Home-grown solution for malaria eradication
Is this tropical disease called malaria becoming untreatable? Why is the resistance-to-treatment level growing? These are relevant questions even ordinary people would want indigenous researchers on this scourge to answer with home-grown solution sooner than later. The main reason for this urgency is that the common tropical disease is becoming more and more ticklish.
Malaria, a tropical disease is caused by the presence of plasmodium falciparum in the blood and usually contracted from the bites of an infected female anopheles mosquito. The disease is endemic in about 40 per cent of the world population. It is nearly five times more than the reported cases of tuberculosis, AIDS, measles and leprosy combined. One new case is contracted every 10 seconds and two deaths recorded per minute.
The dreaded disease is responsible for the intolerable cases of morbidity, mortality and impairment of economic development. In fact, it is ranked globally as the third leading cause of death; and children under five years and expectant mothers are its major victims. Africa’s contributions to this global burden are 60 per cent of morbidity and 80 per cent of mortality, while Sub-Saharan Africa bears the highest burden of the disease and deaths from Malaria. In Nigeria, nine out of 10 persons are at risk; while about 66 per cent of all clinical attendance is due to the killer disease.
According to National Malaria Elimination Programme (NMEP), 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 the world. 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 in Nigeria, resulting in loss in productivity at work and school. The NMEP reports that 97 per cent of Nigerians are at risk from malaria, with an estimated 50 per cent of adults suffering at least one episode of the disease a year. Malaria counts for 60 per cent of out-patient visits and 30 per cent of hospitalisations. Obviously, Nigeria has a heavy burden of malaria, but sadly not in charge of the disease!
More worrisome is the fact that recently, scientists have raised fresh alert to the rapid spread of ‘super malaria’ in South East Asia, which they say poses a global threat to efforts to eliminate the mosquito-borne disease. They fear that this dangerous form of the malaria parasite has become untreatable with the World Health Organisation (WHO) recommended drug-of-choice, Artemisinin-based Combination Therapy (ACT).
The fear is palpable in Nigeria and indeed Africa where resistance to the drugs would be catastrophic, since 92 per cent of all malaria cases happen in the continent. Although, National Malaria Elimination Programme (NMEP), said the other day that malaria resistance in Nigeria and many parts of West Africa has not been documented. Notwithstanding, there may have been few reported cases of delayed parasite clearance in some other parts of Africa, but certainly not resistance. Also, the Nigeria Institute of Medical Research (NIMR) had in June 2017 raised alarm over the increasing incidence of mosquito resistance to Long Lasting Insecticide Nets (LLINs) in 18 states of the federation, even as over 50 million Nigerians still test positive to malaria annually.
To contain malaria, World Health Organization (WHO) launched the Roll-Back-Malaria initiative in May 1998 as part of its recommended interventions. The-Roll-Back-Malaria mechanism is for prompt and effective treatment of malaria with Artemisinin-Based Combination, home management of malaria using Artemisinin Combination Therapy (ACT), prevention of malaria in pregnancy using medication and long-lasting insecticidal net (LLIN), integrated vector management with the use of LLIN, indoor residual spraying, larviciding and environmental management as well as control through intensive media campaign and community mobilisation.
Economically, Nigeria loses billions of naira each year to the treatment of malaria and the money goes back to foreign countries given the fact that Nigeria is import-dependent on pharmaceuticals. Malaria is also the commonest cause of absenteeism from schools, offices, markets and farms. Furthermore, it reduces by one per cent the country’s yearly gross domestic product (GDP), while families spend 25 per cent of their incomes on treatment of malaria yearly. What is more, the emotional pains caused by loss of loved ones to malaria cannot be under-estimated. Also, the money spent on malaria treatment is further impoverishing Nigerians leading to a decline in what families have to spend on other basic necessities of life especially nutrition. This may lead to low immunity from diseases.
While the Roll Back Malaria initiative is laudable as a practical approach that alleviates malaria, but the mechanism may not eradicate the unyielding plasmodium falciparum as there are records of deaths from overdose ignorantly administered by some people. Also, the reduction in grammage of the active ingredients of drugs used for treatment of malaria by some unethical manufacturers in connivance with marketers and non-compliance with dosage administration have reduced their efficacy leading to delayed parasite clearance in the country.
Furthermore, Nigeria is conducive for the parasite to thrive – the hot temperature, and drainages and gutters that are not fumigated. So, no matter the amount of money spent on drugs and mosquito nets, which people cannot wear to work or while at home, the battle against malaria eradication will be a lost one.
It is indeed shameful that malaria has not been eradicated from Nigeria 500 years after a man died of malaria in the country. Therefore, eradication of malaria requires a strategic approach. As such, Nigeria should look inward for pharmaceuticals by setting up a National Malaria and Research Control Centre for afro-centric research and fund researches to mainstreaming local herbal solutions, which would be cheaper and readily available. The Western countries eradicated malaria with DDT and Nigeria can push for a trans-West African effort in vector control, using DDT insecticide to fumigate the entire sub-region because if Nigeria does it alone, the mosquitoes would regroup.
Also, research has shown that paint can be used to repel mosquitoes for a period of about two years, meaning that using chemical products can keep them away temporarily. Ipso facto, Nigeria can learn from the use of sustainable home grown solutions as in Ethiopia and Western Kenya, where studies have also shown the use of mosquito repellent plants in and around residential areas, which also beautify the environment and freshen the air for malaria control.
Therefore, home-grown solution is doable because through food fortification, iodine and vitamin A deficiencies are being addressed. Hence, we call for more ingenious and sustainable complementary solutions towards the eradication of malaria from Nigeria. This is achievable with improved research and development and having a five – 10 year plan for the eradication of the disease. These are realistic goals if our leaders at all levels have the political will to do the needful.
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