By Foday Moriba Conteh
As a show of commitment to the global effort to eliminate malaria, the Government of Sierra Leone through the Ministry of Health and Sanitation and partners will distribute free of cost over 4.6 million long-lasting insecticide treated bed nets to households nationwide from the 22nd to the 31st May 2020.
Giving an overview of the Integrated LLIN mass distribution campaign and house to house Family Sensitization on Covid-19 Prevention at a Press Conference at the Ministry of Information and Communication (MIC) conference hall, 8th floor Youyi Building on Thursday 14th May, 2020, the Director, Disease Prevention and Control Dr. Smith disclosed that the type of insecticide treated nets that will be distributed is Pyrethorid-PBO nets containing a synergist (piperonylbutoxide PBO) meant to address the problems related to insecticide resistance in Sierra Leone.
He said Sierra Leone is the first country in Africa, if not the entire world, to distribute PBO nets throughout the country, adding that this is in addition to the fact that malaria treatment in all public health facilities continue to be free.
He pointed out that the major objective of distributing the bed nets nationwide is to move Sierra Leone towards Universal Coverage with 80% of people sleeping under an insecticide treated nets while contributing to the reduction of malaria-related morbidity in Sierra Leone in the context of the Covid-19 pandemic.
The campaign, he said, will undoubtedly help to contribute towards the prevention and containment of Covid-19 pandemic in Sierra Leone.
14 districts covering 149 chiefdoms and 20 zones in Western Area Urban and 10 Zones in Western Area Rural will be targeted.
He said they will not distribute in the Western Area during this time, because it is the Covid-19 hotspot, but that will be done later.
Deputy Minister of Health and Sanitation I, Dr. Anthony Augustine Sandi, described the mass distribution of long lasting insecticide treated bed nets as one of the strategies identified in the President’s Priorities for Health and part of the Ministry’s Health Performance Tracking Tools.
He continued to say that Malaria, though preventable, still remains a major public health problem in Africa and Sierra Leone in particular and constitutes a major barrier to social and economic development.
“The entire population in Sierra Leone is at risk of malaria while children and pregnant women are seen to be particularly susceptible and more vulnerable to this disease. This calls for a sober reflection and underscores the need to use the opportunity during the COVID-19 pandemic to examine where we need to redouble our efforts at all levels.”
This preventable and treatable disease continues to kill one child every 2 minute for lack of simple, cost-effective tools like an insecticide-treated net or a simple course of effective treatment.
He disclosed that in Sierra Leone, malaria remains one of the prime causes of death among children and the biggest cause for medical consultation and hospitalisation. Malaria is responsible for 47% of the out-patient visits by children under five years to health facilities, malaria accounts for 38% of the out-patient visits for all ages to health facilities; malaria accounts for 37.6% of all hospitalisation; malaria accounts for 35.3% of death in children under five years, and 20.5% of death attributed to malaria for all ages.
“Similarly, pregnant women suffer from malaria, which contributes to maternal anaemia, low birth weight, stillbirths, abortions and other pregnancy-related complications.”
Malaria, he emphasised, continues to cause suffering and dismantle families as it has an immense economic toll and is a major block to all forms of development.
Dr. Sandi added that from 2010 to 2018, the number of deaths was more than halved and the number of malaria cases dropped by 20%, indicating that with the right interventions and multi-sectoral commitments further progress is possible. “We cannot let this incredible progress be undermined by the coronavirus pandemic and must maintain and accelerate progress towards malaria elimination with more determination than ever.”
RushnanMurtaza, UNICEF Deputy Representative, said this distribution of mosquito nets will no doubt contribute towards the reduction of the malaria disease which happens to be the biggest killer disease among pregnant women and children under the age of 5.
“I would like to start by congratulating the Government of Sierra Leone for the positive efforts to reduce deaths and illness due to malaria in the country. Over the past two decades, the National Malaria Control Programme of the Ministry of Health and Sanitation in collaboration with partners have worked to dramatically prevent and control the disease, and progress is tangible and visible in communities.”
She pointed out that despite the progress, the incidence of malaria in Sierra Leone is still worrying. According to the Multiple Indicator Cluster Survey 2017, malaria is responsible for 47% of the outpatient visits by children under five years and account for 38% of outpatient visits for all ages to health facilities.
“The reality and burden of malaria becomes very apparent at the children’s wards of hospitals across the country, where the nurses and doctors fight hard daily to save the lives of children who have malaria. Each death is a tragedy, which is felt strongest when one sees the mourning family members trying to cope with the loss.”
He continue to say, sadly, deaths due to malaria might continue to rise during the current times of COVID-19, when there are some disruptions to regular anti-malaria programmes, preventing the rate of infection is therefore one of the main principles interventions in the country’s malaria programme.
That is why it is a welcome initiative to be distributing bed nets to pregnant women and children under five – the two groups most at risk. Specifically, the campaign aims to reach 95% of households with up to 3 bed nets and to also empower communities with correct information of the use of the nets.
Already UNICEF has procured and distributed 1458 veronica buckets, which have been received by District Health Management Teams ahead of the campaign and which will help to ensure that good hygiene practices such as handwashing with soap is maintained at all distribution sites. Additional to that, a total 1 784 COVID-19 social mobilisers, who include (Community Health Workers and volunteers), have been selected and will be trained to participate in the integrated house to house sensitization activities.
She thanked the Government of Sierra Leone and especially the Ministry of Health and Sanitation for their dynamic leadership in the malaria programme and also acknowledged with thanks, the great cooperation and support from their international partners, the Global Fund and PMI /USAID financed, who have supported the procurement and delivery of the LLINs for the campaign.
The mosquito nets will be distributed to people in Sierra Leone, district by district, chiefdom by chiefdom, sector by sector, village by village and house to house and the formula of two people per bed nets as a strategy to reduce malaria incidence in the country.
This is a laudable initiative. However, to reduce the infections rate of malaria, the sanitation ministry should spray mosquito breeding spots within communities with insecticides on a weekly basis.
Mosquitoes are mostly active at the start of the night and early in the morning. They feed on people before the go to bed under the safety of the bed net. Therefore to decrease the infections rate, the mosquitoes have to be killed at thier breeding site.