Malaria is a disease caused by the blood parasite Plasmodium, which is transmitted by mosquitoes. Infected humans experience flu-like symptoms that can result in coma and death. Malaria, from the Medieval Italian words malaria or â bad air, infects more than 500 million people a year and kills more than a millions” one person dies about every 30 seconds. The disease is particularly devastating in Africa, where it is a leading killer of children. In addition to being home to the deadliest strain of malaria and the mosquito best equipped to transmit the disease, many areas in Africa lack the proper infrastructure and resources to fight back.
The disease is a self-perpetuating problem with large-scale impact on societies and economies. Malaria accounts for up to half of all hospital admissions and outpatient visits in Africa. In addition to the burden on the health system, malaria illness and death cost Africa approximately $12 billion a year in lost productivity. The effects permeate almost every sector. Malaria increases school absenteeism, decreases tourism, inhibits foreign investment, and even affects the type of crops that are grown.
Malaria is Both Preventable and Treatable
Malaria is both a preventable and treatable disease. It can be prevented by giving families and individuals insecticide-treated bed nets to sleep under and taking steps to kill mosquitoes where they breed and when they enter houses to feed at night. At the same time, anti-malarial drugs such as artemisinin and other combination therapies that are widely available can treat malaria before it becomes deadly.
Malaria has been brought under control and even eliminated in many parts of Asia, Europe, and the Americas. Yet in Africa, with increasing drug resistance and struggling health systems, malaria infections have actually increased during the last three decades.
Bed Nets
Despite the magnitude of the problem, there is a simple and cost-effective solution to prevent malaria deaths. For just $10, we can purchase a bed net, deliver it to a family, and explain its use. Bed nets work by creating a protective barrier against mosquitoes at night, when the vast majority of transmissions occur. A family of four can sleep under an insecticide-treated bed net, safe from malaria, for up to four years. The benefits of bed nets extend even further than the family. When enough nets are used, the insecticide used to deter mosquitoes makes entire communities saferâ including even those individuals who do not have nets.
Although $10 for a bed net may not sound like much, the cost makes them out of reach for most people at risk of malaria, many of whom survive on less than $1 a day. Nets are a simple, life-saving solution, but we need your help to provide them to those in need.
Anti-Malarial Drugs
Artemisinin-based combination therapies (ACTs) are the most effective drugs currently available for treating malaria. Less expensive ACTs need to be developed and strategies to deliver them need to be implemented and evaluated so that the therapies can be accessed by the people who need them. Artemisinin-based combination therapies are also used to help pregnant women by administering at least two monthly treatment doses of sulfadoxine-pyrimethamine (SP) during the second and third trimesters of pregnancy. More than 70 percent of pregnant women in Africa attend prenatal clinics at least once during their pregnancy. A regime of SP helps protect pregnant women from possible death and anemia and also prevents malaria-related low birth weight in infants, which causes about 100,000 infant deaths annually in Africa.
Killing Mosquitoes through Indoor Residual Spraying
While bed nets are generally effective in Africa wherever they are consistently used, sometimes specialized teams are organized to spray an insecticide on the inside walls of houses (a process known as Indoor Residual Spraying or IRS). IRS kills female mosquitoes when they rest on sprayed surfaces after feeding on a person, reducing malaria transmission to others. Only female mosquitoes can transmit malaria. In special circumstances, teams are also organized to eliminate or treat mosquito breeding sites with another type of environmentally friendly insecticide. However, because the African malaria mosquitoes are so prolific and have such a broad range of breeding habits, this type of “larval control†may not be applicable in some areas.
Life-Saving Facts
For just $10 we can buy a bed net, distribute it to a family, and explain its use.
Insecticide-treated bed nets can keep a family safe for up to four years.
Nothing But Nets has partnered with the Measles Initiative to deliver the nets to even the most hard-to-reach areas of Africa.
Other Facts & Historical Anecdotes about Malaria
Only female mosquitoes can transmit malaria.
Malaria’s etymological roots are in the Italian language, and “malaria†translates literally as “bad air,†a reference to the early belief that the disease was caused by breathing the stale, warm, humid air found around swamps.
Four Nobel prizes have been awarded for work associated with malaria to Sir Ronald Ross (1902), Charles Louis Alphonse Laveran (1907), Julius Wagner-Jauregg (1927), and Paul Hermann Müller (1948).
Two important, currently used anti-malarial drugs come from plants whose medicinal values have been noted for centuries: artemisinin from the Qinghao plant (Artemisia annual, China, 4th century) and quinine from the cinchona tree (South America, 17th century).
In the poorest parts of the world, where effective window screens are lacking, insecticide-treated bed nets are arguably the most cost-effective way to prevent malaria transmission. One bed net costs just $10 to buy and deliver to individuals in need. One bed net can safely last a family for about four years, thanks to a long-lasting insecticide woven into the net fabric.
Studies show that use of insecticide-treated bed nets can reduce transmission as much as 90% in areas with high coverage rates. Bed nets prevent malaria transmission by creating a protective barrier against mosquitoes at night, when the vast majority of transmissions occur. The African malaria mosquitoes generally bite late at night or early morning, between 10:00 p.m. and 4:00 a.m. A bed net is usually hung above the center of a bed or sleeping space so that it completely covers the sleeping person. A net treated with insecticide offers about twice the protection of an untreated net and can reduce the number of mosquitoes that enter the house and the overall number of mosquitoes in the area.
Currently, nets are treated with pyrethroid insecticides. These insecticides have very low levels of toxicity to humans, but are highly toxic to insects. By repelling the mosquitoes, a bed net can protect other people in the room outside the net. When enough nets are used in an area, the insecticide used in the net fabric makes entire communities safer even for those individuals who don’t have nets.
How Bed Nets get to Africa
With the money raised for Nothing But Nets, the UN Foundation and the campaign’s partners work with the Measles Initiative – one of the most successful vaccination efforts ever undertaken – to purchase bed nets and distribute them in countries and communities in greatest need.
The Measles Initiative is a partnership of the American Red Cross, the U.S. Center for Disease Control, the UN Foundation, the World Health Organization, and UNICEF. Since this integrated campaign began in 2001, nearly 250 million children across Africa have been vaccinated against measles and the number of measles cases reduced by 60%.
Child Health Interventions and Bed Net Distributions
Building on this success, the Measles Initiative has expanded to provide a package of critical child heath interventions, such as Vitamin A, de-worming medicines, the oral polio vaccine and insecticide-treated bed nets.
Since 2002, the Measles Initiative has distributed over 23 million bed nets in 18 countries across Africa through these integrated child health campaigns. In 2006 alone, almost 20 million bed nets were distributed in 10 African countries, including Ethiopia, Kenya and Nigeria.
How Bed Nets are Distributed through the Measles Initiative
Coordination with African Governments
Each year the Measles Initiative coordinates with African governments to determine which countries will undertake measles campaigns. This is based on the prevalence and spread of the disease, the number of years since the last campaign, and the interest and preparedness of each country. Such coordination is necessary to conduct effective and efficient campaigns as well as ensure sustainability. To date, 12 countries have been chosen to conduct measles campaigns in 2007.
Government and NGO Coordination of Bed Nets
During the planning process for a measles campaign (which can take 6 to 9 months), a country can choose to integrate other health interventions such as insecticide-treated bed nets. When a country decides to distribute bed nets during its measles campaign, the Measles Initiative and the country government coordinate the planning for each such that they are fully integrated. Together, WHO, UNICEF and the local ministry of health determine where to purchase the bed nets and who will be responsible for bed net storage, distribution, social mobilization, and follow-up surveying.
Distribution of Bed Nets and Education on their Use
Throughout the integrated child health campaign, children travel to vaccination posts where they receive the measles vaccine and other medicines, as well the insecticide-treated bed net. Health workers and volunteers provide the immunizations and educate children and their families on the use of the bed nets, while observers from various agencies and organizations monitor the activities of the campaign and provide support to the health workers and volunteers as needed.
Evaluation
The evaluation of the bed net distribution generally takes place just prior to the rainy season, providing an opportunity to re-educate families on the use of the bed nets as they enter the time of year during which mosquitoes tend to be more prevalent.
Sending Nets. Saving Lives
This entire process of purchasing and distributing insecticide-treated bed nets to children under the age of five, as well as providing education and follow-up surveying on their use, is accomplished at the cost of just $10 per bed net.
Although $10 for a bed net may not sound like much, the cost makes them out of reach for most people at risk of malaria in Africa, where many people survive on less than $1 a day. Malaria has been brought under control and even eliminated in many parts of Asia, Europe and the Americas. Yet in Africa, malaria infections have actually increased over the last three decades. Malaria is a leading cause of death of children in Africa, killing nearly one million children each year. Every day 3,000 children die from the disease.
LUANDA, Angola (UMNS) -- Sometimes malaria can kill a child before anyone even knows the child has been infected.
The Rev. Domingos Kafuanda says the recent death of an 8-year-old girl in his congregation was a grim reminder of how deadly malaria can be.
The child was singing in the children's choir on Sunday. "She was happy and playing," he says. "We got word she died the next day of malaria."
People sometimes ignore a headache and fever that may be the first symptoms of being infected, he says.
"Malaria can be in your body for a long time. Children can have fever one day and be feeling well the next; that is why it is so important to be tested," he says. "Her death really moved the church and reminded us we need to be vigilant about prevention and testing."
The complications are that not every mosquito carries malaria, and sometimes it is just impossible to avoid getting bitten.
Kafuanda, a United Methodist district superintendent for the Angola West Annual (regional) Conference, was bedridden with a high fever from malaria just two days before he spoke to United Methodist News Service about the killer that claims so many lives in this southwest African country.
He says he sleeps under a mosquito net and is well aware of the danger, "but sometimes you have to get out from under the net, and sometimes mosquitoes get inside."
Breeding grounds
Neighborhoods that lack potable water, adequate sewage systems and are overcrowded create the perfect breeding grounds for misery.
Dr. Pedro Francisco Chagas and Dr. Laurinda Quipungo sat down with a United Methodist delegation from the Board of Global Ministries and United Methodist Communications to talk about the problems they face every day in another part of the country at the Malanje Provincial Hospital.
“We have a population of 1.2 million in 14 municipalities,†Chagas says. “It is a dream of mine to have one doctor for every 10,000 people. Right now that dream is far from coming true, he says.
Setting priorities is hard because the problems are so many, he says. The top diseases the doctors face are malaria, respiratory problems, gastric problems, AIDS/HIV and sleeping sickness. The greatest threat is to children under 5 and pregnant women.
"If a child has a fever, the first thing we must assume is malaria," says Quipungo, a pediatric doctor who is also the wife of Bishop Jose Quipango, United Methodist leader of the East Angola Annual (regional) Conference.
Along with fever and headaches, other symptoms are coughing and convulsions, sometimes followed by a coma. Children often become anemic, which weakens their ability to fight off the disease. Cerebral malaria attacks the brain, and the person never fully recovers, Quipungo says.
"Sometimes parents see the hospital as the last alternative, and it is too late when they bring in their children."
No protection
Jose Vieira Dias Van-Dunem, the vice minister of health for Angola, says 30 years of war have left the country without much protection from deadly diseases.
"Resources are not elastic," he says. "Many resources went to the war and were not used for health or potable water. In the last four years, that is becoming the past."
Angola won its 16-war of liberation from Portugal in 1975 but was thrust into a long civil war that lasted from 1976 to 2001. Thousands died, infrastructures were destroyed across the country, and more than 2 million people were displaced.
The government's top priorities are promoting education, health and national unity, and fighting poverty, Van-Dunem says. The church has a major role to play.
Angola had the deadliest outbreak of Marburg disease ever recorded in 2005. When the fatal disease swept through the country last year, Van-Dunem says he went to see the African religious leaders. He told them to tell people to stop the African tradition of kissing and touching the dead body because the disease was spreading as a result. The word got out and the disease was stopped.
Churches can help with education, he says.
In seven of the 18 northern provinces, sleeping sickness is a major problem. The disease is spread by the bite of a tsetse fly, and 40,000 people die every year in regions of Sub-Saharan Africa. Van-Dunem says the fly is attracted to black or dark blue cloth so the government has made traps of dark cloth to catch the flies.
"People are stealing the traps to make clothing for their children," he says. "Then the children become the traps for the flies.
"We as Africans listen to our elders," he says. "Our relationship with churches is very important, but we have to be greedy, we want more."
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