Namibia recorded 43 malaria deaths in 2020, compared to seven that were recorded the previous year, with the Kavango East and West, Ohangwena and Zambezi regions most affected.
This information was shared by health and social services minister Dr Kalumbi Shangula in light of World Malaria Day, which was observed yesterday.
World Malaria Day is observed internationally every year on 25 April and recognises global efforts to control malaria. Globally, 3.3 billion people in 106 countries are at risk of malaria.
Shangula told New Era that malaria in Namibia is endemic in 10 regions: Kavango East and West, Ohangwena, Zambezi, Omusati, Oshikoto, Oshana, Kunene, Otjozondjupa and Omaheke – regions that have favourable environmental conditions for its transmission.
“While malaria is endemic in the 10 regions, everyone is at risk, as people have to move across the country. The migrant populations are especially at risk, as they move to and from areas with high malaria endemicity – and the children under five, pregnant women and elderly are especially at risk because they have lower immunity than the rest,” noted Shangula.
He said transmission is seasonal and unstable, characterised by focal outbreaks, which mostly affect the regions of Kavango East and West, Zambezi and Ohangwena. These four regions are especially prone to annual epidemics and account for over 80% of the reported malaria cases.
Shangula added that since the ministry rolled out the new National Malaria Strategic Plan in 2017 to achieve malaria elimination in Namibia by 2022, the country observed remarkable reductions in malaria cases and deaths from 66 141 cases in 2017 to 3 404 in 2019.
“However, these achievements are threatened by an increase in cases observed from 2019,” he noted.
Malaria outbreak in Katima Mulilo
Shangula stated that the ministry detected an abnormal increase in malaria cases in Katima Mulilo beyond the expected threshold in the first week of this year. “The government ensured there was a sufficient supply of malaria testing kits and treatments as the first step. This was followed by desk reviews and field investigations to understand what was driving the transmission,” said the minister.
He stated that the investigation team found there was high cross-border movement of people and farmers who spend nights un-protected during ploughing and harvesting and a very low Indoor Residual Spraying (IRS) coverage of 53%; the region managed to spray only 38 487 out of the 72 049 targeted structures with community refusals and locked houses accounting for over 40% of the unsprayed.
Finance
Shangula noted that the country needs N$1.2 billion over the five years of the malaria strategic plan from 2017 to 2022 if it was to achieve the malaria elimination goal.
“The government was able to commit 65% of the funding, which, while substantial, is not enough to launch the malaria elimination interventions at full scale. The MoHSS continuously engages and invites development partners, including the private sector and other community stakeholders to try and cover the gap,” stated Shangula.
He said with efforts from the ministry, it is important for the public to play their part in eradicating the disease.
“The government launched the ‘Zero Malaria Starts with Me’ campaign in 2019 to spark community/grassroots action, summon multi-sectoral investment and mobilise the resources for malaria,” remarked Shangula.
He urged the affected communities to lead malaria prevention, accept, utilise and own the interventions the government is trying to implement such as IRS.
Researcher and entomologist Rosalia Joseph said the government, through the National Vector-borne Disease Control Programme (NVDCP), has made remarkable progress in the fight against malaria and it is well-positioned to become one of the countries in Africa to eliminate malaria by 2030 as part of the SADC malaria Elimination8.
The Elimination Eight Initiative (E8) is a coalition of eight countries, including Namibia, working across national borders to eliminate malaria in southern Africa by 2030.
Joseph said people travelling from high malaria risk countries or areas should be tested for malaria and treated, if necessary, to reduce the importation of malaria.
“People living in malaria-endemic areas can protect themselves and their loved ones by improving their housing structures, by screening off open windows, fixing open eaves and open spaces in the walls. People should also reduce stagnant water in and around their houses to prevent mosquito breeding sites,” she advised.
Dr Eric Dziuban, country director of the Centre for Disease Control Namibia, told New Era there are challenges when it comes to controlling diseases such as malaria.
“Mosquitoes are tiny and they are most active at night when they are hardest to see and kill. It can be difficult to keep mosquitoes out of your home if you do not have the money to buy repellents or if the ministry has not yet been in the area to spray,” said Dziuban.
He noted that in regions where malaria is a problem, patients seeking HIV services can also receive malaria services.
“The sooner malaria is detected, the sooner the patient can receive treatment. The first symptoms of malaria most often are fever, chills, sweats, headaches, muscle pains, nausea and vomiting, [which] can also be mistaken for Covid-19,” informed Dziuban.