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Health officials warn of malaria epidemic
In addition, there is a need to continue to address the immediate threat of a malaria epidemic in the county, particularly in SNNPR. WHO estimates that malaria kills an African child every 30 seconds. Many children who survive an episode of severe malaria may suffer from learning impairments or brain damage. Pregnant women and their unborn children are also particularly vulnerable to malaria, which is a major cause of perinatal mortality, low birth weight and maternal anemia. There are four types of human malaria with Plasmodium Falciparum, prevalent throughout SNNPR, being the most deadly type of malaria infection.
In Ethiopia, malaria affects 75% of the population and 5 million clinical cases are reported annually. In 2000, malaria was the number one cause for medical consultations and hospital admission and the third cause of deaths in hospitals. Malaria is seasonal, with September to December being the high transmission period. Major epidemics occur cyclically every 5 to 8 years. There has been a four-year build up (low transmission years) since the 1998 epidemic when an estimated 150,000 people died. Furthermore, malaria was top on the list of major causes of morbidity in 1995.
Health officials are warning of a major malaria epidemic in Ethiopia leading to thousands of deaths unless necessary precautions are taken to reduce malaria transmission and treat malaria cases. Particularly at risk are the people in the lowlands and midlands of SNNPR where the population is already weakened by malnutrition. The traditional malaria risk areas are located at an altitude of less than 1500 meters above sea level, although due to unseasonably high temperatures, the recent outbreak has also spread to highland areas. Reports are being received indicating that the problem is more severe than previous years with a dramatic increase in the number of cases. The peak period for malaria transmission is projected to occur after the current rainy season concludes at the end of September.
Just over US$ 2 million has been received by UNICEF (through the USA, Belgian and Swedish governments) for malaria control countrywide in July and August 2003, and more support is pledged to address the anticipated epidemic. The malaria response includes procurement of essential anti-malarial drugs (Chloroquine, Fansidar and Quinine), laboratory supplies, insecticide-treated mosquito nets, insecticide for indoor residual spraying (IRS) and training of health workers on malaria epidemic prevention and control, and other supportive and preventive measures. The real challenge now is to reach all people at risk.
A major setback in the response to fight malaria is the lack of malaria morbidity and mortality data available in SNNPR. Only a few woredas were able to collect data and therefore, health officials do not have a regional picture of malaria morbidity and mortality. Without this data, it is not possible to know whether or not this is an epidemic. The majority of data thus far is mostly anecdotal. Certain woredas who have been able to compile numbers, are reporting high mortality rates, like Humba Woreda in Welayita Zone who are reporting that 57% of morbidity is due to malaria, when 30% is normal for malaria. This high level of morbidity is most likely related to increased malnutrition, the physical weakness of the population in the region and the prevalence of the Plasmodium Falciparum strain. Aid workers are reporting that without statistics malaria efforts are similar to firefighting. As hotspots become apparent, efforts are then refocused. The worst areas for malaria are still unknown due to lack of data, but areas that seem to suffer the most are Badawacho Woreda in Hadiya Zone, Humbo Woreda in Welayita Zone and Sidama Zone. However, the Regional Bureau of Health was able to collect the information in the chart on the side panel.
Some assessments are being undertaken to gather data. A quick assessment was undertaken by a Regional Health Bureau (RHB) malaria expert and the team leader a for child health and health service strengthening project in Welayita, Kembata Tembaro, Silti, Gurage and Sidama, the most drought affected zones in SNNPR. The assessment enabled the collection of data on Insecticide Treated Net (ITN) stocks and shortage of drugs that provided a general picture of the malaria situation. The assessment indicated a need over the next eight weeks for 3660 insecticide treated nets. continue
1. Essential Services for Health in Ethiopia (ESHE)/John Snow International (JSI)/USAID Project
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