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Malaria resistance to drugs plagues Tanzania
2008-04-25 09:59:51
By Ritah Wanza
It was a hot afternoon in a tiny coastal village in the south of Pemba five years ago as the funeral procession made its way to the gravesite.
The village was mourning the passing away of a five year-old child.
Very few in the funeral procession knew the cause of Hafidh Aziz`s death. The theories surrounding his death were all conflicting, some said he had been bewitched and others charged he had died as a result of a curse running in the family.
But the doctor who examined Aziz back then saids he died from malaria, a theory the villagers didn`t want to believe and a disease they didn`t react to the same way they reacted to HIV/AIDS back then, yet it was the number one killer back then.
His 23 years old mother still remembers how it all started, she says Aziz developed a high fever, chills and flu like symptoms and she tried to nurse him at home as she could not afford to take him to the hospital, 35 kilometres away.
Three days later, her sister suggested that Aziz had been bewitched and they took him to the village`s witchdoctor who gave him some concoctions which did not seem to help.
With no change and the little boy getting worse, she decided to take him to hospital where he was admitted. Three days later Aziz passed away.
Aziz`s case is just an example of what was happening to millions of children in Africa four or three years ago.
Fortunately, this doesn`t happen anymore due to the continued efforts of African countries to try to reduce the malaria morbidity in endemic zones, and thus began the Africa Malaria Day.
AMD which is being commemorated today is a result of a meeting that was held in 2000 in Nigeria.
African countries met there on April 25, 2000 and signed the Abuja Declaration, committing their countries to decreasing malaria deaths in Africa by 50 percent by 2010.
This event has been commemorated every year since the year 2000.
So what has the United Republic of Tanzania achieved in the fight against this endemic disease and what setbacks are being faced in the fight against malaria?
Has it achieved the targets set by the Abuja Declaration?
To understand all this we need to look at Zanzibar`s example in fighting malaria since it has been considered as one of the major endemic regions in Tanzania.
To reduce the burden of malaria, Zanzibar scaled up malaria control strategies, with major financial support from the Global Fund Against Aids, Tuberculosis and Malaria (GFATM), in addition to resources from other partners such as the President`s Malaria Initiative (a five-year $1.3-billion program announced by US President George W. Bush in 2005 intended to cut malaria-related deaths by half in 15 African countries)
Their first strategic plan, the roll back malaria strategic plan (2003- 2008) was successfully implemented and required a pre-term revision and the formulation of a new plan for the period 2008-2012.
In 2005 the Public Health Laboratory, Italian Cooperation, the President Malaria Initiative (under USAID-Tanzania), the Global Fund, the Center for Disease Control and Research Triangle Institute carried out a survey in Zanzibar that allowed the Zanzibar malaria control programme to assess the mid-term implementation of the strategic plan and to verify the status of achievements of the Abuja Roll Back Malaria target set for that year.
The survey included a consolidated community survey for assessing early malaria treatment behaviour, prevention of malaria in pregnancy and utilization of insecticide treated nets together with the collection of blood films to verify the actual malaria parasite prevalence in Zanzibar.
The completion of the survey represented a milestone in the implementation of malaria control activities.
In 2005, 45.8 percent of children under the age of five were diagnosed with malaria.
That percentage dropped to 5.8 percent in 2007. So what attributes to the drop in malaria cases in this endemic region?
This has been due to an initiative introduced by the Zanzibar malaria control programme (ZMCP) to distribute insecticide treated nets to every household.
Their program is built around distributing bed nets; spraying insecticide inside homes for three consecutive rounds; providing proper case management and proper diagnoses with RDT (Rapid Diagnostic Test) for the most vulnerable groups.
The use of Insecticide Treated Nets in the general population has increased from 2.8 percent in 2002 to 60 percent in 2007.
For the vulnerable groups the increase has even been more impressive: from 0.3 percent to 74 percent for the under-five children and from 3 percent to 73 percent for pregnant women.
Between 2002 and 2007 households with at least one treated net increased from 3 percent to 82 percent.
So what are the setbacks being faced in the fight against malaria in Tanzania?
The biggest setback is drug resistance; mosquitoes that carry malaria have developed resistance to insecticides while the parasites have developed resistance to antibiotics.
Conventional anti-malarial drugs such as chloroquine and sulphadoxine/pyrimethamine (SP) have become increasingly obsolete in the face of growing drug resistance making it a problem to fully eradicate malaria in Tanzania.
This has led to difficulty in controlling both the rate of infection and spread of this disease.
But with the new combination drugs available like ACT, LLITN, IRS and proper diagnosis, still there are some hopes for a better future in controlling malaria.
The other setback is lack of funds and ignorance by many communities.
The statistics are there yet several authorities do not offer the much needed support to non-governmental organizations (NGOs) that are helping in the fight against malaria.
Communities need to be educated about malaria prevention and cure.
People need to be taught how to use the insecticide treated nets.
And this means allocation of more funds dedicated to the prevention and treatment of malaria if the country is committed in the realization of the Abuja target of reducing malaria by 50 percent by 2010.
But with the help and continued support the country has been receiving from USAID through the President Malaria Initiative this looks like a target that Tanzania might just reach.
No child should die from malaria; it only costs $ 4 to prevent it!
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