The theme for World Malaria Day 2023 is “Malaria – a disease without borders.”
- Majority of the cases were reported from WHO African Region (AFR) (90%)
- South-East Asian Region (SEAR) and Eastern Mediterranean Region (EMR) contributed 7 and 2% of global malaria respectively.
- Sub-Saharan Africa region has reported such a high endemicity that shared 80% of total malaria burden.
- The global deadline for the elimination of Malaria is 2024……….???
DRIVERS OF DECLINE/ELIMINATION
Attributed it to a scale-up of combinations of control strategies:
Long-lasting insecticide-treated nets (LLINs) or insecticide treated nets (ITNs), indoor residual spraying (IRS) and intermittent preventive therapy for pregnant women (IPTp) & other special groups for prevention, better diagnostics for case ascertainment, and effective treatments using artemisinin-based combination therapies (ACTs)
EPIDEMIOLOGICAL CHANGES
- The spread of An. stephensi a mosquito species that can transmit both P. falciparum and P. vivax malaria parasites.
- Epidemiological impact of insecticide resistance of LLIN & IRS
- LLIN: net survivorship, fabric integrity and insecticidal activity
(bioefficacy) - IRS: resistance, the timing of spraying and the quality of spraying.
In addition, at large scale, the costs are high.
- LLIN: net survivorship, fabric integrity and insecticidal activity
- Impact of RDT with Pfhrp2/3 deletions in the sen/sep; detecting p.vivax
- Complexity of malarial drugs (ACT) for active trt & drugs for various chemoprophylaxis
- Uninterrupted malaria importation into the malaria free and eliminating countries
- The effect of global warming!!
- Disruptions to malaria prevention, testing and treatment services owing to the COVID-19 pandemic
- Changes in Clinical epidemiology:
- increase in median age of hosp admission
- less anemia but more cerebral malaria
- Emerging population at risk:
- Adults, school age children & teenagers
- geographycal risk areas (Hotspots) & silent sustainers
STRATEGY FOR THE CHALLENGES
- WHO recommends a shift to non-HRP2-based RDT tests & seek to improve diagnostic tools related to P. vivax
- There are several ongoing innovations in malaria medicines for case management and chemoprevention
- The RTS,S/AS01 malaria vaccine for the prevention of P. falciparum malaria in children living in regions with moderate to high transmission.
- The strategies called for collaboration, improved surveillance, information exchange, normative guidance and research as the key to the response.
- Require a multidisciplinary and multisectoral response with trusted national leadership and well-functioning, equitable and resilient health systems.
THE ROLE OF HEALTHCARE WORKERS
Team consist of ALL cadre with varied coordination and responsibilties, accross ALL level of HCF:
- Ensure early diagnosis and treatment EDT: RDT & ACT
- Prompt referal
- Health education & counselling on prevention & control
- Perssive & active surviellence
- Information tech
- Monitoring & evaluation
Thank you!
This presentation was presented at a panel discussion organized by
Shalina Healthcare on 24th April 2023