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Experts, Studies Link Poverty, Net Misuse to Malaria Surge In Sub-Sahara Africa

  • Expert says poverty and  mosquito treated nets misuse are biggest incentive to malaria surge
  • Nigeria accounts for 25% malaria cases worldwide

Isaiah Onwuanumba:

Malaria surge in Nigeria and other sub-Sahara Africa in spite of heavily funded mosquito treated net is strong indication that the protective barrier against the insect bite is abandoned or misused the, according to experts and available studies.

Speaking exclusively today in Lagos, President, Malaria Society of Nigeria, Dr Babajide Puddicombe said people abandon mosquito nets as it is unbearable and frustrating to sleep inside it especially in a country where power supply is poor.

 “Telling people to sleep inside treated net where there is no electricity is waste of time. No matter the efforts to make treated nets available to the population, it would amount to nothing,” he said, adding, “because of heat, is irritating to the skin. There are issues of ventilation in poorly layout houses.”

According to Puddicombe, government’s inability to provide electricity and conducive environment to use distributed mosquito net is the biggest disincentive to its use and contributes to increased case of malaria.

He added that “large population of the country is rural and poor. They cannot provide comfortable sleeping homes to use treated nets”. “Even though people are willing to use the net, the fact that it very inconveniencing discourages people from using net,” he added.

World Health Orgnisation (WHO) revealed that over 7.3 million long lasting insecticide treated nets were distributed in Taraba and Kaduna states alone in 2019 and Nigeria has distributed 51,703,880 Long Lasting Insecticide Nets in recent years. Again, US President’s Malaria Initiative (PMI) budget for Nigeria is $65 million for 2019 alone. There are also interventions from Non Governmental Organisations (NGOs), tiers of government across levels in the country.

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In spite of these, a  September 2019 Study revealed that ten countries currently account for two-thirds of global cases, and the top two alone, Nigeria and the Democratic Republic of the Congo, account for 36%. It added that Nigeria alone accounts for 25% malaria cases in the world. Again, Nigeria is among the 29 countries—all in Africa except Papua New Guinea and the Solomon Islands—with high rates of transmission, reporting more than 100 cases per 1000 population and accounting for 85% of total malaria deaths.

Recent data from two Nigeria Malaria Indicator Surveys (NMIS) show “ownership of at least one insecticide-treated nets in a household increased substantially from 8 percent nationally. The average number of insecticide-treated nets per household doubled from 0.8 to 1.6. From December 2013 to May 2018, the National Malaria Elimination Program distributed more than 72 million insecticide-treated nets through mass campaigns, including over 35.7 million insecticide-treated nets in support states to ensure universal coverage, defined as one insecticide-treated nets for every two persons. However, these efforts have not translated into increased insecticide-treated nets use in the country.

Lagos-based physician, Dr Tosin Olowojebutu, Medical Director of Liberty-Life Hospital, said “the national malaria positive rate either by rapid diagnostic test (RDT) or by microscopy is still above 32 per cent,” adding, RDT now detects malaria more by between 20 per cent and 67 per cent than microscopy across Nigeria.

“RDT detects parasite antigens, while microscopy detects the parasite at different stages of its life cycle in the red blood cell,” he said.

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Nigeria, according to the National Malaria Strategic Plan (2014-2020), malaria is responsible for 60% of outpatient visits to health facilities, 30% of childhood death, 25% of death in children below one year of age, and 11% of maternal death.

However, experts are upbeat Nigeria can over malaria. Dr. Osahon Enabulele, a consultant surgeon and associated professor at University of Benin Teaching Hospital (UBTH), Nigeria, said in a speech during World Malaria Day that “with continued commitment from States and Federal Governments as well as external partners, we are convinced that a national scale of malaria control interventions to protect Nigerians and the world from malaria is achievable”, adding, “malaria is one diseases that can be eliminated.”

Report revealed that momentum towards eradication has been building for decades, and more than half of the world’s countries are now malaria free. Annual domestic and international spending on malaria increased from roughly US$1•5 billion to $4•3 billion in recent four years. At the same time, the number of countries with endemic malaria dropped from 106 to 86, the worldwide annual incidence rate of malaria declined by 36%, and the annual death rate declined by 60%.

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