Malaria risk in Somalia declines by over 50 per cent

NAIROBI / KENYA, 25 April 2010 – New research commissioned by UNICEF Somalia into estimates of malaria transmission in Somalia indicates a major decline in risk from the disease from 2005 to 2009. This decline has resulted in a nationwide reduction of over 50 per cent in the number of Somalis getting sick or dying from malaria.

“UNICEF and its partners in the Global Fund Malaria Program for Somalia have worked hard to prevent malaria cases and improve access to effective diagnosis and treatment. While not all the decline in cases can be attributed to these efforts in improved control and treatment, it is gratifying to see that in such a difficult operating environment real positive change is possible,” said Rozanne Chorlton, UNICEF Representative for Somalia on the occasion of World Malaria Day today.

The Global Fund Malaria Program has focused on community-based distribution of long lasting insecticide treated bed nets to those communities living in higher prevalence areas as well as increased training of health workers to enable them to provide effective diagnosis and treatment of malaria.

In most African countries where malaria is common, treatment is normally based on assumptions – without testing - that fever means malaria. More often individuals start taking action either by self medication with drugs bought over the counter or other local remedies from a herbalist. In response to this, it is imperative to devolve capacity to effectively diagnose and treat malaria. But if a fever is not malaria it must also be treated otherwise medical staff are pressured to treat for malaria no matter what the test says.

The approach to train health workers in fever management is aimed at building their capacity to manage other conditions that present themselves with fever that include measles, ear infections, sore throat or pneumonia. By being trained on how to conduct a simple 15-minute rapid diagnostic test, a health worker is able to conduct a blood test to detect if a patient has malaria parasites or not and to provide the appropriate treatment.

“In some instances the true cause of fever may not be malaria and by not getting tested for malaria, individuals can miss the opportunity to treat the real cause of fever,” says Ahmed Jama - Malaria Coordinator for the Global Fund Program in Northwest Somalia (“Somaliland”). “Generally we see that 1 per cent of persons tested in Northwest Somalia actually have malaria while the others are suffering from other illnesses that require different treatment. Our program aims to ensure all those with fever are treated – but treated for the right disease. ”

Financial support to the program has been made possible through the Global Fund to Fight AIDS, Tuberculosis and Malaria. In 2006, UNICEF introduced the WHO-approved Artemesinin-based Combination Therapy (ACT) to all health facilities across Somalia except health posts (the lowest level of facilities). Now the challenge is to devolve treatment further to the numerous health posts. This has proven a significant challenge in a country with no functioning health system and on-going conflict. Training materials have been simplified to a level that can be understood by Community Health Workers.

In the past six months UNICEF has supported the training of 393 Community Health Workers in the management of fever-related illnesses. These workers serve 180 of the estimated 480 health posts across Somalia. Efforts are under-way to expand the network of effective treatment still further. In addition UNICEF has distributed 732,000 long lasting insecticide treated nets over the last two years in malaria prone districts across Somalia. This has contributed to reduction of malaria morbidity. A recent survey indicates that distribution of nets has enhanced coverage to about 45 per cent of households.

“UNICEF will continue to train health workers and supply all health facilities with rapid diagnostic tests for malaria and effective drugs so that people who suspect they have malaria get tested and treated,” says Ms Chorlton. UNICEF is committed to the achievement of Millennium Development Goal 6 - Combat HIV/AIDS, malaria and other diseases - while guaranteeing universal access to malaria prevention and treatment by all the Somali people.

Malaria remains a major public health challenge in Somalia that requires a concerted partnership to maintain the reductions in risk seen since 2005 and prevent its resurgence.

Source: United Nations Children's Fund (UNICEF).
Link: http://www.unicef.org/media/media_53410.html.