Uganda: In African villages, coronavirus sparks fears of a spike in malaria deaths (Thomson Reuters)

| August 2, 2020

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In her small home in northern Uganda surrounded by the six children she cares for, Acayo Rose, 74, sleeps under a mosquito net she inherited from a dead relative. The net has many holes. Dressed in a T-shirt with the words "never quit," she gestures towards the bedroom in the old, run-down building in Gulu district where she lives, adding, "All the nets have holes." She has just recovered from malaria, which also infected the two-year-old grandchild she cares for. World Health Organization data shows that about 405,000 people died from malaria in 2018, with sub-Saharan Africa accounting for 94% of these deaths. WHO warned in April that the number of annual malaria deaths in sub-Saharan Africa could almost double to 769,000 this year because of the coronavirus pandemic, a level last seen 20 years ago.

In her small home in northern Uganda surrounded by the six children she cares for, Acayo Rose, 74, sleeps under a mosquito net she inherited from a dead relative.

She says, “My net has many holes.” Dressed in a T-shirt with the words “never quit,” she gestures towards the bedroom in the old, run-down building in Gulu district where she lives, adding, “All the nets have holes.”

She has just recovered from malaria, which also infected the two-year-old grandchild she cares for.

She is unemployed and went into debt to pay 25,000 Ugandan shillings ($6.74) for the medication needed to treat both herself and the child, whose life she feared was at risk.

World Health Organization (WHO) data shows that about 405,000 people died from malaria in 2018, with sub-Saharan Africa accounting for 94% of these deaths. More than two-thirds of the victims were under five.

WHO warned in April that the number of annual malaria deaths in sub-Saharan Africa could almost double this year because of the coronavirus pandemic, a level last seen 20 years ago.

The spread of COVID-19 has impacted the distribution of insecticide-treated bed nets and access to anti-malarial medication, with people wary of going to a doctor.

Aware of the risks, many countries are pushing ahead with campaigns aimed at reducing the numbers. Uganda is planning a nationwide mosquito net distribution program this year, the first since 2017, with about 27 million nets to be given out to 43 million people.

The distribution teams have started work, kitted out in protective gear and supported by a variety of governmental and NGO groups.

Jimmy Opigo is a program manager at Uganda’s Ministry of Health National Malaria Control Program. He says: “Mosquitos are not in a lockdown, they are still free. Why survive COVID-19 and die of malaria? The mosquito net distribution is one of the main means of fighting malaria. We do it every three years because mosquito nets, the long-lasting insecticide-treated mosquito nets, last three years.”

Uganda has reduced the prevalence of malaria from 42% in 2009 to about 9.2% in 2018 and Mr. Opigo says it was important that routine public health interventions continued despite the pandemic.

But while efforts are underway to distribute bed nets, some healthcare workers fear the government-distributed nets will be too slow to arrive.

As of July 28, there were more than 878,000 confirmed COVID-19 cases across Africa, and healthcare workers fear the pandemic is deterring people from visiting doctors.

Fabio Biolchini heads a Medecins Sans Frontieres (MSF) hospital in Sierra Leone’s Eastern Province. He says, “There is a general hesitation to visit any health facility because patients, and also parents of patients, are afraid about getting infected.”

Mr. Biolchini said they were only seeing a third of the numbers of patients that came this time last year, with parents bringing sick children only “as a last resort.”

Instead, MSF is now operating outreach programs such as mobile clinics, where Mr. Biolchini said they were seeing “many, many” cases of malaria.

Ghana reported its first COVID-19 case in March and now has more than 34,000 confirmed cases—one of the highest numbers on the continent.

Meanwhile hospital admissions for malaria have decreased.

Keziah L. Malm is a program manager with Ghana’s National Malaria Programme, and says: “People will rather stay at home and buy over-the-counter medications and visit the hospitals only when all other attempts at self-medication has failed.”

In northern Uganda’s Palabek refugee settlement, Ocen David, a 19-year-old South Sudanese refugee, is recovering from malaria.

He says, “This time the mosquitoes are too much. We’re contracting malaria every day.”

At one of Palabek’s health clinics, staff said they were overwhelmed and lacked the resources needed to tackle COVID-19, such as soap and masks or space for social distancing, as about 100 refugees waited outside for appointments. Meanwhile, they are seeing many patients with malaria or anaemia caused by malaria. One person died in the clinic last month from malaria, and others died in hospital after presenting with advanced symptoms.

This story was adapted from an article written by Sally Hayden for Thomas Reuters Foundation, titled “In African villages, coronavirus sparks fears of a spike in malaria deaths.” To read the full story, go to: https://news.trust.org/item/20200715124928-xlijn/

Photo: Family in Amhara State, Ethiopia, setting up their bed net.