- Over 11 million children targeted in 9 northern states
Malaria accounts for 11% of maternal mortality, and three of 10 deaths in children less than five years. Experts estimate that the disease kills about 300, 000 children under five in the country annually.
It is caused by infected female anopheles mosquito and transmitted all year round, with peak transmission during the rainy season.
That is why one of the interventions recommended by the World Health Organisation (WHO) on preventing malaria in children is Seasonal Malaria Chemoprevention (SMC). This involves intermittent administration of full treatment courses of an antimalarial medicine to children in areas of high seasonal transmission during the malaria season.
WHO recommends the administration of full doses of sulfadoxine-pyrimethamine plus amodiaquine to children in the Sahel sub-region of sub-Saharan Africa, where the parasite that causes malaria P. falciparum is sensitive to both antimalarial medicines.
According to the Malaria Consortium, Seasonal Malaria Chemoprevention (SMC) the objective is to maintain adequate therapeutic antimalarial drug concentrations in the blood of the recipient throughout the period of greatest malarial risk.
The organisation said evidence showed that SMC prevented about 75% of all clinical malaria episodes and a similar proportion of severe malaria episodes when complete dosage was taken. “There’s additive effect of SMC given alongside other malaria control interventions, such as Long Lasting Insecticide Nets , LLIN.”
In Nigeria most deaths from malaria occur in the North-East and North-West zones. During rainy seasons in many of these states, mothers spend sleepless nights tending to children with malaria and visit Primary Health Centres (PHCs) or patent medicine vendors, and in worst cases witness death of their children.
Asiya, 40, said she lost her first child to malaria. She said she wholeheartedly presented her twin babies for SMC in her village in Sokoto when she learnt it will protect them from the disease. She said she was happy she didn’t spend sleepless nights or frequented patent medicine shops during the last rainy season.
There are nine states within the Sahelian belt in Nigeria eligible for Seasonal Malaria Chemoprevention (SMC). They are Kebbi, Sokoto, Zamfara, Yobe, Katsina, Kano, Jigawa, Bauchi, and Borno.
The federal government in 2018, implemented Seasonal Malaria Chemoprevention (SMC) in 46 local government areas across Sokoto, Zamfara, Jigawa and Katsina with support from Malaria Consortium and funded by Open Philanthropy , through Good Ventures and UKaid through DFID.
Malaria Consortium is one of the leading organisations supporting the National Malaria Elimination Programme (NMEP) of the Federal Ministry of Health in the implementation of the Seasonal Malaria Chemoprevention (SMC) intervention since 2013.
However with the coverage of four million in four Sahelian states in 2019 (Zamfara, Yobe, Sokoto, Katsina, Jigawa) millions of children in the remaining Sahelian states and local government areas with high prevalence of malaria couldn’t access SMC.
While several success stories have been recorded in these states where the intervention has been implemented, Seasonal Malaria Chemoprevention coverage is still very low in some states that should have it, while others are yet to be covered.
In lieu of this experts from the National Malaria Elimination Programme (NMEP) of the Federal Ministry of Health , Malaria Consortium, state governments and other partners decided to scale up the SMC intervention to all nine states in the Sahelian region in 2020.
They made the disclosure during the recent national review meeting in Abuja.
National coordinator of the National Malaria Elimination Programme (NMEP), Dr Bala Muhammad, who was represented by the Head, Case Management of the organization, Dr Nnenna Ogbulafor said Kano, Bauchi, Borno and Kebbi were added to reduce the burden of the disease among children in the country .
“Last year, we did six states and it was not full coverage but in 2020 we will cover nine states which will give us more impact,” she said.
Dr Olusola, Oresanya, Country technical Coordinator of Malaria Consortium said “ Ultimately our desire is to cover everywhere so that we will not leave any child behind. We hope that in the next few years, the states will be able to take up this interventions themselves because it is quite cheap as it cost less than $ 4 to cover a child.”
In his Overview of SMC Implementation in 2019, Dr Jamilu Nikau said “Seasonal Malaria Chemoprevention (SMC) is one of the strategies adopted by NMEP to combat malaria adding that a total of 11,773,446 children were eligible 3,763,597 children were planned, leaving a gap of 8,009,849 and the local government areas covered 78 out of 222.
He said House to House approach helped in reaching more children but the challenges include stocks out of Rapid diagonistic tools and ACT malaria medicines. He called on states to support facilities with commodities.
For 2020 Seasonal Malaria Chemo- prevention implementation, he said there is planned coverage for nine states, the number of eligible children is 11,981,154, number of children to be covered in the nine states are 11,232,155, with a gap of 748,998. There are 227 local government areas but 219 will be covered.
Director of Pharmocovigilance, National Agency for Food and Drug Administration and Control (NAFDAC) Ali Ibrahim, said challenges of adverse reaction reporting on seasonal malaria chemoprevention were inadequate capacity in Pharmacovigilance,and unwillingness of some stakeholders to report harm caused by medicines, such as adverse drug reactions (ADRs) and lack of efficacy and low reporting of ADRs associated with medicines.
Baba Laminu, State Prog Manager, Saving One Million Lives for Results, who represented the Commissioner for Health, Borno State, Dr Saliu Aliu said that the integration of SMC in polio immunization campaign scaled up acceptance of polio immunization amongst the populace, thereby saving the lives of more children.
