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Malaria-free Sri Lanka is a remarkable public health achievement says WHO



The World Health Organisation (WHO) has declared Sri Lanka malaria-free and a remarkable public health achievement for a country that was once the most affected in the world. The female Anopheles culicifacies mosquito spreads malaria, but no locally transmitted cases of malaria have been reported in Sri Lanka in the last three and a half years. Sri Lanka is now the second country in the South Asia region to eliminate malaria – the first was Maldives.

Almost half the world’s population is at risk of malaria – a preventable and curable disease. Globally in 2015 there were 214 million cases of malaria and more than 438,000 reported deaths (90% of the deaths were in sub-Saharan African countries). Worldwide campaigns have targeted the reduction of malaria. Since 2000 the number of deaths by malaria has reduced by 60%. However in South Asia the parasite that causes malaria is developing a resistance to drug treatment.

In the Sri Lanka 1986/87 malaria epidemic there were 600,000 reported cases. In  the 1999 epidemic there were 265,000 cases. By 2006 there were less than 1,000 malaria cases annually. Since October 2012 there have been no locally transmitted cases of malaria in Sri Lanka.

WHO’s South East Asia director, Poonam Khetrapal Singh, said the elimination of malaria in Sri Lanka was ‘testament to the courage and vision of its leaders.’ More than 80% of Sri Lanka’s 22 million population live in rural areas and, being an island with a high rainfall and warm temperatures, the landscape is an ideal ecosystem for the Anopheles culicifacies mosquito.

WHO says the successful strategies for eliminating malaria in Sri Lanka were: mobile clinics, targeted public health and malaria awareness campaigns, intensively targeting the parasite as well as the mosquito, and providing malaria drugs to people who may unknowingly be carrying the parasite – the parasite can survive in the human body for more than 10 years.

Mobile malaria clinics lead to prompt treatment in high transmission areas. Health education and grassroots community engagement also helped to collectively target the elimination of malaria. The government campaign has been a long one – since the 1980s – but an effective one. However, WHO said it was crucial to remain vigilant so that the parasite will not be re-introduced. WHO indicated that it would continue to help Sri Lanka to maintain surveillance as well as screen high-risk travellers entering the island.

Malaria is caused by a one-celled parasite called a Plasmodium. Female Anopheles culicifacies mosquitoes pick up the parasite from infected people when they suck up blood. Mosquitoes need warm blood of humans and animals to feed their eggs. Inside the mosquito the parasites reproduce and multiply. When the mosquito bites another person, the parasites in the mosquito’s salivary glands are injected into the person’s blood. And hence the parasite in transmitted to that new person. In the human body the parasites live in the liver, and then in red blood cells of the infected person. Symptoms of malaria occur 1-2 weeks after being bitten. The symptoms are fever, headache, chills, and vomiting.

If not treated, malaria can kill a person by destroying the red blood cells and by clogging the capilliaries that carry blood to the brain and other organs throughout the body. This is why it is important to kill the mosquito (that carries the parasite) and the parasite in the person’s body. Most methods of eradication are by spraying insecticides which kill mosquitoes, or by long-lasting insectide-treated netting (LLIN), which prevents a person being bitten. Antimalarial medicines (tablets) help prevent a person getting malaria, but if infected then the person is given drugs to kill the parasites in their liver and blood stream.

WHO’s Global Technical Strategy for Malaria 2016-20130 has the following targets (using 2015 baseline figures) for its Global Malaria Program (GMP):

1.   reducing malaria cases by at least 90% by 2030
2.   reducing malaria deaths by at least 90% by 2030
3.   eliminating malaria in at least 35 countries by 2030
4.   preventing a resurgence of malaria in all countries that are malaria-free.




http://www.foxnews.com/health/2016/09/06/who-declares-sri-lanka-malaria-free-in-truly-remarkable-achievement.html

MARTINA NICOLLS is an international aid and development consultant, and the author of:- The Shortness of Life: A Mongolian Lament (2015), Liberia’s Deadest Ends (2012), Bardot’s Comet (2011), Kashmir on a Knife-Edge (2010) and The Sudan Curse (2009).




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