Malaria now a danger to children older than 5yrs

Youngsters aged between 5-19 in regions like East Africa are now the most vulnerable group to malaria following the successful distribution of the free bednets to protect children under five and pregnant women against the killer fever, according to a new study.

The study, funded by the Wellcome Trust and published in the free online journal BMC Public Health says that the shift in vulnerability is due to the fact that younger children are more likely to have access to the few bednets already distributed than their older siblings, who also are exposed to bites by mosquito vectors when they are outdoors.

Data computed from 18 sub-Saharan Africa countries, including those in the East African Communities, from 2005 to 2009 shows that this trend of shifting vulnerability is generally the same across most malaria-endemic areas, the study says.

According to Dr Abdisalan Noor from the Kenyan Medical Research Institute (Kemri)-Wellcome Trust Research Programme who was lead researcher, the findings are significant because they touch on a huge demographic segment that has not received as much attention as it should from existing malaria control efforts.

“First, they (5-19 year olds) represent a large fraction of the population in most developing African communities,” said Dr Noor. “Second, while they may have developed immunity against clinical disease, they will not have developed immunity to the malaria parasite and will therefore continue to contribute transmission in the community.”

According to Dr Noor and his colleagues, the concentration of prevention activities to the most vulnerable — children under five and pregnant mothers — in a bid to meet the targets set by the Abuja Declaration and Millennium Development Goals (MDGs) may have unwittingly left older children at risk.

This is despite the fact that they play a major role in the transmission cycle of malaria.

An estimated 80 per cent of human-to-mosquito transmission comes from those aged over five years, with young adolescents and older children being the peak transmitters.

This, malaria experts say, helps continue the chain of infections among other age-groups.

The increased vulnerability of older children calls for a change in the manner nets are distributed, said Dr Noor.

“Where school attendance is high, the delivery of nets through schools should be considered as a quick and cost-effective approach to reach universal coverage and improve the likelihood of impacting upon parasite transmission,” said the researcher.

In Kenya, health officials have in the recent past lauded the success of the free bed-nets distribution programme, saying that it has seen the number of children aged below 5 years who die from malaria fall from a high of over 35,000 per year to less than 15,000 currently.

The latest findings are however likely to add to an emerging debate about the role of bednets in a country’s comprehensive malaria control programme, which some experts say must include such components as indoor and outdoor spraying due to the risks of pre-bedtime bites by infected mosquitoes.

Another emerging issue is whether the continued distribution of free bednets, usually manufactured outside the continent, is sustainable.