Mozambique: Cesaltina Lorenzoni elected president of AORTIC, the African Organization for Research ...
Photo: A Verdade
While a certain hysteria surrounds the spread of the new coronavirus in Mozambique, malaria remains the “emergency”, according to the director of the WHO World Malaria Program. Recent studies show that Cabo Delgado, Niassa and Manica have become Mozambique’s worst-affected malaria provinces, overtaking Nampula and Zambézia.
Since the end of January and throughout February, national health authorities and senior officials of the World Health Organisation (WHO) have been meeting to carry out the “Mid-Term Review of the Malaria Strategic Plan, 2017-2022”, and have confirmed that malaria remains the main public health problem in Mozambique.
Malaria is endemic across the country, ranging from hyper-endemic areas along the coast, meso-endemic areas in the interior flatlands and some hypo-endemic areas in the highlands of the interior.
The good news is that deaths from malaria are decreasing – from 4 per 100,000 inhabitants to 2 per 100,000 inhabitants overall. Also, malaria prevalence is not increasing, although at least 10 million Mozambicans, mostly children and women, continue to suffer from this disease every year.
The most recent National Survey on Malaria Indicators found that the disease caused by the Anopheles mosquito “constitutes the main cause of morbidity and mortality in Mozambique among children under 5 years of age”.
“Malaria transmission is high throughout the year, contributing to the development of partial immunity during the first two years of life. However, many people, including children, may have malaria parasites in their blood without showing any signs or symptoms of infection. Asymptomatic infection not only contributes to the subsequent transmission of malaria, but also increases the risk of anaemia and other malaria-associated morbidities among infected people,” the document which @Verdade has seen reads.
The National Survey on Malaria Indicators reveal that 14 percent of children aged 6-59 months are classified as having severe or moderate anaemia, defined as a haemoglobin concentration below 8 g/dl. Compared with similar studies in 2011 and 2015, there have been substantial increases in anaemia prevalence estimates in Mozambique.
Fighting malaria should be carried out in a granular way
“Anaemia is associated with abnormalities in children’s motor and cognitive development. The main causes of anaemia in children are malaria and inadequate consumption of iron, folate, vitamin B12 or other nutrients. Other causes of anaemia include intestinal parasitosis, haemoglobinopathies and sickle cell anaemia. Although anaemia is not malaria-specific, trends in the prevalence of anaemia may reflect malaria morbidity, contributing to more than 50% of malaria-related deaths in endemic areas (Mensah-Brown et al. 2017). Anaemia levels also respond to malaria interventions, which have been associated with a 60% decrease in the risk of anaemia using a limit of 8 g/dl (Hershey et al. 2017), the document details.
Another important revelation is that the prevalence of malaria decreased in the provinces of Nampula and Zambézia from 66 and 68 percent respectively in 2015 to 48 and 44 percent. However, the prevalence of the disease has greatly increased in Cabo Delgado province, more than doubling from 29.4 to 57 percent, in Niassa province, from 36.3 to 49 percent, and also in Manica province, where it almost doubled from 25.5 to 48 percent.
“Several factors contribute to this endemicity, from climatic and environmental conditions such as favourable temperatures and rainfall patterns, as well as favourable places for the reproduction of the vector,” the survey reads.
One of the main conclusions of the mid-term strategy review is that the fight need not necessarily be carried on in the same way throughout the country, but must rather “be carried out in a granular way and at the lowest geographical level possible”.
By Aderito Caldeira
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