Sleep under a treated mosquito net, stay healthy — Ministry of Health

Judith Nawula is a peasant and widow, who lives in Kikoolimbo village in Pallisa district. Her source of income is through farming. Nawula is a mother of four and has a story to tell about the fight against malaria. Malaria is one of her major concerns in her day-to-day life; its treatment was a costly venture that she hated to think about. Her children are often hospitalised due malaria. She runs to the nearest drug shop whenever her children have malaria because the hospitals are far and many times they do not have medicine. Nawula has buried many relatives and children who died from malaria and understands the need to treat malaria immediately with the most effective medication. “We used to buy Chloroquine and Fansidar because the other drugs were expensive.

Today if you are lucky you can get Artemisinin Combination Treatment (ACTs) freeof- charge from public facilities. But we buy it at about sh18,000 from drug shops,” she says. Nawula is not the only woman in the rural Uganda whose children are often hospitalised or who has lost relatives due to malaria. Despite enormous efforts by health professionals, educators and government, malaria remains a health threat to Ugandans and the entire world. In Uganda, records show that every hour we lose about 17 people, every three or four minutes we lose one person and in a day, we lose 330 Ugandans to malaria. This translates into 116,800 deaths a year, says Dr. Myers Lugemwa, the team leader, Malaria Control Programme, Minstry Of Health (MOH) Lugemwa says that malaria accounts for 30-50% of out patients attendances at health facilities, 29% of inpatient admissions and 9-14% of inpatient deaths. Everyone is at a risk of getting malaria, but pregnant women, children below five years and people living with HIV are the most vulnerable.

Today is Word Malaria Day, and Uganda is joining the rest of the world to commemorate the day with the theme,” Invest in the future; Control malaria.” The theme is appropriate because malaria is still a leading cause of death and illness amongst the people in the entire world. Dr.Godfrey Magumba, Uganda Country Director, Malaria Consortium, explains that while we still continue with the global theme as a country, we have localised it to say, “Sleep under a treated net, stay healthy.” “ This is because amongst the key interventions that control malaria are, one, prevention of malaria and two, treatment of malaria as soon as somebody has got an infection of malaria within 24 hours,” he says. Magumba says prevention of malaria has got two main components of public health importance, though there are others. The first is sleeping consistently under a treated mosquito net and the second one is indoor residue spraying.

The third prevention mechanism is prevention of malaria in pregnancy, where pregnant women are given at least two dozes of intermittent presumptive treatment (you presume the woman will get malaria and therefore you treat them with anti-malarial during the pregnancy to avoid the baby that is inside from being infected, aborted or miscarried, or beingJudith Nawula is a peasant and widow, who lives in Kikoolimbo village in Pallisa district. Her source of income is through farming.

Nawula is a mother of four and has a story to tell about the fight against malaria. Malaria is one of her major concerns in her day-to-day life; its treatment was a costly venture that she hated to think about. Her children are often hospitalised due malaria. She runs to the nearest drug shop whenever her children have malaria because the hospitals are far and many times they do not have medicine. Nawula has buried many relatives and children who died from malaria and understands the need to treat malaria immediately with the most effective medication. “We used to buy Chloroquine and Fansidar because the other drugs were expensive.

Today if you are lucky you can get Artemisinin Combination Treatment (ACTs) freeof- charge from public facilities. But we buy it at about sh18,000 from drug shops,” she says. Nawula is not the only woman in the rural Uganda whose children are often hospitalised or who has lost relatives due to malaria. Despite enormous efforts by health professionals, educators and government, malaria remains a health threat to Ugandans and the entire world. In Uganda, records show that every hour we lose about 17 people, every three or four minutes we lose one person and in a day, we lose 330 Ugandans to malaria.

This translates into 116,800 deaths a year, says Dr. Myers Lugemwa, the team leader, Malaria Control Programme, Minstry Of Health (MOH) Lugemwa says that malaria accounts for 30-50% of out patients attendances at health facilities, 29% of inpatient admissions and 9-14% of inpatient deaths. Everyone is at a risk of getting malaria, but pregnant women, children below five years and people living with HIV are the most vulnerable. Today is Word Malaria Day, and Uganda is joining the rest of the world to commemorate the day with the theme,” Invest in the future; Control malaria.” The theme is appropriate because malaria is still a leading cause of death and illness amongst the people in the entire world. Dr.Godfrey Magumba, Uganda Country Director, Malaria Consortium, explains that while we still continue with the global theme as a country, we have localised it to say, “Sleep under a treated net, stay healthy.” “ This is because amongst the key interventions that control malaria are, one, prevention of malaria and two, treatment of malaria as soon as somebody has got an infection of malaria within 24 hours,” he says.

Magumba says prevention of malaria has got two main components of public health importance, though there are others. The first is sleeping consistently under a treated mosquito net and the second one is indoor residue spraying. The third prevention mechanism is prevention of malaria in pregnancy, where pregnant women are given at least two dozes of intermittent presumptive treatment (you presume the woman will get malaria and therefore you treat them with anti-malarial during the pregnancy to avoid the baby that is inside from being infected, aborted or miscarried, or beingJudith Nawula is a peasant and widow, who lives in Kikoolimbo village in Pallisa district. Her source of income is through farming.

Nawula is a mother of four and has a story to tell about the fight against malaria. Malaria is one of her major concerns in her day-to-day life; its treatment was a costly venture that she hated to think about. Her children are often hospitalised due malaria. She runs to the nearest drug shop whenever her children have malaria because the hospitals are far and many times they do not have medicine.

Nawula has buried many relatives and children who died from malaria and understands the need to treat malaria immediately with the most effective medication. “We used to buy Chloroquine and Fansidar because the other drugs were expensive. Today if you are lucky you can get Artemisinin Combination Treatment (ACTs) freeof- charge from public facilities. But we buy it at about sh18,000 from drug shops,” she says.

Nawula is not the only woman in the rural Uganda whose children are often hospitalised or who has lost relatives due to malaria. Despite enormous efforts by health professionals, educators and government, malaria remains a health threat to Ugandans and the entire world. In Uganda, records show that every hour we lose about 17 people, every three or four minutes we lose one person and in a day, we lose 330 Ugandans to malaria. This translates into 116,800 deaths a year, says Dr. Myers Lugemwa, the team leader, Malaria Control Programme, Minstry Of Health (MOH) Lugemwa says that malaria accounts for 30-50% of out patients attendances at health facilities, 29% of inpatient admissions and 9-14% of inpatient deaths. Everyone is at a risk of getting malaria, but pregnant women, children below five years and people living with HIV are the most vulnerable.

Today is Word Malaria Day, and Uganda is joining the rest of the world to commemorate the day with the theme,” Invest in the future; Control malaria.” The theme is appropriate because malaria is still a leading cause of death and illness amongst the people in the entire world. Dr.Godfrey Magumba, Uganda Country Director, Malaria Consortium, explains that while we still continue with the global theme as a country, we have localised it to say, “Sleep under a treated net, stay healthy.” “ This is because amongst the key interventions that control malaria are, one, prevention of malaria and two, treatment of malaria as soon as somebody has got an infection of malaria within 24 hours,” he says.

Magumba says prevention of malaria has got two main components of public health importance, though there are others. The first is sleeping consistently under a treated mosquito net and the second one is indoor residue spraying. The third prevention mechanism is prevention of malaria in pregnancy, where pregnant women are given at least two dozes of intermittent presumptive treatment (you presume the woman will get malaria and therefore you treat them with anti-malarial during the pregnancy to avoid the baby that is inside from being infected, aborted or miscarried, or being born with malaria, underweight or a premature).

Why we localise out of the big theme

Dr. Magumba explains that we chose a portion-sleep under a treated mosquito net, stay healthy because beginning June last year, Uganda, with support from development partners like Global Fund, World Vision, the US and UK governments, Malaria Consortium and others, are distributing 21 million nets across the country. “The aim is to ensure that every person sleeps under a mosquito net, thus the theme — sleep under a mosquito net, stay healthy. Today, we have covered over 60% of the districts in Uganda,” stresses Magumba. He says all the districts in the east beginning with Teso area, two districts in Karamoja, Bugisu, Busoga, Tororo, Buganda and part of the south west, have received their nets.

The target is the entire country. All the remaining parts of Uganda, except Kampala and Wakiso, have been registered. Districts like Ntungamo, Kabale, Kisoro, Rukungiri, Kanungu, Kasese, Fort portal, Bunyoro, Acholi, Lango, Karamoja and West Nile have all been registered. “In the next two months, we expect to have given all the above districts their nets. We will end with Kampala and Wakiso, and therefore, we would have achieved universal coverage. Magumba adds that: “Universal coverage the way we define it in Uganda is not a net for everybody, but a net for two people. For example, if a house has six people, we give them three nets, if you are four you get two and if you are eight you get four. Malaria Consortium is leading this exercise,” he explains.

Magumba says that to receive a net is one thing and using it is another. That is why they are appealing to everybody to sleep under the net when they receive it, because they will prevent malaria in their children, in pregnant women and you prevent malaria in everybody.

Treatment for malaria

Malaria treatment is important because we can kill the organisms before they go to the vital organs like the brain which brings complications.

The policy of the ministry is that we should treat the people who are sick as soon as they develop signs of fever, in 25 hours. In 2006, the Ministry of Health adopted and deployed Artemisinin Combination Treatment (ACTs) — Coartem being one of themas the first-line treatment for uncomplicated malaria, replacing Chroloquine and Fansidar, which research had shown to be ineffective. ACTs are sent to all public facilities free-of-charge.

Govt loses sh25b in malaria control 

Malaria remains one of the leading health problems of the developing world, with Uganda bearing the largest burden from the disease, at over 95%of the country’s population affected, according to statistics from the health ministry. The disease remains a major cause of ill-health, hospital admissions, and death, with children below fi ve years, people with HIV/AIDS and pregnant mothers most affected.

Malaria in pregnancy continues to be a serious health risk causing maternal anaemia and perinatal mortality. Studies show that the prevalence of placental infection with plasmodium malaria in pregnant women stands at about 62.1%. Malaria control in Uganda Every year, through different projects such as the Presidential Malaria Initiative Uganda and the National Malaria Control Programme (NMCP), the Government injects funds to control the spread of malaria.

NMCP has the mandate to control and prevent malaria morbidity, thereby minimising its social and economic effects on the country. To achieve this, in 2013, NMCP distributed long-lasting insecticide-treated mosquito nets to achieve universal coverage. In 2012, NMCP carried out indoor residual spraying in 10 districts in northern Uganda.

Approximately 850,000 households were sprayed twice with up to 92% coverage, protecting about three million Ugandans from malaria. The Government is also training health workers across the country in integrated malaria management as one of the measures to control the spread, and support supervision is done in selected health facilities in all districts. Global Fund also supports the malaria preventative interventions.

During the 2011/12 fi nancial year, Uganda signed a fi ve-year $100m grant to reduce the incidence and mitigate the spread of malaria. The funds were also meant to help with mitigating TB and HIV/AIDS. The country continues to use $5.6m grant to support activities among the integrated malaria training groups in 78 districts. A survey done by the health ministry between 2006 and 2011 shows that treatment using anti-malarial drugs in children stood at 65%, which shows a positive response among parents in treating malaria in children. In 2011/12, malaria cases had reduced to 8,000,000(45%) from 14,000,000 cases in 2009. But 16,000,000 cases (90%) were registered last year.

With inadequate staff levels in Government hospitals and health centres, many of the malaria patients do not get enough medical attention.

According to Dr. Anthony Mbonye, the commissioner for health services at the Ministry of Health, the country loses sh25b annually in fi ghting the epidemic, most of which goes into procuring malaria drugs. Why is malaria persistent? Health experts say in most parts of Uganda, just like in any other tropical country, the climate is conducive for stable, all-year malaria transmission.

Experts, however, say only in the high altitude areas in the southwest and western Uganda, where the weather is relatively cold, malaria transmission is generally low. Mbonye also blames disease prevalence on poverty. He adds that most homesteads in Uganda are surrounded by bushes and stagnant water, which are breeding places for anopheles mosquitoes. Malaria transmitting mosquitos also breed in old tyres, empty containers or plastic bags, which are often dumped around compounds in most homesteads.

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