Malaria re-emergence in Zanzibar, why residents are to blame 

ZANZIBAR was already accelerating to eliminating malaria, the global killer disease. Most of the interventions appeared to work and the prevalence rate was 0.4 per cent for at least a decade.

But the increase in malaria cases between October and December last year, down to this year (2024) was a shock to the health authorities in the Islands, where the hospital ward at Mnazi Mmoja referral Hospital has been filled with patients battling for their lives.

The Isles Minister of Health, Nassor Ahmed Mazrui had in mid-December last year said at a press conference that three people had died from malaria, but two weeks later he was quoted saying that the death toll had increased to 36 people.

Malaria cases increased from 3,223 people diagnosed with malaria in 2022 to 3,563 positives in June last year, while those hospitalised increased from 282 to 423 in the same period.

“After a long period of time without malaria, the immunity of Zanzibaris against the disease has gone down, leading to many people becoming easily affected,” Mazrui said, adding that the government had quickly solicited medicine to treat people.

Mr Mazrui was prompted to strengthen public awareness and ‘Outdoor Spraying’ in residential areas after an impromptu inspection in some parts of Zanzibar City revealed that the level of filthiness and poor sanitation was very high, harboring potential mosquito breeding sites.

The ‘World Heritage site’ (Stone Town), and Bwawani area have turned into prone areas because of filthiness as concluded by the Minister after also inspecting other areas such as Saateni in the city, who furiously said, “The surroundings are very dirty, there is no way we can win the fight against malaria in such a dirty environment.”

The Minister raised concern over the stinking stagnant water, wet areas, broken chambers for liquid wastes and bushes, which he said are good places for mosquitoes to breed and reproduce.

“I take this opportunity to emphasise on collective responsibility in controlling malaria. It is possible to eliminate malaria if we all show commitment,” he said, adding that travellers, students and security guards who spend many late hours outdoors should also take health precautions.

Mr Hija Joseph Hija- Manager, Zanzibar Malaria Elimination Programme (ZAMEP) says outdoor spraying has been going on in some areas of Zanzibar, and that residents in areas such as Stone Town should not be worried, saying the spray is safe for humans, so they should allow their areas to be sprayed.

“Fighting Malaria is possible; we only need to share our responsibility, beginning with behaviour change to keep the environment clean. Stopping mosquitoes from reproducing is important,” emphasised Mr Shija.

Mr Mwinyi Issa Mselem from the surveillance committee on Malaria Projects supported by the ‘Global Fund’ emphasised to people during an inspection tour of some areas in Pemba Island last November that filthiness creates breeding sites for mosquitoes.

“We have recorded admirable achievement in controlling malaria disease with prevalence below one percent. Let us observe health precautions, including keeping our surrounding clean to eliminate malaria,” Mr Mselem said.

During the inspection, he stressed to community leaders (popularly known as Sheha) to promote public awareness so that residents do not allow rain water to become stagnant or create temporary ponds because it becomes breeding areas for mosquitoes.

Mr Mohamed Haroun- Community, leader in Pemba said “We will continue educating people so that they avoid pollution by using inappropriate waste disposal, or leaving water wells and reserve tanks uncovered.”

Mr Yussuf Ali Othman from ZAMEP unit said that they have been working closely to fight malaria and that the target is to eliminate malaria from Zanzibar in the near future.

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