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malaria

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In September, world leaders pledged nearly US$13 billion to tackle some of the world’s deadliest diseases through the Global Fund to Fight AIDS, Tuberculosis (TB) and Malaria. In a time of significant global uncertainty and strife, this was a remarkable display of commitment to the health and well-being of the most vulnerable populations on the planet.

African leaders have committed to ending AIDS, TB and malaria since 2001, and over the past few decades, extraordinary global solidarity and resources have helped transform this fight against Africa’s three biggest public health threats. The Global Fund has been key to this progress, having saved 20 million lives worldwide and averted millions of new infections.

But donor resources are not limitless. In order to build on our progress and accelerate the decline of these diseases, we need to marshal resources and leadership from the countries that, tragically, know them best – many of which are in Africa.

I am all too familiar with the devastating impact of AIDS, TB and malaria on the people of my continent, with hundreds of millions of Africans at risk of these diseases every day. Encouragingly, African governments have taken several important steps to meet the evolving demands of the AIDS, TB and malaria response.

Several African countries committed resources to the Global Fund for its latest replenishment. Pledges from South Africa, Benin, Cote d’Ivoire, Kenya, Namibia, Nigeria, Senegal, Togo and Zimbabwe totaled approximately $34 million, demonstrating the importance African countries place on the Global Fund and sharing responsibility for ending these epidemics. As President Macky Sall of Senegal said, “In an interconnected and interdependent world, diseases know no borders.” The African Union Commission commends the countries that contributed, and commits to work with more African countries for increased pledges for the next replenishment in 2018.

Furthermore, these pledges have also been made alongside significant increases in domestic investments for health by African countries, almost US $11 billion for 2015-17. This surge in resources is critical for positioning countries to take ownership over their health programmes and lead the fight against these diseases.

The 54 countries that make up the African Union (AU) understand how important this is, which is why we place special emphasis on identifying African-sourced solutions to our health challenges. For example, in 2012, country governments adopted the African Union Roadmap on Shared Responsibility and Global Solidarity for AIDS, TB and Malaria, which outlined a path for strengthening country leadership on the essential building blocks of our health systems – including the areas of financing and access to medicines. In 2016 African leaders adopted the Catalytic Framework to end AIDS, TB and Malaria in Africa by 2030 with a clear business plan and bold targets.

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Malaria is a life-threatening disease caused by parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes.

According to the Director, Centre for Malaria Care, University of Ilorin Teaching Hospital, Prof. Olugbenga Mokuolu, malaria is a serious disease that can often be fatal; hence the need to refrain from describing it as “ordinary malaria.”

Mokuolu notes that malaria is caused by parasites that infect specific mosquitoes and, contrary to what many people might think, it is an infection that can be passed from a pregnant mother to her unborn baby!

Mother to child transmission

Experts warn that one in 20 pregnant mothers could infect their babies if they develop malaria very close to the time of delivery. They say it is one reason why pregnant women must not be exposed to mosquitoes at any point in time.

The Managing Director, Society for Family Health, Mr. Bright Ekweremadu, notes that while deaths due to malaria have fallen by half globally since 2000, with about 4.3 million deaths averted, in 2015 alone, there were estimated 438,000 malaria deaths globally. Over the last 15 years, there has been a remarkable decline in the global malaria burden, according to the World Health Organisation.

“What this translates into is that the war against malaria is not over until we achieve zero malarial infection and zero malarial death,” Ekweremadu says.

At risk population

While anyone can come down with malaria, there are people who are heavily exposed to the bites of mosquitoes infected with P. falciparum and on whom malaria can wreak terrible havoc because of their peculiarities.

Mokuolu notes that the disease can have debilitating effects on people who have little or no immunity to malaria, such as young children and pregnant women.

Again, experts say, those whose spleens have been removed, as well as people who suffer from sickle cell anaemia are at huge risk of severe malaria infection.

Symptoms to watch

According to the Centres for Disease Control and Prevention, malaria symptoms can be classified into two categories: uncomplicated and severe malaria.

Experts say uncomplicated malaria is diagnosed when symptoms are present, but there are no clinical or laboratory signs to indicate a severe infection or the dysfunction of vital organs.

“Individuals suffering from this form can eventually develop severe malaria if the disease is left untreated or if they have poor or no immunity to the disease,” experts say.

They note that symptoms of uncomplicated malaria typically last between six and 10 hours and they occur in cycles every second day, although some strains of the parasite can cause a longer cycle or mixed symptoms.

“Symptoms are often flu-like and may be undiagnosed or misdiagnosed if appropriate diagnosis methods are not used,” Mokuolu warns.

Experts at CDC say uncomplicated malaria typically has the following progression of symptoms through cold, hot and sweating stages. They include sensation of cold, shivering fever, headaches and vomiting, while seizures sometimes occur in young children.

They add that the patient can also experience sweating followed by a return to normal temperature, with tiredness.

On the other hand, severe malaria is defined by clinical or laboratory evidence of vital organ dysfunction. This form has the capacity to be fatal if left untreated. Symptoms of severe malaria include fever and chills, impaired consciousness, prostration (adopting a prone or prayer position), multiple convulsions, deep breathing and respiratory distress, abnormal bleeding and signs of anaemia, clinical jaundice and evidence of vital organ dysfunction.

Other symptoms include rigor, headaches and other body aches, not feeling well, loss of appetite, vomiting, joint weakness/pains, palms or eyes may be white; and in complicated cases, the patient may suffer loss of consciousness, extreme weakness, dark urine and jaundice.

Mokuolu says there is no reliable symptom that can make anyone to be sure you have malaria, because not every fever is malaria. “So, the best practice is to have your blood tested for the presence of the parasites. This can be either by rapid diagnostic tests or microscopy,” he explains.

Experts warn that severe malaria is a medical emergency and the person has to be admitted so that they can have sound medical attention.

What we can do

Ekweremadu says the national malaria control programmes have been developed to take special measures to protect vulnerable population groups from malaria infection, taking into consideration their specific circumstances.

He adds that working with the Global Fund’s new funding model, the goal of the Society for Family Health is to ensure timely availability of appropriate antimalarial medicines and commodities required for prevention a and treatment of malaria in Nigeria by 2018 and sustained through to 2020, among others.

PUNCH.

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Malaria in pregnancy should be considered a medical emergency as it does more harm to the fetus than envisaged, the Head, Case Management Branch, National Malaria Elimination Programme, Dr. Godson Ntadom has said.

He noted that while malaria parasites in non pregnant persons feed on nutrients from the red blood cell of its host, that of pregnant women prefers to stay in the placenta where it feeds on the nutrients meant to supply the fetus because of its richness, thereby starving the fetus to death.

Speaking during the NMEP, Health Communication Capacity Collaboration and Health Editors interactive section in Lagos recently, he said, “during the period the parasites are feeding on the nutrients coming into the placenta meant for the fetus, the woman will not feel the signs of malaria because technically the placenta is not part of her body. It is when the parasites are full and satisfied that they now move into the woman’s blood stream, and at which point, she will start noticing malaria symptoms.”

Ntadom said it was a medical emergency because the point the woman starts noticing malaria signs means the parasites have starved the fetus of its needed developmental nutrients and are satisfied with the placenta.

“By this time they will then move to the woman’s blood where she will start filling the symptoms of the disease. There is a high possibility that at this point the damage may have been done to the fetus. That is why it is a medical emergency to see if the situation can be remedied,” he added.

He said contrary to popular belief that anti-malaria drugs were not good for treating malaria in pregnancy, the medical expert said it was the parasites that kill the fetus and not the drugs.

“Often times, pregnant women start treating malaria when they start noticing malaria signs, but what most people don’t know is that before a pregnant woman start noticing the symptoms, the parasites must have done damage to the fetus through feeding on the placenta. It is when the parasite is done with the placenta (probably damaged the fetus) that the woman can start noticing signs,” Ntadom said.

Meanwhile, Ntadom has reiterated Federal Government’s earlier decision to ban the use of Chloroquine and mono-therapy drugs for the treatment of malaria in Nigeria.

He said the emphasis on the ban on Chloroquine and mono-therapy drugs were necessary as some persons still sell them to unsuspecting patients.

“Apart from mono-therapy injections which are used for treatment of severe malaria, its drugs and Chloroquine have long been banned by government. It is a criminal offense for any health personnel to sell them to patients,” he added.

In the same vein, he said Nigerians do not need medicines for the prevention of malaria, adding that only pregnant women and foreigners should be given such recommendations.

“The one presently recommended now is Malarone which is a combination of two medicines and it is for foreigners who probably would be staying in the country for a short time.

He said the citizens were free to visit NMEP website www.ncmp.gov.ng for informations on malaria in Nigeria.

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A 25-minute do-it-yourself Urine Malaria Test (UMT) kit has been unveiled in Lagos by Fyodor Biotechnologies Nigeria Ltd, a subsidiary of Fyodor Biotechnologies Corps, United States (US).

The kit, marketed  by Geneith Pharmaceuticals Nigeria Ltd,  is the first- ever non-blood malaria test kit that will tell in less than 25 minutes if a fever is caused by malaria or not.

The technology, according to the company, requires a few drops of urine without any reagent or equipment.

The Chief Executive Officer, Fyodor Biotechnologies Corps, Mr. Eddy Agbo, said despite the huge success recorded in the fight against malaria, it remains the single most deadly disease across the world.

Malaria, he said, affects about 3.2 billion people in 97 countries.

Agbo said half a million people die of malaria yearly, stressing that most malaria deaths occur within 48 hours of fever onset and children under-five years are particularly vulnerable.

“Fever is a sign of malaria, but many other diseases can also present with fever. So, prompt accurate diagnosis is critical before initiating treatment,” he said.

He said the UMT was the first to have its clinical trial and validation done in the country.  ”It is a one step, no blood, no reagent, no equipment, read by eyes, which performs equivalently with malaria rapid blood tests.

“The UMT is a simple dipstick test that uses immunochromatographic technology to detect malaria proteins shed in the urine of persons with fever due to malaria. The test process is simple: add patient urine into sample cup provided in kit; dip and leave UMT strip in the sample for 25 minutes; read result: one line indicates no malaria and two lines indicate malaria,” he said.

Agbo said UMT will enable healthcare providers to follow national and international guidelines of test before treating malaria.

Besides, it is suitable for public and private healthcare setting.

“Fyodor has worked closely with many collaborators and partners to ensure that the UMT undergo full-scale pivotal clinical trial. Pre-clinical and clinical validation studies were conducted in partner with College of Medicine, University of Lagos; University of Nigeria Teaching Hospital; Johns Hopkins University United States; Duke University USA; the Federal Ministry of Health and National Malaria Elimination Program; Lagos State Ministry of Health and National Agency for Food and Drug Administration and Control,” he said.

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A 25-minute do-it-yourself Urine Malaria Test (UMT) kit has been unveiled in Lagos by Fyodor Biotechnologies Nigeria Ltd, a subsidiary of Fyodor Biotechnologies Corps, United States (US).

The kit, marketed  by Geneith Pharmaceuticals Nigeria Ltd,  is the first- ever non-blood malaria test kit that will tell in less than 25 minutes if a fever is caused by malaria or not.

The technology, according to the company, requires a few drops of urine without any reagent or equipment.

The Chief Executive Officer, Fyodor Biotechnologies Corps, Mr. Eddy Agbo, said despite the huge success recorded in the fight against malaria, it remains the single most deadly disease across the world.

Malaria, he said, affects about 3.2 billion people in 97 countries.