Malaria is one the leading cause of deaths in the world. According to the World Health Organization report in 2017, an estimated number of 219 million malaria cases were recorded worldwide and the African region alone recorded the highest of 200 million cases, representing 92%.
Out of the total number of 2019 million malaria cases recorded in 2017, there were an estimated number of 435 000 deaths globally, compared with 451 000 estimated deaths in 2016 and 607 000 in 2010. According the report, children under 5 years are the most vulnerable group affected by the malaria. Africa accounted for 93% of all malaria deaths in 2017 and this was recorded in 17 African countries and India.
The global fight against the menace of malaria, especially in Africa has suffered various degrees of setbacks as huge sums of investments waged into preventive measures seems to fetch little results. Among the challenges in the fight against malaria is inadequate funding, parasite resistance to antimalaria medicines and mosquito resistance to insecticides. These have been a major threat in the fight against malaria in Africa.
One of the ways of preventing malaria is by eliminating the vector and ensuring that the home environment is rid of filth. Surrounding gutters should be clean, weeds should be cleared, getting rid of stagnant water among other measures. To prevent pregnant women from being infected in areas with high transmission of malaria, the WHO recommends the “intermittent preventive treatment in pregnancy” (IPTp) with the antimalarial drug sulfadoxine-pyrimethamine.
Other preventive measures include sleeping under the insecticide treated net (ITN), indoor residual spraying (IRS), a prevention method that involves spraying the inside walls of dwellings of mosquitoes with insecticides.
The ITNs are effective tool for malaria prevention, even in areas where mosquitoes have developed resistance to antimalaria. The ITN is also the cheapest, easy and economical to use since they are given out free of charge. People are also educated on how to effectively use and preserve it. Areas with high rate of malaria incidence but low income find the free ITNs a safe haven to combat malaria as far as its prevention is concerned since they can’t afford buying the insecticide spray and coils.
However, these preventives measures are not properly adhered to, perhaps due to ignorance or inadequate knowledge and understanding of the cause of malaria. Other reasons are the belief system, especially among the rural folks where the malaria disease is believed by some to have spiritual cause.
Here in Ghana, there is a worrying trend and perhaps barbaric behavior of some rural folks who instead of using the ITNs for the purpose to which it was provided to them free of charge, find the ITNs rather suitable for making their gardens and farms. These people use the nets to fence their gardens and farms to ward off animals from destroying their crops but do not see it prudent to use the it to ward off mosquitoes from destroying their health and killing them. This trend may not be limited to Ghana only but widespread in some parts of Africa.
Despite the widespread education on the use and importance of the ITNs by the public health workers at the health centers and in the communities and the caution that it should not be sold or use for any other purpose other what is meant for, thus preventing malaria, the trend continues to fester in some parts of rural and even urban dwellers in Ghana.
The introduction of the malaria vaccines in Ghana is a new dawn and best alternative in the fight against malaria and it is expected that Ghanaians welcome and embrace the program. But this has rather attracted some opposition on social media with some issuing stern warning with the fear that the vaccines may contain chemicals that can cause infertility in woman in the future and this, they argued, will be a way of controlling the population of Africa, among other misguided utterances. This pronouncement only goes to accentuate the fact of the misconception held by many about the malaria disease. It also explains why ITNs are used for fencing gardens and farms instead sleeping under it to protect themselves from getting malaria.
The development of the malaria vaccine has been in existing for over 30 years in Europe and the first humans to receive it were volunteers in US in the phase one clinical trials about 20 years ago.
Similarly, the vaccines have been tried and tested in Africa and are safe to be used, contrary to the belief of some section of Ghanaians who are trying under the influence of ignorance, to throw dust into people eyes. The first trials of the vaccines in Africa was in 2006 and it was done in 7 African countries including Ghana under strict monitoring per the WHO protocols. In Ghana, it took place in Kintampo and Agogo and about 15000 children received the vaccines and no adverse effects have been reported since then till date. WHO news release April 2019.
Ghanaians should be assured that the malaria vaccines are safe to use with no harm since every experiment on human populace such as medications trials are governed by international laws. For example, the Nuremberg Code states that every experiment on human populace must “avoid unnecessary suffering, be no predictable death or disability, not have risk greater than importance of problem…” or the Declaration of Helsinki which also states that in every human experiment “interest of subjects must always prevail over interest of science and society, importance in proportion to risk, informed consent…”.
The misconception, myths, supernatural belief and ignorance of the cause of malaria are some of the reason mitigating the progress of the global fight against the malaria and governments in the sub-regions need to intensify the education on the fight against malaria to demystify the myths and related wrong notions held high by some people.
Government should also intensify its public health education by adequately resourcing public health unit to be able to carry out its mandate effectively, especially to the hinterlands. The education will help people to understand the essence of the malaria vaccines and appreciate advancement in science and technology.
EMMANUEL KOJO OFORI
BSc. PHYSICIAN ASSITANT STUDIES
LEVEL 200 (UNIVERSITY OF CAPE COAST)
SENIOR STAFF NURSE
ANKAFUL PSYCHIATRIC HOSPITAL