10 Top Malaria Control Methods in Nigeria: Journey towards Malaria Free Society
10 Top Malaria Control Methods in Nigeria: Journey towards Malaria Free Society
Nigeria, a country with population of about 190 million people (United Nations Department of Economic and Social Affairs: Population Division, January, 2017) is burdened with malaria health problems. It is estimated that 90% of the total malaria cases and deaths occur in Africa and Nigeria accounts for a large percentage of this population. According to USAID, 2013, people mostly affected live in extreme poverty and have no access to potable water and adequate healthcare. Nigeria is also a low-income country already saddled with a huge foreign debt burden. She risks sinking further into debt as she struggles with a sick populace whose good health is essential for her economic growth. The rural area of the country records the highest death toll because of the difficulties of accessing health facilities. Part of the problem is that most people prefer over the counter drugs instead of going for confirmatory diagnosis. It was reported by Chukwuocha, in 2012, that malaria, a highly endemic disease in Nigeria accounts for 60% outpatient visits to health facilities, 30% childhood death, and 11% of maternal death with over 4,500 dying annually.
In a journey to malaria free society, Nigeria has adopted measures to cob mosquitoes and malaria. Method of preventive and control of malaria in Nigeria involves the control of its carrier vector mosquito especially the female anopheles. Lehmann et al, 2010, reported that the rate of transmission of parasite causing malaria differ depending on local factors such as rainfall patterns, the proximity of mosquito breeding sites to people and the type of mosquito species in the area. As malaria control intensifies, World malaria report; (2008) suggested malaria monitoring is vital to trends, control and track the coverage and impact of interventions while malaria undoubtedly imposes a major public health burden in Nigeria and around the world. Vector control has saved millions of lives worldwide. Some of the malaria control methods adopted in Nigeria are discussed below:
Insecticide Treated Nets
Insecticide Treated Nets, (ITN) and Long Lasting Insecticide Treated Nets (LLITN) are two most widely adapted mosquito control and consequently malaria. In this method of control, a person sleeps under insecticide treated nets [ITNS]. The method works not only by creating a barrier between the mosquito and the intended meal, but also by killing the mosquito if it lands on the net. This was reported by Grover et al, 2006. Reduction of human-vector contact through insecticide-treated bed nets is better suited for malaria control in Africa (Nigeria inclusive). It enjoys greater community acceptance in Nigeria and is as efficacious as indoor residual spraying. Although they are inexpensive and effective, fewer than 2% of Nigerians sleep under them WHO; (2000). Massive campaigns to increase awareness and consequently use of ITN are required as a matter of urgency especially in rural Nigeria. It’s reported over 17million Insecticide Treated Nets provided for over 190million people is grossly inadequate.
Chemicals Control of Victors
Vector control using Dichlorodiphenyltrichoroethane (DDT), an organochlorine pesticide, became widely used in pest control after its discovery in 1972. Although there are fears these chemicals might be potential human carcinogen. However, some nations including Nigeria still effectively use DDT formulae control. This method too is adopted in some quota in Nigeria especially in open camps of with mosquitoes to prevent malaria prevalence. According to NMEP, 2014 reports, workers are being trained by Ministry of health and other health agencies on how to spray the various sites and surrounding environment properly. This training involves how to wear protective clothing and nose masks and other necessary safety precautions that should be taken when on a spraying mission. This is not so widely known and adapted in most rural areas in Nigeria. However, Insecticides like Raid, Rambo and mosquito wipers are been used.
Nigeria is doing quite well is area enlightenment campaigns against malaria for her people. The Nigeria government through the effort of agencies National Malaria Elimination programme, NMEP, Roll Back Malaria Programme, RBMP and regular Annual Re-union on Malaria, ARM is able to sensitize her people. This has gain momentum over the last ten years, but has also led to acceptance of other control method like Use of ITN, IRS, DDT, and so on. The ARM provided NMEP the opportunity to assess the status of malaria control across the States and the FCT, updated participants knowledge on the current trend of malaria interventions globally, highlighted best practices, identified bottlenecks and at the same forum, proffered possible solutions. The meeting platform was leveraged for advocacy to key stakeholders for increased funding for malaria control activities in Nigeria as well as initiate resource mobilization efforts for implementation of New Strategic plan.
Indoors Resident Spraying (IRS)
This method as reported by Alnwick, 2001, is effective vector control adopted in Nigeria. This method involves spraying of inside wall of houses with residual insecticides. When the mosquitoes rest on walls, they absorb the insecticides through their feet. The pesticides either kill them immediately or soon afterwards. Its cost, logistical complexity and moderate efficacy make it poorly suited for controlling malaria in the rural areas. Although unpopular, IRS has finding its way into mosquito and malaria control methods in Nigeria.
Housing Control Method
According to WHO, 2016, Nigerian Government through housing programme is provide alternative malaria control for the urban dwellers. Most local dwellers, however, live in mud houses and the method is limited. Wall plastering and painting are part of the education NMEP and RBMP is taking to the rural dwellers as malaria control measures. This will prevent water from being collected in the walls for mosquitoes breeding and attraction.
Use of Anti-mosquito Plant and Repellants
It was reported by RBM, 2008, some local herbs contain mosquito repellant properties when burnt. These natural plants produce chemical substances against insects such as the mosquito. In some rural Nigeria, these plants are gather and burnt once night falls. Although, this method is not scientifically proven, it is commonly practices. The diverse and dense savannah and rainforest regions could hold the key to malaria control. It’ time to start looking within communities for measures to use to fight the mosquito. More research on indigenous plants and trees which local people claim contain anti-mosquito properties are being prioritized.
TDR Sponsored Research
Falade et al, 2007, Reports Topical Disease Research (TDR) implementation research to increase access to necessary drugs, more especially anti-malarial drugs was launched in Nigeria in 2006. This focused on home management and community directed models for malaria treatment. This does not target only discovery of malaria drugs but also identification of active ingredients in locally used repellants. This is giant stride toward drug discovery, mosquito and malaria control.
Clinical Treatment of Malaria with Use of Drugs
Many options are available for malaria treatments. As reported by Olowe, 2015, new methods of treatments are coming up daily due to modern techniques of understanding parasite mode of drugs resistance. Accessibility of primary healthcare centers and affordability is important to malaria treatment. Units within primary healthcare centers had been set up across the country to diagnose, treat and monitor cases malaria. These centers are provided with basic equipment required to check blood films for malaria parasites and a full blood count. According to RBM, 2008, all drug resistant cases are expected to be reported/referred to tertiary health centers for alternative lines of management, such as radical drug treatment combinations. Also, during seasonal outbreaks of malaria, anti-malaria prophylaxis are provided for children and pregnant mothers.
Use of Artemisin Combination Therapy (ACT)
In Nigeria, Arthemeter lumefantrine combination has been adopted as the first line drug due to its safety and effectiveness for treatment of acute uncomplicated malaria. This drug comes in several brand names and has been subsidized by the Nigerian government to make it more widely available for prompt, effective and affordable treatment. This was reported by Falade et al. 2007 with the hope that effective treatment will assist in reversing the apparently increasing death rates of children Nigeria. The National Malaria Control Program (NMCP) delivered 4.5 million courses of ACT in 2006 and 9 million in 2007.
Walker 2002, reports that other methods of vector control with varying degrees of success had been recorded in Nigeria. These methods include larviciding, removal of breeding grounds by drying up wet lands or ensuring that pools of standing water are drained or by using biological agents such as fish that eats mosquito larvae. The success of these controls depend highly on type of vector and its breeding habitat, geography of the area and socioeconomic status of the population at risk. Although some of these methods have not really foot their leg on ground in Nigeria despite government and agencies’ effort at sensitizing people. They are being practice in some quota at individual level.
These are some of the methods adapted and use in the control of malaria in Nigeria. Although the journey has not been easy. However, the country and her government are not sleeping. The desire and effort to see a malaria free Nigeria society is at top gear by government, corporate bodies and individuals.
Alnwick D (2001). Meeting the malaria challenge. Africa Health Supplement. Pp18-19.
Chukwuocha UM (2012) Malaria Control in Nigeria. Primary Health Care 2:118. doi:10.4172/2167-1079.1000118
Grover KE, Kawano M, Klaver R, Blumental B, Connor S (2006). An online operational rainfall monitoring resource for epidemic malaria early warning systems in Africa. Journal of Infectious Disease.185 (8):1143-1146.
Lehmann T, Dao A, Yaro A S, Adamou A, Kassogue Y, Diallo M, Sékou T and Coscaron-Arias C Aestivation of the African Malaria Mosquito, Anopheles gambiae in the Sahel. Am J Trop Med Hyg September 2010 vol. 83 no. 3 601-606
National Malaria Control Programme. Federal Ministry of Health. 2011. Implementation Guide for Parasite-Based Diagnosis of Malaria
Nigerian Demographic and Health Survey (2011) Federal Ministry of Health, Abuja.
Olowe O. A, Makanjuola O. B., Awa A. o. and Olowe R. A (2015) Malaria in Africa and Historical Perspective: The Journey so Far. Journal of Biology and Medical Sciences. An international Peer-reviewed Journal. Vol. 3, 2015
United Nations Department of Economic and Social Affairs: Population Division, population report, January, 2017
USAID (United States Agency for International Development), and PMI (President’s Malaria Initiative). 2013. Country Profile.
Walker K (2002). A review report of control methods for African malaria vectors. Environmental Health Project, Activity Report 108.
World Health Organization (2012) Roll Back Malaria (RBM) Partnership. WHO Technical Report Series, Geneva.