Ways private sector can help eliminate malaria
By Azoma Chikwe
Malaria elimination is the interruption of local mosquito-borne transmission; continued measures are required to prevent re-establishment of transmission while eradication is defined as the permanent reduction to zero of the worldwide incidence of infection caused by human parasites. Once eradication has been achieved, intervention measures are no longer needed.
Countries adopt different methods to eliminate the disease. The rate of progress depends on the strength of the national health system, the level of investment in malaria control and a number of other factors, including biological determinants; the environment, social, demographic, political and economic realities of a particular enclave.
Elimination efforts are driven by ministries of health in endemic countries. As NATONS approach IT, they continue to receive technical support from World Health Organisation(WHO) and partners and, in some cases, financial support from the Global Fund and other donors. However, most elimination efforts are financed largely through domestic resources.
In Nigeria, the private sector, led by National Malaria Ambassador and President, Dangote Foundation, Alhaji Aliko Dangote, has rolled out a plan to eliminate malaria in the country. The private sector is expected to work with the Federal Ministry of Health to achieve this goal by 2020.
In countries with high or moderate rates of transmission, national malaria control programmes aim to maximise the reduction of cases and deaths. This can be achieved by accessing to the WHO-recommended package of effective tools that prevent, diagnose and treat malaria for all people at risk of the disease.
This package of tools which include quality-assured vector control, chemoprevention, diagnostic testing and treatment of confirmed malaria cases can dramatically reduce morbidity and mortality. The metrics of success are reductions in case incidence and in rates of malaria mortality.
As countries approach elimination, enhanced surveillance systems can help ensure that every infection is detected, treated and reported to a national malaria registry. Patients diagnosed with the disease should be treated promptly with effective antimalarial medicines for their own health and to prevent the disease in the community.
In some countries nearing elimination, a high proportion of cases are found among migrant and mobile populations living in hard-to-reach areas, often near international borders. Cases of the disease imported by visitors and migrants must be identified and treated rapidly.
The problem
Nigeria has 25 per cent of the world’s disease burden for malaria and reports more deaths due to this disease than any other country. In Nigeria, malaria is responsible for the deaths of an estimated 300,000 children per year and contributes to over 4,000 maternal deaths annually. It is also the number one cause of absenteeism among workers in Nigeria, resulting in loss of productivity at work and school.
Ninety-seven per cent of Nigerians are at risk from malaria, with an estimated 50 percent of adults suffering at least one episode of the disease a year. Malaria counts for 60 percent of out- patient visit and 30 percent of hospitalisations.
Also, Nigeria is a major exporter of malaria to other countries -45 percent of reported malaria cases in London between 2000 and 2012 occurred due to travel from Nigeria, hence, the requirement of most major international airlines to spray planes with insecticide before departure from Nigeria .
Malaria prevalence varies across the country, with zonal variations with children under five years old.
Macro-economic impact
Speaking on private sector involvement, Dangote said Nigeria loses an estimated US$ 1.1 billion each year due to malaria-related absenteeism and treatment costs. “In addition to direct costs to business and the economy, the disease indirectly damages the economy through the deterioration of human capital and the loss in savings, investments, and tax revenues.
“A healthy population is crucial to driving economic growth. Therefore, given the pervasiveness of malaria in Nigeria, there is a reason to deduce that the disease greatly hinders poverty eradication prospects and strategies in the nation. Compared to other large African economies, Nigeria has a greater macro-economic impact . Nigeria and the Democratic Republic of Congo (DRC) make up nearly half of the world’s malaria burden.
“Reducing the impact of malaria in Nigeria could boost the nation’s economy in several ways. First, good health improves children’s education, as healthy children are able to attend school regularly. Experts say malaria accounts for 15 percent of health- related absenteeism from school in some areas. The effect of malaria on learning and cognitive abilities is also important when considering the disease’s economic impact. Cerebral malaria kills over 100,000 children in Africa each year. Of the children who survive, 10 to 15 per cent are left with some neurological damage. Improved cognitive ability in children, however, is associated with higher earnings and, therefore, potentially stronger economies- in adulthood.
“Malaria also affects economies through its impact on labour and productivity. Healthier workers, like healthier school children, attend work more frequently and are more energetic and creative at their jobs. A one- year increase in life expectancy is thought to boost labour productivity as much as 4 per cent. Moreover, if workers’ communities are healthier, they will need less time to look after sick relatives. According to experts, the value of malaria-related lost production to be between 1 and 5 per cent of Nigeria’s GDP. The service sector bore the brunt of losses, losing 8 per cent of production. Given the increasing importance of the service sector in the growing Nigerian economy, this could be quite detrimental.
“Reducing the impact of malaria could also boost Nigeria’s economy by promoting savings and investment. Experts found circumstantial evidence showing that the eradication of malaria in southern Europe in the 1940s and 1950s spurred economic growth by allowing for a sufficient increase in foreign investment and tourism to the region. For economies to grow, investment- which promotes job creation, higher incomes, and improved technology is essential,” he said.
Another way malaria affects economies is by reinforcing poverty. Its economic impact of malaria, particularly in third world countries, is disproportionately felt by the poor. Many poor families live under housing conditions that afford little protection from mosquitoes. For example, their windows and doors lack nets and are less able to afford protection and treatment than wealthier families.
A national study revealed that malaria fever was more common in Nigerian children who lived in rural areas compared to urban and who were from the lowest income quintile compared to the highest. Drawing from savings or selling off limited assets to pay for malaria treatment may make it more difficult for already impoverished families and individuals to escape poverty. Also, rural families are less likely to have access to health facilities; for example, 66 percent of the rural population live five kilometres of a primary health care center compared to 80 percent of the urban population.
Dangote said, “with 25 percent of the world’s disease burden for malaria, Nigeria has experienced and continues to experience significant financial and human costs as a resul t of this condition. Over 350 billion naira is lost annually in the country due to workplace and school absenteeism as well as high treatment costs. This is hardly surprising as 97 percent of NIgerians are at risk of malaria infection, with 60 percent outpatient visits and 30 percent of hospitalizations due to the disease.it is estimated that approximately 1 to 5 percent of Nigeria’s Gross Domestic Product(GDP) is lost on account of malaria.
“In spite of these dismal statistics, the goal of malaria elimination by 2020 as outlined in the National malaria strategic plan, though ambitious,is achievable through private sector participation. As seen with the recent success in the fight to eradicate polio in the country, leveraging the private sector’s strengths, unique capabilities and reach is instrumental to achieving significant health gains. The private sector already plays a significant role in the Nigerian health industry over 75 percent of health facilities nationwide are private, while 60 per cent of patients seek initial medical care from private providers.
“Therefore, the need for a strong public-private sector collaboration to accelerate the efforts of the national malaria elimination programme (NMEP) towards a malaria – free Nigeria cannot be over – emphasized. This report, a result of detailed research, describe the opportunities, strategies and potential actions through which the private sector can actively engaged in the fight against malaria. It is hoped that such partnership will prevent the further spread of malaria by bridging the significant funding gap and scaling – up coverage of impactful interventions, thus ultimately strengthening the capacity of the nations health care systems to combat malaria.
“I therefore want to call on all stakeholders, healthcare-investors, donors, non governmental organizations, and healthcare providers to renew their commitments to providing support and cooperation for overcoming the malaria scourge and achieving the goal of elimination,.” he added.
Minister of Health, Prof. Isaac Adewole, said, “it is indeed sad to know that malaria is still a leading cause of death for under-five children in Nigeria, snuffing out the lives of about 30 children every 60 minutes and rendering a substantial number of them incapable of effective learning. Our pregnant women are particularly vulnerable to malaria, which increases the probability of poor pregnancy outcomes such as anaemia, miscarriages and low birth weight children.
“The Federal Ministry of Health through the National Malaria Elimination Programme (NMEP), and her Roll Back Malaria (RBM) partners have over the years carried out a lot of activities and provided various interventions such as Long Lasting Insecticidal nets, Rapid Diagnostic Test kits, Artemisinin-based combination therapy and Sulphadoxine Pyremethemine (SP) for our pregnant women, aimed at controlling malaria in the country. It is sad to note that Malaria though preventable, easily treatable and curable, still continues to be a major public health problem and constitutes a major barrier to social and economic development. This we must together fight against.
“Malaria has undoubtedly transcended from a public health problem to a developmental concern. Malaria makes people physically miserable and reduces productivity. It has perpetually ravaged our communities, making poor people poorer. It lowers GDP and retards economic growth. Unless malaria is tackled, the five key Sustainable Development Goals (SDGs) on Ending poverty, ensuring healthy lives and well being of all ages, inclusive and equitable quality education, economic growth and productivity and the eradication of hunger may not be achieved.
“At the community and household levels, we see malaria not only affecting poor people but also contributing to poverty through imposition of a heavy ‘disease tax’ burden. Globally, there is an increasing demand by the development partners for domestic funding for malaria. In order to achieve this, the public-private partnership becomes crucial and needs to be properly coordinated in order to harness the needed resources.
“Eliminating malaria : Engaging the private sector document will act as a roadmap. It will serve to specify actions which the private sector can support in the fight to eliminate malaria in our country. I must recognize the invaluable contributions of all malaria stakeholders in its development. I want to particularly thank the Malaria Ambassador, Alhaji Aliko Dangote for his unalloyed commitment to malaria elimination in Nigeria.
“There is much to be done in the fight against malaria as it requires a multi-pronged approach to be able to curb its menace. I am confident that we can collectively work to achieve the objective, thereby preventing our people from dying from the malaria scourge. I quite appreciate the private sector and I call on you all to join me in making Nigeria a malaria- free nation,” he said.
Small amount of salt essential for good health
By Chukwunyere Akunna
Small amounts of salt are essential for our health.Adults need less than 1 gram per day and children need even less.As a nation, we are all eating approximately 8.1g of salt per day,far more than we need and more than the recommended maximum of 6g per day. It puts us at risk of these health problems.
Importance of salt to the body
1. Salt helps regulate the water content of the body.
2. It helps relieve stress symptoms.
3. It helps in the removal of acidity from brain cells.
4. It helps the kidney to function correctly.
5. It helps the digestive system to properly absorb the food we eat.
6. When taken with water before exercising,it helps you breathe better and sweat less.
7. It helps to bring down the blood sugar level and reduce the need for insulin for diabetic patients.
8. It also helps when having erection problems.
9. It helps our bones to be hard.
10. It helps our body maintain the proper stomach PH.
11. It also helps improve sleep quality.
Health risks and diseases related to excess salt intake
Asthma : A high salt diet is not thought to cause asthma,but studies have shown that it can aggravate symptoms.
Coronary heart disease: CHD is the term used to describe what happens when the heart’s blood supply is reduced or blocked leading to heart failure and attacks.
Stomach cancer : A high salt diet increases the risk of stomach cancer.salt can damage the lining of the stomach, men are at a higher risk than women for stomach cancer.
Blood pressure : Certain factors such as being over-weight, lack of exercises, and in particular, a high salt diet can raise your blood pressure .
Osteoporosis : It is a condition which causes thinning of bones,making them brittle and prone to breaking. Most calcium in the body is stored in bones.A high salt intake can cause calcium to be lost from bones and excreted in the urine.
Tips to reduction of salt intake
1. Use fresh instead of packaged meats,pork.
2. Choose fresh fruits and vegetables.
3.Select spices or seasoning that do not list sodium content.
4. Beware of products that do not taste especially salty but still have high sodium content such as cottage cheese.
5. Prepare your own meals (and limit the salt in recipe).
6.Rinse canned foods before usage.
7. Avoid adding salt to foods already dished.
8. If you would need to use salt while cooking add it at the end,you will need less.
People who are at high risk of developing problems related to salt
1. People over age 50.
2. People who have diabetes.
3. People who have high/ slightly elevated blood pressure.
Things your nails reveal about your health
By Chinenye Molokwu
I was told when i was a very young child by my grandmother that a person can tell a lot about you by your hands, and that they can often be a person’s first impression of you. I really took this to heart, making sure that my nails were as close to perfection as i could get them, with no annoying hang nails or crooked edges.
However, some things that may be going on with our nails may be a bit bigger than having a good manicure or remembering not to peel off your nail polish. Some things may be indications that other more serious things could be going on within our bodies. Let’s take a look at some indications that we may want to see a doctor.
Thick nails
Most people just assume that hard, thick nails are typically caused by some sort of fungus that has grown deep beneath the bed of the nail, and this can be very true, especially in the toe nails.
However, keep in mind that there are plenty of other reasons to see thickened nails when peering down at your hands.
One cause of this can be several forms of psoriasis. While it typically manifests on the skin, it may also affect the nails, causing them to be thick and almost rough. Thick, brittle nails can also be a side effect of diabetes.
Yellow nails
If your nails seem to look healthy in other aspects but a little yellow to you, don’t just assume that this is caused by your nail polish or the remover. Some people even believe that discolouration can be caused by constantly wearing polish. A yellowing of the nails can, however, indicate a type of infection. Learning a bit more to the serious end, yellow nails, along with frequent urination and some tiredness, could be a side effect of diabetes. When this occurs, glucose attaches itself to the nails, taking away the usual pink colour and replacing it with a yellow hue. Smoking can also cause yellowed nails.
White spots and scrapes
Leukonychia are the small white spots and scrape-like marks that show up occasionally on our fingernails.
Sometimes they are caused merely by scrapes and scuffs that are made when manicuring, such as when filing or removing nail polish, or by hitting our nails up against other objects on accidents. However, they can also show allergic reactions, as well as many types of infection that can occur throughout the body. But more than likely, the small white spots indicate a type of deficiency, most often calcium-based or vitamin B12. They can also be a sign of a type of kidney or liver disease.
Darkened nails
Sure. Sometimes we bang our hands up against something or swing down a hammer a little too close to our fingers, creating what looks like an angry bruise on our fingernails. But other times, when we know we haven’t injured our fingernails in some other way, we must look to other health reasons for why our nails are developing these dark spots.
Typically, these spots occur due to too much melanin, or they can also be caused by fungus underneath the nail. However, they can also be an indication of melanoma, a serious type of skin cancer, psoriasis and a myriad of infections.
White nails
Our fingernails should be a healthy pink, quite close to the rosy color of a pig’s snout. If your nails tend to be way more of a white hue than anywhere close to a color that resembles pink, then you may want to see if you have any type of infection within your body. If nothing is found, and if your skin might also be looking a little jaundiced or yellowed, then you should definitely make an appointment to see your physician , as this could be a sign of a form of liver disease, which is usually also accompanied by a tired, lethargic feeling.
Lumpy nails
Nails that have grooves and something even resembling pits that go deep into the nail can sometimes just be one of the many signs of ageing, and may not be much to worry about. But sometimes our nails are trying to tell us something more serious and, if other causes cannot be discovered, we should consult with a doctor. Sometimes these lumps are created by very serious psoriasis.
These grooves are made when thin portions of the nail itself begin to peel away. This puts a stop to healthy nail growth, making it very hard for the nails to return to their normal smooth feel.