Winning The War Against Malaria

The war against mosquitoes and by extension, malaria, rages on in most Nigerian homes. It is daily fought through the use of insecticides, mosquito nets and the clearing of surroundings.

Quite often, medical experts allude to the increasing resistance of the malaria parasite to some drugs available in the markets.

For expectant mothers and children especially, malaria is a perennial nightmare, just as it is a scare to the entire humanity.

It is salutary, however, that malaria is fast losing its grip on many communities in Nigeria, such as Lere Community in Kaduna State, courtesy of the Long-lasting Insecticide-treated Mosquito Nets (LLINs), fondly called the “magic” nets.

Malam Hassan, who lives in Lere community with his family of three wives and several children, was among several citizens whose households benefitted from the distribution of LLINs in June, last year.

Nine months after, Hassan’s family members, as well as others in Lere now appear much more radiant, going by their physical looks. It is obvious that the scourge of malaria in the community has subsided, thus boosting the people’s health.

Officials say that thousands of LLINs were distributed to households, especially to mothers and children, who have used them “continuously, consistently and correctly”.

“It works like magic,” says 45-year-old Katume, the eldest of the three wives of Hassan, who shared her perspective on the efficacy of the LLINs.

“Since we started the use of the nets, neither me nor my children; neither the other wives nor their children have visited hospitals for malaria, except for other ailments.

“Our husband now has ample time to devote his attention to other issues, while our children now attend school more regularly,’’ Katume says.

Katume has good reasons to be elated. Since they started using LLINs, she and all members of her household are no longer regular patients at the Lere Health Centre, adjacent to their home.

They have also been lucky that no members of the family died from malaria in those days without LLINs.

However, Bala, another resident of the community, had not been as lucky, as he lost two children to the scourge of malaria.

“I lost two of my daughters to malaria two years ago,’’ says Bala, 52, and a father of eight.

Now that he personally directs the religious use of LLINs in his home; Bala vows that “never again will malaria gain a foothold on my family members”.

Last June, Japan International Corporation Agency (JICA), through UNICEF, provided 150,000 bed nets to the Lere community for use by all young children and pregnant women in over 124,000 households, to protect them from mosquitoes.

The gesture was part of Japan’s development support for Nigeria in many spheres, which runs into several millions of dollars.

So far, UNICEF is optimistic that the strategy to reduce malaria prevalence by 80 per cent in Nigeria may succeed, going by signs from Lere.

A survey conducted by UNICEF officials showed that the community’s bed net hanging rate now stood at 85 per cent, while 92 per cent of pregnant women and children below five years, now slept under their LLINs.

Alhaji Isa Ahmed, the officer-in-charge of Lere Health Facility, corroborates the survey’s findings, saying that a 90-per-cent distribution of the bed nets has been achieved in the community.

“Before the use of the nets, we treated an average of 100 malaria patients every week in any particular health facility but now, it is just four and they are mainly adult males, who are not covered by the distribution of nets.

“This feat was achieved through correct use of the nets. Anti-malaria drugs for treatment are just lying unused in all the five health facilities in the community because they are not needed,” he says.

Ahmed points out that those health institutions in the area will now focus their energy on other urgent health areas, while the services of town criers and traditional rulers will continue to be engaged, so as to sustain the people’s mobilisation to use LLINs.

Ahmed says that the gains of the programme will be consolidated upon through the citizens’ mobilisation to clean their surroundings to forestall breeding grounds for mosquitoes.

Ahmed adds that reduced incidence of malaria among the people will enhance productivity in the community, whose population comprises civil servants and farmers.

He, nonetheless, stresses the need to change the nets periodically, while distribution coverage of the nets should be extended to the males.

“We want the nets re-treated or changed periodically, where possible; we want male adults to be covered in the next distribution phase, so as to keep mosquitoes and malaria out of our community forever,’’ Ahmed says.

For Alhaji Umaru Muhammed, the District Head of Lere community, his joy knows no bounds over the success of the anti-malaria programme.

Umaru, who is a retired civil servant, says: “We are very grateful for this gesture; we appeal that government should not be too far from us. They should include the men in the next distribution phase.”

The community leader is happy that members of his household now suffer less from malaria and pledges to make personal efforts to sustain the campaign on the use of LLINs.

“I have experienced reduced problem of malaria in my home and we will sustain the high tempo of the awareness campaign in mosques and through town criers,’’ he says.

No doubt, malaria remains a major public health concern in Nigeria, as an estimated 300,000 children under the age of five still die from the disease annually.

Official statistics also indicate that up to 11 per cent of maternal mortality is caused by malaria, translating into one in every four deaths of children and one in every 10 deaths of expectant mothers.

Health analysts express the viewpoints that many lives can be saved if all children under five years, as well as all pregnant women are encouraged to sleep under LLINs, generally described as “simple and cost-effective”.

One of the UN Millennium Development Goals (MDGs) aims at halting and reversing malaria prevalence in 2015 via the provision of LLINs and more efficacious anti-malaria drugs.

In combating malaria effectively, the World Health Organisation (WHO) adopts three main strategies. These are prevention with LLINs; prevention with indoor residual spraying; and rapid treatment with effective anti-malaria medicines.

WHO further recommends a special focus on pregnant women and young children in the fight against malaria.

Observers are optimistic that the target of WHO and the Roll-Back Malaria Programme to cut down malaria’s prevalence by half in 2010, will be a good march toward achieving the MDG target of 2015.

It is noteworthy that Nigeria is not relenting in the war against malaria and part of its strategy is to distribute and ensure the use of 63 million LLINs to 32 million households in all 36 states and Abuja, the Federal Capital Territory (FCT).

Partners rallied by government in the ongoing efforts include UNICEF, which is expected to distribute 6.5 million nets, all in an effort to achieve 80 per cent coverage of expectant mothers and children below five years.

By experts’ analysis, the scope of Nigeria’s current LLINs distribution is the largest in history and anywhere in the world.

Dr Babajide Coker, the Coordinator, Roll Back Malaria (RBM) Programme in Nigeria, says that the Federal Government has spent N26 billion since 2009 on the procurement and distribution of 29 million insecticide-treated nets to 17 states.

He says that Lagos, Enugu, Kwara, Yobe, Borno and the FCT, not previously covered in the distribution, will benefit in the next phase that is expected to start soon.

Coker describes as “robust” the country’s partnership with international agencies involved in the anti-malaria programme.

“The Global Fund provides the major support as it covers 25 states; World Bank has seven states, while the Federal Government, through the Office of the MDGs, covers only five states in all.

“Plans are underway to make the coverage universal and not limited to only those at risk of malaria.

“The purpose of bed net distribution is to help in the reduction of maternal mortality and morbidity rate as contained in the MDGs 4, 5, and 6 and so far, we are on course,’’ Coker stresses.

No doubt, the strides so far attained by Nigeria are fundamental, although a lot more still remains to be done to completely eradicate the scourge of malaria in the country.

Ponle writes for News Agency of Nigeria.

Buki Ponle