Nigeria.
According to Dr Godwin Ntadom of National Malaria Elimination Programme (NMEP) “Fever is one of the common signs of malaria, which can also be found in other illnesses. Despite this fact, research shows that majority of Nigerians treat all fevers with antimalarial medicines, without consulting a health provider and testing with Rapid Diagnostic Test (RDT) or microscopy to confirm malaria. RDT is an easy, safe and effective way to confirm whether the fever is malaria. This can also prevent clients from wasting time and money.
“Long Lasting Insecticidal Nets (LLINs) are a type of mosquito net that is treated with insecticides that repel and kill mosquitoes. Sleeping inside LLIN every night is an effective means of preventing malaria by protecting yourself and family members from mosquito bites. Additionally, the chemicals used in making LLINs are safe to use and not harmful to human beings.
“LLINs are an effective tool in preventing malaria, and as such, large quantities of LLINs have been distributed across Nigeria. However, despite wide spread of LLINs, there are many cases of low and incorrect usage of LLINs in Nigeria, reducing net’s ability to protect against malaria. For example, the Nigeria Malaria Indicator Survey (NMIS) 2015 shows that while 69% of household own a net, only 37% of individuals – 44% of children under 5 and 49% of pregnant women – sleep inside one. Everyone can sleep inside LLIN indoor and outdoor, however priority should be given to vulnerable population (pregnant women and children under five).
“Nigeria has adopted the use of LLINs as one of it’s key interventions for malaria prevention, and it is recommended that every person sleep inside a LLIN every night. The National Policy and Guideline on malaria identifies LLINs as a critical element for malaria elimination in the country. This is in agreement with the World Health Organization’s global recommendations to end malaria.”
Antenatal care known as ANC is the special care pregnant women receive from skilled health workers during pregnancy. In Nigeria, pregnant women are given free Long Lasting Insecticidal Nets sand SP as part of ANC to help them prevent malaria.
In Nigeria 97% of the population is at risk of malaria. The pregnant woman and her unborn child are most at risk of dying from the disease. According to the 2015 Nigeria Malaria Indicator Survey ( NMIS), 37% of pregnant women take 2+ doses of SP at least once during an ANC visit. This is significantly low given that malaria during pregnancy affects both the mother and the unborn child.
Early attendance of ANC is very important for pregnant women for a safe pregnancy. Pregnant women should take at least 3 doses of SP for intermittent Preventive Therapy ( IPT) to prevent malaria. The World Health Organization ( WHO) says every pregnant woman should go to a health facility for ANC early, during her pregnancy.
Ntadom said, “many years of use of a single drug ( monotherapy) for treatment of malaria around the world has led to resistance of the malaria parasite to the these drugs once considered effective against them. As a result,WHO recommended a change to the use of a combination of drugs – artemisinin or its derivatives and one or more other active ingredients. The umbrella term for these combination therapies is ACT, Artemisinin based combination therapy.
“The Artemisinin-based combination Therapy ACTs have been adopted by Nigeria for the treatment of malaria in agreement with WHO recommendation. ACTs are effective in the treatment of malaria. They are the best medicines for malaria all over the world.”
For many countries, strong political leadership and support from the Global Fund to Fight AIDS, Tuberculosis and Malaria has seen more than US $4 billion for malaria control and elimination projects since 2002, including more than 210 million insecticide-treated nets distributed and millions of malaria cases treated in accordance with effective national guidelines.
Yet much work remains to overcome the disproportionate burden malaria continues to place on some communities around the world. Experts have called for stronger commitment by governments, philanthropists and non-governmental organizations, urging multisectoral action to ensure all necessary measures are taken to eliminate malaria by 2030.
Increased financing will be critical to further advancements, as current international and domestic financing for malaria of US $2.5 billion in 2012 amounts to less than half of the US $5.1 billion Roll Back Malaria(RBM) estimates needed annually through 2020 to achieve universal coverage of malaria control interventions. Many countries in Africa alone face a funding gap of an estimated US $2.8 billion through 2017 for adequate scale-up of malaria control and elimination interventions.
World Malaria Day was instituted by WHO Member States during the 2007 World Health Assembly and is celebrated on 25 April each year to highlight the need for continued investment and sustained political commitment for malaria control and elimination. The theme for the 2013-2015 campaign is “Invest in the Future. Defeat malaria”.
According to a medical personnel“ the most vulnerable group that are easily affected by this disease are young children, pregnant women and people who are just moving into the area or who just relocated. Most of the young children are not immune to the disease which is why they are constant prey to the disease. Scientifically pregnancy reduces immunity which is why most pregnant women are victims to malaria especially if it is the first or second pregnancy.”
There are over a hundred type of the plasmodium parasite; however, only five of these species affect humans. They are plasmodium falciparum, plasmodium vivax, plasmodium ovale, plasmodium malariae and plasmodium knowlesi. Plasmodium Falciparum is located worldwide in the tropical and suburban areas but predominately in Africa, it is estimated that one million people are killed by this strain every year, plasmodium vivax is popular among Latin America, Asia and also Africa, it is widespread due to the population of the Asians, this strain can stay dormant in the body and activate itself after months or years causing patients to have a relapse.
The disease is quite common in Africa, this is due to the one or the combination of the some of these reasons; scarce resources and socio-economic instability which have hindered efficient malaria control activities, weather conditions specifically humidity and temperature that allows transmission of the disease to linger year round, the presence of the insect that is responsible for the transmission of the disease.
When an infected mosquito bites a human, the parasite enters the bloodstream and lays dormant within the liver, for the next few days usually 4-16 days the parasite begins to multiply asexually, the parasite is then released back into the bloodstream which has already affected the red blood cells and begin to multiply, some parasites are not released at the same time which explains why there is recurrence.