The Rainy Season Strategy To Stop Malaria

Nov 16, 2016
Originally published on November 17, 2016 2:35 pm

In Western and Central Africa a new technique to combat malaria is rapidly gaining traction across the Sahel. Health officials in 11 countries are now giving children antimalarial drugs during the rainy season in this semi-arid region and seeing a dramatic drop in the number of malaria cases.

The technique is called Seasonal Malaria Chemoprevention. Over four months, health workers give four doses of anti-malaria drugs to children under age 5. And it's been incredibly successful. Studies have shown that this health intervention can reduce the number of malaria cases in some parts of Africa by as much as 75 percent.

Issaka Sagara, a researcher from the Malaria Research and Training Center at the University of Bamako in Mali, says this is the first new strategy to show significant impact in the country since the mass distribution of bed nets.

"Malaria is the No. 1 disease in Mali," Sagara says. Forty percent of all visits to hospitals and health clinic, he says, are due to malaria. And the majority of the cases happen during the rainy season from August to November.

"If you can target this season when the most transmission will be ongoing, then you really can control malaria," Sagara says.

Children are more likely to get severe or fatal cases of malaria than adults because their bodies haven't yet built up immunity to the parasites. So Mali and other countries are focusing on the mass distribution of anti-malarials to kids.

Pilot studies were so successful that in 2012, the World Health Organization recommended the technique of seasonal doses for millions of children across the Sahel.

The antimalarial drugs used in the Sahel are different (and cheaper) than the malaria meds an American tourist would take but the concept is the same — the drugs offer temporary protection against the disease.

And Seasonal Malaria Chemoprevention has produced remarkable results. In Senegal it's credited with slashing the number of malaria deaths among children under age 5 by 79 percent, from 2013 to 2014 when the program was introduced.

"Now that we don't have a vaccine on hand I would say that this is the most effective strategy we have to control malaria today," Sagara says.

The technique is supposed to be a supplement, not a replacement, for bed nets and other malaria control measures.

At the American Society of Tropical Medicine and Hygiene's annual meeting this week in Atlanta, Jean Bosco Ouedraogo was showing off the results of research he's doing on the rollout of the Seasonal Malaria Chemoprevention program in Burkina Faso. The program started in parts of Burkina Faso in 2014 and this year expanded across most of the country.

Ouedraogo says getting these drugs into every village and making sure kids take them properly is not an easy task.

First the health workers have to identify all the children under age 5.

"Then we use a door-to-door distribution strategy to give all the drugs to the children during each round of the transmission season," he says.

By "each round" he means each month. The kids are given a pill a day for the first three days of the month. The next month the health workers return with three more pills. This goes on for four months.

Glitches do occur. Ouedraogo says at times the health workers in Burkina Faso have run out of medicine. "Sometimes there is a difficulty to get them," he says.

He says the logistical challenges are being hammered out and he's excited that this new way to fight an old disease could have a lasting impact.

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STEVE INSKEEP, HOST:

We have news now in the fight against malaria. Up until now, there have only been two major tools in that fight - spraying for mosquitoes and bed nets. Now, in western and central Africa, there's another new technique that's being praised as a potentially major development. NPR's Jason Beaubien reports.

JASON BEAUBIEN, BYLINE: Issaka Sagara, who's with the Malaria Research and Training Center at the University of Bamako, says malaria dominates the healthcare system in Mali.

ISSAKA SAGARA: Malaria is the number-one disease in Mali.

BEAUBIEN: But most of those malaria cases happen only during the rainy season, from August to November.

SAGARA: If you can target this season, where the most transmission will be ongoing, then you really can control malaria.

BEAUBIEN: And this is the big change in the fight against malaria in this part of Africa. The idea here is very similar to the way Westerners use anti-malarial drugs, but the medications tourists take are far too expensive for most Africans. They're also too toxic to take year round. And in much of Africa, the idea of trying to deliver preventative malaria drugs constantly through already overburdened health systems seems impossible.

But in 2012, the World Health Organization said this type of a system could protect children from the most severe forms of malaria, even if only used for a few months out of the year. So that's what's happening now in 11 countries across the Sahel, and it's produced remarkable results.

In Senegal, the technique is credited with slashing the number of malaria deaths among children under 5 by 79 percent in just one year. Sagara, from Mali, says the best tool would be a highly effective vaccine. But short of that, he's very excited about this seasonal distribution of anti-malarials.

SAGARA: I will say that this is the most efficient strategy we have to control malaria today.

BEAUBIEN: As effective as this is, this is still a huge undertaking. At the American Society of Tropical Medicine and Hygiene's the annual meeting this week in Atlanta, Jean-Bosco Ouedraogo talked about the difficulties Burkina Faso has faced. Ouedraogo says getting these drugs into every village is not an easy task. First, the health workers have to identify all the children who are under the age of 5.

JEAN-BOSCO OUEDRAOGO: And then use a door-to-door distribution strategy to give all the drugs to the children during each round for the transmission season.

BEAUBIEN: The kids take three pills - one each day over the first three days of the month. Then, the next month, the health workers return with three more pills. And this goes on for four months. And Ouedraogo says, at times, the health care workers have run out of medicine.

OUEDRAOGO: The big challenge is how to get, every year, the drugs because sometimes it is difficult to get it.

BEAUBIEN: Despite all this, he believes this new tool in the fight against malaria will have a lasting impact in his country.

Jason Beaubien, NPR News, Atlanta. Transcript provided by NPR, Copyright NPR.