By Onche Odeh
Nigerian pharmacist, Livy- Elcon Emereonye, has unveiled a catalogue of strategies that could help Nigeria and Africa effectively tame the menace of malaria.
In a book titled 'Malaria War-the winning strategies' unveiled last week, Emereonye articulated strings of available strategies that, if effectively harnessed, could swiftly reduce the incidence of malaria in endemic countries.
The pharmacist who is President of Public Health Promoters Initiative and member, Commonwealth Pharmaceuticals Association highlighted how the burden of malaria in Nigeria and Africa could be tackled through proper documentation of data, reliable diagnosis, appropriate drug prescription and dispensing, research and development.
Speaking on these strategies as documented in the book, Emereonye said, "As stated in the preface, the primary objective of this work is to reduce the malaria menace to the barest minimum."
"The emphasis is on how to reduce the disease burden and mortality among children under five years, reduce severe morbidity and mortality in all age groups, as well as reduce the occurrence of epidemics and at the same time reduce its incidence and mortality among migrant workers and their dependants," he further explained.
Highlighting the need to imbibe comprehensive strategies in malaria control across the continent the author stated that, "Every day, about 25 million pregnant African women risk severe illness and harm to their unborn children from malaria infection."
This adds to the fact that 30 countries in Sub-Sahara Africa accounts for 90 per cent of the global malaria deaths, with Nigeria, Democratic Republic of Congo (DRC), Ethiopia and Uganda accounting for 50 per cent of the global deaths from malaria.
Narrowing this trend to the situation in Nigeria, Emereonye said, "In Nigeria, malaria is indeed a major public health problem as it accounts for more cases of illnesses and deaths than in any other country in the world."
According to him, 90 per cent of Nigeria's over 160 million people are at risk of being infected with the malaria-causing parasite.
"There are estimated 100 million malaria cases with over 300,000 deaths per year in Nigeria, as more than 50 per cent of Nigerians will have at least one malaria attack in a year," he highlighted in the book.
Although a lot is known about the incidence of malaria in Nigeria and other African countries, the statistics are still far from reliable.
Emereonye buttressed this in his book, where he said, "Documented statistical medical records are scanty in Nigeria."
"For instance, who documents malaria morbidity and mortality in most of the rural areas?" he further queried in justification of the enormity of malaria burden in the country.
He, however, proffered solutions that cut across various stages of interventions. These include the use of long lasting insecticide treated nets, the use of effective insecticides for indoor residual spraying (IRS), the use of mosquito-repellant creams, easy access to prompt and effective treatment after proper diagnosis, intermittent preventive treatment for pregnant women and maintainance of clean and healthy environments.
"Prompt and accurate diagnosis of malaria is necessary for effective disease management and, if implemented, will help to reduce the unnecessary use of antimalarials," the pharmacist noted.
According to him, malaria diagnosis could be ascertained when there is either evidence of parasites in the blood through microscopic examination or presence products of the parasites based on detection of antigens or enzymes of the parasites.
He listed a range of antimalarials that are used to treat malaria, to include Quinine, Amodiaquine, Pyrimethamine, Sulfadoxine, Mefloquine, Atovaquone, Primaquine, Halofantrine, Lumefantrine, Artemisinin and others, which he said are best used in appropriate combinations based on WHO recommendations.
He, however, warned against indiscriminate use of these medicines to avoid the parasite developing resistance.
"Resistance has arisen to almost all classes of antimalarials, especially those used as monotherapies, increasing the global malaria burden and major threat to malaria control," he said.
Speaking on commitments that could drive malaria control efforts, Health Editor with Vanguard Newspaper, Mr. Sola Ogundipe, who reviewed the book said, "Although there have been gains arising from interventions In terms of total numbers and threat potential to human life, malaria is public
health enemy Number one in Nigeria."
He said, "In July this year, the Malaria Situation Room, an intelligence malaria gathering unit put together by the Roll back Malaria (RBM) and its partners for the 10 hardest-hit African countries, ranked
Nigeria with Africa biggest malaria burden," highlighting the need for effective actions to control malaria in Nigeria.
Citing data from the World Health Organisation (WHO), Ogundipe said, "a quarter of all malaria cases in Africa occur in Nigeria," adding, "Indeed the numbers are numbing. In absolute figures, malaria is the biggest killer of Nigerian children under five years of age and a major contributor to the nation's maternal mortality indices."
Although there is currently no universal vaccine available for malaria, the book's author said any effort in that regards must target several stages of the parasite's life cycle.
"Science still has no magic bullet for the disease and there are doubts that such a single solution will ever exist. Nevertheless, effective low-cost strategies are available for its treatment, prevention and control and the Roll Back Malaria global partnership are still vigorously recommended," Ogundipe said, affirming the need to imbibe a war posture in all efforts to control malaria in Africa.
