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Kenya among countries ‘exporting’ malaria to China

By GATONYE GATHURA

NAIROBI, KENYA: After decades of tragically lopsided trade imbalance with Africa, China has finally and cruelly got one major ‘export’ from the black continent — malaria!

Lately, China has grabbed big tenders on the African continent and is dominant in Kenya. From massive infrastructure projects to flooding the markets with cheap wares, China’s influence in the region is fast rising. Kenya’s dalliance with China is particularly blossoming; with China is particularly blossoming; the Sh347 billion-rail project is the country’s biggest infrastructural project in history. But some have complained about the trade imbalance in the involvement with the Chinese, saying they take away much more than they give. However, it turns out that the Chinese are actually “importing” some stuff from Kenya. The East African state is among 30 African countries “exporting” malaria to China and is now being blamed for threatening the Asian giant’s efforts to eliminate the disease. The Asiatic state’s Ministry of Health says Chinese labourers travelling back from African countries, including Kenya, are responsible for a malaria surge in regions that had almost eliminated the disease.

MALARIA DEATHS

A new report compiled by the Chinese Health Ministry with assistance from US scientists, the World Health Organisation, Unicef, UNDP and World Bank recommends that exiting Chinese labourers be screened for malaria at the point of departure and if positive be treated before travelling.

“In the last decade there has been an increase in the number of malaria cases imported from other countries into Jiangsu Province. At the same time the number of locally acquired cases has declined sharply,” says the report published in Malaria Journal three weeks ago.

The report covering the period 2001-2011 says some 918 malaria cases and six malaria deaths were due to a strain imported from other countries, accounting for 12.4 per cent of all malaria cases and 100 per cent of all malaria deaths.  “During this period the annual number of local cases decreased from 1,163 to 13 while the number of imported cases increased from 86 to 366, majority of them from Africa.”

The Chinese health authorities say they are worried because the type of malaria being exported, especially from Kenya, is caused by the parasite P. falciparum which was eliminated from Jiangsu Province over 20 years ago. So far the biggest construction involving Chinese labourers in Kenya has been the Nairobi-Thika superhighway, but traversing an area that is generally a low malaria zone.

With the start of the Mombasa-Malaba Standard Gauge Railway line, which will cut across long stretches of malaria endemic zones, especially at the Coast and the lake region, this could further complicate elimination efforts both in China and Kenya.

The Division of Malaria Control in Kenya targets at eliminating the disease by 2017 and already prevalence levels at the Coast have dropped by about 40 per cent.

This success, experts at the Kenya Medical Research Institute (Kemri) say, are delicate and could be undermined by poorly understood environmental interference.

At a scientific conference held at Kemri a fortnight ago, Dr Peter Githeko, said the use of bed nets seemed to have pushed malaria mosquitoes to change their feeding habits. It is believed they are starting to feed on unprotected male adults working outdoors.

The Chinese report says construction workers have proven attractive to local mosquitoes because the men are working outdoors without any protection against mosquito bites.

And further complicating matters for the Chinese, unlike the indigenous population is their lack of a natural immunity against local malaria strains. Worse still, Chinese contracts come with requirements that labour would be supplied from their country, thus the influx. “

MEDICATION

Exported labourers are generally poorly educated and many do not know how to protect themselves against malaria while on the other hand they are most likely to be living in poorly constructed houses,” says the report. Apart from possible screening at border points, the Chinese report recommends that labour recruiting companies should be compelled to make sure workers live in good houses, get health education and are on malaria prevention medication.

Dr Githeko, who has done extensive studies on the effects of climate warming and malaria transmission, says the proposed measures should have already been put in place to protect the foreign labourers as well as Kenyans along the line.

“We have substantial evidence indicating an increase of malaria infections in the highland areas of central Kenya, Kisii as well as elevated areas of the Rift Valley,” Dr Githeko told The Standard yesterday.

The researcher, who developed the first early malaria outbreak warning system six years ago, says health authorities and project owners must put measures in place to protect all the site workers against mosquito bites.  “But I am against the suggestion that such people be put on preventive medication. These are long term workers and prescription of preventive medicines called prophylaxis for long periods could come with serious medical side effects.” “If the Chinese do not want their citizens to take the disease back home, residents returning home after visiting a malaria zone must carry a medical certificate indicating they are clean from the disease,” he added.

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