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Rwanda: Malaria Battle Shifts to Rural Areas
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Rwanda News Agency/Agence Rwandaise d'Information (Kigali)
25 April 2008
Posted to the web 25 April 2008
Kigali
As Rwanda joins the world on Malaria Day, health officials should be smiles following a recent UN assessment that malaria prevelance was down by more than 60% in just two years of intensive intervention, RNA reports.
Increased use of insecticide-treated mosquito nets and the latest drugs in Rwanda cut malaria deaths in half, the World Health Organisation said in February.
In 2005, the rate at which infections were happening has been rocketing 67% and often hitting high. Rwanda had actually been classified - along with Ethiopia - as "high risk" countries' where malaria was biting hard with thousands of deaths annually.
WHO scientists carried out an assessment of the effects of bed nets and latest medicines in Rwanda, Ethiopia, Zambia and Ghana. It said the "most striking" results were found in Rwanda.
However, indication from the rural areas suggests that despite free-treated bednets and massive sensitisation programs and other measures, malaria cases are still prevalent.
The Health Ministry has now taken its resources to these areas. Malaria Day festivities (April 25) were today held in the Eastern Rwanda district of Kirehe. This is a largely hot and arid area in which mosquitos have bred so easily. However, some areas to the west and north are also considered high risk.
As this year's theme 'Malaria - disease with no borders' suggests, government wants the still affected areas to learn from successes in other areas. Health officials also say the impact of migration, poor water management practices and border movements.
Border areas in Eastern Rwanda linking to Tanzania and Uganda, as well as to the south to Burundi are taken as high risk because new communities are formed there from time to time.
In Kirehe district - thousands of people are now resettled there after they were expelled from across in Tanzania. They have come with new settlement partners. Officials have had to redo the sensitisation programs.
According to the Health Ministry's 2005 assessment, 21 areas covered with a population of about 4million are classified as of epidermic risk.
Armed with a $ 3.3 million (about Rwf 2 billion) plan running up to 2010, health officials want the battle extended to more than an 82 percent redaction despite recorded successes, as the WHO reported in February this year - of 66 percent.
In 2006, and later 2007, government launched a vigorous campaign supported by numerous donor partners to provide treated bed nets for all children less than five years and pregnant mothers. The campaign was pushed to include a national requirement that everybody sleeps in a bed net.
For example, in September 2006, up to 3 million nets were supplied in a population of about 9.4 million. In October, artemisinin-based therapies were stocked in all public hospitals and clinics - ending the use of Amodiaquine/Sulfadoxine-Pyrimethamine combinations.
The two key items in the current "tool kit", as it has been called, were bed nets treated with insecticide that lasts as much as five years, and treatment with at least two drugs, one of them artemisinin, a compound derived from a Chinese herbal medicine.
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Later in February 2007, government also ended the use of historically known malaria drugs such chloroquine and quinine, and ordered that all health centers prescribe Coartem - a drug heavily subsidized.
Prices moved down from $10 (about Rwf. 5,000) to Rwf. 250 and Rwf. 150 for patients in urban and rural areas, respectively.
From this whole program dubbed by the WHO as an unplanned "natural experiment" implemented in 2 months, experts report that Rwanda had 66 percent fewer child malaria deaths in 2007 than in 2005. Hospital wards often full of malaria victims were beginning to empty up.
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