Rasak Musbau,
In spite of the huge amount that government, both at the federal and state levels, spends on the provision of curative drugs with the support from the Global Fund, malaria has remained endemic in Nigeria. Indeed, it is impossible to calculate the actual harm malaria has done to us. The malaria parasite has been sapping the strength of the whole population.
It impairs the health of our people and consequently restrains economic development. It leads to loss of productive hours, productivity, money, persistent absenteeism and maternal and child mortality among others. For Nigeria to move forward, we really have to get rid of malaria just as we need to do with similar preventable diseases such as measles, diarrhea and tuberculosis. The question here is: since malaria is a preventable disease, why is it so endemic to the extent that our country alone bears about 25 per cent of Africa’s malaria burden? The answers are simple and straightforward.
In Nigeria, one of the essential family practices that most Nigerians are found wanting in is sufficient protection from mosquito bites. Two, most illnesses, including malaria, are treated at home or in the community before or without seeking care at a formal health facility. Added to these are our coastal environment, poor environmental sanitation and improper diagnoses. In many places, hospitals don’t do a proper check. Anyone with the minutest symptoms of malaria is often offered treatment without a proper diagnosis. The consequence of this is that while a growing number of countries have recorded a decrease in the number of confirmed cases of malaria, the disease has remained a scourge in Nigeria.
As such, it is crucial for everyone to be aware of and adhere to essential family practices to promote mosquito control and prevention. You can’t contract malaria if you aren’t bitten by mosquitoes, and the type of mosquitoes that transmits malaria usually bites at night. For this reason, it is important to sleep every night inside a long-lasting insecticide-treated bed net. Long-lasting bed net is a tool that is most associated with the recent progress against malaria.
Another way is for people to be ensuring that all windows and doors are properly screened to prevent mosquitoes from coming in. Many people also do something called “indoor residual spraying” where they spray insecticide on the walls inside their house to kill any mosquito which may come in.
It is equally advisable for those who frequently have malaria attack to wear long-sleeved clothing in the evenings and at night to stop mosquitoes from biting them. Furthermore, it is important to make sure that one is diagnosed properly. People need to be aware that having symptoms of fatigue, weakness, nausea and cold which are very typical of malaria is not enough to conclude it is malaria, thereby resorting to self-medication without visiting a health facility for proper diagnosis and treatment.
The World Health Organisation recommends that anyone suspected of having malaria should receive diagnosis and treatment with an effective drug within 24 hours of the onset of symptoms. It is only when a sick person cannot have access to a health care provider within that timeframe that home treatment is acceptable as first aid.
Moreover, in Nigeria, you should NOT be given Chloroquine to treat malaria, unless your case is confirmed as not being caused by plasmodium falciparum. Virtually all the plasmodium falciparum in Africa is resistant to Chloroquine, and so it is no longer an effective treatment. Instead, first-line treatment for malaria is recommended as an Artemisinin-based Combination Therapy. However, the truth is that whether the malaria map will keep shrinking, as it has in the past decade, or be reclaimed by the malaria parasites, depends, to a great extent, on the resources that will be invested in control efforts over the next few years.
Thanks to malaria elimination efforts in the United States in the 1940s, most people in the US today have never had any direct contact with the disease, and most doctors have never seen a case. That success means other nations including Nigeria can also achieve reduction or complete elimination with the right investment and positive attitude. In this direction, the Lagos State Government’s investment in malaria control has progressed appreciably with lots of steps taken to clinically stamp out the prevalence of malaria and its parasites. The topography and ecological features of the state, the abundant coastal features, rapid urbanisation and inadequate drainage systems are some of the major factors that contribute to all-year transmission of malaria in the state. But the state through its Directorate of Disease Control is doing all it can to invest heavily towards reducing the burden of the disease.
Investments in malaria control in the state have created unprecedented momentum and yielded remarkable returns in the past years, particularly in the scale-up of insecticide treated nets, indoor residual spraying of insecticides, and prevention of malaria during pregnancy.
The goal of the Lagos State Malaria Elimination Programme is to significantly reduce the burden of disease consequent upon malaria. The activities of the Malaria Control Unit are carried out in collaboration with the Lagos State Malaria Research, Technical and Advisory Committee which is chaired by the commissioner and includes all partners – donors, researchers and NGOs in the state.
Musbau writes from Ikeja, Lagos
