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Health Ministry Warns Of Malaria Upsurge, Lists Measures To Curb Deadly Disease

Uganda’s Health Ministry has warned of an upsurge of deadly malaria in the country caused by a prolonged rainy season.

This was revealed by the Health Minister, Ruth Aceng on Wednesday saying the cases of Malaria have increased by over 400,000 cases when compared with 2018 and 2019 from about 1 million cases in June 2018 to 1.4 million in June 2019 (40% increase).

Below is the full statement

The Ministry of Health informs the general public that there is a Malaria upsurge in the country, which started from June 2019. This is due to the rainy season that the country is currently experiencing where the cases of Malaria are gradually increasing from the baseline seasonal peak usually experienced following a rainy season.

The cases of Malaria have increased by over 400,000 cases when compared with 2018 and 2019 from about 1 million cases in June 2018 to 1.4 million in June 2019 (40% increase). However, it is worth noting that cases are still low compared to 2017 and 2016 in the same period.

With all the efforts of government and my ministry, major gains have been made in the national malaria response over the last decade. Malaria prevalence dropped from 42% in 2009 to 19% in 2014 and now to 9% in 2019; annual malaria deaths dropped by 57% from 30 to 13 deaths/100000 people. Reported malaria deaths dropped from 6100 in 2015 to 5800 in 2016, to 5100 in 2017and to 3000 in 2018 over 40% drop in one year. A trend of drop of malaria cases have followed the same trend over the years.

The Malaria upsurge has affected half the country with approximately 65 districts involved. The affected areas include;

1. West Nile region

2. Acholi region

3. Lango except where Indoor Residual Spraying is ongoing (Dokolo, Alebtong, Lira, Otuke)

4. Busoga Region

5. Bunyoro Region

6. Buganda Region: Kyotera, Butambala, Kalangala, Luweero, Kampala, Kayunga, Buyikwe, Rakai, Kyankwanzi, Mubende, Nakasongola

7. Karamoja Region

8. Teso Region; Soroti, Kumi, Amuria

9. Eastern Region: Namissindwa, Busia, Bulabuli, Mbale, Sironko, Manafwa

10. Western Uganda; Kamwenge, Kisoro, Kanungu

The increase in Malaria cases is attributed to the following reasons;

· Seasonality: The most number of Malaria cases occur during the period of June- July due to the rainy season

· Climate change: Prolonged intermittent rains in various parts of the country that have lasted till to date (August 2019)

· Reduced net ownership and use due to the aging of nets distributed in 2017/18 mass Long Lasting Insecticide treated mosquito Nets (LLINs) campaign

· Low Malaria prevalence in areas such as Kampala – and this has led to laxity in the population’s prevention practices such as sleeping under a mosquito net, closing doors and windows early, early seeking of care and treatment.

· Population growth and refugee immigration in specific regions

· Movement of populations from high burden areas (Busoga, West Nile, Northern Uganda, Karamoja) to low burden areas (Kampala, South Western Uganda) and vice versa for festive season, employment like farming. This was supported by evidence received from Naguru hospital in July 2019 where 85% of the malaria patients had travel history outside Kampala.

People in areas with low Malaria such as Kampala and Kigezi region (parasite prevalence less than 1%) are prone to severe malaria due to reduced/low immunity.

Reported increase of Malaria cases in Kampala

Whereas there is a slight increase in Malaria cases in Kampala in the previous months, this is similar to what was registered in the same period last year (for example; for the month of June, there were 27,159 in 2019, 28,086 in 2018 and 36,391 in 2017). However, the number of severe forms of Malaria requiring admission (severe malaria ) has increased by 60% compared to the same period last year ( 920 severe cases in June 2019, total of 570 in 2018 and 540 for 2017)

This is due to the seasonal variations and low immunity of Kampala residents. The total number of malaria deaths in Kampala has remained unchanged at an average of 6 deaths per month despite the increases in severe malaria cases.

The most affected are the people who travel to high burdened areas and their household members.

In order to mitigate this upsurge, the Ministry of Health working with partners has put in place a number of interventions that will lead to a decrease in the overall number of Malaria cases. These are;

· Supported districts with increased cases to order and get emergency supplies (Artemisinin-based Combination Therapy (ACTs) and Rapid Diagnostic Tests (RDTs) to ensure facilities are well stocked. We have revised the quantification of ACTs for this financial year to take into account this increase in cases.

· Redistribution of Malaria Commodities from facilities and districts with overstocks to those with inadequate stock of malaria commodities

· The Ministry is working with the private sector to ensure they have adequate stocks of subsidized antimalarial medication.

· We are monitoring malaria cases, admissions and deaths in all districts on a dashboard and using the data to guide decisions at all levels, this has helped identify and contain many outbreaks

· Strengthening the management of malaria by village health teams at community level through training and providing adequate stock

· Continue the routine distribution of LLINS to pregnant women in Antenatal care clinics and to Children in immunization clinic

· Fast tracking the implementation of the 2020 LLIN Mass Campaign

· Introducing new channels of LLIN distribution such as school distribution in selected districts with high malaria burden.

· In 2018, H E President Yoweri Museveni launched the MAAM (Mass Action Against Malaria) drive for every individual to actively take on malaria preventive services and ensure they are malaria free. In this regard, we are working with leaders to intensify education and prevention.

· Community outreaches in high burden areas to conduct testing and treatment and tracking.

· Mobilization drive for resources to scale up interventions such as Indoor Residual Spraying and routine LLIN distribution (increase IRS beyond the current 15 districts)

The Ministry of Health would like to inform the public that the Malaria cases are expected to decrease a month after the end of the current rainy season. The end of the rainy season is however different in the various regions.

Malaria is transmitted by female Anopheles mosquitoes which normally bites at night. An infected mosquito bites a human being and transmits the plasmodium into the blood of the person.

The signs and symptoms of Malaria are; fever, headache, vomiting, Chills ( shivering), sweating, Backaches, Body weakness, loss of appetite and diarrhea.

The Ministry of Health would therefore like to appeal to the general public to;

1. Sleep under a mosquito net every night to avoid Malaria

2. Always seek early treatment from the nearest Health Facility within 24 hours of onset of symptoms

3. Take and complete your dosage of Malaria medicine as advised by the health worker

4. Use of mosquito repellents are encouraged for those who can afford.

5. Clear all mosquito breeding sites (stagnant water, bushes and broken containers) around your homestead

6. All pregnant women must attend all antenatal care visits and take the intermittent preventive therapy.

7. Avoid self-medication and sharing of medicine.

The public is further urged to be vigilant and report any suspected Malaria cases to the nearest health facility, or call our toll-free line on 0800-100-066.

Dr Aceng Jane Ruth

Minister for Health

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