Uganda ranks 8th in the number of Countries with the highest malaria infections in the sub-Saharan Africa with some of the highest reported malaria transmission rates in the world according to the World Health Organisation.
The country ranks 3rd in the countries contributing towards the global malaria burden with an estimated total of 6,000 people dying of malaria annually in Uganda.
As the Ministry of Health takes on the fight against the disease by employing various measures like the ongoing distribution of treated mosquito nets, larviciding in areas affected by floods, residual spraying among others, revisiting the transmission, prevention and treatment basics is key.
“An infected mosquito carries the plasmodium parasite; when this mosquito bites you, the parasite is released into your blood stream which continues to travel to the liver where they matures and multiplies,” Dr. Abeso Sharon, a health worker said.
She added that after several days, the mature parasites enter the blood stream and begin to infect the red blood cells. Within 48-72 hours, the parasites inside the red blood cells multiply causing the infected cells to burst.
“The parasites will continue to infect red blood cells resulting into symptoms that occur in cycles that last 2-3 days at a time,” she explained.
Abeso said that there are 4 types of malaria parasites; these include plasmodium vivax, plasmodium ovale, plasmodium malariae and plasmodium falciparum.
“Plasmodium Falciparum is the most common and when severe, it even causes death,” she added.
Dr. Abeso noted that with a couple of symptoms including; diarrhoea, vomiting, bloody stools, flue like illnesses, profuse sweating, high fever, abdominal and muscle pain among others, there are various kinds of treatment.
Some of them include administering Artemether-Lumefantrine (Cortem), Quinine, Artesunate among others.
She said that the patient’s signs and symptoms are looked at; and patients are also asked the last time they got sick. Then, a patient is taken to the lab for a blood testing to ascertain any presence of malaria parasites.
“The type of malaria parasites in the patient’s body will determine the kind of treatment to be given,” she said.
However, those with more than one parasite are given Intravenous therapy (IV) to destroy all parasites and also to ensure that malaria doesn’t relapse. This involves the administering of medicinal fluids directly into the vein, a procedure locally termed as “drip”.
It should be noted that if not treated well, malaria can gradually cause serious health issues.
Dr. Abeso explained that malaria can result into; pulmonary oedema which is the accumulation of fluids in the lungs which causes breathing problems, cerebral malaria which involves swelling of the blood vessels in the brain, organ failure (liver, kidneys, spleen) and even anaemia due to destruction of red blood cells.
Also, she said, there are various reasons why malaria relapses in a short time.
“Some parasites are resistant to medications and there are some parasites that can stay in the liver without being active,” she added.
She also said that some patients, upon noticing the disappearance of some symptoms, do not complete the dose and therefore allow some parasites to survive within the body, risking a malaria relapse later on.
For pregnant mothers, Dr. Abeso said, Fansidar is given from 4 months so that if they get malaria, the unborn baby is not affected.
However, for malaria treatment among expectant mothers, some medicines may be pose a danger to the growing foetus as Dr. Abeso explained, “Sometimes with pregnant women, if quinine is administered in large amounts, it may cause miscarriages.”
Taking risks during COVID-19
Abeso said that as health workers, they are challenged during this period in the course of their duty as they are in fear of contracting the coronavirus.
“If a patient comes with covid-like symptoms, there is always fear of working on them because they might be having the virus. Meanwhile, some patients may not be able to afford the malaria medication because of poverty brought about by the pandemic.”
Dr. Aisha Namagembe, a retired physician from Mulago National Referral hospital and clinic owner at Kawempe agreed with the health reports that “malaria incidents have reduced from the past years, where by an outbreak would kill hundreds of people.”
“However, people should not relax,” Namagembe said adding, “the prevention of malaria is better than cure.”
She recommended that people should sleep in treated mosquito nets to keep mosquito bites at bay, make use of mosquito repellents and maintain good sanitation around their homes.
It should be noted that the government, through Ministry of Health is distributing Long Lasting Insecticidal Nets (LLINs) to Ugandans. Two waves covering various districts in Eastern and Western Uganda have so far been completed.
A total of 40 districts are expected to acquire mosquito nets in the forthcoming wave 3 of the “Under the net” campaign.