Malaria prevention increases the chances for survival and healthy growth of Mozambican children
Maputo, 27 July 2007 – Malaria remains one of the main threats to the survival of children in Mozambique. It is estimated that this disease is the cause of more than two out of every five deaths among children under five years old in the country. With the support of UNICEF and several other partners, the Government of Mozambique has been undertaking effective actions among the communities, to prevent, control and treat malaria.
The Ministry of Health has made malaria prevention and control a priority. In 1999 it adopted the principles of the global initiative “Roll Back Malaria” – a partnership between WHO, UNICEF, UNDP and the World Bank. Among the various preventive interventions undertaken in this area, particular attention has been paid to the Indoor Residual Spraying (IRS) and to the promotion of the use of insecticide treated bed nets. Concrete examples of these programmes were witnessed by the First Lady of the United States, Laura Bush, when, in late June, she visited programmes supported by the US President’s Initiative for the fight against malaria in Mozambique, Zambia, Senegal and Mali.
In the Action Plan for the Reduction of Absolute Poverty (PARPA), the Mozambican Government set itself a target of 50 per cent IRS coverage by 2009, compared with about 18 per cent in 2005. Spraying campaigns have been promoted in districts regarded as priorities in all Mozambican provinces.
In late June, for example, a brigade led by José Teixeira, who is also manager of the insecticide warehouse, visited Benfica neighbourhood, on the outskirts of Maputo. His team consisted of about 24 agents, each of whom was to spray an average of 5 houses per day.
“We have to obtain good results so that the community becomes aware of the importance of spraying”, said José Teixeira. “Sometimes the community resists, but after we have sprayed several houses, the beneficiaries remark on the good results to their neighbours, and the rest of the community ends up by joining in”.
On one day, officials from the Ministry of Health and a crew from the US television channel CNN, which was in Mozambique to cover Laura Bush’s visit, joined José Teixeira’s brigade. In one house the team surprised Elisa Jeremias, who lives with her husband and four young children.
Elisa did not know that her house would be sprayed that day, but she was aware that spraying was being undertaken in her neighbourhood, and was awaiting her turn. Her 4 year old daughter Isabel seemed to be sleeping peacefully on her lap. But when José Teixeira and his team came closer, they once again understood the importance of their work in that neighbourhood. Little Isabel was unable to stand up on her own. Few days earlier she had been diagnosed with malaria, and she was fighting tenaciously for survival.
“We have lots of problems with mosquitoes here in our neighbourhood. There’s been a lot of malaria. I like the work that is being done to help us fight this disease”, said Elisa, as she comforted Isabel and looked hopefully at the team members who were heading inside her house with the spraying materials.
After the work was over, Elisa and her husband received a detailed explanation of what had been done, and recommendations to follow. They were told that the brigade would return to the neighbourhood three months later.
While spraying interventions are directly led and managed by the Ministry of Health, UNICEF and other partners are supporting a range of other programmes for malaria prevention and treatment. The programme to distribute insecticide-treated bed nets is among those supported by UNICEF in Mozambique since 2000. Pregnant women and children under five years old, as well as orphaned and vulnerable childre are prioritised in this expanded distribution programme.
It is estimated that by late 2006 about 2.1 million of these treated mosquito nets had been distributed in the country. UNICEF has contributed to the distribution of 64 per cent of these nets. In the first 6 months f 2007, about 172,000 mosquito nets were also distributed through programmes supported by UNICEF. About 20,000 of these nets benefited orphaned and vulnerable children, 64,000 went to pregnant women, and 88,000 long lasting insecticide nets were distributed to people affected by the floods during the emergency.
As for treatment, Mozambique now uses artemisinin-based combination therapies (ACT) as a first line treatment. The combination of multiple drugs enhances clinical efficacy and may delay the development of resistance of parasites. In order to reduce the health risks associated with malaria in pregnant women, the Ministry of Health introduced intermittent preventive treatment in 2006. This treatment involves providing pregnant women with two or more doses of anti-malaria drugs during routine antenatal visit regardless of whether women have symptoms of malaria or not.
Malaria accounts for 40 per cent of all out-patient consultations and up to 60 per cent of in-patients in paediatric wards are suffering from serious malaria. Malaria can contribute to the death of a child through an overwhelming acute infection, which frequently manifests as seizures or coma. Repeated malaria infections contribute to the development of severe anaemia, which substantially Increases the risk of death. Low birth weight – frequently the consequence of malaria infection in pregnant women – is also a major risk factor for death in the first month of life.
Malaria is also a health risk to pregnant women as it has adverse effects on both the mother and the unborn child, including maternal anaemia, foetal loss, premature delivery and low birth weight babies. Malaria contributes to maternal mortality when it compounds conditions such as tuberculosis, HIV infection, malnutrition and iron deficiency.