New strategy for malaria-prone areas in bid to eradicate disease

Saturday November 07 2015

The indoor residual spray method has been hailed by health experts for its efficiency in fighting malaria. PHOTO | CYRIL NDEGEYA

The Rwandan government has embarked on an anti-malaria campaign targeting the districts most affected by the deadly disease, which will involve use of the indoor anti-malaria spraying method.

Earlier this year, concerns were raised over an increase in malaria cases in many parts of the country despite remarkable progress made in recent years to eradicate one of the most deadly diseases in the country and Africa.

According to the Ministry of Health, the most affected districts are Nyanza, Kirehe, Nyagatare, Bugesera and Gisagara.

Although the reason behind the rapid increase in malaria cases in Rwanda was unclear, health professionals and government officials cited substandard mosquito nets, ignorance and lack of awareness, rainy weather and high temperatures in many parts of Africa as among the major causes.

According to some of the health professionals who spoke to Rwanda Today this week, cases have been reduced in recent months but the country is yet to reach the level where the disease was almost eradicated. This means more effort will be needed to fight the deadly disease.

“After the April rainy season, through May and June till the end of August, malaria cases had risen, but from the end August till now, although the cases were not few, they did not increase,” said Flavien Ngendahayo, a medical practitioner and lecturer at the University of Rwanda’s College of Medicine and Health Sciences. “Also, we used to have severe cases but now we don’t.”


According to official statistics, by 2012 malaria prevalence in Rwanda had declined by 74 per cent and deaths caused by the disease by 68 per cent.

“I think the reason for the recent reduction is that people have been aware of malaria, and when someone falls sick they immediately bring him or her to a health centre,” said Mr Ngendahayo. “That’s why no recent severe cases that could lead to death were recorded, at least here at our clinics.”

According to the Health ministry, however, the situation in highly prone districts is still alarming. Last year, 132,000 patients were admitted in Nyanza with severe malaria while 128,000 were admitted in various hospitals in the district over the first nine months of this year.

Appoline Kambayire, the district vice-mayor in charge of social affairs, was quoted as saying “the disease is becoming a serious life taker” and urged citizens to be “vigilant and take all measures possible to deal with the disease.”

“Rwanda has recorded a 95 per cent year round coverage of long-lasting insecticidal nets (LLIN) and/or indoor residual spraying (IRS) interventions, the most important tools in preventing malaria,” says a Health ministry report.

However, the ministry was rocked by substandard mosquito nets scandal earlier this year, where a net procurement deal that went wrong could have cost the taxpayer more than Rwf10.5 billion after a Danish company that had agreed to supply three million nets offered substandard ones.

READ: Dispute over supply of fake nets headed to court

The Minister for Health, Dr Agnes Binagwaho, then asked citizens to continue using available nets, saying the bad ones would be replaced.

Mr Ngendahayo however said there was no replacement for the substandard nets at the clinic where he works or even at some other health centres.

“They can’t remove them completely because even the sub-standard ones can prevent malaria by using mechanical actions,” said the lecturer. “However, they should look at ways to replace them.

He nonetheless added that the nets are not effective in preventing malaria.

Another challenge cited by health professionals is affordability. Some citizens can not buy nets to replace expired ones.

However, indoor residual spraying has been hailed by health experts for its efficiency in fighting malaria.

Elie Byukusenge, a nurse at Gitwe Hospital in Southern Province, said malaria cases had reduced in recent months but if houses were sprayed again that could help to prevent the spread of the disease.

“The hospital used to receive more than 200 patients a month but now we get only 40,” Mr Byukusenge told Rwanda Today.

He added that they still treat a few severe cases due to negligence and ignorance in communities.

“Last Thursday, I treated a young man in critical condition,” said Mr Byukusenge.

Medical experts say that malaria can kill if it is not treated early. Community health workers play a key role in malaria prevention by screening children under five years and educating people on measures to fight the disease.

Most vulnerable are people living with HIV/Aids, children under five and pregnant women.

Theresie Mukamfizi, head of Muhima Health Centre, said malaria cases had reduced in recent months but rapidly increased last month to 112 from nine and 10 recorded in August and September, respectively.

Ms Mukamfizi said she believed the sharp increase could be linked to the rainy season.

“Rains generate a favourable environment for mosquitos to reproduce,” she explained.

She said residents reported to them that the mosquito nets were expired but the health centre did not have stocks to replace them save for pregnant women.

“We believe our mosquito nets are not fake because we have been getting them for a long time,” said the head nurse, adding that to eradicate malaria concerted efforts were needed in sensitisation of the community on preventive measures.