Malaria has a profound impact on mothers and infants, contributing to high morbidity and mortality rates. According to documents, following the conducive climatic condition for the spread of malaria throughout the year, coupled with inadequate health systems, the situation is more severe in Sub-Saharan Africa resulting on the deaths of millions of people every year. Millions of people, most of whom are young children die every year from the disease, according to documents.
Over 90 percent of all malaria deaths occur in Sub-Saharan Africa, with children under the age of five being disproportionately affected. A child dies of malaria approximately every two minutes. What is more, the growing challenge of drug resistance complicates efforts to combat the disease.
In pregnant women, the disease can lead to severe complications, including anemia, preterm delivery, low birth weight, and maternal death. The malaria parasite disrupts the placental blood supply, which impairs fetal growth and increases the risk of stillbirths. For infants, malaria significantly raises the likelihood of neonatal mortality, particularly if the mother is infected during pregnancy. Newborns that contract malaria in the first few months of life face a higher risk of severe illness and death due to their underdeveloped immune systems. They [newborns] may experience low immunity, which makes them more susceptible to malaria infections. Moreover, maternal malaria can contribute to malnutrition and weakened immune systems, making both mothers and infants more vulnerable to other diseases.
The burden of malaria on healthcare systems is huge, as prevention and treatment efforts require specialized care, including intermittent preventive treatment for pregnant women. Efforts to reduce malaria transmission and provide timely care are crucial in improving the health outcomes for both mothers and their infants, as to studies.
In recognition of malaria’s devastating effects—both in terms of fatalities and long-term health complications for survivors—Ethiopia has taken extensive measures and implemented various approaches targeting to combat malaria and safeguard public health although the disease has not yet been eliminated.
In relation to the burden of malaria and its long term health impacts, mainly on pregnant women and newborns, The Ethiopian Herald approached Abel Gedefaw, an Associate Professor of Obstetrics and Gynecology at the College of Medicine and Health Sciences, Hawassa University to gain deeper insights on this same issue.
With his extensive background in maternal and child health and infectious diseases, coupled with his role as the national Principal Investigator for the PREGART clinical trial,Abel (MD) is uniquely positioned to illuminate the impacts of malaria on vulnerable populations. His expertise provides a crucial perspective on the challenges and opportunities in addressing this ancient disease within an evolving health landscape.
According to him, malaria has serious potential consequences, particularly for perinatal health, and significantly impacts on mothers, newborns and infants, contributing to higher rates of miscarriage or spontaneous abortion, intrauterine fetal death (IUFD), preterm delivery, and low-birth-weight newborns. Even the fetus is born alive, low birth weight and premature newborns are the highest risks of death before their first-year of life. What makes the situation worse is that even if premature babies survive, they are at high risk of neurodevelopmental impairments, learning disabilities, and vision, and hearing problems.
Not only that, apart from affecting pregnant women, malaria also disproportionately affects other vulnerable populations, including children and individuals with compromised immune systems, such as those living with HIV. Beyond its devastating health and economic impact, malaria can pose severe challenges to the country’s economy, education system, and societal stability. The disease also disrupts development through various channels, including increased healthcare costs, decreased worker productivity, absenteeism, premature mortality, and impeded educational progress. Without decisive action to control malaria, any country canface severe challenges, he remarked.
Top of FormWhile talking what preventive measures are currently in place to combat malaria outbreaks, and how effective have they been,Ass. Prof. Abel said referring to the national malaria control guidelines, malaria control and prevention strategies in Ethiopia focus on two primary approaches. The first strategy is vector control interventions and preventing approach which aims to reduce human contact with malaria- carrying mosquitoes. The vector control targets both the larval and adult stages of the mosquito. Larval control is achieved through environmental interventions, such as eliminating water reservoirs to disrupt breeding sites mechanically and using chemicals called larvacidal specifically designed to kill mosquito larvae by spraying them in the water sources.
Adult mosquitoes are managed through Indoor Residual Spraying (IRS), where chemicals are applied to walls and surfaces to kill mosquitoes that come into contact with them. The primary strategy for preventing mosquito bites relies on the widespread use of insecticide-treated mosquito nets (ITNs), which provide a protective barrier against mosquito vectors. The second strategy focuses on ensuring that all malaria cases are promptly diagnosed at healthcare facilities and treated with effective antimalarial medications to prevent mortality and further transmission.
However, a detailed investigation is needed to assess the extent to which these prevention measures have been implemented in malaria outbreak districts and to evaluate their effectiveness. The rising incidence of cases since 2021 suggests that either the control interventions face significant challenges, such as financial constraints and operational limitations, or that their outcomes have been unsatisfactory, said Associate Professor Abel.
With its diverse ecological characteristics in terms of malaria transmission, ranging from low to high, Ethiopia is one of malaria-prone countries. About 75 percent of the country’s land and 69 percent of its population are exposed to the risk of Malaria. In fact, over the past few years; Ethiopia has made significant progress in controlling the spread of malaria and reducing the number of individuals affected by the disease. Through a combination of effective interventions, including widespread distribution of insecticide-treated nets (ITNs), indoor residual spraying (IRS), and improved access to healthcare services, the country successfully managed to reduce malaria transmission in many regions.
Strategic efforts to enhance early diagnosis and treatment, coupled with increased public awareness campaigns, have contributed to a substantial decline in both the incidence of malaria and related mortality. However, despite these successes, challenges remain, particularly in high-risk areas where malaria transmission persists. Continuous monitoring, resource allocation, and adaptation of control strategies are crucial to maintaining and furthering these gains in the fight against malaria.
As Ethiopia reflected on World Malaria Day 2024, unified, focused, and sustainable action is essential to curb the malaria burden, embark towards national elimination, and ensure health equity for all.
BY MENGISTEAB TESHOME
THE ETHIOPIAN HERALD SATURDAY 28 DECEMBER 2024
