It’s 6:00 a.m. as usual Accra is bursting at the seams. As usual, the Obetsebi Lamptey Circle and the Kwame Nkrumah Interchange stretch on the Ringway West is quite busy. People are walking briskly to their business locations within the metropolis to eke out a living.
Parked along the stretch are VIP buses“on scale” which have spilled over to the Accra Digital Centre, waiting for their turns to take to the terminal to load to their destinations to Kumasi, Wa, Mampong etc.
In the boot of one the buses wasa driver’s mate sleeping soundly in his mosquito net.I reminisced my days with the Navrongo Health Research Centre in the Kassena-Nankani District of the Upper East Region in the ‘90s, when as field assistant in the Mosquito Bednet Studies, I was mandated to visit the compounds in the study area at dawn and night to observe how the beneficiary communities use the insecticide treated bed nets.
I was so curious that I reached out to the driver’s mate. He groaned at me when I interrupted his sleep. But he was still courteous to respond to my intrusion into his privacy.
He told me that he had made it a point to sleep in the net wherever he finds himself to prevent mosquito bites.
Paradoxically,the same mosquito net has been used to cover coconuts parked at the same spot ready for the market. The coconut sellers claim the nets are the old ones.
The Insecticide treated bed nets have been found in many researches to prevent malaria transmission and have been incorporated into the healthcare delivery system in many endemic countries including Ghana.
However, inappropriate use of the life-saving insecticide bet nets in communities within Ghana and other endemic countries where they are used to cover their food stuff, for fishing, for curtains, and for goal post net in some communities, is a source of concern for donor agencies and efforts at eliminating or eradicating the infection in endemic countries.
Some beneficiaries just refuse to sleep in the net claiming that it is warm in the net and others say they look like ghost when they sleep in the net.
“Some people find other use for the net, we are engaging Behavioural Change Communication to get people use the net for the intended purpose, Non-governmental organisations, the Metropolitan, Municipal and District Assemblies and health facilities are advising beneficiaries on the need to sleep in the insecticide treated nets,” Wahjib Mohammed, of the National Malaria Control Programme(NMCP) said.
Although, some of the nets maybe so old (more than three years) that the effectiveness of the insecticide may have expired, the malaria control programme says sleeping under the “old”net is still very effective as a barrier between the human being and the marauding mosquitoes.
Malaria is a life-threatening disease caused by the plasmodium parasites that is transmitted to people through the bites of the infectedanopheles (female) mosquito. It is preventable and curable!
Ghana continues to be a malaria endemic country with malaria affecting all ages but the most vulnerable being children under five and pregnant women.
In 2018, the country recorded 11million suspected malaria cases representing about 35 percent of all outpatient cases seen. Out of the 11million suspected cases 5.5million were confirmed as malaria using microscopy and RDT.
Between 22 percent and 1.5 percent of total admission and death respectively were attributable to malaria, according to statistics made available by the NMCP.
By end of 2018, malaria related deaths all ages, reduced by 85 percentandunder-five malaria case fatality rate reduced by 73 percentusing 2012 as baseline.
The NMCP is consolidating the gains so far chalked up in the fight against malaria, by implementing the scientifically proven interventions under the National Malaria Strategic Plan (NSP) 2014-2020.
Current preventive and curative control interventions being implemented in Ghana are;
Prevention: Insecticide treated Mosquito nets distribution and Intermittent Preventive Treatment for pregnant women (IPTp) implemented nationwide. Indoor Residual Spraying (IRS) and Seasonal Malaria Chemoprevention (SMC) implemented in the Upper East, Upper West and Northern Region
Case Management: Testing symptomatic patient using microscopy and Rapid Diagnostic Test Kit (RDT). For treatment of uncomplicated malaria Artemisinin-based Combination Therapies (ACTs); Artesunate-Amodiaquine, Arthemeter-Lumefantrine and Dihydroartemisinin Piperaquine are used. For severe malaria, Injection artesunate is used with Quinine or Injection Arthemether as alternative.
Implementation of the above interventions are supported by extensive advocacy and behavior change communication and robust surveillance, monitoring and evaluation system.
So far eight countries:United Arab Emirate, Morocco, Turkmenistan, Armenia, Maldives, Sri Lanka,Kyrgyzstan and Paragua have been given a clean bill of health by World Health Organisation for eradicating malaria; that is permanent reduction of worldwide incidence of malaria to zero.
Ghana is stillfar from the elimination stage, where a country is credited for interruptingthe transmission of the malaria parasite species within a defined geographical areas as a result of deliberate action.
Scientistshave been working around the clock to find new tools to tame the tiny stubborn creature that is estimated to killan African child every 30 seconds.
Ghana, by virtue of being in the tropics, is unenviably endowed with the dangerous plasmodium falciparum that kills faster, especially vulnerable groups like children and pregnant women, when not detected and treated early.
The new generation of tools being developed include the RTS, S vaccine which has shown partial protection against malaria among young children. It is currently being rolled outin large scale clinical trial in Ghana, Kenya, and Malawi with a potential of being widely deployed if the vaccine proved safe, efficacious and considered acceptable.
By Salifu Abdul-Rahaman
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