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Anemia, Malaria Rates Drop in Malawi Children
FrontLines - May 2009
NKHOTAKOTA , Malawi—
Fighting malaria through indoor
insect sprays and other strategies
does more than reduce
malaria—it also substantially
reduces anemia among young
children in this part of Malawi.
Malaria is one of the major
causes of childhood anemia. So
the reduction in anemia is often
used as an indication that malaria
control programs are working.
After spraying the interior
walls of homes, anemia in young
children dropped from 22 percent
to 12 percent in Nkhotakota
District’s spray area, the anemia
and parasitema (A&P) survey
reported.
A second round of spraying
began in October 2008 and was
scheduled for evaluation in April.
The A&P survey confirmed
the understanding that indoor
residual spraying is highly effective,
particularly when used with
insecticide-treated bed nets and
prompt treatment, said USAID
Senior Malaria Advisor
Katherine Wolf.
The drop in anemia rates here
is due in part to efforts by the
U.S. President’s Malaria
Initiative (PMI). The five-year,
$1.2 billion initiative, housed
within USAID, aims to reduce
malaria-related deaths by 50 percent
in 15 focus countries.
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A home in Malawi’s Nkhotakota District
is sprayed with insecticide to combat
malaria—a major cause of childhood anemia.
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USAID and the
Department of
Health and Human
Services’ Centers
for Disease Control
and Prevention
began the pilot
indoor spraying
program in
Nkhotakota
District two years
ago. The district
was hard-hit by
malaria, and its
natural boundaries
provided an ideal
pilot site.
The program
worked closely
with the Ministry
of Health,
Nkhotakota District
Health Office, and
Illovo Sugar
Estates to spray
approximately
28,000 houses in
2007 and 25,000
houses in 2008.
The spray, a
biodegradable
insecticide, was applied on walls
inside houses to repel and kill
malaria-spreading mosquitoes,
which are most active late at
night when people are sleeping.
Nearly 90 percent of the houses
in the designated area of the district were sprayed during the
first round—coverage high
enough to protect even people
living in houses that weren’t
sprayed.
The study concluded that
high coverage with spraying,
along with use of long-lasting
nets and effective case management,
reduces anemia rates.
PMI also worked with the
Ministry of Health to procure a
national supply for 18 months—
over 9 million doses—of
artemisinin-based combination
therapy, the country’s new firstline
malaria treatment; and
approximately 1.2 million longlasting
nets, used as protective
barriers when people are asleep.
“On the basis of this successful
pilot,” Wolf said, “the
Malawi Ministry of Health is
planning to scale up the [spray]
program to include six additional
highly malaria endemic
districts.”
PMI is working with the
National Malaria Control
Program and the University of
Malawi’s Malaria Alert Center
to evaluate the effect of the
scale-up of these malaria prevention
and treatment programs.
★
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by the Bureau for Legislative and Public Affairs
U.S. Agency for International Development
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