Z’bar needs swift action to control malaria

ZANZIBAR: ZANZIBAR has made substantial progress in malaria control with vector control, continued availability of public health care and availability and use of rapid diagnostic tests, combined medicines and continued efficacy of these therapies.

Parasite prevalence in the population has remained below one-percent, and widespread use of these effective vector management strategies have led to a reduction in persistently high prevalence rates in children younger than 5 years and other high prevalence groups older than 5 years.

But according to the Ministry of Health, imported infections from outside Zanzibar, and filthiness that lead to mosquito breeding, contribute to sustained local transmission.

Researchers have also indicated that Zanzibar faces other challenges in its campaign to eliminate malaria, including insecticide resistance, climate change and change in biting behaviours of malaria vectors.

Other challenges include counterfeit drugs, inadequate community participation and awareness, shortage of healthcare workers and inadequate funding.

It is behind these problems that the Zanzibar Ministry of Health is strengthening its campaign, urging all people, particularly ordinary citizens and community leaders (Sheha) as they have a great role to control the spread of malaria, to join the fight.

Malaria prone areas include Stone Town and areas in Unguja Urban-West region, where residents are being asked to change their behaviour by stopping discarding empties which can store water, and not to allow ponds with stagnant water because it becomes a breeding site for the mosquitoes.

In Zanzibar, the period regarded as “spring,” is in the months of October and November, but there are many more mosquitoes during the period of heavy rains- from mid-March to late May.

In a meeting with Shehas from the Urban-West Region, Dr Salim Slim, Head of Preventive Services and Health Education department at the Ministry of Health said “We need collective effort to stop reemergence of malaria.

We only need to be serious.” He said that the Urban District has been leading in malaria at the moment due to the existence of various reasons, including changes in the country’s climate and lack of proper sanitation, asking the community leaders to spare no efforts in ensuring that in their respective areas there are no ponds and cleanliness is maintained.

Mr Bakar Hamad Magarawa, Health Education Manager, emphasised the importance of educating the public to keep their surroundings clean, and not to use drugs without medical prescription by a physician to treat malaria, and instead go to hospitals for proper diagnosis.

According to statistics from the Ministry of HealthZanzibar Malaria Elimination Program (ZAMEP), 5,300 Malaria patients were registered this year (Jan to MidMarch) in health centres and hospitals, where the island of Unguja had 5,020 patients and Pemba 280.

Mr Mwinyi Khamis from ZAMEP said that among the reported malaria patients, 11 died, but the actual number of patients in 2023 were 18,174 for the whole of Zanzibar (Unguja 17,567 and Pemba 607), and that men are leading in contracting malaria, followed by bodaboda drivers, because they spend most of their time in the open.

Sheha of Malindi, Mr Hassan Masoud Ali said that his area was one of the prone areas in the Urban District, but due to the efforts made by the Ministry of Health, malaria is now under control.

The Sheha of Sebleni street, Mr Mohamed Mussa promised “We will ensure that we manage to control malaria by improving environmental sanitation. It is possible to eliminate malaria, if we work collectively.”

The Zanzibar Minister for Health, Mr Nassor Ahmed Mazrui said that although Zanzibar has achieved these reductions by scaling-up the use of long-lasting insecticidal nets, indoor residual spraying, effective diagnosis using rapid diagnostic tests (RDTs) and treatment with ACT, reluctance in interventions is leading to reemergence.

He said the result of these efforts, supported by substantial funding from development partners for malaria elimination, is that the prevalence of malaria declined drastically, “But if we continue to relax with the success, malaria is coming back.”

According to World Health Organisation (WHO), malaria is a life-threatening disease caused by parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes, and that it is preventable and curable.

WHO says malaria-endemic countries are situated at different points along the road to elimination, and that the rate of progress depends on the strength of the national health system, the level of investment in malaria elimination strategies and other factors, including biological determinants, the environment and the social, demographic, political and economic realities of a particular country.

It says that over the last two decades, significant progress has been achieved towards malaria elimination, and according to World Malaria Report, 27 countries had fewer than 100 cases of the disease in 2022, up from 6 countries in 2000.

Countries that have achieved at least three consecutive years of zero indigenous cases of malaria (a case contracted locally with no evidence of importation from another endemic country) are eligible to apply for the WHO certification of malaria elimination.

Since 2015, 12 countries have been certified by the WHO Director-General as malaria-free, including Maldives (2015), Sri Lanka (2016), Kyrgyzstan (2016), Paraguay (2018), Uzbekistan (2018), Argentina (2019), Algeria (2019), El Salvador (2021), China (2021), Azerbaijan (2023), Tajikistan (2023) and Cabo Verde (2024).

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