Behaviour change vital in fighting mosquitoes: Manjoro


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By Thabani Dube

As over 440 people die of malaria

Social and Behaviour change communication (SBCC) is an integral strategy for malaria prevention and elimination. SBCC takes into account the way people conduct their day to day businesses and how they affect their environment has a great impact in the fight against malaria, says a government official.

In an exclusive interview, the National Malaria Control Programme Social and Behaviour change communication (SBCC) officer, Fortunate Manjoro said SBCC was very crucial in the fight against malaria. While the government and its health partners may pump in tens of million dollars in aequipment and protective wear for indoor residual spraying (IRS), long lasting insecticidal nets (LLINs), malaria medicines and diagnostics), however, if the community is not mobilized for uptake of the prevention and control of the commodities the resources will come to naught.

According to the Ministry of Health and Child Care (MoHCC), weekly disease surveillance report of week 1-41 (January to mid-October), at least 448 people have succumbed to malaria while 368,731 malaria cases have been recorded compared to the same period in 2016 where 204,750 malaria cases and 199 deaths were reported.

Beitbridge and Gwanda in Matabeleland South Province also recorded a sharp increase in both malaria cases and deaths this year though fairly low with 16 deaths and 4,084 malaria cases.

Manicaland is leading the table of both cases and deaths so far registering 113,135 malaria cases and 121 deaths followed by Mashonaland East in cases with 97,937 while Masvingo Province seconds Manicaland Province in deaths with 97 deaths respectively.

The increase in cases was attributed to the heavy rains which increased the mosquito breeding sites resulting in the increased mosquito population and subsequent malaria outbreaks experienced in most provinces. The floods also increased communities’ vulnerability to malaria due to displacement. In some districts bridges were washed away by the heavy rains thereby making access to health facilities difficult.

Zimbabwe uses a combination of strategies to prevent and control malaria. These include:

  • indoor residual spraying (IRS)
  • use of long lasting insecticidal nets (LLINs)
  • prompt diagnosis and provision of effective medicines to treat confirmed cases of malaria
  • use of medicines to prevent malaria during pregnancy (intermittent preventive treatment in pregnancy (IPTp) ) in areas of moderate to high malaria transmission areas
  • advocacy and SBCC to enhance involvement and participation of communities and other stakeholders in malaria control initiatives
  • early detection, containment and prevention of epidemics
  • strengthening of local capacities in basic operational research for development of interventions

“The challenge being faced by the community is that the major vector control strategies in use (IRS and LLINs) are only effective when one sleeps in a sprayed house or sleeps under a net daily, however the communities are bitten by mosquitoes doing outdoor activities early morning and evening. On the other hand we also know that the only way to prevent malaria is to prevent mosquito bite when outdoors. Hence she urged the communities to wear clothing that cover most of their body and use mosquito repellents (traditional or modern repellents)”.

The national Meteorological Department this rain season predicts that between November and December 2017 the country is expecting normal to below normal rainfall while from January to April 2018 they forecast normal to above normal rainfall. As such we are anticipating an increase in the vector density which also subsequently increases the cases of malaria this season. Manjoro urged the communities to take care of themselves and avoid mosquito bites by whatever means. She also called for the communities to avoid activities that promote mosquito breeding such as digging pits near their homes.

“In Chiredzi for example, some bridges were washed away and some communities could not access their nearest health facilities and some village health workers could not get their malaria commodities replenishments, so this time around those areas will be prioritized during prepositioning of malaria commodities” said Manjoro.

“We also had some refugees from Mozambique, a high malaria transmission country, seeking refuge in Manicaland. This also increased malaria cases in the province. In Matabeleland North province some communities in Tsholotsho district were displaced from their sprayed homes due to flooding, something that also precipitated the malaria cases and deaths,” she said.

A snap survey by this reporter in one of the newly formed residential areas in the periphery of Harare, in Caledonia where malaria is increasing confirm that human behaviour is contributing to mosquito breeding.

Rita Chinokumba, a brick moulder said poverty and lack of employment were driving her in the business which is not only harmful to the environment but exposes her and community to danger.

While she was aware of malaria present in her area, little did she know that living pits after brick making was a threat to her family and surrounding people.

“I am not employed, neither is my husband. We have three children to take care of and in the face of poverty brick making is the only job that has proved to put food on our table.

“I have tried selling vegetables and fruits in the city centre but police and city authorities have displaced us,” she said.

City of Harare, Director of Health Services, Dr Prosper Chonzi admitted that malaria was prevalent in Caledonia Farm and efforts to fight the disease were ongoing.

“Malaria is on the increase due to variations in weather and more rains we received this year but as council we have a budget of $200,000 for disease prevention and control.

“We have started spraying houses in the area and distributing mosquito nets especially in Caledonia Farm which we inherited from Mashonaland East Province where malaria is still prevalent,” he said.

Manjoro said that indoor residual spraying started in early October, and vector control officers started were already in the field doing coordinating the IRS programme targeting 44 districts in the country.

“We have since started rotating three different chemical groups in the spraying exercise in line with the national insecticide resistance management plan to manage vector resistance. The chemical groups include Pyrethroids (Deltamethrine, Lambda-cyhalothrin), Organochlorines (Dichloro- Diphenyl Trichloro-ethane (DDT)) and Organophosphates (Malathion)”.

Manjoro said training of village health workers across the country had already started as well as equipping them with malaria rapid diagnostic kits and medicines.

“We are already mobilizing the community to participate during the IRS programme as well as placing emphasis on encouraging the community to avoid mosquito bites.

“People should also seek treatment for suspect malaria and finish their courses when put on one,” she said.