In 2000, the prevalence rate of Plasmodium falciparum infections in Gambian children ages 2-10 was 23.7%. In 2015, that same prevalence rate is 0.98% (Source: Malaria Atlas Project). Plasmodium falciparum is the most dangerous malaria parasite and the one most seen in West Africa. The species of mosquito, discovered in The Gambia and aptly named Anopholes Gambiae, transmits the parasite from infected person to infected person via blood meals. Due to malaria prevention and control measures carried out by local governments, NGOs, and federal agencies like Peace Corps, we have seen a major reduction in malaria in West Africa.
However, that’s not the same story for all of Africa. CDC’s Malaria Report actually reports an increase in malaria cases in 2016 compared to 2015. In December, 75 Peace Corps representatives from 16 African countries met for the 20th and final Stomp Out Malaria Conference in Senegal. We spent two weeks learning about malaria prevention and control, the state of malaria in Africa, and current initiatives to stomp out malaria in the continent. We heard from experts at the CDC, Johns Hopkins and Presidents Malaria Initiative and compared our local knowledge and best practices as Peace Corps volunteers.
I’ve already posted a blog about Malaria (link) during World Malaria Month, but The Gambia and Senegal are working their ways toward pre-elimination of the disease, a huge step forward in Public Health. This is only possible due to government interventions, NGO support, and effective behavioral change communications. Right now, The Gambia has initiatives like nationwide bed net distributions (bed nets are the most effective way to prevent malaria – 1 net was distributed for every 2 citizens in 2017), seasonal malaria chemoprevention, indoor residual spraying (spraying inside to kill the mosquitoes), and IPTP – intermittent preventative treatment in pregnancy.
With regards to Peace Corps, we mostly work at the village level. We advocate for community members who were missed during bed net distributions, encourage people to use old bed nets outside at night, bring pregnant women to the clinic for preventative treatment, and support health workers to test and treat malaria patients early.
In my village, we’ve done a few trainings with all community health workers on rapid malaria diagnostic tests, compound inspections to check for bed nets, malaria education at the school, and we have a map at the clinic where we track cases to remove standing water (mosquito breeding sites) in that area of the village.
As much as I believe in and love grassroots movements and behavior change communications, the big breakthroughs with regards to malaria prevention came through innovation. Right around 2000, Medical Research Center (MRC) was piloting bed nets and testing their effectiveness in The Gambia. Now we know they’re cheap to produce and distribute and very effective at preventing malaria. We learned about a malaria vaccine that’s undergoing randomized control trials which has good efficacy. What we need now in regards to malaria is more organized governmental campaigns and more innovative preventative techniques.
One of the best parts about this conference was meeting Peace Corps volunteers from other countries but also getting to know our Peace Corps The Gambia staff members better. One had malaria as a child and his mother was convinced there was a demon inside him. Through time and medicine and other interventions, he was the last person in his family to have malaria.