Malaria remains source of concern

With summer on the way, health experts are warning of a possible increase in the number of malaria cases in Kyrgyzstan, especially in the south of the country, as happened in 2002. "We are concerned. I think that we will face malaria again this year. We have got local contraction of malaria, our mosquitoes are already infected and this year again there will be problems," Nurbolot Usenbayev, deputy head of the epidemiological department at the Kyrgyz Health Ministry, told IRIN from the capital Bishkek on Thursday. "We are trying to do something but the problem remains." Rossitza Kurdova-Mintcheva, a World Health Organisation (WHO) consultant, told IRIN from the southern city of Osh, where WHO maintains a field office to coordinate efforts to fight malaria, that the situation with regard to malaria this year would greatly depend on the measures taken, the weather and mosquitoes. "There are a lot of factors impacting this process, but I don't exclude the possibility that there could be an outbreak because looking at present climatic conditions they are more favourable in comparison to the last year when there was a decrease of malaria morbidity in Kyrgyzstan. The weather this year is warmer than last year," she said. Their comments followed a statement on Tuesday by the Kyrgyz Health Ministry, saying that, as of 25 May, 15 cases of malaria had been registered in the country, of which 13 were in the south. The ministry blamed intensive migration and economic relations with several countries with endemic malaria, the situation with malaria in neighbouring Tajikistan, the unsatisfactory state of irrigation and drainage systems, and an increase in rice plantations in the vicinity of settlements. According to the Health Ministry, there were around 470 registered indigenous cases of malaria in 2003, while in 2002 that figure stood at some 2,750. "Last year winter was cold and there was an early spring, so the season was short, but this year it is already hot. And in May, the first cases of malaria occurred," Usenbaev explained, adding that, according to meteorologists, summer this year was expected to be hot and autumn last longer, possibly prolonging the breeding season for mosquitoes - vectors of the disease from infected to healthy people. "Those infected last year under went radical treatment and were treated once more in the spring. Therefore, mosquitoes should get infected from probable infected persons - local citizens or foreigners coming from malaria endemic countries. That's why it is difficult to say whether there will be an outbreak or not," Kurdova-Mintcheva added. The Health Ministry said that all those patients, more than 400 people, who contracted malaria in 2003 had under gone preventive treatment in March 2004. There haven't been any new cases to date, the WHO official maintained, adding that the 15 recent cases were from last year, either with a longer incubation period or recurring cases of the disease. But, according to Usenbayev, there could still be infected people - carriers of the disease among the population and the disease could be propagated by mosquitoes showing up this year. "But I think that they [new cases] will appear soon and it wouldn't be a surprise, as malaria is an endemic disease and it takes years to eradicate it," Kurdova-Mintcheva said, adding that new cases may occur especially in Batken province's Leylek and Kadamjay districts, by malaria having come from Tajikistan. "The epidemiological investigation showed that the indigenous malaria cases in Batken were related to Tajik citizens who came from Tajikistan, while in Kadamjay there were ethnic Kyrgyz people who came from Tajikistan as well and settled in the region of Min-chinar, Ak-kalpak and Akturpak. They became a source of infection," she said. Given a lack of resources, health officials face challenges in averting the risk of malaria. The most serious problem is a dire need of insecticides to control mosquitoes. "We lack insecticide means and we need at least three metric tons of it every year to treat the mosquito breeding places. Now we don't have a mere kilo of insecticides and we are hoping for assistance from WHO. Perhaps they will help us this year like they did last year," Usenbayev noted. But according to the US Agency for International Development (USAID), which has been sponsoring the WHO project on malaria in the country, Kyrgyzstan was about to get a certain amount of insecticides in the forthcoming weeks. But experts said the USAID programme on malaria was likely to be finalised by June, which could seriously affect the anti-malaria efforts in the impoverished ex-Soviet republic. Furthermore, most of the medical equipment in the country dates back to Soviet times, making it difficult to conduct effective diagnostic tests. Laboratory equipment, including microscopes, dyes and glass slides, was urgently needed to conduct effective tests on detecting malaria, Usenbayev noted, adding that insecticide sprayers were also needed. The UK-based NGO Merlin is expected to provide a number of mosquito nets and microscopes for the southern region of the country in an effort to prevent malaria. Meanwhile, Sabyrjan Abdikarimov, head of the sanitary and epidemiological department, urged the population to be on the alert and avoid mosquitoes and consequent malaria by using various protective measures.