MALARIA: Nigeria statistics

Experts say that every 30 minutes, a child dies of malaria.
In Africa, the disease causes about one in six childhood deaths, taking the lives of more than 750,000 children a year and placing an unacceptable burden on health and economic development.Mrs. Taiwo Olarinde, an assistant Manager, Global Fund Malaria Programmes, Society for Family Health (SFH), Ibadan, stated that statistics show that about 63 per cent of hospital attendance in Nigerian health facilities is as a result of malaria. According to her, “this disease also accounts for three out of every 10 childhood deaths, and 705 of illnesses in children under the age of five. More precisely, a child in Nigeria dies of malaria every 30 minutes! Malaria also accounts for one-tenth of maternal deaths in Nigeria! The climatic condition that obtains in the tropics, where Nigeria is geographically located, further favours the breeding of ‘culprit’ mosquitoes that act as vectors for the disease.”She stated, “it is rather ironical and unfortunate that an average citizen still seems to be unaware of the severity of this recognised ‘common disease’. In fact, it is a general believe now that once you have not had Malaria, you are yet to be a Nigerian! The disease has been so trivialised among the rank and file so much that parents now resolve to have malaria in their children treated at home first as compared with some other less severe diseases that are referred to health centres. This disturbing phenomenon of having malaria (in children especially) treated at home, she declared, could lead to the disease progressing to the severe or cerebral stage, which will doubtlessly necessitate urgent and advanced medical attention.Sadly, pregnant women constitute another vulnerable group to malaria, because pregnancy reduces a woman’s immunity to malaria, making her more susceptible to malaria infection and increasing the risk of illness, severe anaemia and death. For the unborn child, maternal malaria increases the risk of spontaneous abortion, stillbirth, premature delivery and low birth weight - a leading cause of death in children.About two thirds of pregnant women in sub-Saharan Africa attend antenatal clinics at least once during pregnancy, presenting a major opportunity to prevent and treat malaria through ‘intermittent preventative treatment’. Pregnant women, as part of their routine antenatal care, are provided at least two doses of a safe and effective antimalarial (currently, sulphadoxine-pyrimethamine) during the second and third trimesters of pregnancy.The World Health Organisation (WHO) recommended a three-pronged approach to the prevention and management of malaria during pregnancy based on scientific studies. These included the use of insecticide-treated nets (ITNs), intermittent preventive treatment and effective case management of malarial illness.However, boosting access to malaria in pregnancy services was central to making pregnancy safer as evidenced by the situations in Akwa Ibom State, where community service delivery of malaria in pregnancy interventions caused more pregnant women seek antenatal care from the registered government clinics.When Jhpiego, an affiliate of John Hopkins University, USA, made an assessment visit to Akwa Ibom State in 2006, they found that health staff were unfamiliar with intermittent preventive treatment of malaria for pregnant women (IPTp). They also did not have stocks of insecticide treated bed nets (ITNs) to give pregnant women and children.Attendance at local government area (LGA) antenatal care (ANC) clinics, where IPTp and ITNs should have been available, was less than 20 per cent of pregnant women in the area. Community members complained of poor quality ANC services. Finally, the antenatal care staff had not been trained in malaria in pregnancy (MIP) control as part of antenatal care services.It was on this basis that an intervention to address these gaps in MIP services in four LGAs and 15 primary care health facilities (PHCs) and their surrounding communities was started by Jhpiego in partnership with ExxonMobil Foundation, USA and Akwa Ibom State Ministry of Health, Uyo. It involved training of staff, provision of sulfadoxine-pyrimethamine (SP) for IPTp and basic MIP training, including Prevention of Mother-to-Child Transmission of HIV/AIDS (PMTCT) and Health Management Information System (HMIS). In the intervention LGAs Staff were also trained in community mobilisation including how to implement the community directed interventions (CDI) approach that had been found so successful by the African Programme for Onchocerciasis Control.The CDI ensured an extension of the provision of MIP services through community directed distributors (CDDs) who were selected by their kin groups and trained and supervised by the PHC staff. They were given kits containing SP for IPTp, record books and health education materials as well as ITNs for distribution to pregnant women. They referred pregnant women to ANC to receive all the other basic ANC services such as additional doses of IPTp, blood pressure monitoring and tetanus toxoid immunisation.Indeed, the Akwa Ibom project led by Jhpiego’s country director in Nigeria, Professor Emmanuel Otolorin, marks an important demonstration that NGOs, private corporations, communities, state and local governments can work together to provide malaria services to people who need them. Certainly, the CDI approach that links communities and clinics apart from improving ANC attendance, can now add MIP control to its successes in efforts to eliminate other tropical diseases.At the onset of the interventions, the number of women that had received the required two doses of IPTp increased from 28 per cent in two years interval to 77 per cent in the intervention areas compared to 50 per cent in the control group. ITN use by these recently pregnant women increased from 44 per cent and 46 per cent in the intervention and control areas at beginning of the study to 73 per cent and 58 per cent respectively. Dr. Martins Ogundeji, Executive Director of Primary Health Care & Health Management Centre, Yemetu, Ibadan, Oyo State, corroborated the need for interventions at the community level that would ensure early detection and appropriate treatment of malaria.According to him, a recent trial of the Ward Health system that was carried out in two local government areas in Oyo state, which ensured trained community members can identify dangers in malaria in pregnant women and ensure that appropriate steps corroborate the importance of interventions that link communities and clinics apart from improving ANC attendance.
Written by Sade Oguntola
http://www.tribune.com.ng/index.php/your-health/4606-malaria-deadly-and-can-kill-within-hours