Co­moros say on the cusp of erad­i­cat­ing malaria

Kuwait Times - - HEALTH & SCIENCE -

MORONI, Co­moros: Though vic­tory is yet to be of­fi­cially de­clared, Co­moros health au­thor­i­ties be­lieve the three is­lands of the In­dian Ocean ar­chi­pel­ago are on the cusp of be­ing malaria-free. “With eight cases in 2015 in An­jouan and three in Mo­heli, we can say we have reached the phase of to­tal elim­i­na­tion of the epi­demic, al­though spo­radic cases are still recorded on the Grande Co­more,” said Mbae Toyb, a doc­tor with the Co­mo­rian Association for Fam­ily Wel­fare. Af­ter a 10-year anti-malaria cam­paign, health work­ers in the cap­i­tal Moroni say the par­a­site is no more than a bad mem­ory.

“We can go for one or two months now with­out a sin­gle case,” said a caregiver at El-Maarouf hos­pi­tal. This has changed life for busi­ness­man Has­sane As­soumane, who suf­fered re­cur­rent at­tacks of the mosquito­borne disease that can be fa­tal if not di­ag­nosed and treated early. “I was (like) a malaria sub­scriber,” said As­soumane. “For me it was (like) my monthly pe­riod.” “But for the last four years, noth­ing.” The erad­i­ca­tion of malaria from the im­pov­er­ished is­lands off the coast of Mozam­bique is a huge ac­com­plish­ment for their 800,000 in­hab­i­tants.

It means fewer ma­ter­nal and in­fant deaths, less ab­sen­teeism from work and school, and sub­stan­tial fi­nan­cial sav­ings. “Treat­ment for a child with malaria costs 15,000 francs ($33),” As­soumane says, and “if you add a brother, fa­ther, mother ...” Some 214 mil­lion cases of malaria were re­ported world­wide last year, killing 438,000 peo­ple, mainly in Africa, ac­cord­ing to the World Health Or­ga­ni­za­tion. There is cur­rently no vac­cine against malaria, which is caused by par­a­sites trans­mit­ted to peo­ple bit­ten by in­fected fe­male mos­qui­toes. “Un­til 2004, the Co­moros was ranked among coun­tries with in­tense and peren­nial malaria trans­mis­sion,” af­fect­ing 40 per­cent of the pop­u­la­tion, espe­cially chil­dren, said Toyb.

Await­ing cer­ti­fi­ca­tion

But in less than five years the num­ber of deaths from malaria has fallen dras­ti­cally to al­most zero, he said. The Co­moros launched its first five-year anti-malaria drive in 2005 with ini­tial fund­ing of $2.4 mil­lion from the Global Fund against malaria, tu­ber­cu­lo­sis and AIDS. The tar­gets of the drive were early treat­ment, pre­ven­tion among preg­nant women and the wide use of treated mos­quito nets. But the key to its suc­cess was prob­a­bly more at­trib­ut­able to a treat­ment blitz of Arte­quick, a com­bi­na­tion drug ther­apy de­rived from a Chi­nese plant, artemisinin, and an an­ti­malar­ial called piper­aquine.

Artemisinin, a de­riv­a­tive of a plant called sweet worm­wood, has in re­cent years be­come the front­line anti-malar­ial drug, af­ter chloro­quine and sul­pha­dox­inepyrimetha­nine lost their par­a­site-killing pow­ers. Its use has re­duced the num­bers of death to one in 10 in se­vere cases, ac­cord­ing to ex­perts. The ther­apy was first rolled out in Mo­heli, the small­est of the three is­lands which has a pop­u­la­tion of 40,000 peo­ple. In 2012, govern­ment ex­tended the treat­ment to An­jouan is­land be­fore tak­ing it to the Grand Co­more in 2013.

The sec­ond five-year cam­paign val­ued at $11 mil­lion started in 2010. “The num­ber of cases went from 54,078 in 2004 to 1,052 in 2015, a drop of more than 98 per­cent,” said Toyb. Since 2014, the num­bers of deaths from malaria have dropped to nearly zero at hos­pi­tals, said Toyb.

What re­mains now is to en­sure the gains achieved are sus­tained and to await WHO cer­ti­fi­ca­tion. “This is the most del­i­cate phase,” warns Toyb, adding that while some peo­ple still suf­fer from the disease, there have been no new in­fec­tions.

A new anti-malaria cam­paign to run un­til 2018 has al­ready been launched with the back­ing of a team of Chi­nese prac­ti­tion­ers.

LILLE, NORD, France: This file photo shows a mos­quito on a per­son’s arm in Lille, north­ern France.

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