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Thursday, 30 April 2015

World Malaria Day: Beyond Mosquito Nets Distribution

Mother and child under mosquito treated net

Nigerians continue to shun the use of mosquito-treated nets, despite the prevalence of malaria scourge in the country, writes Martins Ifijeh
With the target set by United Nation that by 2015, Nigeria will be free from malaria if the estimated 60 million long lasting insecticide treated nets (LLITN) projected to be distributed across the country are actually judiciously distributed, it has unfortunately not achieved the set goal even with the statistics from the Federal Ministry of Health, Abuja, showing that over 60 million LLITN have been distributed across every nuke and cranny of the country since 2009 till date.

Despite the various awareness campaigns carried out by both the government, health bodies and corporate organisations in the country, malaria has unfortunately continued to ravage Nigerians with children under age 5 and pregnant women most hit by the scourge, while its incidence level is continually increasing every year with no significant drop in the number of deaths recorded in the country.
Available information suggests that the various efforts to curb the menace in the country has however been undermined with the underutilization of the mosquito nets been distributed across the country.
Judicious use of the insecticide treated nets have been scientifically proven to prevent mosquito bites thereby preventing malaria which results when an anopheles mosquito infects a human, hence causing malaria.
As Nigeria, April 25th joined the rest of the world to mark this years World Malaria Day with the theme “Invest in the Future, Defeat Malaria,” investigations revealed that majority of Nigerians are unprepared to defeat the scourge as those with these mosquito nets do not sleep under them or do not rid their environment of stagnated water where mosquito broods.
For instance, a hair stylist who lives in Lagos, Mrs Rose Agabi, said since this year, she has so far been given two LLITN at different fora, but unfortunately she has never used them either to protect her children or herself.
According to her, she said, “I don’t feel free using the nets because I learnt it contains chemicals which repel mosquitoes, but how can I sleeping under something that has chemicals. Anytime I use it I often feel I am inhaling chemicals. So I prefer using other methods like mosquito spray or constantly closing my doors to prevent mosquitoes from entering.
Agabi, however agreed that the various methods she has been adopting have not been effective in preventing mosquito bites or malaria among her children or herself, as they are sometimes been treated for malaria.
Asked what she does with the mosquito nets given to her, Agabi, said she keeps them, pending when she will have a new baby. “I can only use it when I have a new child because during antenatals, we are often told never to substitute any other method for use of mosquito nets for our children.” She also explained that her children do not like using it too as they believed it causes heat.
Aganbi, is one among millions of Nigerians who have at one point or the other collected these LLITN (which are in most cases distributed free of charge) without using them.
Experts believed the big war may not be won if there are no collaborations between the citizens, who are meant to use the insecticide treated nets as well as other preventive methods, which the various health bodies, government agencies and corporate are advocating for.
They reckoned that very few Nigerians are using the LLITN which has slowed down the set goals to drastically reduce malaria scourge in the country by the end of this year, hence the need to put up other strategies to curb the menace.
However, in a bid to looking beyond just distribution of mosquito nets, which has not yielded desired results, the World Health Organization (WHO) is of the view that a multi-pronged strategy be applied.
This includes strong malaria surveillance, proper monitoring of vector control interventions, preventive therapies, diagnostic testing and treatments with quality-assured Artemisin-based Combination Therapies (ACT).
According to a medical expert and an advocate against diseases in Nigeria, Dr. Rufus Atim, policies and strategies should be put on ground that would encourage people to use these insecticide treated nets.
“It is often said that you can force a camel to the river but you cannot force the camel to drink water. That is the case we are presently experiencing regarding the fight against malaria in the country.’’
He said no matter how much the government and other bodies try to put in resources and finance into the fight against malaria, if the citizens do not embrace these methods, it would be difficult for the country to be malaria free.
“Even if we say let’s look for other methods apart from the well-known mosquito nets to curb the menace, the truth is that, these nets still represent the most viable methods of prevention of mosquitoes in areas ravaged by the scourge.”
Among the strategies he is advocating for, is that government and health organizations distributing the mosquito nets must go beyond mere distribution. “They should go as far as taking carpenters or people who can help in erecting these nets in the homes of the people who are been given the nets.
“Instead of giving out 1 million mosquito nets and only five per cent would eventually make use of the nets, they should go extra mile such that even if they are distributing mosquito nets to the people, they should let such citizens know that they cannot stop at mere distribution, but rather, that they would also go into their homes to erect the LLITN above their bed space.”
He believed if this is done, majority of beneficiaries would not see the need to remove them since the nets have already been fixed. He also said that the new mosquito nets should be done with human friendly designs and colours that would be attractive enough for use.
Also among the strategies he is advocating for, is the addition of human friendly lasting perfumes to the nets. “I believe if the nets have good inviting smell, it would encourage our women to use them in their bed rooms without been forced to.
He also called on the government and other organizations to intensify awareness campaigns against malaria, while stressing on the need for the use of mosquito nets.
According to WHO, Nigeria has one of the highest malaria deaths in the world, with over 90 per cent of its 170 million citizens at risk of the scourge.
The health body has at various times stressed that when insecticide treated nets are appreciated and people sleep under them, especially at nights, that malaria would be drastically reduced in the country.
Various studies have also shown that LLITN offers 30 per cent of protection against severe malaria disease and drastically reduces death rates, especially in children and pregnant women.
Meanwhile, in marking this year’s World Malaria Day, the WHO has reiterated its commitment to accelerating its plans towards eliminating the scourge in ravaged countries like Nigeria.
According to the body’s communication officer, Christian Lindmeier, WHO has developed a new global malaria strategy for the 2016-2030 period, which will be reviewed by the World Health Assembly in May 2015.
He said the strategy was developed in close consultation with endemic countries and partners, for the reduction of the disease burden by 40 per cent by 2020, and by at least 90 per cent by 2030. It also aims to eliminate the disease in at least 35 new countries by 2030.
“The strategy provides a comprehensive framework for countries to develop tailored programmes that will sustain and accelerate progress towards malaria elimination,” he added.
“We must take the malaria fight to the next level. Moving towards elimination will require high-level political commitment and robust financing, including substantial new investments in disease surveillance, health systems strengthening and research,” says Dr Pedro Alonso, Director of the WHO Global Malaria Programme.
“In addition, we urgently need new tools to tackle emerging drug and insecticide resistance, as well as innovative approaches that will accelerate progress,” he added.
He states that increased political commitment and greater funding have averted more than 4 million malaria deaths since 2001, and 55 of the 97 countries and territories with ongoing malaria transmission are on track to meet the current World Health Assembly target of reducing malaria incidence by 75 per cent between 2000 and 2015.
World Malaria Day was instituted by WHO Member States during the 2007 World Health Assembly and is celebrated on 25 April each year. It is an occasion to highlight the need for continued investment and sustained political commitment for malaria control and elimination.

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