Fight against Malaria: Insecticidal nets and cross-border infections

In January this year President Kagame received on behalf of Rwanda the prestigious 2012 African Leaders Malaria Alliance (ALMA) award. Rwanda was among the seven African countries to receive the Excellence Award for ‘exemplary leadership in accelerating and sustaining access to malaria control and treatment’.

In his acceptance speech, President Kagame noted that the reduction of malaria is a result of the numerous efforts geared towards improving the welfare of the Rwandan people. The battle against Malaria in the country was characterized by massive distribution of insecticide treated bed nets, indoor residual spraying and a combination of therapies.

But recently remarks were made by the Ministry of Health has warned that the current strategies used for prevention and fight against malaria might end up not helping if the communities are not involved in the fight.

Dr John Githure, the Advisor on Malaria related issues in the Ministry of Health and USAID contractor, says mosquitoes have become resistant to pyrethrum drugs used for the indoor residue spray.

“The mosquitoes have now resorted to biting humans during day and hanging out in the night and they continue to survive,” said Githure.

The team of health officials now wants the communities to be mobilized through the month community services the Muganda on the importance of environment management, especially on water bodies, because they are the major habitats for the mosquitoes.

“Although the Ministry of Health has been custodian to vector control program, there is need for collaboration with other ministries, like Ministry of Agriculture, to sensitize farmers” said Dr Githure.

He added that there had also been lack of collaboration even among the departments in the ministry of health.

The strategic plan will not only deal with malaria but also other vector born diseases like yellow fever, trypanasomiasis or sleeping sickness, among others.

Meanwhile, the ministry is also worried of the cross- border infection that is said to be on the increase, and has announced plans to mobilize their counterparts in neighbouring countries to adopt the same measure of vector control.

Mobile community health workers at the Rukara Health Facility in Rwanda.

The official says although there has been a decline in the prevalence of malaria in various parts of the country, border districts still register many cases of malaria due to cross border movement.

The Head of Malaria and Other Parasitic Diseases Division at the Rwanda Biomedical Centre (RBC), Dr Corine Karema, says the ministry is targeting a five percent reduction of infection from the current 15 percent.

She also allayed fears that there could be fake drugs on the market following recent reports. A recent study carried out by the Fogarty International Centre at the US National Institute of Health (NIH) in Bethesda, Maryland, stated that more than a third of malaria drugs analysed by scientists in Africa were below standard.

“All the drugs that are being used in the treating malaria in this country are hundred per cent genuine,” said Karema.

In Rwanda, the recent scaling up of interventions has made significant reductions in morbidity by 87 percent from 1,669,614 malaria cases in 2005 to 212,200 cases in 2011 and reduced mortality by 76 percen,t from 1,582 deaths in 2005 to 380 death in 2011, largely attributed to the increased coverage and use of long lasting insecticidal nets (LLINs).

According to the 2010 DHS results, “82 percent of the population have at least one LLIN, and 72 percent of pregnant women and 70 percent of children under-five years were using bed nets.”

Key facts

  • Malaria is a life-threatening disease caused by parasites that are transmitted to people through the bites of infected mosquitoes.
  • In 2010, malaria caused an estimated 655 000 deaths (with an uncertainty range of 537 000 to 907 000), mostly among African children.
  • Malaria is preventable and curable.
  • Increased malaria prevention and control measures are dramatically reducing the malaria burden in many places.
  • Non-immune travellers from malaria-free areas are very vulnerable to the disease when they get infected.
Source: Evaline Namuwaya (The New Times, 09.06.12: “New Anti-Malaria Strategy launched”),

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