In this report, HEMBADOON ORSAR writes on the challenges of ending the malaria epidemic in Nigeria.
Nigeria has a high prevalence rate of malaria with statistics indicating that over 300,000 people die annually from malaria related cases in the country. Alarmingly, 6 out of 10 deaths of children under the ages of 5 and, 3 out of 10 deaths of pregnant women, are caused by malaria.
It is more worrisome to understand the fact that most nations across the globe have effectively tackled the challenge of malaria which is a disease caused by mosquito bite.
Only recently, the Nigerian philanthropist, Aliko Dangote, through his Dangote Foundation, has launched an expansive scheme aimed at contributing, in partnership with the federal government, to combat the menace of malaria. Indeed, the latest effort by Dangote are one out of the many of such efforts by government at all levels including development partners.
Some years back, Nigerian government in collaboration with Roll Back Malaria partners like USAID, waged battle to stem the high prevalence and death caused by the disease in the country.
Reflectively, the move started with the distribution of Long Lasting Insecticide Nets (LLIN) since 2011 in all states of the federation.
The Long Lasting Insecticide Nets are recommended by World Health organization WHO as one of the most effective and cheap means of preventing malaria in the country.
In some states, the initial nets distribution campaigns have been replaced but Benue state had her own LLIN campaign this year which was not evenly distributed because half of house hold was not covered.
Answering questions In a Health event organized by The White Ribbon Alliance Nigeria, the permanent secretary, Benue state ministry of Health and Human services, Dr Joseph Kumba disclosed that the state would soon commenced another round of distribution of nets to households that could not be reached during the last exercise and also hinted that 20 health facilities in 10 wards in the state are currently offering free malaria testing and administering anti malaria drugs.
But like most government programmes and policies, the distribution of the nets and even the much talked about free testing and administration of anti-malaria drugs appears to be a luxury beyond the reach of many especially those in rural areas who unfortunately, are the most prone.
Nigeria has also responded to the issue of presumptive treatment of fever by adopting the simple Rapid Diagnostic Therapy to confirm cases of malaria before administering anti malaria drugs.
In this regard, free RDTs kits and ACTs are provided to several health facilities in the country and taken to some rural health facilities to help reduce the cases of treating malaria without first conducting a test.
Until perhaps recently, there is a widely held believe that for fast treatment of malaria, a dose of chloroquine will do.
But speaking with LEADERSHIP Sunday, Dr Mathew Odoma, the health provider Initiative focal person for Health Communication Capacity (HC3) project in Benue State, disclosed that chloroquine is no longer used for the treatment of malaria because of wide spread resistance of people to the drug by abuse and wrong prescription.
“The reason why chloroquine has been faced out as anti-malaria drug was due to wide abuse and irrational prescription by unauthorized persons” he said adding that “The common practice here in the country is that once an individual complain of fever, it is taken to be malaria, however not all fevers are as a result of malaria.”
Our correspondent reports that in Benue state as in most states, an average Nigerian prefers to patronize chemists Shop for quick fix to their health challenges including anti malaria and in a case of fever because of lack of money to access primary Health services.
This is inspite of the fact that government claimed both testing and anti-malaria drugs are free. In instances where the government matches its words with action and ensure that such services were provided free, the awareness creation is low, because many are not aware of such information, why some health facilities are busy collecting monies both for the testing and drugs.
Of late, Nigeria has adopted the use of Arthemisine-based combination Therapy (ACT) for treatment of malaria. The new national guideline protocol for the treatment of malaria is prescribed simple test using RDTs to confirm malaria, if the result is positive then treatment should be done using ACTs. Experts said this is the best approach in stemming the scourge of malaria so that issues of resistance will no longer arise.
However, there have been many complaints about the RDTs in the country because there are situation where a patient who test negative of malaria in a particular PHC is tested positive in a secondary hospital.
Investigation by our correspondent revealed that this depends on the temperature of the room where the machines and drugs are stored or in some cases the inexperience of the Health personnel to follow the right procedure.
Evidently, RDTs are simple, fast and cheap test for malaria and are available and affordable to everyone, this underscore why several malaria partners are supporting health facilities with free test kit to carry out free test.
Reports however have it that many supported facilities have resorted to charging fee for RDTs and ACTs especially in the rural areas the practice which is preventing most people from accessing the services.
The supervisory agencies should put in place strict supervision and monitoring team to checkmate the fraudulent and sharp practices of some health services