1.9 million cases reported annually in PNG

Lydia Kaia




 

On a small hospital bed at the Vanimo General Hospital’s Pediatric Ward, three-year-old Francis Warawe from Yoko Village in Sundaun Province is recovering from malaria which left him unconscious the previous evening.
Warawe braves a smile that not only warms the heart but also signals that he is regaining his strength.
Ravaged by high fever and chills for days, he is considered lucky: the malaria parasite is leaving his tiny body. He’s one of the lucky ones, thanks to his mother’s quick action to seek treatment.
Malaria, caused by a female Anopheles mosquito that bites only at night, is found commonly in tropical climates, including Papua New Guinea.
In PNG, malaria has been identified as one of the top five health priorities in the country and the leading cause of hospital admissions.
Approximately 1.9 million cases of malaria are reported annually at health centres and hospitals, and every year between 600 and 700 Papua New Guineans die from malaria in health care facilities. The socio-economic burden the disease poses to PNG is substantial.
Papua New Guinea is attempting to reduce malaria morbidity and mortality through delivering preventative, diagnostic and treatment services to all people at risk of malaria, especially pregnant women and children younger than age five who are more vulnerable to the devastating effects of malaria.
The National Department of Health is set to roll out the new efforts nationwide. The new efforts are detailed in the new National Malaria Control Programme Strategic Plan under the “Yumi Rausim Malaria” campaign.
“The strategic plan is a guide for the provinces and districts on how to implement effective malaria control measures. It identifies the key areas they need to plan for as part of the annual planning process,” said Leo Makita, Principal Advisor for Malaria and Vector Borne Diseases at the health department.
The plan, launched in a traditional PNG ceremony at the World Malaria Day event on April 26, brought together traditional singsings groups, students, global and national health organisations, and provincial leaders to the coconut fringed coastal village of Waromo, outside Vanimo.
Much of the plan’s elements will be funded by the five-year $120 million grant from the Global Fund to Fight AIDS, Tuberculosis and Malaria.
With this funding, the National Department of Health is leading collaborative efforts with partners Rotarians Against Malaria (RAM), Population Services International (PSI), Divine Word University and Papua New Guinea Institute of Medical Research.
As well, other organisations, businesses and donors are carrying out malaria work with the health department under separate funding streams.
The plan has six key service delivery areas: leadership and governance, system and capacity development, acute diagnostic and prompt, effective treatment for malaria, malaria control, epidemic preparedness and response, and behaviour change communication through community outreach and mass media.
Under the plan, a new first-line antimalarial drug—an Artemisinin-based combination therapy called Artemether-Lumefantrine—will be available in September. One component of the new treatment Artemisinin, derived from the sweet wormwood or Artemisia annua plant, is the best drug available against malaria, especially when used in combination with another anti-malarial.
ACT treatments are approved by the World Health Organisation and used globally. Switching to an ACT in PNG is highly necessary—the main malaria parasite in the country is largely resistant to Chlorquine, which is one drug widely used in the current treatment system.
Deputy Health Secretary Paison Dakulala said the new strategy is designed to provide easy access to effective antimalarial drugs available at health centres throughout the country.
Health care facilities will also be equipped with Rapid Diagnostic Tests (RDTs) for the quick diagnosis of malaria. Unlike laboratories that require electricity to test for the presence of the malaria parasite in a patient’s blood, RDTs can be used anywhere.
RDTs will allow health care workers to confirm if fever or signs and symptoms of malaria are truly being caused by the malaria parasite; not all fever equates to malaria.
Proper diagnosis, in theory, can allow patients to recover more readily. The new drug must be taken by each patient it is prescribed to for three days, with the dose varying according to the patient’s weight. order to cure malaria, it is critical that all patients given the drug follow the dosing instructions.
Health care workers will be trained in the use of the new drug and the diagnostic tests. The training is being organised by Divine Word University.
The government is also stepping up preventative measures with the distribution of free long lasting insecticide treated mosquito nets to all households by Rotarians Against Malaria (RAM).
Population Services International (PSI) is conducting outreach in rural communities to encourage all Papua New Guinea to use mosquito nets with a simple message that prevention is better than cure.
PSI is also encouraging all people to report to a health care facility within 24 hours of fever onset for diagnosis, and reminding all about the importance of following dosing instructions.
Mosquito net use in the country must be increased in order to continue fighting malaria in any significant way.
A recent study from the Papua New Guinea Institute of Medical Research found that 64.6% percent of households surveyed in PNG owned a long lasting insecticide treated mosquito net, but only 39.5% of children younger than five  years old and 41.3% of pregnant women reported having slept under their net.
It is hoped that many like little Warave —who might otherwise coqntract malaria while sleeping in thatched roof huts—are encouraged to sleep under a treated mosquito net each and every night and report to a healthcare facility on the onset of a fever for proper diagnosis and treatment. 

• The writer is the Information, Education and Communications Coordinator with PSI PNG’s Malaria Programme.