Malaria on decline in prone regions as world day marked this week

Christine Atieno’s grave stands in front her mum’s grass-thatched hut in Randago village, Siaya County.

The eleven-year-old died of malaria in February; in an irony of sorts, since her family’s home shares a fence with Randago Dispensary.

The local community health volunteer (CHV), Alice Anyango, said the girl was rushed to the facility late and quickly referred to the Siaya County Referral Hospital where she died.

“If I had been informed earlier she would have been treated in time, her life could have been saved but the parent delayed and did not even call me,” says Anyango.

On April 25, Siaya County will host the World Malaria Daycelebrations at a time when the county boasts having cut malaria prevalence from 37 per cent to 27 per cent between 2016 and 2019.

Malaria remains an ever present danger with the World Health Organisation (WHO) World Malaria Report (2017) stating that 100 per cent of the Kenyan population is at risk of infection.

The National Malaria Strategy 2009-2017 noted that one in three outpatient attendance in public health facilities is due to malaria. It identified six areas to deal with malaria – the use of nets, intermittent preventive treatment during pregnancy, epidemic preparedness, case management, surveillance and health education behavior change communication.

Other health matters

Children are the most vulnerable with the Kenya Demographic and Health Survey 2014 noting that 52 children of 1,000 under the age of five die from malaria.  

Currently, 63 per cent of Kenyan households own at least one treated mosquito net while 87 per cent of public health facilities have diagnostic capacity.

The Ministry of Health states that Indoor Residual Spraying (IRS) of households, the diagnosis-based treatment policy, supply of the preventive medicine and other integrated vector management measures, have likely contributed to low transmission.

In 2018, a 36-day indoor residual spraying supported by the US President’s Malaria Initiative (PMI) targeted 14 sub-counties in Migori and Homa Bay counties and sprayed 440,000 structures thus protecting some 1.8 million people.

A pilot programme is underway in Busia County on the use of wall paper repellants to keep mosquitoes at bay. The Kenya Malaria Indicator Survey (KMIS) 2015 found that the Lake endemic region still leads in malaria prevalence followed by the Coast endemic and Highland epidemic areas.

Dr Kennedy Oruenjo,Siaya County director of health, attributes the decline in prevalence to the use of long-lasting treated nets and the critical role played by community health volunteers.  

He says that while the distribution of these nets is at 97 per cent, the use of nets currently stands at 50 per cent in the county. But this has been complemented by the engagement of CHVs.

“We have CHVs who are supported by our partners like WorldVision; they have been trained to trace, track and treat malariawhich means these cases no longer have to wait to be referred to health facilities,” said Oruenjo.

Governor Cornel Rasanga adds that the construction, equipping and staffing of 27 dispensaries and 10 health centres has also helped. “We have also opened up roads to ensure people get to health centres easily unlike before. We have also come up with a bill that seeks to recognise CHVs so that they can be properly remunerated,” said Rasanga.

CHVs have become an important pillar in education, detection and treatment of malaria. A number of counties have engaged the services of this cadre of health workers. Each CHV in Siaya covers at least 100 households.

Irene Mukudi, a community mobiliser with World Vision in Siaya says 279 CHVs have had capacity building to handle not only malaria but also child health and HIV issues.

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