Malaria is life threatening and is still among the top five leading causes of death in Africa today, especially amongst young children. Concern's Breda Gahan explains what we’re doing to combat the disease.
Florence Mutungi (32) with twin daughters. The family’s Community Health Volunteer has encouraged them to use the mosquito net to protect them against malaria. Photo: Peter Caton / Concern Worldwide.
How is malaria transmitted?
Malaria is caused by a parasite transmitted through the bite of an infected female Anopheles mosquito. There are five parasite species that cause malaria in humans. A number of Concern staff and colleagues have sadly died as a result of the most severe form of malaria, plasmodium falciparum. This form now accounts for more than 99% of all malaria cases in the African region.
The good news is that malaria is preventable and treatable.
Anyone who develops a fever, headache, joint pains or shivering in a malaria zone needs immediate testing. Don’t wait. Early treatment is often life-saving.
According to latest data, there were 219 million cases of malaria in 2017, up from 217 million cases in 2016. The estimated number of malaria deaths stood at 435,000 in 2017.
How to prevent malaria?
In terms of malaria prevention, if you don’t get bitten, you won’t get malaria. Most bites occur at dawn, dusk or after dark. Covering up is important, whatever the temperature, with light long trousers, skirt, socks, shoes and hat and scarf.
It is especially important to protect refugees, migrant or displaced populations, children, pregnant women, travellers and people living with HIV or malnourished individuals whose immune systems may be compromised.
Mosquito nets that are insecticide-treated are invaluable for the protection of people in malaria zones. Mothers and young children should always sleep under insecticide-treated nets. Increasingly, men and boys are sleeping under nets as well.
In 2017, about half of all people at risk of malaria in Africa were protected by an insecticide-treated net, compared to 29% in 2010. Many of the nets are provided by international organisations.
Today is #WorldMalariaDay 🦟.#Malaria still kills a child every two minutes. No child should die because they cannot access life-saving services to prevent, detect & treat the disease.— World Health Organization (WHO) (@WHO) April 25, 2019
Zero malaria starts with me – are you ready to #EndMalaria? pic.twitter.com/A4E8N6Wo8o
What we are doing
Concern Worldwide has been learning of and responding to malaria since the inception of the organisation in 1968, as it was a threat to staff and target populations alike in Biafra and in Bangladesh in the early days.
Today, malaria is still found in twenty of the countries in which Concern works.
Concern’s focus is on health promotion, education for malaria prevention, building local health systems and community resilience, as well as the provision of mosquito nets, supporting prompt treatment referral, and vector control through environmental health interventions within national indoor spraying programmes.
Malaria was a primary intervention in Concern Rwanda’s Child Survival. It was reported as the leading cause of mortality and morbidity amongst adults and children alike when the programme was launched in 2000. From a baseline of 0.1% in 2001, the number of children 0-23 months who slept under an insecticide-treated net the night before, this had increased to 47% by the endline in 2006.
Mum-of-three Scholastica has a net over her daughter's bed to try and prevent her falling ill with malaria. Photographer: Peter Caton.
In phase two (2006-2011) based on the experiences of our consortium partners with home-based management of malaria, the programme focused on enhancing the role of community-based volunteers to include respiratory illness and diarrhoea as well as malaria, and expanded the comprehensive model in all six districts. The Rwandan government later adopted home-based management of malaria as national policy.
In the Niger Child Survival project (2009-2014), activities fell into two main categories; strengthening the health care system at the facility level and investing in intensive community-level activities to promote sustained behaviour change and integrated Community Case Management of malaria, as well as pneumonia and diarrhoea. The programme was led by local ‘Mother Leaders’.
Concern South Sudan is currently working with the Ministry of Health to roll out Community Case Management (treatment for malaria, pneumonia and diarrhoea in children under five-years-old) and has trained and equipped 497 community volunteers to provide malaria preventive and curative care at the household level.
In Burundi, Concern is strengthening integrated Community Case Management to treat malaria in Cibitoke province. A Concern programme in Sierra Leone, ‘Empowering communities to TAP (Treat and Prevent) Malaria’ works with the District Health Team and Health Facilities to build their capacities to treat and prevent malaria in Tonkolili District.
Flooding and Malaria
Recent flooding in Malawi, Mozambique and Zimbabwe caused by Cyclone Idai may be posing a further threat of malaria for survivors and affected as the flood waters subside.
According to the WHO, flooding may initially flush out mosquito breeding, but it comes back when the waters recede. The lag time is usually around six-eight weeks before the onset of a malaria epidemic.
The WHO is preparing for a spike in the coming weeks by procuring 900,000 insecticide-treated bednets to protect all affected families, and ensure rapid diagnostic tests and anti-malarials are positioned to high-risk areas.
Concern has recently purchased and distributed 2000 mosquito nets as part of a life-saving NFI (non-food item) kit to displaced communities in Nhamatanda, Sofala Province in Mozambique. Concern staff working in the area are protected by taking anti-malarial medication, using skin repellents and by sleeping under mosquito nets.
Workers unload emergency kits from a truck at a distribution in Ndeja, Mozambique, which was hard hit by cyclone Idai in March 2019. Photo: Tommy Trenchard / Concern Worldwide.
A future malaria vaccine?
Creating a malaria vaccine is not an easy task, due to the different types of malaria. However, a vaccine has been in development over the past three decades. A large-scale trial being co-ordinated by the WHO, which says the vaccine is the first to provide some protection to children is due to start in Malawi.
In clinical trials, this #malaria vaccine was found to prevent approximately 4 in 10 malaria cases, including 3 in 10 cases of life-threatening severe malaria. https://t.co/EWv4KXu1Vz pic.twitter.com/BfwR4CKwHh— World Health Organization (WHO) (@WHO) April 23, 2019
Remembering those on World Malaria Day
There are regrettably over 1,100 malaria deaths globally every day, from a disease that is technically preventable and is treatable if detected in time. Complacency in the response can kill, and climate change with rising temperatures can result in new areas becoming breeding grounds for malaria if active surveillance is not undertaken.
This year's campaign, ‘Zero malaria starts with me’, emphasises country ownership and community empowerment of malaria prevention and care. Concern works with national ministries of health and with local communities and community health workers in all countries to support delivery on Sustainable Development Goal (SDG) Target 3.3, to end malaria by 2030.
With determined leadership, resourcing and community engagement, this can be achieved.
About the author
Breda Gahan is Concern’s Global Health & HIV and AIDS Programme Adviser. She has over 30 years’ experience working with Concern overseas.
Follow us on Facebook
To keep up-to-date with our lifesaving work around the world join the thousands already following us on Facebook.