60% at risk in YemenMalaria still the one [Archives:2005/901/Health]

December 8 2005

Recently, Yemen is subjected to many diseases and epidemics attack such as dengue fever, polio, and hepatitis. However, Malaria was and is still the biggest health challenge in Yemen. Dr. Mohammed Alnumi, Yemeni health minister, has revealed that 60 percent of Yemeni population at risk of Malaria, according to the last population statistics in last December, which estimated the population of Yemen to be around 19.7 million.

“Malaria has been a major challenge for some decades” Dr. Alnumi said in a seminar that held on last November in Sana'a. He referred that the disease spreads in coastal regions as well as in mountain regions. However he added that Yemen had made progress in its fighting against the disease, for example, in Socotra island the rate of infection of Malaria had fallen from 36% to 1%, whereas the rate of infection in Tihama region was 46% in 1998, and raised to 11,5% in 2003. Dr. Mohammed Khalifah, expert on Malaria in World Health Organization (WHO), insisted that Yemen is still one of most malaria-effected countries in the Middle East with an estimated 800.000 cases per year.

According to the WHO report, Yemen managed to control this disease successfully in 1980s. However, Yemen was hard hit by malaria in 1998 after an extremely heavy rain season. The number of annual cases during that period increased from 1.5 million to three million, with mortality rate between 15.000 and 30.000.

In 2001, Yemen with the cooperation of WHO established its National Malaria Control Program (NMCP) whose strategy includes elements such as early diagnosis and prompt treatment, surveillance and information system and applied researches.

Yemen also gets support from its neighbors Oman and Saudi Arabia that provided Yemen with pesticides, space-spraying machines and vehicles. There are also supports from United Arab Emirates Red Crescent Authority, the World Bank and UN Children's Fund (UNICEF).

In this regards, Yemen through WHO presented a proposal in 2002, to Global Fund for AIDS, TB and Malaria, asking for strengthening the infrastructure of the NMCP. The fund has offered to Yemen $12 million for five years, according to Dr. Khalifah.

A report of Ministry of Public Health and Population mentioned that 90% of the total Malaria cases are due to Plasmodium falciparum parasites that cause 1% of mortality that takes place among children below 5 years old and pregnant women. This data was confirmed by a field study titled (Malaria in Pregnancy in Hodeidah, Republic of Yemen). The study, which was conducted by A.M. Assabri and A.A Muharrm in 2002, dealt with 500 woman and showed that the rate of malaria was higher among pregnant women (55%) than non pregnant women (20%). Moreover, Anemia was significantly more noted among malarial-infected pregnant woman than malaria-infected non-pregnant women.

According to a report issued by the regional office of WHO for the Eastern Mediterranean, which discusses the Epidemiological situation in the Middle East countries, the main factors that lead to deteriorating the situation in Yemen with regards to Malaria include:

– The discontinuation of organized vector control activities.

– The increase of breading places due to water resource development projects, such as agricultural irrigation schemes, lakes and dams.

– Heavy rainfall and floods.

– Increased population.

– Weakened organizational structure of national malaria control programme

– Absence of core group of experts in general, logistic support and transport.

– Miss classified diagnosis, due to weak quality of laboratory diagnosis and absence of quality control.

– Lack of appropriate case management, national policy leading to increased numbers of carriers in the population.

– Availability of sub standard antimalarial drugs in the market.

– Absence of appropriate surveillance system.

– Low health awareness particularly in women and children due to inadequate information, education and communication (IEC).

The report recommended to strength the NMCP's infrastructure both at central and peripheral levels. It stressed on the importance of the decentralizing of Diagnosis, treatment, surveillance and health education to district level and be integrated in PHC system. The report referred also to the importance of community participation by information, education and communication (IEC) systems.

Malaria is a chronic disease caused by parasites and spread through the bite of the female Anopheles Mosquito. This disease characterized by chills, shaking, and periodic bouts of intense fever. In recent years, malaria has become more difficult to control and treat because malaria parasites have become resistant to drugs, and mosquitoes that transmit the disease have become resistant to insecticides.