Sleeping inside insecticide-treated nets: A little step, but big help

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1 year ago

MRS Bintu Bako, a 24-year-old mother, has come for antenatal care at the Alape Primary Health Care Centre in Lagelu Local Government Area in Ibadan. The centre is busy, with children on their mothers’ laps, pregnant women waiting for their antenatal care visits, and others receiving their test results.

Bako, a first-time mother, was aware of malaria and treatment, but she never knew that having nutritious meals was just as important as sleeping under insecticide-treated nets to stay free of malaria.

The facility has skilled health care providers trained on malnutrition and malaria prevention and treatment that give education sessions that cover topics ranging from the importance of sleeping under insecticide-treated nets, intermittent preventive treatment during pregnancy, nutrition during pregnancy, to family planning services.

“During the centre’s education sessions, we learn about a lot of things. For example, it never occurred to me that a malnourished pregnant woman stands a higher risk of losing more blood during childbirth or that a baby that is malnourished may end up experiencing the worst malaria case.”

Despite substantial improvement in the control of malaria and decreased prevalence of malnutrition over the past two decades, both conditions remain heavy burdens that cause many ill health and deaths in children and pregnant women in Nigeria every year.

WHO reports say that in Nigeria, an estimated 68 million cases and 194,000 deaths occurred due to the disease in 2021, and that the country has the highest burden of malaria globally, accounting for nearly 27% of the global malaria burden.

UNICEF also reported that 37 percent of children, or 6 million children, are stunted (low height for age), more than half of them severely in Nigeria. In addition, 18 percent of children suffer from wasting (low weight for height), and half of them severely. Twenty-nine percent of children are underweight.

However, in an effort to reduce deaths in infants and pregnant women, Rotary International, under its Maternal and Child Health Project, has commenced training for health professionals on malaria and malnutrition in Oyo, Lagos, and Ogun states with the aim of enhancing their knowledge and skills in reducing maternal and child mortality and morbidity in these states.

Past Rotary District Governor Raji declared that malaria remains a foremost public health problem that is taking its greatest toll on children under the age of five and pregnant women, especially in rural areas, and 60 percent of its project efforts will centre on Oyo State, with the highest malaria and malnutrition prevalence among Oyo, Lagos, and Ogun states.

Rotarian Adedotun Amori, Oyo state chairman for the programme, stated that through little steps like sleeping under insecticidal-treated nets, that the people will make a habit, large impacts can be made in terms of lives that are saved and a reduction in the number of disabilities that result from malaria and malnutrition in the community.

Dr. Hassan Adelakun, a consultant obstetrician and gynaecologist, speaking at the events explained that there is a link between malaria and malnutrition in pregnancy and in children under the age of five years.

“The two conditions are quite critical issues that can affect women in pregnancy and children below the age of five years.

“We know that the pregnancy state is a delicate state and every pregnancy is unique on its own, but every pregnancy can be infected and, at the same time, affected by malaria. Also, the baby growing within depends on the mother for feeding, and malaria can be transmitted through the placenta to the unborn baby.

“If a person is sick because of malaria, it can make their under nutrition status worse because they may not eat well and may be vomiting. At the same time, when they are malnourished and they now have malaria, they won’t have enough immunity to defend themselves. So the malaria tends to be severe in them, and more likely it can lead to death. This is even more pronounced in under-five children.

“Moreover, pregnancy reduces a woman’s immunity to malaria, rendering her more susceptible to infection and at greater risk of illness, severe anaemia, and death. Also, malaria interferes with growth in the womb, increasing the risk of premature delivery and low birth weight, a leading cause of child mortality.

“It’s rather unfortunate that our women are dying, and we know the reason why they are dying, yet we are not doing enough about it. That is why Rotary has come up with this project and to be able to address these issues contributing to mortality and morbidity in pregnant women and children under the age of five years.”

Dr. Adelakun however charged pregnant women to always sleep under insecticidal-treated nets to prevent mosquito bites and reduce their chances of coming down with malaria.

“Only about 20 percent of women sleep on insecticidal-treated nets. The use of insecticidal-treated nets alone will significantly reduce the chance of coming down with malaria since they won’t be beaten by mosquitoes.”

Dr. Ayodeji Adebayo, a community health physician, emphasised the need for increased community involvement, awareness, and sensitisation in stemming ill-health and deaths from malaria and malnutrition. Also, the misconceptions and beliefs contributing to the increasing burden of these conditions need to be corrected in the community, too.

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