Africa needs to respond to new crown ahead of time, and malaria control cannot be relaxed
With the new crown epidemic pandemic, Africa is not immune.
However, African countries with relatively weak health conditions and medical
systems also need to face more difficulties at the same time, and high malaria
in the region is one of the problems.
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On March 16, local time, 14 scientists from Singapore,
Germany, China, Gabon, Senegal, and the United Kingdom published a review article
"Preparedness is essential for malaria-endemic regions during the top
medical journal The Lancet" COVID-19 pandemic ". They reminded that
given the contagious potential of the disease and its ability to undermine
malaria control efforts, Africa needs to be prepared to respond to COVID-19.
In
addition to the vigilance of countries around the world, Africa also needs to
consider its local malaria epidemic and take additional precautions.
Corresponding author is Tu Yi, a lifelong researcher at the
Artemisinin Research Center of the Chinese Academy of Chinese Medical Sciences.
On October 5, 2015, the 2015 Nobel Prize in Physiology or Medicine was awarded
to Tu Yan, this is the first time that a Chinese scientist has won a Nobel
Prize in science and technology. The award recognizes the great contribution of
artemisinin discovered by Tu and his team in the fight against malaria in the
world.
Malaria is an infectious disease caused by a parasite called
a Plasmodium, also known as a "swinger", which is transmitted by the
bite of an infected mosquito.
This parasite multiplies in the human liver, and
then infects and destroys red blood cells, which continue to multiply and
destroy.
Among all tropical diseases, the number and incidence of malaria
threats are the highest, ranking first among the six tropical diseases that the
World Health Organization focuses on.
So far, the population threatened by
malaria has reached more than 3 billion people, with an annual incidence of
300-600 million people.
The new crown pneumonia OVID-19 initially broke out in Wuhan,
China, and then quickly spread to other parts of China and abroad. In just
three months, as of March 12, more than 125,000 people had been infected, and
the number of deaths worldwide had exceeded 4,600. The Chinese government has
made unprecedented efforts to control the epidemic and has invested huge
resources.
Cases of COVID-19
It is worth noting that as of March 12, a number of cases of
COVID-19 have also been reported in endemic areas of Africa, including Nigeria,
Senegal and the Democratic Republic of the Congo.
Tu and others believe that given the contagious potential of
the disease and its ability to undermine malaria control efforts, Africa needs
to be prepared to respond to COVID-19. In addition to the vigilance of
countries around the world, these regions of Africa also need to consider their
local malaria epidemics and take additional precautions.
The article points out that the lessons learned from the
2014-2016 Ebola virus outbreak in West Africa are worth learning from. During
this period,
Ebola emerged in malaria-endemic countries, including Guinea,
Liberia, and Sierra Leone, and caused public health emergencies that severely
hit malaria control efforts.
In Guinea alone, the number of malaria cases found in health
facilities is estimated to be 74,000 fewer than expected due to a reduction in
the number of malaria patients seeking appropriate health care and a reduction
in the number of malaria treatments that can be provided compared to the years
when the Ebola epidemic did not occur example. The paper also mentioned that
the reason for the above is that the early symptoms of Ebola are very similar
to malaria, which makes early diagnosis difficult, and community members are
also afraid of contracting Ebola in health facilities.
It is also because of the Ebola virus overwhelming health
care infrastructure that 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), while the number of deaths reported in 2013 was 108. By comparison, the
number of people who died of Ebola virus disease in 2014 was 2,446.
More
worrying is that it is estimated that about 7,000 children under 5 years of age
died from malaria-related diseases in Guinea, Liberia and Sierra Leone due to
the outbreak of the Ebola virus.
Therefore, Tu and others believe that malaria-endemic areas
face real and urgent dangers when facing the threat of emerging infectious
diseases.
In terms of transmission trends, in addition to China, local
outbreaks have also occurred in countries such as Italy, Iran, and South Korea.
These outbreaks may lead to disease output and increase the risk of exposure.
And with Africa's increasing global connectivity. The article mentioned: The
possibility of an outbreak on the African continent cannot be ruled out.
Much like Ebola virus, the early symptoms of COVID-19 include
fever, myalgia, and fatigue, which may be confused with malaria, making early
clinical diagnosis challenging.
Tu Yan and others said: These characteristics
of COVID-19 and previous Ebola outbreak experience show that malaria-endemic
countries need to consider not only precautionary measures against the threat
of COVID-19, but also its existing efforts to control malaria Possible impact.
They pointed out that the containment measures and research
momentum adopted by China and other affected countries have earned valuable
time for the rest of the world, and this time window should be effectively used
in vulnerable areas for epidemic prevention and control.
WHO is monitoring the rapid development of the COVID-19
epidemic and needs to provide advice to countries in malaria-endemic areas on
how to formulate and effectively implement public health policies. COVID-19
precautions should be taken, including case and contact tracing, isolation and
screening, and education designed to encourage good hand hygiene practices.
Tu and others suggested that African countries must take
additional and proactive measures to control malaria, and foresee the potential
challenges that public health systems will face during the COVID-19 outbreak.
Taking Ebola as an example, it is estimated that malaria cases in Guinea,
Liberia and Sierra Leone could increase to as much as 1 million in 2014 due to
the cessation of distribution of insecticide-treated bed nets.
The article mentions that governments and health leaders in
malaria-endemic areas must ensure that this pressure on medical infrastructure
is minimized in the event of a COVID-19 outbreak. Resource allocation should be
optimized as much as possible to ensure minimal interference with malaria
control when COVID-19 control is necessary.
Management of medical supplies and
storage of surgical masks and other protective equipment should be carried out
in advance, and medical staff should be adequately trained. In emergency
situations, large-scale drug management and the distribution of mosquito nets
in high-endemic areas may be considered for short-term relief of malaria. These
measures will also assist COVID-19 management by reducing pressure on medical
resources and minimizing confounding factors in diagnosis.
According to WHO guidelines, such measures were successfully
implemented during the outbreaks of Ebola in Sierra Leone in 2014-2015 and in
the Democratic Republic of the Congo in 2018.
Tu Yu and others concluded that in malaria-endemic areas,
malaria diagnosis should be systematically increased in fever management,
including the management of suspected cases of COVID-19, and health
institutions should have sufficient artemisinin combination therapy drugs. In
addition, to increase social distance, wear a mask, seek diagnostic tests and
necessary treatment in a timely manner, these preventive measures should also
be communicated in advance.
Importantly, these measures will require concerted efforts by
African countries and the need to show collective political will and
solidarity.
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