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Zanzibar winning its fight against malaria

[Tanzania] Some of the 452 workers hired to spray households in Zanzibar in efforts to control malaria-causing mosquitoes on the island. The spraying began on 10 July 2006 and would last 54 days. [Date picture taken: 07/10/2006]
Yussuf Yussuf/IRIN

Health clinics have reported a marked decrease in the incidence of malaria in Zanzibar with the completion of the first phase of an anti-malaria campaign.

Health Minister Sultani Mohammed Mugheiry said records from hospitals and health centres showed that malaria declined immediately following a 54-day Indoor Residual Spraying (IRS) effort that ended on 9 September.

"I have visited some of the public health centres in Unguja and Pemba [the two main islands that make up Zanzibar]; I visited some wards without malaria patients. Before the campaign, such a situation would not be common," Mugheiry said.

The Health Ministry is expected to publish definitive results of the campaign in six months’ time. By then, the second phase of the spraying campaign is expected to be under way.

Malaria is the biggest killer in Africa, with more than one million deaths attributed to it every year, most of whom are children under the age of five. Until recently, the virus was the leading health problem in Zanzibar.

The World Health Organization (WHO) and the United States government have supported attempts to control the disease in Zanzibar in the 1960s, 1970s and 1980s but all failed, Mugheiry said.

"We were not serious and committed, that is why malaria came back, but this time we are committed and so are the majority of Zanzibaris," he said.

However, the incidence of malaria in Zanzibar has fallen significantly over the past two years - from 54 percent in 2003 to 31 percent at the end of 2005, according to government records.

"It was the result of proper diagnosis and treatment, and the use of treated mosquito nets," Juma Muchi, a malaria health official in Zanzibar, said.

He added that the United States government had given more than 200,000 Insecticide Treated mosquito Nets (ITNs) to pregnant mothers and children younger than five in Zanzibar.

Current control programme

The current anti-malaria programme aims to halve the previously recorded 31 percent incidence.

WHO officials visiting the islands at the end of the spraying campaign reported favourably on the initiative. "Political commitment and good planning have helped Zanzibar to move fast in controlling malaria in the island. Hopefully, at this pace malaria will soon disappear," Shiva Murugasampillay, the WHO representative, said.

The recent anti-malaria initiative cost at least US $2 million and reached 240,000 homes, or 90 percent of all homes on the island, according to the government.

Charles Llewellyn, an official with the USAID, which funded the project, says it was a great success. "In the past, the people of Zanzibar were worried about malaria whenever the rains came, but now the worry is over," he said.

Not everyone, however, shares the government’s and international agencies’ optimism. Paradoxically, despite a reduction in malaria cases following the spraying campaign, mosquitoes continue to multiply.

"We believed that after the spraying exercise, mosquito disturbances would end, but instead mosquitoes have increased drastically!" Rukia Mohammed, a resident of Unguja Island, said.

Mohammed is among the many mothers who received treated mosquito nets in May this year, and says that although there are more mosquitoes, "none of my family members, including children, have suffered from malaria since May this year".

The Health Ministry was keen to point out that the spraying campaign – using a 10-percent solution of the chemical lamda-cyhalothrin, known as ICON - was focussed only on those mosquitoes on walls inside people’s homes. However, most mosquitoes are found outside.

Poor drainage and sanitation systems, coupled with the onset of the rainy season, may well have led to an increase in the numbers of mosquitoes on the islands, Health Minister Mugheiry said.

He said now the government was working with the population to get them to keep the environment clean, use treated nets, and to use the right treatment for malaria.

"Malaria is already becoming rare in Zanzibar. Now we need to unite and strengthen our efforts and we can eradicate it," Mugheiry said.

View Related Film: Malaria: Killer Number One

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