By Tumininu Ojelabi Hassan
Malaria is a life-threatening disease and a major public health problem in Nigeria mostly prevalent during the rainy season. It is endemic in Nigeria, hence accounts for 27 percent of malaria cases in the world and 32 percent of malaria mortality rate globally.
According to Dr. Osagie Ehanire, the Minister of Health, about 55 million cases of malaria and 90,000 malaria-related deaths occur annually in Nigeria. The economic burden of malaria in Nigeria was estimated at $1.6b (N687bn) in 2022 and may increase to about $2.8bn (N2tn) in 2030.
Dr. Ejiro Aiyenuro, a medical doctor, who spoke with our correspondent on the prevalence of malaria during the rainy season, attributed its widespread presence in the rainy season to environmental factors.
“Malaria is transmitted by mosquitoes, specifically the female anopheles mosquitoes. They transmit malaria through the organism in their body. When they bite a human being, they transmit the organism called plasmodium, which in turn goes to the liver and the blood cells.
“Malaria is prevalent during the rainy season because of our environment. There are more mosquitoes where there is stagnation of water and of course there’s more stagnant water during the rainy season.
“Also, we don’t have good drainage system in Nigeria. An environment with lots of stagnant water breeds mosquitoes which can in turn increase the transmission of malaria. Places where there are bushes that aren’t cleared regularly can breed mosquitoes too,” she explained.
According to her, the symptoms of malaria include fever, headache, joint pain, bitterness in the mouth, loss of appetite, amongst others. In addition, Dr. Ejiro suggested tips to prevent malaria disease in the rainy season.
“This disease can be prevented by using insecticide treated net, insecticides like fleets and coils, wearing long sleeves to avoid being bitten by mosquitoes, eating well is key because if someone has the organism but has good immunity by eating well, the person might not come down with malaria. Basically, eating well and resting well is key because stress, poor appetite, poor diet can affect one’s immunity which is how well one can stand against infections,” she added.
In addition, She explained the malaria tendencies of people with AS, AA and SS genotype, the treatment process of malaria as well as the consequences of not treating the disease properly.
“We give pregnant women and people with sickle cell medications to prevent malaria because they have lower immunity. It affects people with low immunity more, like children, pregnant women and people with illnesses that can affect their immunity.
“Let me add this, people with AA genotype have a high tendency to have malaria infection without coming down with malaria, this is because the plasmodium organism goes to the liver and then to the blood. The turnover time for their blood is three months, so they are more likely to have malaria because the infection can last for three months in their bodies until there is a cell turnover and it goes away.
“However, people with AA genotype might not come down with malaria if they are eating well and resting well such that their bodies can fight against it. For people with SS genotype, the turnover time for their blood is within a few weeks and less than a month.
“The malaria infection doesn’t last in their bodies but due to their low immunity, they can easily come down with malaria which can be very severe. For instance, in Lagos, people don’t usually protect themselves from malaria.
“Most people here don’t eat well and we are always stressed. Even when an AA person comes in contact with malaria infection, there’s more likelihood for it to affect them often because of low immunity as a result of stress and not eating well.
“For people with AS genotype; the turnover time for their blood is less than that of AA genotype but not as low as the SS genotype. That’s why we say AS genotype is a protective mechanism against malaria.
“Based on research, people with this genotype are more protected against malaria because they have the immunity of the AA genotype and Low cell turnover term of SS genotype. They hardly have malaria because the malaria infection only last for two months or six weeks in their bodies and they also have the immunity to fight against it.
“There are preventive drugs for malaria but we give them to those who are more at risk of having malaria. Treatment is administering anti-malarial medications and painkillers for those who have headache and body pain.
“Ideally, we don’t advise people to take malaria medications regularly because their bodies can become resistant to it and after a while it won’t work. It’s better to take malaria medications only when you have confirmed you have malaria.
The most effective medication is the combination therapy which is used in the morning and at night. Although, there are different types of anti-malarial drugs but it’s the most common and effective one.
Sometimes, it might be severe that the medication may not be effective and one would need to take injection for that.
“Generally, malaria is something that can be treated with oral medication or injection medication, however if it is not well treated, it can recur and be more severe. It can be serious such that it can lead to other illnesses that can affect other parts of the body like the brain, kidney and liver which can eventually result to death,” she explained.
With regard to the effectiveness of the malaria vaccine, which was released recently, Dr. Ejiro said its effectiveness hasn’t been ascertained because it isn’t available in Nigeria yet.
The Pest Control Association of Nigeria (PECAN), Abuja chapter, has said Malaria is the major cause of morbidity and mortality in Nigeria. In a statement to commemorate the World Malaria Day, the Chairman of PECAN in Abuja, Terungwa Abari lamented that Nigeria accounted for 55.2 percent of Malaria cases in West Africa in 2020, however there has been a significant decline.
“Today is another commemoration of the world malaria day, a day set aside as a common platform for countries to discuss issues on the dreaded scourge, appraise their efforts in malaria control and unify diverse initiatives in the changing global context.
“Malaria remains a significant cause of morbidity and mortality in Nigeria. The World Malaria Report, 2021 shows that Nigeria had the highest number of global malaria cases (27 % of global malaria cases) and the highest number of deaths (32 % of global malaria deaths) in 2020.
“The country accounted for an estimated 55.2% of malaria cases in West Africa in 2020. Nonetheless, there has been a progressive decline in malaria prevalence in Nigeria. From 42 percent in 2010 to 27 percent in 2015 and 23 percent in 2018, with variations across the States,” he stated.
Abari revealed that Malaria was the cause of developmental challenges, poverty and deaths in Nigeria and Africa. He attributed its prevalence in Africa to neglect of a key component which is Pest and Vector control.
“This endemic disease has caused developmental challenges, poverty, and millions of deaths in Africa. In the years past, governments and regional institutions in Africa have launched numerous programs on Malaria but the disease and other vector-borne diseases peculiar to sub-Saharan Africa still linger.
“This could be because of the interventions not being multi-sectoral or lack of sustained and diligent implementation of critical components such as vector management. In most cases, approaches are focused more on activities to diagnose, control and treat malaria-like establishment of disease management centers and provision of Malaria drugs and Long-Lasting Insecticides Treated Net (LLITN), etc. leaving a key component like Pest and Vector control through source site management out of the focus,” he added.
Abari further emphasized the importance of giving ample attention to Pest control through source site management as a measure to achieve the Zero malaria goal by investment, innovation and implementation.
“So how do we achieve this goal of Delivering Zero Malaria through Investment, Innovation and Implementation? To achieve it, there must be a paradigm shift, a change from the neglect of controlling the mosquito vector from the source. To achieve this goal, we must give serious attention to Pest control through source site management. Source-site management which includes Sanitation and vector control more than anything else is the solution to Malaria.
“Government must not continue to spend huge resources solely on drugs and nets to stem the tide of disease outbreaks, but a significant percentage of these resources should be channelled to pest control, which is the focal point of integrated vector management.What needs to be done to end Malaria for good is prevention not treatment, pest control not drugs,” he suggested.
Furthermore, the Civil Society for Malaria Control, Immunisation and Nutrition (ACOMIN) has urged Nigerians to manage their environments in order to guard against malaria prevalence and widespread of water borne diseases in the rainy season.
Ayo Ipimoye, the National Coordinator of ACOMIN advised Nigerians to manage their environments properly and also avoid the existence of stagnant water which can increase the population of mosquitoes.
“And now that the rains are here, remember that there are water and mosquito borne diseases that we need to be careful of. When we do not manage our environment well, and allow stagnant waters to exist, the population of mosquitoes increases and mosquito borne diseases as well as water borne diseases become prevalent,” he warned.
Malaria can be life-threatening despite being a preventable disease. As the saying goes, “Prevention is better than cure”, It is advisable to prevent malaria by all means especially during the rainy season by keeping one’s environment clean, keeping the drainage clean to ensure free flow of water, fixing mosquito nets on doors and windows, and clearing bushes regularly, among others
