Thursday, January 4, 2007
Malaria – an easily preventable disease
By: James Addy
t is a real pity that the graveyards in the country are always full of bereaved persons and mourners at weekends expressing profound grief over the passing away of loved ones, most of whom have died of an easily preventable disease like malaria.
Patients who seek treatment for malaria, the medical authorities say, constitute the highest of recorded cases in Out-Patient Departments in Ghanaian hospitals but this fact is often taken for granted. Lack of knowledge on the havoc that malaria could wreak on individuals has led to a state of complacency in most families and communities.
paigns on the seriousness of the disease and its fatal consequences has often been down played by especially people who patronize local herbal concoctions for the treatment of malaria. They often consider the disease so common and proudly claim that their clansmen and women have over the years relied on local remedies and not conventional scientific medicine for the effective treatment of malaria.
Dr Margaret Gyapong, a social researcher at the Dodowa Health Research Centre in the Dangme West District, explains that: “Attempts at malaria control in the past failed because too often behavioural and socio-cultural aspects that influence peoples attitude were considered an afterthought.” She disclosed that early work on malaria focused on vector control without reference to human behaviour and belief systems.
According to the WHO, at least 300 million people suffer from acute malaria each year. Children aged under five years; pregnant women, unborn children and the elderly are the most vulnerable with about 3,000 deaths a day. Malaria attacks are associated with poor social and economic environment conditions and victims are mainly the poor.
Dr Gyapong said local perceptions about the causation of malaria include standing in the sun, eating sweet and oily food, poor environmental sanitation, poorly cooked food and convulsion.
Surprisingly, most organizations and individuals embark on frequent public clean-up campaigns to clear rubbish and other filth in gutters as a measure to eradicate mosquitoes in general. But the anopheles mosquito, the peculiar specie prevalent in West Africa is found in “clean and stagnant waters” and at even unexpected places like flower pots, where it tends to seek shelter.
Of course keeping a clean environment is desirable but targeting the actual breeding site of “clean and stagnant waters” for effective control should be the ultimate. Some people mistake malaria symptoms to be typhoid and would pursue the wrong treatment until their physical conditions worsen, sometimes resulting in death. The matter is not helped when some clinicians sometimes misdiagnose malaria cases in their haste to attend to other patients.
Nafisatu, a JSS student in Accra, told her story: “I reported to the doctor that I was feeling feverish and was looking forward to further guidance from him on possibly a laboratory test, but before I could finish my story he handed me a prescription to go and buy medicines and I wondered whether I have had a thorough examination.”
Again, the problem of incomplete treatment of malaria which leaves some of the malaria parasites uncleared in the blood-stream had been hammered so often that it now sounds like a boring subject yet it is at the root of the resistance of some malaria drugs to effective treatment.
Of course, if the cost of malaria drugs is to high, people especially in rural communities might tend to defer treatment, oblivious of the adverse consequences. Sometimes the long travel distance to a clinic or hospital, combined with cost of drugs, tend to offer an easy excuse to some people to resort to local remedies, some of which have not gone through certification by the Food and Drugs Board for their efficacy and safety to be ascertained.
Again, data collection on malaria cases in the country has become difficult because a lot of malaria related illness or deaths often take place at private homes and health authorities cannot obtain the figures for policy planning.
Mrs. Constance Bart-Plange, programme manager of Ghana’s Malaria Control Programme, said malaria is the leading source of illness and absenteeism in school-age children and teachers, and the leading cause of child mortality in endemic areas.
It causes anemia in pregnant women and low birth weight in infants. Malaria morbidity and mortality, Mrs. Bart-Plange says are increasing in Africa. She said the current malaria control strategies are to provide early diagnosis and prompt treatment. Another strategy is to detect malaria prevalence early, contain it or prevent the epidemic.
Dr Fred Binka, Executive Director of INDEPTH-Network, and international network of field sites which continuously evaluates populations and their health in developing countries, has called for vigilance against malaria drugs that are imported into the country.
He said the Food and Drugs Board should be properly equipped to test and also certify malaria drugs to prevent the consumption of fake drugs with adverse consequences on the health of people.
The initiative by a group of African journalists trained by Women Media and Change, (WOMEC) a local non-governmental organization on malaria prevention to use the media to disseminate accurate information about the disease is commendable. They will have to monitor and advocate the implementation of effective malaria polices in their respective countries.
National governments who devote less amounts from their health budget for malaria control and only look up to overseas donors for gifts in the form of insecticide treated nets (ITNS) with its attendant delays in shipment and other cumbersome procurement procedures may be denying their citizens early preventive care.
Why should some African states sign up to the 2000 Abuja declaration, pledging that by the end of 2005, 60 per cent of the people at the highest risk of malaria would have insecticide treated nets and effective treatment of the disease and yet did not make adequate provision in their budgets to procure such nets on their own?
District Assemblies should begin to take seriously the inputs of the health representatives on their assemblies and comply with the utilization of the statutory “not less than one per cent” allocation of the Common Fund for Malaria Control and HIV/AIDS preventive programme.
Arguably, the use of the ITNS has been the most effective means of preventing malaria and efforts should be made to convince more people to use the nets in addition to managing stagnant waters where the mosquitoes breed. That way, they could enjoy continuous good health free of the discomfort that malaria brings
The Ghanaian Times - - Page 7