The Citizen (Dar es Salaam)
Rose Athumani
18 September 2008
Zanzibar is among four countries in Africa that have reduced the burden of malaria by 50 percent or more between 2000-2007, according to the World Malaria Report 2008.
The other countries are Eritrea, Rwanda and Sao Tome, which are on course to meet the World Health Assembly 2010 target of 80 percent surveillance and high intervention coverage.
According to the report, which uses data collected in 2006, there was an estimated 247 million malaria cases among 3.3 billion people at risk in 2006, causing nearly a million deaths, mostly children under 5 years old.
Eighty-six percent, or 212 million cases, were in Africa. Eighty percent of the cases in the continent were in 13 countries. Over half were in Nigeria, the Democratic Republic of the Congo, Ethiopia, Tanzania and Kenya.
The report- to be launched this morning in Geneva- cites Zanzibar as a unique case for successfully distributing the Artemisinin-based combination therapy (ACT).
ACT, which is more effective than older treatments, was made freely available at all public health facilities from September 2003.
By 2005, there was a clear decline in in-patient cases (35 percent) and deaths (41 percent).
The Isles also succeeded through spraying insecticides in 200,000 households in 2006 protecting about one million people. An additional supply of 203 000 long-lasting insecticidal nets two years ago saw the number of cases and deaths drop by 34 and 90 percent.
There were an estimated 881, 000 malaria deaths in 2006, of which 91 percent were in Africa where 85 percent of the deaths were of children under 5 years of age.
Despite serious interventions in combating malaria, with an increase in procurement of anti-malaria drugs through public health services, access to treatment was still inadequate in all countries surveyed in 2006.
Household surveys and data from national malaria control programmes (NMCPs) show that the coverage of all interventions in 2006 was far below the 80 percent target set by the World Health Assembly in most African countries.
Several countries and a number of African nations have, however, managed to cut by half malaria deaths by following control measures recommended by WHO.
"Some of the clearest evidence of strong public health measures leading to a sharp drop in malaria comes from three countries and one part of a country in Africa," says the report.
Eritrea, Rwanda, Sao Tome and Principe, and Zanzibar, each has a relatively small population, and each has mounted large-scale efforts implementing prevention and cure.
The countries were said to have cut malaria deaths by 50 percent or more between 2000, and 2006-2007.
The combination of tools and methods to combat malaria now includes long-lasting Insecticidal nets (LLIN) and artemisinin-based combination therapy, supported by indoor residual spraying of insecticide (IRS) and intermittent preventive treatment in pregnancy (IPT).
But despite huge increases in the supply of mosquito nets, especially of LLINs in Africa, the number available in 2006 was still far below need in almost all countries.
Of 647 million people at risk in Africa, the portion covered by insecticide-treated nets rose from 3 percent in 2001 to 26 percent in 2006 and an estimated 39 percent in 2007.
Surveys in 18 African countries in 2006 show that 34 percent of households have mosquito nets, from 6 percent in Côte d'Ivoire to 65 percent in Niger.
However, despite this progress, coverage of nets and all other interventions are still below the 80 percent target for 2010 established by the World Health Assembly.
According to surveys, only 23 percent of children and 27 percent of pregnant women slept under an ITN.
Indoor insecticide spraying in 2006 protected more than 100 million people, including 70 million in India and 22 million in Africa, where it appeared linked to a decline in cases in Namibia, South Africa and Swaziland.
Thirty-eight percent of African children under five who had a fever got some anti-malarial drug in 2006, but only 3 percent of sick children were given the more effective artemisinin-based combination (ACT) therapy.
Eighteen percent of pregnant women in 16 African countries received anti-malaria medicine as a preventive treatment to reduce the risk of babies with low birth weight.
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