MALARIA AND SICKLE CELL DISEASE: SPOTLIGHT ON NIGERIA
Introduction
Malaria, a mosquito-borne disease, has long been a global health concern, affecting millions of people each year. While it poses a risk to anyone living in or traveling to endemic regions, individuals with sickle cell disease (SCD) face even greater dangers when infected with malaria. In this article, we will explore the devastating combination of malaria and SCD, focusing on the prevalence of malaria worldwide and its particularly severe impact in Nigeria, where SCD is most prevalent. We will also discuss ways to prevent malaria in SCD warriors .
Malaria Worldwide: A Global Health Challenge
Malaria is a major public health issue, with a significant global burden. According to the World Health Organization (WHO), in 2020, there were an estimated 241 million malaria cases worldwide, leading to 627,000 deaths, predominantly in sub-Saharan Africa. These alarming statistics underscore the urgent need for effective malaria prevention and treatment strategies.
Nigeria: A Hotspot for Malaria and Sickle Cell Disease
Nigeria, the most populous country in Africa, is also home to one of the world’s highest burdens of both malaria and sickle cell disease. Let’s delve into the statistics:
1.Malaria Prevalence in Nigeria: Malaria is endemic in Nigeria, with the entire country classified as a high transmission area. According to the WHO, Nigeria accounts for approximately 27% of all global malaria cases. In 2020, there were an estimated 57 million cases of malaria in Nigeria, with over 400,000 deaths reported.
2. Sickle Cell Disease in Nigeria: Nigeria has the highest prevalence of sickle cell disease globally. It is estimated that 150,000 babies with SCD are born in Nigeria each year. SCD affects approximately 2% of all Nigerian births, making it a significant public health concern.
The Deadly Synergy: Malaria and Sickle Cell Disease
Now, let’s explore why the combination of malaria and SCD is particularly perilous:
1. Increased Vulnerability: Individualswith SCD have compromised immune systems and are more susceptible to infections, including malaria. Malaria can trigger severe hemolytic crises in SCD warriors, causing a drastic reduction in hemoglobin levels (anemia), leading to life-threatening complications such as organ failures.
2. Higher Mortality Rates: Studies have shown that people living with SCD who contract malaria are at a higher risk of severe illness and death compared to those without SCD. This makes malaria a leading cause of mortality in SCD warriors in endemic regions like Nigeria.
Preventing Malaria in Sickle Cell Warriors
Given the dire consequences of malaria in individuals living with SCD, prevention becomes paramount. Why we await the availability of malaria vaccines in Nigeria and most parts of Africa, here are some strategies we can deploy to help us combat malaria.
1. Insecticide-Treated Bed Nets (ITNs): Sleeping under insecticide-treated bed nets can significantly reduce the risk of mosquito bites and malaria transmission. Sleeping under insecticide-treated bed nets is crucial for individuals with SCD due to their increased vulnerability to developing severe malaria. Insecticide-Treated Bed Nets are a proven and cost-effective method for preventing malaria transmission. They create a physical barrier between the individual and malaria-carrying mosquitoes, reducing the likelihood of infection.
Statistics on ITNs and Malaria Reduction:Using ITNs have been shown to reduce malaria cases and deaths significantly. According to the World Health Organization (WHO), sleeping under an ITN can reduce the risk of malaria transmission by up to 90%.
Lives Saved Annually: The use of ITNs has saved countless lives, particularly in malaria-endemic regions. While specific numbers may vary by region and population density, millions of lives are estimated to be saved each year due to the widespread distribution and use of ITNs.
Vulnerable Populations: It’s important to highlight that individuals with SCD, along with pregnant women and young children, are considered especially vulnerable to malaria. Therefore, ensuring they have access to and use ITNs is crucial in preventing severe malaria cases and fatalities within this population. Thankfully, this intervention has contributed to saving millions of lives annually in malaria-endemic regions.
To ensure the effectiveness and safety of Insecticide-treated nets (ITNs), follow these steps before using ITNs on beds:
Check for damage: Inspect the net for any holes or tears. If you find any, repair or replace the net to maintain its integrity.
Wash and air out: Wash the ITN once or twice with mild soap and cold or lukewarm water. Avoid using harsh detergents or hot water, as they can reduce the insecticide’s effectiveness. Rinse thoroughly and let it air dry in the shade.
Handle with care: Always handle the ITN gently to prevent damage to the insecticide coating. Avoid contact with sharp objects.
Hang properly: When attaching the net to the bed, ensure it is securely tucked in and hangs evenly without touching the floor. This prevents mosquitoes from entering underneath.
Re-treat if needed: ITNs have a limited lifespan for insecticidal effectiveness. Follow the manufacturer’s recommendations for re-treatment to maintain protection.
By following these steps, you can maximize the effectiveness of insecticide-treated nets in keeping you and your family safe from mosquito-borne diseases.
Remember to regularly check and maintain the ITNs to ensure they continue to provide protection.
2. Malaria Prophylaxis: Proguanil
(paludrine), one tablet daily, is the recommended drug for life-long malaria prevention (chemoprophylaxis) for persons withSCD in Nigeria. Proguanil is generally considered safer for people with SCD than some other antimalarial drugs which may induce hemolysis, which is the destruction of red blood cells, and this can be particularly problematic for individuals with SCD, who already have fragile red blood cells.
3. Regular Check-ups: Routine medical check-ups for individuals with SCD is crucial to detect and treat malaria early.
4. Education and Awareness: Raising awareness about the risks of malaria in SCD and educating communities on preventive measures can make a substantial difference.
Conclusion
Malaria poses a grave threat to individuals with SCD, particularly in countries like Nigeria, where both diseases are prevalent. The statistics are alarming, but there is hope through effective prevention and treatment strategies. It is imperative that healthcare systems, governments, and communities work together to combat both malaria and SCD. Sickle cell warriors and caregivers should take charge of their health and that of their wards, and adopt all the preventive measures to help them live malaria free. By doing so, we can reduce the complications caused by malaria and save countless lives.
