Malaria and the cost of a mosquito bite

malaria

Malaria madness is a custom incentive program within Peace Corps to help fuel volunteers to promote and increase malaria prevention programs, health talks, net checks, and village participation into reducing malaria in Africa and especially in our specific provinces in Zambia.

This year and last year in March, we have worked hard to win as a province to win more points in each program. This year, I have done health talks in every public area and facility but also net checks of homes and distribution of nets.

Here is some information that can help you understand the problem and seriousness of malaria, brought to you by UNICEF.

Key Statistics

•  Of all people who die from malaria in Zambia, 50 percent or more are children under 5 years of age;
•  50 percent of under-5 hospital admissions are due to malaria;
•  Malaria accounts for 20 percent of maternal deaths.

Background

Though Zambia has made strides in malaria prevention and control in the last five years, it still kills more children under the age of five than any other disease or illness. Malaria affects more than 4 million Zambians annually, accounting for approximately 30 percent of outpatient visits and resulting in almost 8,000 deaths each year.  Under five-year-old children and pregnant women are the most vulnerable, especially those in more remote and impoverished areas, with 35-50 percent of under-five mortality and 20 percent of maternal mortality attributable to malaria.

Combating malaria is vitally important in the battle to save young lives and protect children from losing their mothers.

Malaria is both preventable and treatable, but it is a complicated disease whose prevention and control requires multiple interventions. Preventing malaria requires creating a malaria-free environment, which means spraying the inner walls of populated structures (homes, schools, hospitals, businesses, and other institutions) with insecticides and always sleeping under insecticide-treated nets (ITNs). Other measures include environmental control to prevent the development of mosquito breeding grounds.

For those for whom prevention measures fail, prompt and effective treatment is imperative. Treatment begins with recognizing the symptoms of malaria, seeking treatment immediately at the onset of illness, and having access to community or facility based health care workers who have the knowledge to treat malaria at its various stages.

Issue

Malaria prevention and treatment is expensive. Only over the last 5 years, as a result of partnership between the Government of the Republic of Zambia (GRZ), UNICEF, the World Health Organization, the President’s Malaria Initiative, the Bill and Melinda Gates Foundation, the World Bank, and other partners has affordable ITNs been made widely available. In the past, nets were financially out-of-reach for poor Zambians, costing upwards of US$12 each. Free distribution and highly subsidized nets are now widely available, but need still outstrips supply. Currently 64 percent of households in Zambia own at least one ITN.

Drugs for the treatment of malaria are constantly evolving and improving. The new and improved medications are more costly and many hospitals and clinics face challenges in supply and logistics management. Despite having Global Fund and other approved resources for procurement of anti-malarial medications, occasional stock outs occur due to lapses in the supply chain. Further prior to 2006, most cases of malaria in Zambia didn’t get a confirmed laboratory diagnosis, as the capacity for diagnosis was low. In the last five years, the Ministry of Health and partners have introduced new diagnostic technology-rapid diagnostic test (RDTs), which can be used in remote rural districts where microscopic diagnosis is impractical.

Poor health seeking behavior among communities is another challenge related to low awareness about malaria. Mothers and caregivers sometimes do not recognize the signs of malaria in infants or they seek other types of treatment from traditional healers. While user fees for basic health services have been removed in rural areas of Zambia where the poorest children and families live, communities still face the dilemma of indirect health costs  such as for transportation among others and hence delays in seeking care.

Action

In partnership with the Government and under the National Malaria Control Programme, UNICEF supports a variety of interventions aimed at mitigating the impact of malaria on children and women. ITNs are periodically mass distributed at no cost to recipient households, while highly subsidized low-cost ITNs (costing less than US$1) are available at antenatal clinics for pregnant women and children under the age of five. Free nationwide provision of intermittent presumptive treatment (IPTp) allows pregnant women to receive at least three doses of Fansidar to protect them from malaria during pregnancy.

UNICEF also supports the Integrated Management of Childhood Illnesses (IMCI) programme, which aims to reduce child illnesses and deaths by focusing on the greatest threats to child survival. IMCI addresses the multiple layers of newborn and child health care by ensuring that common diseases like pneumonia, malaria, HIV, and malnutrition are treated at every level, from households to Government hospitals. IMCI stresses training for healthcare workers in the aggressive treatment of common childhood illnesses within the first 24 hours of its onset and helps train mothers and caregivers in household management of common childhood illnesses, malaria included.

Impact

• Significant progress has been made in malaria control with increases in access to treatment, ITN ownership and utilization, indoor spraying, and public education.
• Zambia passed the Roll Back Malaria target of reducing malaria mortality by half between 2000 to 2010.
• Zambia was among the first two countries in the region to programmatically introduce the new dispersible formulation of first-line anti-malarial drug Artemether-Lumefantrine (Coartem®) suitable for under five children in the weight range 5 to 35 kg.
• The percentage of households with at least one ITN increased from 38 percent to 64 percent between 2006 and 2010.
• Percentage of children ages 0–59 months who slept under ITNs increased from 24 percent in 2006 to 50 percent between 2006 and 2010.
• Percentage of pregnant women who sleep under an ITN increased from 24 percent in 2006 to 50 percent between 2006 and 2010.
• Further, 89 percent of pregnant women received at least one dose of malaria preventive medicine and more than 70 percent received two or more doses.

How Malaria spreads from people and forms inside the body is something I have  been trying to teach as people in my village believe that mangoes bring mosquitoes or the green maize that grows in fields or witches bring it to children and people they have cursed.

 

Malaria is important to Peace Corps volunteers and an incredible way to continue preventing it is teach, teach, teach.

  1. about the disease
  2. about the course of treatment and importance of finishing the treatment to prevent resistance
  3. about the high risk populations
  4. and the use of nets and spraying of homes and buildings to continue prevention and stop malaria

Malaria can be prevented and it is important to continue spreading the knowledge to make sure we keep up the good work, Central Province!! And you can help too!

 

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