Nigeria: Extended malaria season in Borno claims lives
Nigeria has some of the highest number of deaths from malaria worldwide.
However, this year, Médecins Sans Frontières/Doctors Without Borders (MSF) medical teams working in northeast Nigeria’s Borno state have witnessed a spike in malaria cases in the dry season, which is unusual.
Usually, peak malaria season takes place during the rainy season from August to mid-October, when mosquitoes breed. After this time, patient numbers typically begin to decrease.
During this year’s rainy season, MSF teams conducted or supported four rounds of seasonal malaria chemoprophylaxis, a treatment which prevents malaria, in different locations across Borno state, including in camps for displaced people.
MSF teams have also been supporting the Ministry of Health by carrying out seasonal malaria chemoprophylaxis in Gwange district and at informal camps for displaced people in Maiduguri.
The campaign was aimed at children aged between three months and five years old. MSF delivered more than 350,000 doses in the first three rounds, while the Nigerian Ministry of Health had planned to reach around two million children in total.
However, this fourth round of the campaign was meant to be carried out during the rainy season in mid-October, but shortages of medical supplies meant that it was delayed until mid-November.
Despite the preventive campaign, a number of young children sadly died in hospital from the disease.
COVID-19 disruptions
In response to the high numbers of people with malaria and the shortage of antimalarial medications, MSF has provided the Ministry of Health and other organisations with 120,000 antimalarial tablets after COVID-19 restrictions disrupted or delayed the import of the drugs into Nigeria.
MSF teams have also distributed mosquito nets to people across Borno state, including in Banki camp for displaced people.
“If it weren’t for MSF, I wouldn’t have been able to afford [my grandson's] treatment, because [he] lost his parents and I too have been alone since my husband died."
In Banki, MSF teams are also carrying out rapid malaria tests and providing treatment to people who test positive, as well as malnutrition screening for children.
"We’re a family of eight and we have only two mosquito nets – they’re not enough for us,” says Bintu, a resident of Banki camp, whose son Ali died of malaria some years ago, when he was just two years old.
“All my [other] children recently had seasonal malaria chemoprophylaxis and they are all doing fine."
October saw almost half of all 2020 malaria cases
In total, almost 29,000 patients were confirmed with malaria from January to October 2020 in MSF facilities across Borno state. Of these, 12,000 patients were registered in October alone.
In the same period, MSF teams in Gwange treated around 8,000 patients, while MSF teams in Fori paediatric hospital, which mainly deals with malnutrition, treated 1,800 children suffering from both malaria and malnutrition.
MSF teams in Ngala and Rann treated more than 2,000 people for malaria, while teams in Pulka and Gwoza treated almost 17,000 patients.
Hussaini, five years old, is being treated for malaria in Gwange hospital, cared for by his grandmother, Hajja. “He has been having this sickness for about a month, though he has sickle cell anaemia as well,” says Hajja.
“If it weren’t for MSF, I wouldn’t have been able to afford his treatment, because Hussaini lost his parents and I too have been alone since my husband died."
Hussaini arrived at the hospital just in time for his treatment to be successful, but many patients are not brought in until it is too late to save them.
Community education
MSF teams are keen to spread the message among communities that children should be brought to hospital as soon as they fall sick with malaria.
“Parents, community leaders and the public should bring sick children to a hospital as soon as any of the malaria symptoms are noticed, as it is essential to treat malaria at an early stage to save lives," says MSF medical coordinator Jacob Maikere.
After seeing the high number of malaria patients arriving at Gwange hospital from the Bolori neighbourhood, on the outskirts of Maiduguri, MSF has extended its activities to Bolori, as well as to the neighbourhoods of Dusman, Musari, Zambarmari and Ahmed Ghemra.
In Bolori, MSF teams tested children for malaria and treated all those who tested positive. During the first half of November, they provided treatment to 323 children.
Bashir, aged two, was one of those who received treatment, after his mother Hafsat brought him to see the MSF mobile team.
29,000
CONFIRMED MALARIA CASES IN MSF FACILITIES
from January to October 2020 in Borno state
12,000
MALARIA CASES IN OCTOBER ALONE
“We could only give him paracetamol syrup when he started having this fever and a runny nose,” says Hafsat. “Me, my husband and our seven children all had malaria last month.”
The seasonal malaria chemoprophylaxis campaign in Borno state was challenging to implement, given regional insecurity and the COVID-19 pandemic, but it is likely to have saved many children’s lives.
To save even more lives in a country that accounts for more than half of all malaria cases in West Africa, MSF is calling for seasonal malaria chemoprophylaxis to be given to all children aged from three months to 10 years.
“We’ve noticed the positive effects of the campaign,” says Dr Emmanuel Berbain, MSF medical team leader in Gwange hospital.
“Children under five mostly weren’t affected by malaria during the peak season. However, there were deaths among children over five.
"Because of the death rates, I think we should lobby for next year’s malaria prevention campaign to cover children up to the age of 10. It’s certainly possible, but it will require coordination, resources and preparation.”
MSF in Nigeria
With over 190 million inhabitants, Nigeria is the most populous country in Africa and the seventh most populous country in the world.
Nigeria also has one of the fastest-growing economies, which is based primarily on the petroleum industry. However, a decade-long conflict has devastated the northeast of the country.
Thousands have been killed and nearly two million people have been uprooted since fighting broke out between the military and non-state armed groups.
Médecins Sans Frontières/Doctors Without Borders (MSF) has been responding to disease outbreaks and emergency health needs in Nigeria for many years, focusing on maternal and paediatric healthcare throughout the country and scaling up our activities in the northeast as vast numbers of people caught up in the conflict depend on aid to survive.