During a pandemic, precautions are critical in malaria-endemic areas
An article in The Lancet, states that during the pandemic of
new coronavirus disease pneumonia (COVID-19), precautionary measures are
essential in areas where malaria is endemic.
At the end of 2019, the outbreak of new coronary pneumonia in
Wuhan, Hubei Province, China has rapidly spread to other parts of China and
even the world. As of March 12, 2020, more than 130,000 people worldwide have
been infected and more than 5,000 deaths have occurred.
To curb the spread of the virus, the Chinese government has
made unprecedented efforts and invested huge resources. As of March 12, 2020,
malaria endemic areas in Africa have reported a number of new cases of coronary
pneumonia, including Nigeria, Senegal and the Democratic Republic of the Congo.
Given the infectious potential of the disease and its
devastating efforts to control malaria, in addition to the common vigilance of
countries around the world, the local epidemic of malaria needs to be
considered and additional precautions required.
The lessons learned from the Ebola virus outbreak in West
Africa from 2014 to 2016. The emergence of Ebola virus in malaria-endemic
countries, including Guinea, Liberia, and Sierra Leone, has caused public
health emergencies and severely undermined previous efforts to control malaria.
In Guinea alone, malaria patients at medical institutions are estimated to be
74,000 fewer than expected compared to years without Ebola, due to a reduction
in the number of malaria patients seeking appropriate health care and the
allocation of malaria treatment. The amount has decreased.
The reason for this
is that early symptoms of Ebola virus infection are similar to those of
malaria, which makes early diagnosis difficult, and local residents are worried
about getting Ebola infection in medical institutions.
As Ebola overwhelms health care systems, insufficient
resources to control malaria in these areas have led to increased mortality and
morbidity. In Guinea, the official number of malaria deaths reported in 2014
was 1067 (who is estimated to be 9,428), and 108 in 2013. The number of Ebola
deaths in 2014 was 2,446.
What is even more shocking is that it is estimated
that as a result of the Ebola outbreak, approximately 7,000 deaths in children
under 5 years in Liberia and Sierra Leone have been linked to malaria.
Therefore, malaria-endemic areas face real and urgent dangers when they face
the threat of new infectious diseases.
Although our knowledge of neocoronary pneumonia is still
evolving, it is a highly contagious disease that is believed to spread from
person to person primarily through direct contact and inhalation of respiratory
droplets. People with mild or asymptomatic carriers may spread the virus. In
addition to China, Italy, Iran, and South Korea are also high-endemic
countries. These countries may have virus exports and increase exposure.
With Africa's growing global ties, the possibility of an
outbreak in Africa cannot be ruled out. Like Ebola virus, early symptoms of new
coronary pneumonia, including fever, muscle soreness, and fatigue, can be
confused with malaria, leading to early clinical diagnosis errors.
These
characteristics of new coronary pneumonia and previous experience with the
Ebola virus outbreak suggest that malaria-endemic countries need to consider
precautions not only against the threat of new coronary pneumonia, but also the
possible impact on existing malaria control efforts.
The containment measures
and research momentum that China and other affected countries are taking have
earned valuable time for the rest of the world, and weak areas should make
effective use of this time window.
WHO is monitoring the rapid evolution of the new coronary
pneumonia epidemic and needs to provide advice to countries in malaria-endemic
areas on how to formulate and effectively implement public health policies.
Preventive measures for new coronary pneumonia should be developed, including
case and contact tracking, isolation and screening, and education designed to
encourage good hand hygiene practices.
Other advance measures must be taken in
these countries to control malaria to foresee the potential challenges that the
public health system will face during a new coronary pneumonia outbreak.
Although new coronary pneumonia may not occur in
malaria-endemic areas, we must be cautious and recognize that such pre-emptive
measures are ultimately worthwhile.
Preparedness is key to responding to any
public health crisis, and malaria-endemic countries must be prepared to address
the challenges that new coronary pneumonia may pose, while minimizing
disruption to malaria control.
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