Malaria menace is being fought from all fronts across the globe. It is against this milieu that partnership all over the world continuous to form in order to curb and reverse the success gain by this dreadful disease.
Malaria is caused by Plasmodium parasites and is spread to people through the bites of a “malaria vector” called Anopheles mosquitoes which bite mainly between dusk and dawn. According to the latest estimates by the Malaria Fact Sheet compiled in January 2013, there were about 219 million cases of malaria in 2010 and an estimated 660,000 deaths. Most deaths occurred among children living in Africa where a child dies every minute from malaria.
Malaria is a killer disease in Africa general and Ghana in particular. Notwithstanding all the interventions put in place by National Malaria Control Programme, UNICEF, JICA and other NGOs to reduce the burden of malaria, it still continues to top the list of outpatient attendance (OPD) in the Upper West region. The total malaria cases reporting at the OPD increased from 110,092 in 2005 to 115,687 in 2006 and further increased to 172,906 in 2007. A further analysis of the top ten diseases in the region revealed that malaria continues to top all OPD attendance as shown in the table 2 below;?
Table 1: Malaria cases from 2005 ? 2007 in Upper West Region.
| Category | 2005 | 2006 | 2007 |
| Total malaria cases | 110,092 | 115,687 | 172,906 |
| Cases among children under 5 years | 85,665 | 43,351 | 55,554 |
| Total number of malaria admissions | 12,091 | 6882 | 11,779 |
| Total malaria cases among pregnant women (confirmed) | 729 | 360 | 272 |
| Admissions among children under 5 years | 5,709 | 3,686 | 4,803 |
| Total number of malaria deaths | 184 | 138 | 193 |
| Deaths among pregnant women due to malaria | 3 | 2 | 0 |
| Deaths among children under 5 years | 155 | 116 | 142 |
| CFR (all malaria admissions) | 1.5 | 2.0 | 1.6 |
| CFR (malaria admissions among children < 5 years) | 2.7 | 3.1 | 3.0 |
| CFR (malaria among pregnant women) | 0.4 | 0.56 | ?0 |
Source: ?Malaria Fact Sheet 2013
?
Table 2: Top ten OPD attendance in Upper West Region from 2005-2007.
| 2005 | 2006 | 2007 | ||||||
| Disease Condition | No. | Per. (%) | Disease Condition | No. | Per. (%) | Disease Condition | No. | Per. (%) |
| Malaria | 110,092 | 52.6 | Malaria | 115,687 | 54.2 | Malaria | 172,906 | 38 |
| Skin Disease | 14,736 | 7.0 | ARI | 13,995 | 6.6 | ARI | 58,907 | 13 |
| URI | 14,184 | 6.8 | Skin Diseases& Ulcers | 10,877 | 5.1 | Skin Diseases& Ulcers | 46,008 | 10 |
| Acute eye infection | 7751 | 3.7 | Acute EyeInfection | 7,009 | 3.3 | Acute EyeInfection | 22,486 | 5 |
| Other Diarrhoeal | 5,386 | 2.6 | Diarrhoealdiseases | 5,074 | 2.4 | DiarrhoeaDiseases | 21,437 | 5 |
| Malaria in pregnancy ? | 5065 | 2.4 | Pneumonia | 4,880 | 2.3 | Hypertension | 16,883 | 4 |
| Hypertension | 3498 | 1.7 | Hypertension | 3,802 | 1.8 | Pneumonia | 14,851 | 3 |
| Home/Occupation accident ? | 3158 | 1.5 | Anaemia | 3,422 | 1.6 | Rheumatismand Joint | 14,112 | 3 |
| Pneumonia | 3090 | 1.5 | Malaria inpregnancy | 2,891 | 1.4 | Acute EarInfection | 9,124 | 2 |
| RTA | 2875 | 1.4 | R T A | 2,785 | 1.3 | Road TrafficAccidents | 9,061 | 2 |
| All others | 39,445 | 18.8 All | Other | 43,208 | 20.2 | All Others | 70,764 | 15 |
Source: Malaria Fact Sheet
The trend in other regions in Ghana is no different and serves as
the reason why Ghana Health Services in collaboration with other entities have tried many interventions such as using Long Lasting Treated Insecticide Net (LLTIN), using mosquito repellents, practicing environmental cleanliness amongst others in fighting this menace in the last decade. One potent method approved by the World Health Organisation (WHO) is the Indoor Residual Spraying- applying required amount of insecticides on the interior walls and ceilings of houses to repel and kill anopheles mosquito upon settling on the treated wall. Its full potential is realized when at least 80% of houses in targeted areas are sprayed. Indoor spraying is effective for 3?6 months, depending on the insecticide used and the type of surfaces on which it is sprayed.? Quiet apart from the fact that the adult anopheles mosquito dies which is the target; other exoskeleton organisms are also killed upon direct contact with the insecticide.
Ghana as a whole and Northern Ghana in particular have benefited from this great intervention which has been made possible by the courtesy of AngloGold Ashanti Malaria Control Limited (AGAMAL). The Upper West Region became the first beneficiary in Northern Ghana to embrace the intervention in January 2012.
WHAT HAS AGAMAL DONE?
AngloGold Ashanti Malaria control programme is one of the few non- governmental organisations that has helped communities with the IRS project which was piloted in Obuasi in 2006. ?A great success has since been chalked and it has been privileged to gain a grant from the Global Fund (GF) to implement such intervention in 40 districts across the country by the end of its fifth year of operations. The gesture was extended to the Upper West region in January 2012 where three districts (Wa Municipal, Wa West and East) were the first to benefit from the programme. Six months down the lane it has been extended to other ten districts, namely Jirapa-Lambussie-Karni, Lawra, Nadowli, Sissala East and West, Builsa, Kassena-Nankana East and West Bolgatanga, Bongo and Tallensi Nandam.
At the commencement of the programme intensive community entries to solicit the support of the stakeholders (DHMT, District assemblies, chiefs etc.) as well as using diverse approach of reaching the indigenes as much as possible were done. School children- major change agents were also engaged in a route match to sensitise community members prior to the spraying activity was effectively done.
The programme has made inroads in all its catchment areas- from malaria control to job creation. It has since recruited and trained close to 1000 spray operators in these districts who have successfully sprayed most communities in their respective catchment areas.
ARE THERE CHALLENGES?
The programme has seen some challenges in the district since its implementation. Amongst these are lock ups, refusal due to the unpleasant odour of the insecticide, and inadequate logistics in terms of vehicles to transporting spray operators to and from the field. ?Also the gory nature of the road network coupled with the rains make it difficult to access some communities as they are cut off from reach by the rains. Furthermore, the unavailability of electricity in most communities makes it difficult to use video shows as a means of educating community folks by the information, education and communication team with the help of advocates who hail from those communities.?
WHAT IS THE MOTIVATION?
Despite the numerous challenges, the districts derive their fulfilment in seeing every household ??sprayed so that the fight against and making the districts free of malaria can be accomplished. It is therefore greatly envisaged that regardless of the above mentioned challenges, the districts in the Northern Ghana would go against all odds to ensure that a 100% coverage is attained.
This is the little contribution that can be made for time immemorial and the people of the North will eternally be grateful to AGAMAL.
Muniratu Venu
District Operations Manager
Jiripa/Lambussie-Karni District
