Wednesday, November 10, 2010

Malaria threat looms large in Rwanda as rainfall diminishes

Kigali: Low rainfall, extended dry spells and warmer weather in parts of Rwanda are creating ideal breeding conditions for mosquitoes, raising the prospect of severe outbreaks of malaria.Rwanda has drastically reduced malaria cases in past years through the use of treated mosquito nets, widespread distribution of anti-malarial medicines and improved services to expectant mothers, including improved medical check-ups, but medical practitioners fear a season of low rainfall could undo much of the progress.
When rainfall is low, lakes and rivers dry up, forming smaller pools of standing water - a fertile breeding ground for mosquitoes.

Rwanda's southeast is particularly hard hit by malaria and dryer weather - linked to climate change - is expected for the region.

The southeast is forecast to receive little rainfall between now and December, according to the central African country's meteorological service. Rainfall in the region could drop to as low as 10 millimetres a year, compared to a national average of 700 mm.

Temperatures are also rising, another factor that encourages mosquitoes to breed.

In Ruhuha, a village southeast of Kigali, long queues form every day at the local health centre. Many patients are unaware their symptoms are linked to malaria or that the disease is spread by mosquitoes breeding in nearby lakes and marshlands.

Margaret Mukanyarwaya, a 38-year-old pregnant mother, is one of a growing number of Ruhuha residents who has been to the doctor since early August. She had been suffering from a high fever but thought her condition was linked to her pregnancy.

"I hadn't thought to check my temperature the past few days but when I decided to go for a medical consultation, the doctor detected malaria symptoms," she said.

Despite huge progress in fighting malaria, the disease remains the main cause of sickness and death in Rwanda, which is situated in an area of Africa where malaria is endemic, according to the World Health Organisation.

Malaria was responsible for 30 percent of outpatient visits to doctors in Rwanda in 2008, although this was down from 70 percent in 2001. There is no data available on death rates from malaria.

The Rwandan plains in the east of the country are considered an endemic area for malaria while the country's central high plateau suffers occasional malaria epidemics, researchers say.

Awareness campaigns

While transmission rates of vector-borne diseases like malaria are linked to greater population density, migration, and human activities like rice farming, brick making and mining, changing rainfall patterns are a major factor in surges of the disease, experts say.

Rwandan officials recognize the need for awareness campaigns to educate people on how environmental and climatic factors impact the spread of malaria.

"Once local people have a stake in adapting to climate change, they will be able to help contain seasonal diseases like malaria at an early stage," said Charles Habyarimana, a nurse at the Ruhuha health centre.

Experts suggest residents could be trained to understand changing weather patterns so they can help their communities adapt better.

For example, higher than average temperatures - two to four degrees above normal - which occur one or two months before the rains indicate a high risk of a malaria epidemic, experts say.

In hilly areas with good drainage and rainfall above 250 mm per month, an epidemic is likely to occur about one month after rain falls, when mosquito breeding habits stabilize, said Andrew Githeko, an expert at the Kenya-based Centre for Global Health Research.

"The government should start public health awareness campaigns, communicating the risk associated with forecasts of changing weather patterns," he said.

There also needs to be greater distribution of treated mosquito nets, experts say. Forty-four percent of the wealthiest households in Rwanda had mosquito nets, more than twice the national average of 18 percent, according to a government health survey in 2005.
"It is important to sensitise local communities living in areas with high malaria transmission on how they can prevent the disease before the outbreak, because prevention may be better than cure," said one Ruhuha resident.

Spraying homes

Health officials also stressed the importance of spraying homes in areas at risk to kill mosquitoes.

Since August 2007, a national campaign of indoor spraying has been in place to combat malaria.

"The looming threat of vector-borne diseases means that any failure to spray houses in areas of risk will leave the population exposed to a high risk of malaria," said Corine Karema, head of the malaria unit at Rwanda's Treatment and Research AIDS Centre (TRAC), a centre for disease prevention and control.

Original source: Reuters Thompson

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