Stress, walking in sun do not cause malaria —Expert

It was the cry that Ponmile Jacob was convulsing that drew women working on palm nuts to him. The mother noticed he was experiencing a high fever and had given him paracetamol; she asked his sister to babysit while she was busy at work.

April in many palm oil-producing communities is a time many women are deeply involved in farm work and palm oil milling. And many children are left to play around as the women work taken.

Three-year-old Ponmile had convulsed before he was to a community malaria medicine distributor (CMD) in Araromi-Aperin, a suburb in Ibadan, who tested him with malaria rapid diagnostic test (RDT) kit and found he had malaria.

“The boy was given suppository artesunate (rectal). Thanks to God the boy fully recovered. Of course, the training we received as CMDs had helped us to save many children that would have died of malaria,” said Mrs Felicia Okunlola, one of the community medicine distributors at Ona Ara local government area, Oyo State.

Mrs Kehinde Adeyemi, like Mrs Okunlola, is one of the 40 women trained as CMD that are helping to curb deaths in children due to malaria in rural communities.

“Since we started, I have become more knowledgeable about malaria treatment, far above what I learnt when in training as a patent medicine vendor,” she added.

Mrs Adeyemi expressed happiness at saving lives since they could easily refer serious cases of malaria to the health centre.

“In 2015, when a child that I treated for uncomplicated malaria suddenly convulsed, the child was taken to the University College Hospital (UCH), Ibadan and the child survived,” she added.

Professor Ikeoluwapo Ajayi (Nee Sosanya) and a team of experts have been working in these field sites since 2004. They had trained these CMDs (lay mothers) to be able to identify early symptoms and signs of uncomplicated malaria as well as severe malaria.

The CMDs were given the malaria treatment guidelines to ensure they can appropriately treat uncomplicated malaria cases in children with artemisinin combination therapy (ACT) drugs as stipulated by the World Health Organisation.

For severe cases of malaria, they were trained to administer rectal artesunate and facilitate the child’s referral to a higher level hospital for the continuation of care.

The drugs and testing materials, which were provided to the CMDs for free, came from the National Malaria Elimination Programme (NMEP) of the Federal Ministry of Health and World Health Organisation.

Mrs Okunlola declared that many mothers still have the notion that allowing children to play in the hot sun causes malaria. Even mothers assume that stress is the reason they come down with malaria.

Global efforts cut the malaria death toll by more than 60 per cent between 2000 and 2015, but the disease still kills more than 400,000 people per year, mostly babies and young children in sub-Saharan Africa, according to the World Health Organisation.

Professor Ajayi, a Professor of Epidemiology and Family Physician at the Department of Epidemiology and Medical Statistics at the University of Ibadan, speaking at a meeting with the CMDs on their roles in malaria treatment to children stated that malaria is not caused by stress or walking in the sun.

The event aimed at marking the World Malaria Day with the theme ‘Zero Malaria Starts With Me’ was also to celebrate these women offering free home management of malaria services.

They were empowered with cash and material gifts from part of the  fund she got as a joint award winner of the Nigeria Prize For Science, 2017 awarded by Nigeria Liquefied Natural Gas (Nigeria LNG) Company.

According to her, malaria is an infection caused by a parasite (plasmodium) that is only transmitted by the  female anopheles mosquito from an infected person’s blood to another person through its bite.

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“There has been this notion by many people that stress or exposure to too much sun causes malaria. This is not true. The only thing that causes malaria is the malaria parasite.

“Nonetheless, people under severe stress can have the symptoms that somebody who has malaria also has, like tiredness, feeling unwell and loss of appetite for food.

“This is similar to a person that after walking in the sun for long feels tired, dehydrated or hot in the body. All the symptoms make them think that they have malaria.”

Paradoxically, she declared that if the blood of many people living in malaria-endemic areas like Nigeria are tested, it may contain malaria parasites even though they do not have signs and symptoms of malaria.

Professor Ajayi, however, said under severe stress, such individuals already with malaria parasite in their blood stand a higher risk of developing malaria.

“It has been shown that when people are stressed up, the body immunity comes down. The lower immunity now affords the malaria parasites in the blood to exhibit itself in the form of signs and symptoms of malaria.

“So whether it is stress arising from daily living or walking in the sun, you must have that parasite in your body for stress to precipitate malaria infection,” she declared.

The public health expert advise that mothers should always prevent malaria in their children, and where it occurs attend to it promptly.

“Some people feel that malaria is a simple illness and then they do not treat early enough and with the right type and correct doses of medications. This is wrong because malaria can kill,” she stressed.

Professor Ajayi declared that in the community, mothers can avail themselves of prompt malaria testing and treatment from CMDs.

In a community, people such as the community malaria medicine distributors can help to diagnose malaria early and commence appropriate treatment. It is an integral part of Nigeria’s national effort at eliminating malaria.

“At every phase, community malaria medicine distributors from the evaluation was found competent and acceptable to the community in carrying out the diagnosis and treatment of malaria.

“Our studies provided evidence to the national malaria elimination programme to scale up ACT use at the community level as well as for rectal artesunate for children with severe malaria being referred to a high level of care.

“Some of these studies include those which won the Nigeria Prize for Science, 2017 awarded by Nigeria Liquefied Natural Gas (Nigeria LNG) Company,” she said.