Malaria-free Cuba helps lake region counties reduce infections

Kenya is working with Cuban specialists to implement biological methods for controlling mosquito breeding and curb the spread of malaria in eight counties in the lake region.

The two-year larvicide malaria control programme was launched by President Uhuru Kenyatta last year as one of the key ways of tackling malaria by fighting the mosquito larvae in breeding places in stagnant water.

Health Chief Administrative Secretary (CAS) Rashid Aman said the programme involves destroying eggs laid by mosquitoes in stagnant water by use of larvicide.

“We decided to pick the new intervention after seeing how other countries, including Cuba, that have achieved universal health coverage were eliminating malaria. The project is highly successful in combating malaria in Cuba and we are optimistic that it will help us,” said Dr Aman.

Dr Amman spoke when he presided over celebrations to mark World Malaria Day at the Bukhungu stadium on Monday.

Controlling mosquitoes

The CAS said Cuba eliminated malaria in 1973 by controlling mosquitoes through spraying their breeding sites in stagnant water with larvicides.

The project will be conducted in eight endemic counties around Lake Victoria in a partnership between the Ministry of Health, county governments and specialists from Cuba.

The programme will involve periodical spraying of stagnant water, the breeding spots for mosquitoes, with biological larvicides that are harmless to human beings but kill the larvae.

The programme will run for two years, after which they will transfer the skills to malaria control experts in the counties of Kakamega, Busia, Bungoma, Vihiga, Kisumu, Homa Bay and Migori.

Dr Aman said the counties have the highest level of malaria in the country with a prevalence of 19 per cent.

“Last year, the lake region reported a total of 3.2 million confirmed malaria cases, representing 75 per cent of malaria cases nationally. This is evident that despite the progress we continue to report, as a country, there is still more that we need to address to attain the status of malaria-free Kenya,” he said.

He said the country has experienced a significant drop in malaria cases.

The Ministry of Health said it prioritised the fight against malaria through increased resource allocation for fighting the disease and enhanced partnerships for control by working with the Global Fund to fight HIV, TB and malaria.

Malaria prevention

Other partners include USAID, which supports the procurement of malaria prevention, diagnosis and treatment commodities. This has seen all malaria commodities provided free of charge across the country.

Dr Aman said: “This financial year, the national government, through the Treasury, has allocated Sh800 million to boost the fight against malaria.”

Kakamega is one of the eight malaria endemic counties in the lake region that experience malaria throughout the year. The county, according to Dr Aman, is one of three that have received the latest modern-technology nets.

The county received the new pyrethroid PBO nets that are being provided to pregnant women and children under five years and have helped reduce malaria infections in the county.

Promising that Kenya will continue working with partners and regulatory authorities to ensure that malaria control commodities are available, Dr Aman urged lake region counties to own the commodities and distribute them to all county and sub-county health facilities especially during this rainy season when the spread of malaria is high.

He recognised Kakamega as one of the eight counties that have successfully deployed a malaria vaccine that has put Kenya on the map as one of the three African countries that lead in efforts to generate sufficient data on the use of the vaccine.

“The data informs the World Health Organization (WHO) decision to recognise the vaccine for use across the continent. As a ministry, we will scale up the malaria vaccine to all sub-counties in Kakamega County and other counties in the lake region by June this year after mobilisation of resources and favourable advice from the Kenya Immunisation Group,” he promised.

Global malaria community

He said national grading of malaria had reduced by 50 per cent in the last decade, from 11 per cent in 2010 to 6 per cent in 2020, and urged parents with children of six months old to take the children to the nearest health facilities to be immunised against malaria.

“In the lake region counties, the infection has reduced by 38 per cent in 2010 to 19 per cent in 2020, with Kakamega recording a reduction of 15.2 per cent,” he said.

He said the collaboration between the global malaria community, the Ministry of Health, development partners and county governments has re-energised the fight against the disease, reducing infections.

He said the government had launched malaria cross-border collaboration initiatives in Busia County under the Great Lakes Malaria Initiative as a measure to expand access through regional malaria score cards and improve the quality of health data.

Ms Rachel Okumu, representing Kakamega Governor Wycliffe Oparanya, said Kakamega is prone to malaria infections around the year.

“Ten sub-counties have been classified as endemic prone areas while Lugari and Likuyani are pandemic prone. Pregnant women and children under five are at high risk of malaria infection,” she said, noting that the county is one of those participating in the malaria vaccine pilot.

Ms Okumu pointed out that the malaria incidence has reduced in Kakamega from 438 cases per 1,000 people in 2015 to 295 per 1,000 in 2021.

Inpatient mortality

“Further, there has been a drop in the number of confirmed malaria cases treated in the county from 635,294 in 2016 to 540,331 in 2020, and an increase from 700 to 741 cases in 2021,” she said.

“Four per cent of inpatient mortality is due to malaria. [The county distributed] over 1.3 million mosquito nets with support from partners including USAID and PMI.”

Dr Dan Otieno, standing in for WHO country representative Dialo Abdourahmane, said the health group had updated the Global Technical Strategy for malaria to provide a framework for all countries to accelerate efforts against malaria.

He said Kenya is among 29 countries that account for 96 per cent of global malaria deaths and that WHO was supporting Kenya, Malawi and Ghana to pilot the first malaria vaccine in Africa.

“WHO recommended the use of the RTS.S malaria vaccine for children aged less than five years in countries with moderate to high malaria transmission in sub-Saharan Africa. Over 900,000 doses have been administered to children in Kenya today,” said Mr Abdourahmane.

According to WHO’s world malaria report for 2020, there were 627,000 malaria deaths in the world, with 602,000 in Africa.

“In the WHO African region, malaria deaths and cases increased by 13 per cent and 7 per cent respectively in 2020 compared to 2019. There were 59 new cases for every 1,000 population at risk and 15 deaths per 100,000 population at risk in 2020,” said Dr Abdourahmane.

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