When sickness strikes, most people naturally reach out to doctors and other health practitioners to find solutions to their illness.
The belief that clinicians or health workers hold the ‘magic wand that can fight all diseases is ingrained in the minds of a majority of Kenyans.
And even though they play a key role in any country’s health sector, experts warn that overdependence on clinicians prevents people from playing their part in disease prevention and management.
This school of thought is in line with the 2019 World Malaria Day theme titled: ‘Zero Malaria Starts With Me’. The day is marked annually on April 25.
“We want people to know that they have a role to play in malaria control,” says Dr Njagi Kiambo, a senior officer at the Ministry of Health’s Malaria Control Division.
“By the time you come to the doctor, you are already sick and in need of treatment. Yet, there is much more you can do as a person to prevent or lower your chances of getting malaria.”
Malaria is the second leading cause of death in Kenya based on the 2018 Kenya Economic Survey. It is responsible for about than 17,000 registered deaths in the country annually. The most vulnerable to diseases are children below the age of five and pregnant women.
A past study published in the Malaria Journal showed that malaria costs Kenya about $109 million (Sh10.9 billion) annually. This amount increases to $250.7 million (Sh25 billion) when costs associated with productivity losses due to the disease deaths are captured.
Dr Kiambo states that individuals can play a key role in fighting malaria by adhering to, or adopting recommended health practises and behaviours that aid in controlling the deadly disease.
“Key among them is the use of insecticide-treated bed nets which kill malaria mosquitoes before they bite and transmit the disease to humans,” says Dr Simon Kariuki, the head of the malaria programme at the Kenya Medical Research Institute’s (Kemri) Centre for Global Health Research.
Indeed, research shows that the nets can cut malaria transmission by about 50 percent.
But due to ignorance or low awareness on their importance, sometimes communities shun them or use them for other purposes such as fishing, covering vegetables for pest control or preserving them for special guests.
The current Kenya Malaria Indicator Survey (KAIS 2015) shows that only 56 percent of children below the age of five, and 58 percent of pregnant women between the ages of 15 and 49 sleep, under the recommended insecticide-treated nets.
“Bed nets are critical in preventing malaria, especially in children and pregnant women. So they should be used at all times,” notes Dr Kariuki.
He states that expectant women in malaria zones should also ensure that they take malaria preventive drugs - sulfadoxine-pyrimethamine (Fansidar) - to allay infections.
Malaria during pregnancy causes anaemia and other complications that can lead to miscarriages, premature deliveries, low birth weight, infections to the unborn child, as well as increased risk of stillbirths or death of children in the first week of life. In addition, pregnant mothers usually have low immunity, which reduces their bodies’ ability to effectively clear malaria parasites.
They are thus highly likely to develop severe malaria compared to non-pregnant women from the same area.
This fatal condition which can cause death fast if left untreated is characterised by fever and chills, impaired consciousness, extreme physical weakness, multiple convulsions, breathing problems, abnormal bleeding, liver complications (jaundice) and improper functioning of body organs including the brain (cerebral malaria).
“We encourage all expectant women to attend all antenatal care (ANC) clinics during pregnancy so they can get information and assistance on how best to protect themselves from malaria.”
During these ANC check-ups, mothers usually get malaria preventive drugs at no cost as well as insecticide-treated bed nets.
To prevent misuse of anti-malaria medicine, which contributes to the growth of drug-resistant malaria, Dr Kariuki notes that it is important for people to seek care from health facilities and get tested before treatment begins.
“There are many infections or conditions that can present with symptoms similar to malaria such as fevers and body weakness. So it is always important to be sure it’s malaria before treatment starts.”
He says patients should also adhere to recommended drug doses by ensuring they complete their medicines even if they are no longer feeling sick. This also guards against drug-resistant malaria whilst enhancing full recovery.
Dr Kiambo notes that the recommended treatment for malaria is a class of drugs known as Artemisinin Combination Therapy (ACTs).
“Always countercheck and ensure that you are getting the right drugs as they will effectively treat the disease,” he says.
Going by the Health ministry guidelines, all public health facilities and major private hospitals dispense ACTs for malaria treatment.
But some pharmacies, private clinics or health centres operating without strong supervision or those that deliberately choose to ignore the guidelines for selfish gains, may issue other types of drugs to patients.
The incorrect treatment gives malaria parasites time to multiply and cause damage to the body. This might turn a case of mild malaria into a severe disease with life-threatening consequences.
With regards to the environment, Dr Kariuki says destroying breeding grounds for mosquitoes — such as clearing bushes and draining stagnant waters — can also help in preventing the disease.