Mosquito nets to boost anti-malaria efforts

Eritrea, one of the few African countries that have been able to significantly reduce the number of reported malaria cases, is to further boost its campaign against the killer disease using a donation of 30,000 long-lasting mosquito nets. According to officials, the number of reported malaria cases in Eritrea fell from 200,000 in 1999 to 45,000 in 2003. "The success of Eritrea can be explained by various strategies. One of those is using impregnated bed nets," Berhane Ghebretinsae, the Eritrean director general of Health Services, told IRIN in the capital, Asmara. "Another is case detection and early treatment of the case. [And] By involving the population we try and drain wherever there are small pockets of water where mosquitoes can breed," he added. Initially Eritrea tried to sell bednets to the population, but the take up rate was so low that the Ministry of Health decided to offer them free to vulnerable groups such as women and young children. Now the Ministry estimates that there are 600,000 nets in use in the country. "The decision to give out bednets free of charge especially to the most vulnerable populations was probably the most important step," Ivan Camanor, head of Health and Nutrition for the United Nations children's fund (UNICEF), Eritrea said. "The second component has been the role the malaria agents play at the community level - they distribute the bednets, give information on malaria prevention and treat all cases of fever at a community level," Camanor added. The malaria agents are often uneducated members of the local communities who are trained by the health ministry in basic treatment of malaria cases, the reimpregnation of malaria nets and general malaria information. They travel around their local area dispensing medication, nets and advice. According to UNICEF, two thirds of Eritrea's population live in malaria endemic areas. Since the launch of the Eritrean government's "Roll Back Malaria" campaign in 1998, the number of cases has dropped by more than three quarters. The last four years have also coincided with a period in which the Eritrean government has recorded poor rains and regularly appealed for large amounts of food aid. Mosquitoes need standing fresh water in order to breed. "Some people may say it is because of the scarcity of the rainfall that the rate is coming down," Berhane said. "Sure in 2000 there was scant rainfall, but last year and the year before the rainfall was very healthy. If we follow the trend and the amount of rainfall you can see our interventions are making a difference not just the rainfall," he added. At present the malaria nets in use in Eritrea, need to be reimpregnated with insecticide every six months. The new long-lasting nets donated by the Japanese government are more expensive, but are stronger and can last for five years without being reimpregnated. According to UNICEF, using impregnated nets reduces the risk of catching malaria by half when compared to untreated nets. The insecticide with which the nets are impregnated, actually kill the mosquitoes, meaning that family members who do not have a net to sleep are also less at risk of being bitten. The donation of mosquito nets by the Japanese government was coordinated by UNICEF.