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Experts ask gov’t to change approach to malaria prevention

FILE PHOTO: Mosquito net one of the malaria prevention strategies.

Kampala, Uganda | THE INDEPENDENT | Public health experts have asked the government to change its approach in malaria prevention strategies.

According to the experts, some of current interventions that government is currently implementing are not effective in some parts of the country and have instead become a money-making venture for different parties involved in the fight against malaria.

The researchers want government to carry out more indoor residual spraying and develop malaria diagnostic equipment based on Uganda’s malaria patterns instead of buying insecticide-treated mosquitoes that are often abused.

Malaria is one of the leading causes of death in Uganda is estimated to be endemic in 95 percent of the country, affecting around 3 million people annually. Over the years, several campaigns have been developed to eliminate the disease. Currently, Uganda uses a combination of approaches which includes use of insecticide-treated mosquitoes, indoor residue spraying, social behaviour communication, larviciding and the provision of subsidized antimalarial medicine.

Prof Freddie Sengooba, an associate professor of health and systems management at Makerere University Public School says that other methods of eradicating malaria-like indoor residual spraying-IRS should be prioritised just like the distribution of mosquito nets.

Prof Sengooba says that government needs to look into increasing the coverage area since IRS has been proved to be a very effective control method.

Currently, residual spraying is carried out in around ten districts in the country with high malaria burdens-Kitgum, Amuru, Adaku, Apac, Gulu, Kole, Lamwo, Nwoya, Oyam and Pader.

A study carried out by Makerere University School of Public Health under their SPEED project in 2016 revealed that indoor spraying using Actellic 300 CS in Lira showed a decrease in the number of malaria deaths in the district. The study revealed that a reduction in the number of outpatients suffering from Malaria from 18.7 percent to 15.1 percent over a five year period.

IRS can be carried out using insecticides such as Dichloro Diphenyl Trichloroethane- DDT, Pyrethroid Alpha-Cypermethrin and Carbamate however resistance to DDT and Pyrethroid Alpha-Cypermethrin has been reported by the Ministry of Health.

Prof Sengooba adds that some of the methods that are being used are not necessarily the most effective but are rather being fronted as a means of making money.

Maureen Nantume a Biochemist says that government needs to invest in technology development instead of using what is sold in the world market and may not necessarily be effective.

“Currently Rapid Diagnostic kits are used to test for malaria but so many of these kits give results that cannot be quantified. They are general. As a result, there are some people who have developed resistance to anti-malarial. In a year they receive treatment for malaria more than three times.”

In 2015, the health ministry embarked on a five-year malaria strategic plan aimed at eliminating the disease by 2030. The campaign included mosquito net distribution, residue spraying, and larviciding and would cost 4 trillion shillings.

By the end of last year, more than 2 trillion shillings had been used. As of last year, 27 million mosquito nets had been given out at a cost of 172 billion shillings.

Annually 500 billion shillings is spent on malaria control and according to data from the health ministry, the number of malaria deaths have been reducing.

In 2015 6,100 people are reported to have died. In 2017 the figure stood at 5100 from 5700 in 2016. Last year, the figure stood at 1,600.

Dr Jimmy Opigo, the head of the Malaria Control Programme at the Ministry of Health says that Uganda is on the path to eliminate malaria by 2030. He says government’s malaria preventive and control measures have been effective.

According to the Malaria Consortium, IRS is one of the most effective measures to prevent and control malaria. It controls malaria by killing mosquitoes every time they enter a house.

It is estimated that at least one mosquito enters a house every 2-3 days for a meal. If all houses are properly sprayed, IRS has the capacity to reduce on the number of mosquitoes in an area before they can pass on malaria parasites.

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