In the Senegalese district of Khombole, the number of people stricken by malaria has dropped by 98 percent in the past decade. While government-subsidised US$2 long-lasting mosquito nets and new medications have helped reduce malaria infections, house visits throughout the district’s 60 villages have also made a difference, according to a local malaria control association.
“It is not enough just to give someone a net,” said El Hadj Diop, the president of an association to fight malaria in Thienaba, one of Khombole’s villages located 80km north of Dakar. He said volunteers make unannounced house visits after net distribution.
“We take hanging nets up seriously. If someone has not hung up their nets, we charge them $1.” He said since fines were levied in 2006, only six people have had to pay. “It is considered a shame to not have a net hung. No one has had to pay for awhile now.”
In 2008 Khombole reported 57 malaria infections versus 3,542 infections nine years ago, according to district medical records.
Net use increases typically by 10 to 23 percent when house visits are conducted after net distribution, according to the US-based Centers for Disease Control and Prevention, based on studies in Togo, Niger, Sierra Leone and Madagascar.
|Khombole malaria case reports|
|Source: Khombole district health office|
Since 2004 there have been no reports of malaria deaths, according to Diop. “I could not even tell you how many deaths we had a decade ago. More than I could count. I lost my 12-year-old daughter.”
He told IRIN his daughter came home from school feeling ill and after two days died at home.
Diop told IRIN after 60 villages established committees to enforce net use, sent volunteers to give health talks and began setting up loan circles in 2001 to buy nets and malaria medication for families who could not afford them, malaria deaths have “faded to the past”.
Nationwide, while 60 percent of households had received nets only half of the nets were in use, according to a December 2008 survey. This rate depends on the season, the country’s National Malaria Control Programme deputy director Mame Birame Diouf, told IRIN. “More people use the nets during the rainy [malaria] season, which ends in October for us.” The goal is to reach 80-percent use, said Diouf.
If nets are given without instructions that priority should go to women and under-five children – who are most vulnerable to malaria infections – men may sleep under a family’s only net, leaving children to sleep uncovered in kitchens and common areas, according to researchers at Tulane University School of Public Health and Tropical Medicine.