On April 25 every year, Ghana joins the rest of the world to celebrate World Malaria Day (WMD), a day set aside to highlight the need for continued investment and sustained political commitment for malaria prevention and control of the disease.
The Day, which was instituted by the World Health Organisation (WHO) Member States during the World Health Assembly of 2007, is also observed to highlight successes in the fight against malaria, and individual responsibilities to end malaria and ensure malaria-free world.
Research shows that over the past two decades, the world has made great progress in the malaria fight, saving more than seven million lives and preventing over one billion malaria cases.
Despite the progresses made, malaria remains one of the oldest diseases and kills more than 400,000 people, mostly young children around the world every year.
In recent times, the use of proven tools and methods such as insecticide-treated bed nets, better case management of malaria in children and pregnant women, expanded use of preventative medicine during high malaria transmission season, and insecticide resistance monitoring have contributed to reduction of the disease burden in most countries.
According to the World Health Organization (WHO), Africa shouldered 94 per cent of all malaria cases and deaths worldwide in 2019, with the remaining six per cent recorded in the WHO South-East Asia Region, the Eastern Mediterranean, the Western Pacific Region and America.
Research shows that in 2019, there were an estimated 229 million cases of malaria and 409,000 malaria-related deaths in 87 countries and children under the age of five years in sub-Saharan Africa continued to account for approximately two thirds of global deaths from malaria.
Malaria is a potential life-threatening mosquito-borne blood disease caused by a plasmodium parasite.
It is transmitted to humans through the bite of an infected mosquito, which sees the parasite multiplying in the hosts’ liver before infecting and destroying the red blood cell.
Symptoms of malaria include fever and chills, colds with shivering, headache, impaired consciousness, prostration or adopting a prone position, multiple convulsions, deep breathing, respiratory distress and abnormal bleeding.
The most vulnerable, such as; persons with little or no immunity against the malaria disease, children and pregnant women are at risk.
Malaria can however be prevented with the use of Insecticide Treated Nets, Indoor residual spraying and antimalarial medications and recently, as preliminary results have shown, newly developed vaccines.
The WHO has recently announced that a malaria vaccine pilot project in Africa is going well. In Ghana, Kenya and Malawi, more than 650,000 children have been vaccinated with RTS,S since 2019.
The vaccine reduced the number of infections by 39 per cent, according to preliminary results from an earlier study.
In Ghana, a total of 322 malaria deaths were recorded in 2020 amid the COVID-19 pandemic.
Despite the gains made in containing malaria infections and deaths, Ghana remains part of the 11 countries that accounted for 70 per cent of the global burden of malaria in 2020, according to the World Health Organizations World Malaria Report.
It is estimated that at least one person dies from malaria each day in Ghana.
Dr Keziah Malm, Programme Manager for the National Malaria Control Programme says although access to efficient health services in Ghana has improved, with the country running a nationwide bed net coverage campaign and a variety of effective malaria control interventions available to all the population, much work is left to be done.
Malaria, she explains accounted for 42 percent of outpatient suspected cases, 21 percent confirmed cases at the OPD, and 18 per cent inpatient in 2020 public health facilities.
The disease puts the entire country still at risk. It is the highest disease expenditure on National Health Insurance Scheme (NHIS).
Dr Malm told the Ghana News Agency (GNA) in an interview, in Accra, that there was reduction in Out-Patient Department (OPD) attendance in 2020 due to a decrease in malaria cases reported at the health facilities.
She explains that in 2020, there was an increase in malaria testing among the public despite reduction in OPD attendance.
In the wake of the pandemic there were uncertainties and panic among the population, this affected general health seeking behaviour within the early period of the pandemic, when we observed a reduction, she said.
Dr Malm said the Northern Region recorded the highest of 47 malaria deaths, with 192,028 confirmed infections recorded from OPD attendances, while the Upper East Region recorded the lowest of one malaria death with 487,680 cases.
Although Ghana had achieved its target with respect to mortality, not much progress had been made with the containment of the disease, she said.
Malaria related deaths by all ages in Ghana has however reduced by 89 per cent from 2,799 in 2012 to 322 by end of 2020.
Similarly, under-five malaria case fatality rate reduced by 80 per cent from 0.6 per cent in 2012 to 0.12 per cent in 2020, and all malaria related admissions reduced by 28 per cent from 428,000 in 2012 to 307,513 in 2020.
Dr Malm said the NMCP had also observed a minimal progression in the use of Insecticide Treated Nets (ITNs) among the public.
She advised that everyone slept under Long Lasting Insecticide Nets (LLIN) or used Indoor Residual Spraying in areas where it was being undertaken to protect themselves from the disease.
The Programme Manager encouraged the public to avoid creating breeding sites, saying: Basically, we all have to do our best to prevent ourselves from getting malaria.
However, if you happen to feel unwell and you think you have malaria, get tested, especially because of the similarities of symptoms with the COVID-19.
Dr Malm says the journey to achieving zero malaria started with everyone, hence the need for the public to adopt lifestyles that prevented them from getting malaria.
Dr Malm says an effective multi-pronged approach to tackle malaria is needed and investment in building robust health systems in public and private sectors should be a priority.
She added that a strong advocacy is critical at this time to continue investments in strengthening the health system and in life-saving malaria interventions such as bed-nets, diagnostic commodities such as rapid diagnostic test kits, indoor residual spraying,.
Dr Malm called on stakeholders to join the fight against malaria, saying, and Lets all make decisions that will translate to better health outcomes.
Although progress in the global response to malaria has stalled in recent years, a growing number of countries with a low burden of malaria are approaching, and achieving the target of zero malaria transmission.
The WHO is calling on all people living in malaria affected countries to beat the fear: people with fever should go to the nearest health facility to be tested for malaria and receive the care they need, within the context of national COVID-19 protocols.
The theme for this year’s WMD is “Zero Malaria Starts with Me” and it emphasises the need for all to fight against the disease, because every malaria case is preventable, and every malaria death is unacceptable.
The theme for this year’s celebration is a clarion call on the government of Ghana, health authorities and every individual to take malaria prevention seriously and do everything possible to prevent infections, even if you feel you have malaria, get tested before getting a medication.
By Linda Naa Deide Aryeetey