Malaria Control: First Promising Steps [Archives:1998/32/Health]

August 10 1998

The “Malaria Coordination Meeting Between Bordering Countries of the Eastern Mediterranean and African Regions’ was held in Sanaa during 27-29 July. Organized by the Ministry of Health in cooperation with WHO, the meeting was concluded with a number of recommendations.
Participants from Yemen, Sudan, Djibouti, Somalia and Eritrea suggested that a comprehensive plan should be adopted to monitor the malaria epidemic, a joint political policy should be formulated by the governments of the countries concerned to eradicate this disease as well as calling on the WHO to provide the necessary funds, medicines and training facilities.
A paper Prepared and presented by Dr. Mohammed Saeed Amer, Director of the National Malaria Control Program (NMCP) at the Ministry of Health, indicated the following:
Malaria Situation in Yemen:
* About 60% of the total population live in endemic malaria areas (at risk all through the year).
* 20% in areas were malaria is seasonal.
* 20% in malaria-free areas or slightly affected by the disease.
* It is estimated that 1,500,000 malaria cases occurred annually. Fatality rate is more than 1% of total cases, mostly among children under the age of 5 and also pregnant women.
* More than 90% of the total malaria cases were due to plas. Falci, the remaining 10% is divided between PL. Malaria and PL. VIVAX 7-3% accordingly.
* The main malaria vector is A. Arabiansis followed by A, cuilicficasis mainly in Socotra Island and the eastern part of the country.
There is a great need for entomological studies to determine the roles of A. Costani, A. Sergenti, A. Detheli and A. Multicular.
* Generally speaking, malaria in Yemen is characterized as an Afro tropical type.
Status of Malaria Control:
During the past few years (1994-1997) the NMCP was plagued by many difficulties which affected its control measures in general and the vector control in particular. This led to an increase in malaria cases due to epidemics occurring here and there, and now and then.
The main difficulties are:
* Lack of transportation, (only 6 old vehicles in service for the whole country).
* Inadequate support and finance.
* Lack of administration connections between the Sanaa HQ and the primary units at governorate levels.
* High turnover of technical and trained personnel.
* In this year, 1998, the anti-malaria activities were upgraded in 8 governorates as a first step to be followed by 6 other governorates during the 4th quarter of this year.
* During the past 2 months, the NMCP received 8 new cars, drugs, spraying equipment, laboratory equipment and supplies from WHO, and 20 tons of DDT WDP 75% gift from the Sultanate of Oman.
* 396 persons will be trained locally for different controlling methods, such as microscopical diagnosis, entomology, treatment of severe cases, data analysis, etc. Training will take place in Sanaa, Aden, and Hodeida. Another 15 persons will be trained abroad.
Malaria Control Strategy in Yemen
The malaria control strategy in Yemen is planned according to the 4 technical elements of the global malaria control strategy. The recommendations of the regional malaria adviser are as follows:
* Early diagnosis and prompt treatment.
* Selective and sustainable prevention.
* Control of epidemics.
* Applied researches.
Taking into account the implementation conditions leading to success control:
* Political commitment.
* Malaria control is an integral part of the health systems.
* Resource mobilization.
Dr. A.V Kondrachine, Chief Medical Officer, Malaria Control, Division of Control of Tropical Diseases, WHO, Geneva:
The objectives of this meeting are to exchange information between the neighboring countries, share the same philosophy of malaria control, make recommendations as to the development of their respective national malaria control plans, and to make recommendations as to how to proceed with coordination efforts.
There is one particular most important type of malaria, the so-called Afro Tropical. Yemen and the rest of this territory is plagued by this particular type of malaria.
WHO has assisted this country as well as other countries in terms of support and finances to control malaria. The most important thing about this meeting is that it was the government of Yemen who had demonstrated very high political commitment to control malaria. This is very much appreciated. But it is not only political commitment the government of Yemen made. It was also a financially demonstrated support to the malaria control program, in terms of personnel, equipment and support from other sectors.
I was very pleased during the first. It was not only the Minister of Public Health who attended but also the Minister of Agriculture. However, I would be more pleased to see the administrators who are responsible for those areas as forestries, fisheries, etc. These departments are also very important in contributing to different aspects of malaria and the implementations of the activities of malaria control.
The attendance of the Minister of Education, for example, is particularly important. It is the children who fall victims to malaria and they are the best communicators to their families. They can share the information on the causes of malaria, the appropriate methods of control, etc. I would like this to be the concern of the government of Yemen.
We had been very pleased to see the health service staff very much aware of malaria. They know how to treat people, so they appreciate the magnitude of malaria. The government of Yemen has provided drugs practically to all the areas affected by malaria epidemics.
Unfortunately there is no laboratory for diagnosis. But nevertheless in spite of these, the health personnel are very well trained to deal with the clinical diagnosis of malaria. Fortunately now because of this awareness, there is no severe cases of malaria.
There is still a long way to go. It takes time and much effort. The second thing I would like to mention is that the organization of this meeting was superb. I was extremely pleased to see the honorable ministers and I must congratulate my Yemeni colleagues on organizing this meeting and of course the malaria control program. There is a long way to go, but the start is very optimistic.
Ismail Al-Ghabiry,
Yemen Times