Malaria has been a life threatening parasitic disease transmitted by the bite of female anopheles mosquitoes. This has contributed to high child morbidity and hence motility the world over. It threatens 2.4 billion people, or about 40% of the world’s population living in the world’s poorest countries, and more than one million deaths are attributable to the disease annually (WHO, 2000). According to WHO/UNICEF (2005), the disease is a major public health problem in Africa with over 200 million clinical episodes annually.
The country through the Ministry of Health and partners has put in place strategies and policies meant to reduce the malaria prevalence. Guided by the WHOs recommendations the country focuses on;
- Early identification and treatment of cases
- Affordable malaria medicine
- Advocacy Communication and Social Mobilization
- Prevention through Long Lasting Insecticide Treated Nets
With limited access to healthcare by most of the Country’s poor and the availability of malaria drugs as an over the counter medicine due to the affordable medicine strategy, many people resort to self medication even without proper diagnosis. CINCO through the GF-malaria project therefore strives to ensure 100% of malaria cases receiving treatment as per the national guidelines. The project funded by the Global fund through AMREF Health Africa as the Principle Recipient. CINCO a Sub Recipient in the fund implements the program in Kisumu and Nakuru Counties with the key goal of contributing to the 2018 National goal of reducing the morbidity and mortality attributable to malaria in the various epidemiological zones by two thirds of the 2007/08 level .
The project strives to guarantee community access to quick and effective treatment, to significantly reduce illness and deaths from malaria. We establish and strengthen Community Health Units to sensitize the community on the various issues pertaining to malaria prevention and control measures. Community Health Volunteers(CHVs) training on community case management of malaria is done to build the capacity of the CHVs to diagnose malaria through rapid diagnostic test kits (RDTs) and provide first line treatment using the Artemether Lumefantrine (AL) tablets for the uncomplicated malaria while referring the complicated malaria and Malaria in Pregnancy for further care. This is done under close supervision by the Community Health Extension Workers (CHEWs). Community Health Committee members (CHCs) offer management functions for the CHUS while the CHEWs provide the technical support to the CHVs and reviews their reports before compilation and forwarding to the Sub County Health Records and Information Officer who enters the information into the District Health Information System.
- Community case management for malaria
- Institutional Strengthening through formation of Community Health Units and provision of incentives to 710 community health volunteers.
- Advocacy Communication and Social Mobilization
- Capacity enhancement through;
- Training of both the health workforce on malaria case management.
- Support Supervision to Health Care workers.
Malaria causes fatal complications in pregnancy. Having cut a niche in the Malaria Lake Region endemic areas, CINCO recognizes the need for early diagnosis and treatment of Malaria in Pregnancy (MIP). Through the CHVs, data on all pregnant women are kept by name, trimester and health indicators. The CHVs conduct regular visitations to pregnant women where they deliver key health messages while identifying key MIP signs and symptoms for prompt referral and hence prompt treatment.
A pupil presenting during quarterly review meeting for malaria net use promotion
Frequently Asked Questions in Malaria
What is Malaria?
Malaria is a common, serious and sometimes fatal tropical disease. It is a protozoal infection transmitted to human beings by mosquitoes biting mainly between sunset and sunrise. Human malaria is caused by four species of Plasmodium protozoa: Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale and Plasmodium malariae. Malaria is a public health problem in over 100 countries worldwide.
Who are the people most at risk of server and fatal malaria?
People who are heavily exposed to the bites of mosquitoes infected with Plasmodium falciparum are most at risk of dying from malaria. People who have little or no immunity to malaria, such as young children and pregnant women; or travellers coming from areas with no malaria, are more likely to become severely ill and die if no prompt treatment is sought. Poor people living in rural areas who lack knowledge, money, or access to health care are more vulnerable to the disease. As a result of all these factors, an estimated 90% of deaths due to malaria occur in Africa south of the Sahara; most of these deaths occur in children under 5 years of age.
Is malaria a serious disease?
Yes. It has been estimated that the incidence of malaria in the world may be in the order of 300 to 500 million clinical cases each year. Countries in tropical Africa account for more than 90% of these. Malaria mortality is estimated at almost 3 million deaths worldwide per year. The vast numbers of malaria deaths occur among young children in Africa, especially in remote rural areas with poor access to health services. Other high risk groups include women during pregnancy, and non-immune travellers, refugees, displaced persons, or labour forces entering into endemic areas
Who is at risk of getting malaria?
Anyone can get malaria. Most cases occur in residents of countries with malaria transmission and travellers to those countries. In non-endemic countries, cases can occur in non-travellers as congenital malaria, introduced malaria, or transfusion malaria.
What are the signs and symptoms of Malaria?
Symptoms of malaria include fever and flu-like illness, including shaking chills, headache, muscle aches, and tiredness. Nausea, vomiting, and diarrheal may also occur. Malaria may cause anaemia and jaundice (yellow colouring of the skin and eyes) because of the loss of red blood cells. Infection with one type of malaria, Plasmodium falciparum, if not promptly treated, may cause kidney failure, seizures, mental confusion, coma, and death.
How soon will a person feel sick after being bitten by an infected mosquito?
For most people, symptoms begin 10 days to 4 weeks after infection, although a person may feel ill as early as 7 days or as late as 1 year later. Two kinds of malaria, P. vivax and P. ovale, can occur again (relapsing malaria). In P. vivax and P. ovale infections, some parasites can remain dormant in the liver for several months up to about 4 years after a person is bitten by an infected mosquito. When these parasites come out of hibernation and begin invading red blood cells (“relapse”), the person will become sick.
Is malaria a contagious disease?
No. Malaria is not spread from person to person like a cold or the flu, and it cannot be sexually transmitted. You cannot get malaria from casual contact with malaria-infected people, such as sitting next to someone who has malaria.
How do I know if I have malaria for sure?
Most people, at the beginning of the disease, have fever, sweats, chills, headaches, malaise, muscles aches, nausea, and vomiting. Malaria can very rapidly become a severe and life-threatening disease. The surest way for you and your health-care provider to know whether you have malaria is to have a diagnostic test where a drop of your blood is examined under the microscope for the presence of malaria parasites or through rapid diagnosis test kits. If you are sick and there is any suspicion of malaria (for example, if you have recently travelled in a country where malaria transmission occurs), the test should be performed without delay.
Treatment of malaria
Currently in malaria endemic countries there are effective treatment, the World Health Organization (WHO) recommends use of Artemisinin Combination Treatment (ACT). In most forms it’s a 3 day dose which should be taken as advised by the health worker. It is important to comply with the instruction and completion of the dose so that the parasite is eliminated in your system.
Prevention of malaria
- By making sure that you use of insecticide treated nets in every sleeping area by everyone, every night
- By allowing your house or house like structures are done indoor residual spraying (IRS) by competent authority (Ministry of Health)
- For pregnant women in malaria endemic zones to take Intermittent Presumptive Treatment (IPTp)
Most adults from endemic areas have a degree of long-term infection, which tends to recur, and also possess partial immunity (resistance); the resistance reduces with time, and such adults may become susceptible to severe malaria if they have spent a significant amount of time in non-endemic areas. They are strongly recommended to take full precautions if they return to an endemic area.
Choosing a drug to prevent malaria
Considerations when choosing a drug for malaria prophylaxis:
- Recommendations for drugs to prevent malaria differ by country
- No anti-malarial drug is 100% protective and must be combined with the use of personal protective measures, (i.e., insect repellent, long sleeves, long pants, sleeping in a mosquito-free setting or using an insecticide-treated bednet).
Source: CDC – USA