Opadiran Oluwatunmobi, Oluwafemi Ajumobi, Victoria Ibeh, Ogu Omede, and Godwin Ntadom from the National Malaria Control Programme, Federal Ministry of Health, Abuja, Nigeria presented their experiences on malaria in an emergency setting at the recently concluded Multilateral Initiative on Malaria 6th Pan Africa malaria Conference in Durban, South Africa. Below, they have shared their experiences with our readers.
Nigeria accounts for 25% malarial disease burden in Africa. Malaria accounts for 25% under-five mortality. In 2012, flood disaster ravaged certain areas of the country leading to internal displacement and significant environmental degradation. Though mass screening and treatment (MSAT) is recommended by world health organization (WHO) in areas in the pre-elimination phase for detection of asymptomatic parasite carriers and rapid reduction of the parasite pool, we explored its use in a disaster situation. We conducted MSAT for malaria amongst displaced persons and at risk groups in Bayelsa, Nigeria.
Residents in Yenogoa local government area, Bayelsa state, Nigeria were mobilised for MSAT and screened for malaria using Histidine Rich Protein-II-based Standard Diagnostic Bioline malaria rapid diagnostic (RDT) test in November 2012. All RDT positive cases were treated with Artemisinin-combination therapy (ACT). Data were analysed using Epi Info version 3.5.3 and Microsoft excel.
Of the 1684 tested, 611(36.3%) were male, 43 (2.6%) were pregnant women, 303 (18%) had fever ?37.5oC, 447 (26.5%): generalised weakness, 536 (31.8%): headache, 368 (21.9%): joint pains, 111 (6.6%): vomiting, 113 (6.7%): diarrhea, 454 (27%): cough, 180 (10.7%) tested positive and 5 (0.3%) had invalid test result. Of the 180 RDT positives, 138 (76.7%) received ACT. Of the 1504 RDT negatives, 64 (0.1%) received ACT. Of 480 (28.5%) under-fives (U5), 81(16.9%) had fever, 67(14%) had danger signs. Of 51 RDT positive U5, 39 (76.5%) received ACT. Of the 429 RDT negative U5, 29 (6.8%) received ACT. Two RDT positive pregnant women received ACT. Severe malaria cases in U5 were referred to the health facility.
The prevalence of malaria is low. The RDT met the WHO criteria for invalid rate of <5%. Non-rational use of ACTs thought relatively low, was higher in U5. It cannot be assumed that prevalence of malaria is higher in flood disaster victims. The use of MSAT in internally displaced population in disaster situation is necessary to ensure rational use of ACTs.