The risk of malaria remains high in Myanmar's cyclone-affected Ayeyarwady Delta, health officials warn, almost three months after Cyclone Nargis struck.
Close to 140,000 people were killed or registered missing when the category four storm hit the southern coastal area on 2 and 3 May, affecting some 2.4 million people.
"As the rainy season is ongoing, there is still a high risk of malaria transmission," Leonard Ortega, a medical officer with the World Health Organization (WHO) in the former Burmese capital of Yangon, told IRIN.
There was always a possibility of a malaria outbreak, though very difficult to quantify, due to the destruction of the storm, coupled with the sheer size of the affected area, he said.
The delta comprises about 23,500 sqkm - almost twice the size of Lebanon - of labyrinthine inland rivers and waterways.
Yet according to the National Malaria Control Programme, since Nargis struck, there have been very few cases of the mosquito-borne disease, with the UN Children's Fund (UNICEF) reporting just over 100.
"So far we have been able to control malaria [in the cyclone areas]," Osamu Kunii, UNICEF's health and nutrition chief in Yangon, said, despite heavy monsoon rains over the past few months.
The townships most at risk include Labutta, Bogale, Ngaputaw and Myaungmya, UNICEF said.
But according to Ortega, the cyclone and accompanying tidal surge created a number of risk factors.
The influx of salty water inland created perfect breeding sites for Anopheles sundaicus, the principal malaria vector in coastal areas, while the early onset of this year's monsoon rains created favourable breeding grounds for Anopheles dirus and minimus, the main malaria vectors in inland areas.
In addition, there is a high chance the mosquitoes would seek humans to feed on, since the cyclone killed large numbers of animals, he added.
Having no protective shelter and going to the forest for food, fuel or building materials would also make people more vulnerable to malaria, the WHO official said.
The serious disruption to basic health services, including the malaria control programme, could also lead to an increase in malaria transmission in the delta.
Prevention programmes
WHO and its partners continue to work on malaria prevention, distributing a guide on prevention and control, as well as anti-malaria drugs, insecticides, diagnostic kits, and long-lasting mosquito nets. It has also provided training for NGOs and volunteers.
Moreover, WHO has mobilised regional surveillance officers from other parts of the country and in cooperation with the Ministry of Health and deployed them to areas across the delta to monitor any outbreaks.
In collaboration with NGOs and the Ministry of Health, WHO set up an early warning and response system for communicable diseases. It also supports the health ministry and some NGOs in revitalising basic health services.
To mitigate the risk factors, UNICEF is providing bed netting, insecticides and drugs in high-risk areas, reaching many pregnant women and children under five, Kunii said.
Early detection and treatment of malaria and the use of insecticide-treated mosquito nets are seen as key measures to prevent potential outbreaks, Ortega said.
If outbreaks do occur, such interventions would be further intensified and indoor residual spraying would be undertaken where appropriate, he added.
An ongoing problem
Malaria - which kills some 2.7 million people worldwide annually - is reportedly the leading cause of morbidity and mortality in Myanmar.
According to WHO, a major risk group is adults who work in gem mining, logging, agriculture, plantations and construction in the forests. Such internal migrant workers lack access to laboratory and treatment services.
As a result, about 70 percent of reported malaria cases in Myanmar are older than 15, and about 60 percent are related to forestry work.
Given poor access to healthcare in remote areas where most cases originate, the total malaria burden is likely to be much higher than reported. Moreover, self-treatment is common, and reporting does not include cases treated in the private sector or with traditional medicine.
Since 1999, reported malaria mortality has declined, but the number of reported cases has increased. The latter is probably explained by improved availability and use of malaria treatment services, the world health body reports.
lm/ds/mw
Close to 140,000 people were killed or registered missing when the category four storm hit the southern coastal area on 2 and 3 May, affecting some 2.4 million people.
"As the rainy season is ongoing, there is still a high risk of malaria transmission," Leonard Ortega, a medical officer with the World Health Organization (WHO) in the former Burmese capital of Yangon, told IRIN.
There was always a possibility of a malaria outbreak, though very difficult to quantify, due to the destruction of the storm, coupled with the sheer size of the affected area, he said.
The delta comprises about 23,500 sqkm - almost twice the size of Lebanon - of labyrinthine inland rivers and waterways.
Yet according to the National Malaria Control Programme, since Nargis struck, there have been very few cases of the mosquito-borne disease, with the UN Children's Fund (UNICEF) reporting just over 100.
"So far we have been able to control malaria [in the cyclone areas]," Osamu Kunii, UNICEF's health and nutrition chief in Yangon, said, despite heavy monsoon rains over the past few months.
 Photo: Contributor/IRIN  |
| Cyclone Nargis ravaged much of the Ayeyarwady Delta, leaving nearly 140,000 people dead or missing |
But according to Ortega, the cyclone and accompanying tidal surge created a number of risk factors.
The influx of salty water inland created perfect breeding sites for Anopheles sundaicus, the principal malaria vector in coastal areas, while the early onset of this year's monsoon rains created favourable breeding grounds for Anopheles dirus and minimus, the main malaria vectors in inland areas.
In addition, there is a high chance the mosquitoes would seek humans to feed on, since the cyclone killed large numbers of animals, he added.
Having no protective shelter and going to the forest for food, fuel or building materials would also make people more vulnerable to malaria, the WHO official said.
The serious disruption to basic health services, including the malaria control programme, could also lead to an increase in malaria transmission in the delta.
Prevention programmes
WHO and its partners continue to work on malaria prevention, distributing a guide on prevention and control, as well as anti-malaria drugs, insecticides, diagnostic kits, and long-lasting mosquito nets. It has also provided training for NGOs and volunteers.
Moreover, WHO has mobilised regional surveillance officers from other parts of the country and in cooperation with the Ministry of Health and deployed them to areas across the delta to monitor any outbreaks.
| Global facts on malaria | |
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Approximately 40 percent of the world's population, mostly those living in the poorest countries, are at risk of malaria |
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Of these, 2.5 billion are at risk, more than 500 million become severely ill with malaria every year and more than 1 million die from the effects of the disease |
|
Malaria is an especially serious problem in Africa, where one in every five (20 percent) childhood deaths is due to the effects of the disease |
|
An African child has on average between 1.6 and 5.4 episodes of malaria fever each year. And every 30 seconds a child dies from malaria |
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Source: WHO | |
To mitigate the risk factors, UNICEF is providing bed netting, insecticides and drugs in high-risk areas, reaching many pregnant women and children under five, Kunii said.
Early detection and treatment of malaria and the use of insecticide-treated mosquito nets are seen as key measures to prevent potential outbreaks, Ortega said.
If outbreaks do occur, such interventions would be further intensified and indoor residual spraying would be undertaken where appropriate, he added.
An ongoing problem
Malaria - which kills some 2.7 million people worldwide annually - is reportedly the leading cause of morbidity and mortality in Myanmar.
According to WHO, a major risk group is adults who work in gem mining, logging, agriculture, plantations and construction in the forests. Such internal migrant workers lack access to laboratory and treatment services.
As a result, about 70 percent of reported malaria cases in Myanmar are older than 15, and about 60 percent are related to forestry work.
Given poor access to healthcare in remote areas where most cases originate, the total malaria burden is likely to be much higher than reported. Moreover, self-treatment is common, and reporting does not include cases treated in the private sector or with traditional medicine.
Since 1999, reported malaria mortality has declined, but the number of reported cases has increased. The latter is probably explained by improved availability and use of malaria treatment services, the world health body reports.
lm/ds/mw
This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions
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