Several threats could hamper the fight against malaria in Africa
A health worker prepares a dose of malaria vaccine in Ndhiwa, Kenya.
(illustrative image) AFP - BRIAN ONGORO
Text by: RFI Follow
4 mins
This Monday, April 25 is World Malaria Day.
A disease that continues to kill massively.
630,000 people, mostly children living in Africa, succumbed to the disease in 2020. The number of cases is around 240 million.
Many tools exist to fight against malaria, and the palette continues to expand.
But at the same time, threats could hamper the fight on the African continent.
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The weapons to fight against malaria are not yet sufficiently deployed: mosquito nets impregnated with insecticide, repellents, preventive treatments for pregnant women and children, curative drugs.
A first vaccine, intended for children, tested in 3 countries and 30% effective, should soon join this arsenal and should be more widely deployed.
In short, a combination of tools exists, and the palette continues to expand.
Even if research remains largely underfunded, innovations have been developed, particularly in the field of the fight against mosquito vectors of malaria.
“
There are novelties with regard to impregnated mosquito nets.
We now make combinations of insecticides for certain mosquito nets with different chemical classes,
explains Dr. Pascal Ringwald, coordinator of the malaria department at WHO
.
This helps fight resistance to insecticides, and increase efficiency.
As soon as there is authorization, it can be put in place.
Then there are the targeted sweet baits for mosquitoes.
These are baits that are hung at a certain height so that children cannot access them.
It hangs on the outside of the houses, about 1.8 meters away.
The fact that there is sugar attracts mosquitoes.
And since there are also insecticides, it also kills mosquitoes.
We're still waiting for permission.
It is tested in Mali, Zambia and Kenya.
These are quite innovative things.
It is especially for vectors outside, it is very difficult to kill mosquitoes.
For those who return, we can impregnate the walls of the houses, but those outside pose a certain problem.
»
But despite these innovations, several threats could greatly hamper the fight on the African continent.
First threat: resistance to antimalarial drugs based on artemisinin.
Several combinations of molecules exist, very effective.
However, recently, parasites partially resistant to artemisinin have been detected in Rwanda, Uganda and the Horn of Africa.
Controlling these resistant parasites and their spread is crucial.
“
The first cases were found in Rwanda, then we found some in Uganda, then in the Horn of Africa,
explains Doctor Pascal Ringwald
.
This resistance emerged in Africa.
It was not imported as some researchers had predicted from the Mekong region to Africa, but it emerged spontaneously in Africa.
The WHO is in the process of developing with partners a strategy to avoid the spread of this resistance to neighboring countries.
To avoid other emergences, it will be necessary to better regulate the use of drugs, drugs of poor quality.
Care should be taken in how the drugs are used.
We will really have to work a lot with the countries to ensure that they follow the WHO recommendations, from a treatment point of view, from a prevention point of view, from a of vector view.
»
The second threat, on which the World Health Organization also warns, concerns diagnosis: many rapid diagnostic tests detect a particular protein of the parasite responsible for malaria.
However, some parasites have mutated and no longer produce this protein, thus rendering these tests ineffective;
the Horn of Africa is disproportionately affected, says the WHO.
The evolution of mosquitoes also complicates the fight against malaria;
some have become resistant to insecticides contained in mosquito nets or repellents.
Finally, a species, baptized Anophele stephensi, native to Asia, established itself in Djibouti about ten years ago then was detected more recently in Ethiopia, Somalia and Sudan, and could continue to gain ground. .
However, this mosquito easily adapts to the urban environment, which increases the risk of malaria epidemics in African cities, points out the WHO.
For children under 5, malaria represents 44.1% of causes of hospitalization and 28% of causes of death in hospitals.
In Congo-B, malaria, the leading cause of death among 5-year-old children
Loicia Martial
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Malaria
Health and medicine