Malaria interventions and control programes in Sub-Saharan Africa: A narrative review

Abstract

Abstract: Malaria transmission and prevalence involves a triangular web of interactions between man, vector, and the environment. Any meaningful effort in malaria control, elimination and or eradication should target weakening and or breaking the forces of interactions within the triangle. In sub-Saharan Africa, effective malaria control programme is encumbered by myriad of challenges. The unabated burden of malaria could be ascribed to efficient malaria vectors with strong niche for ecological expression that maintain high levels of transmission at all seasons. Parasite genotypic heterogeneity, multiple expressions of traits of adaptations to parasitism and unpredictable behavioural changes are the smart ways the infectious agent thrives, persists and expresses ecological niche with scaring symphony. Environmental factors and climatic changes, population movement, deteriorated socioeconomic situation, lack of access to effective and timely antimalarial treatment, use of sub-standard and or fake anti-malarial drugs, self medication and non-compliance to drug dosage are the galvanizing factors to poor intervention outcomes. Above all, for ages, in most settings and communities, there is lack of knowledge regarding the causative agent of malaria. Diversionary factors and misconceptions such as eating too much palm oil, standing in the sun, drinking too much of alcohol, jinxing and witchcraft attacks are brands of porous perceptions on causes and risk factors of malaria. And if a thousand and one sophisticated strategies are put in place to eliminate malaria in sub-Saharan Africa where indigenous and factorial perceptions with rhetorical contrast of ideas hold sway, then, a predictable defeated performance is the expected result. For the sustenance of the gains already recorded in the fight against malaria in sub-Saharan Africa, the role of the community as a strong partnership for change cannot be underestimated.

Keywords:

• malaria
• intervention
• elimination
• control
• Malaria, Intervention, Elimination, Control

PUBLIC INTEREST STATEMENT

The outlook for malaria elimination in sub-Saharan Africa is deciphered. At the moment, no one can say authentically when it will be possible to eliminate malaria in sub-Saharan Africa. Year in year out, the narratives for reporting morbidity and mortality of malaria in sub-Saharan Africa remains almost the same: Every second, an African child dies of malaria! Pregnant women and children are at risk of malaria! Malaria is a disease of public health concern! These are the unending narratives from time immemorial.

While it is a common knowledge that malaria is one disease that we all know the causative agent, the breeding place, the biting mode and transmission, yet it is difficult to contend the disease. It is on this basis that our team made a thorough review by gleaning through literatures on various malaria elimination efforts in sub-Saharan Africa, made recommendations and suggestions that will help policy and consolidate gains and change the recurrent narrative.

Acknowledgements

We are grateful to our colleagues and friends for their valuable contributions in the successful completion of this paper. We are indebted to you all.

We thank late Prof. A. F. Beyioku, my PhD supervisor, who read this paper before her departure to the world beyond. May her blessed soul Rest in Peace.

Ethical approval

Nigerian Institute of Medical Research, Lagos, Nigeria, IRB/14/275

Additional information

Funding

The authors received no direct funding for this research.

Notes on contributors

Akwaowo Bassey Orok

Akwaowo Bassey Orok completed his first degree in Microbiology from The University of Uyo, Medical laboratory Sciences in The University of Calabar, Master’s Degree in Medical microbiology and Parasitology, University of Lagos and enrolled for a PhD program in Medical microbiology & Parasitology, University of Lagos Nigeria. Presently, he works as a Research Fellow in The Nigerian Institute of Medical Research (NIMR), Lagos Nigeria in The Department of Biochemistry & Nutrition. His research interest focuses on Malaria Immunology, Drug Therapeutic Efficacy Trial (DTET) and Babesiosis with Malaria concurrent infection. He is also The Focal Person, Research, Innovation and Products development, NIMR where he and his team developed a number of medical products and devices. He has published more than fifteen articles in both national and international journals.

His career objective is to serve, contribute and achieve organizational goals and objectives, upholding the values of transparency, accountability, in serving humanity towards the growth of the organization.