Nigeria calls for better approach to eliminate malaria

Gloria Essien, Abuja

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National Malaria Elimination Programme (NMEP), has called for collective efforts, which requires a multi-pronged approach that includes both preventive and curative measures for the elimination of malaria in Nigeria.
The National Coordinator of the programme, Dr Audu Bala Muhammed, stated this at the Second Quarter Media Chat in Abuja.
He said that major stakeholders need to combine efforts to fight malaria.
“Malaria is still a major cause of morbidity and mortality in Nigeria, though its prevalence has reduced from 42% in 2010 to 27% in 2015 (MIS). The symptoms associated with malaria which includes fever, headache and body pains are also symptomatic of a number of other infections. What we have observed is the tendency for the average Nigerian, once he/she exhibits these symptoms, to go for malaria treatment immediately. The World Health Organization (2017) reports that of 57.3 million estimated cases only about 12.4 million cases were confirmed within the sub-Saharan region. WHO noted that a median of 47% (of febrile children with reported fever in the past 2 weeks) were taken to a trained provider i.e. to public sector health facilities, formal private sector facilities or community health workers). When the proportion of febrile children aged under 5 years for whom care was sought with the proportion of those for whom care was sought who received a parasitological test were combined, it reported a median of 30% of febrile children received a parasitological test within the region”.
He said the media parley was aimed at enlightening the general public on the guidelines for the treatment of malaria which recommends diagnosis in all suspected cases before administration of treatment where positive results occur with the recommended medicine –Artemisinin Combined Therapys (ACT)
“Usually, there are two types of tests – microscopy and rapid diagnostic test. The test is meant to provide evidence of the malaria parasite in the blood of the patient before he can be treated. Our guidelines emphasize the importance of high-quality microscopy and, where not feasible or available, quality-assured Rapid Diagnostic Tests (RDTs)”, he explained.
The National Coordinator also said that the Social and behaviour change communication underpins the entire spectrum and ensures improvement in uptake of the malaria interventions and, subsequently, in achieving the elimination goal.
Dr Muhammed pointed out that in collaboration with Rollback Malaria partners, ACTs and RDTs are being made available free to public health facilities in most states of the federation and efforts are on-going to ensure that these are upscaled to all public health facilities across the country.
He added that the national Malaria Elimination Programme is also embarking on advocacy with all relevant partners and governments at various levels to ensure the provision of malaria commodities to the private sector health facilities at subsidized rates and encourage Nigerians to adopt the right health-seeking behaviors for the elimination of malaria through credible information.
In a paper titled Diagnosis for effective malaria treatment in contemporary Nigeria, the head of Malaria Case Management Unit NMEP, Dr. Nnenna Ogbuluafor, said that Malaria Case Management entails early Diagnosis and Prompt Treatment within 24 HOURS of onset of symptoms.
She said that Nigeria has adopted the WHO recommendations that all cases of fever must be; TESTED, TREATED AND TRACKED (3Ts)
“To test all care-seeking persons with suspected malaria using a malaria Rapid Diagnostic Test (mRDT) or microscopy by 2020” (NMSP 2014 – 2020). Treatment of confirmed cases of uncomplicated malaria is with Artemisinin based Combination TherapiesAll Oral Antimalarial Monotherapies, Chloroquine and Sulphadoxine-pyrimethamine, Halofantrine etc have been BANNED for the treatment of uncomplicated malaria,” She emphasized.
The unit head also called for increased awareness and sensitization on the need for testing before treatment of all fever cases, exploration of ways to increase accessibility to diagnosis in private sector, training and retraining of malaria microscopist across the country and continuous monitoring of health workers for Quality Assurance.
Challenges
Dr. Ogbuluafor pointed out some of the challenges facing malaria elimination in Nigeria to be but not limited to: Inadequate/lack of awareness of the need for diagnosis before treatment
Accessibility to diagnosis in the private sector is minimal due to cost and other factors
Inadequate number of trained malaria microscopist across the country.
Inadequate monitoring of health workers to ensure quality, aming others.
The second quarter media chat was organized by the National Malaria Elimination Programme (NMEP) with the support of Global Fund (GF).
Bilkisu Pai