Malaria uptick in Botswana: No, more DDT can’t help

March 28, 2017

Health workers in Botswana use a cell phone to report malaria diagnoses and commencement of treatment, enabling real-time tracking of malaria outbreaks and rapid public health service responses. Photo from MalariaNoMore.

Health workers in Botswana use a cell phone to report malaria diagnoses and commencement of treatment, enabling real-time tracking of malaria outbreaks and rapid public health service responses. Photo from MalariaNoMore.

Interested, and interesting, to discover Botswana has a Facebook page where it appears is posted almost every press release or news item from the government.

I found it because some wag claimed on Twitter that Botswana faces a malaria crisis, and therefore DDT should be ‘brought back from the dead.’

Botswana did post about a malaria outbreak, but the nation appears to have good sense about how to fight malaria. The Tweeter missed that Botswana is already doing what a nation would use DDT for, Indoor Residual Spraying (IRS), and that phrase alone means Botswana’s malaria fighters are alert to any need for DDT should it arise, but also to the severe limitations on DDT use. DDT doesn’t work in about 95% of the nations on Earth.

Botswana is among the ten nations remaining on Earth who use DDT when and where they find a population of mosquitoes still susceptible to DDT. Almost all nations on Earth signed the Persistent Organic Pollutants Treaty (POPs, or Stockholm Agreement), which requires annual reporting of DDT use. But there are 11 other pesticides the World Health Organization (WHO) recommends for IRS. Botswana is unlikely to use DDT where it won’t work, which is most places.

Botswana is one of the DDT Ten in 2016, too. But this is down from 43 nations in 2001. DDT’s effectiveness and time as a tool to fight malaria is mostly gone, vanishing quickly.

Botswana has DDT if it can find a use for it; no more DDT is needed. A malaria outbreak in Botswana is no reason to remove the ban on DDT use on U.S. farms.

Here is the story/press release from Botswana’s government:

MALARIA CASES RISE IN OKAVANGO

North West District has been hard hit by a malaria epidemic with 670 recorded cases and five deaths since the beginning of the rainy season.

Head of the District Health Management Team, Dr Malebogo Pusoentsi revealed this at a press conference aimed at evaluating efforts made in the district to control the disease, recently.

A task force was in the district to assess and appreciate the situation as well as discuss what more could be done going forward.

Dr Pusoentsi said the highly affected region was Okavango which recorded over 90 per cent of the cases.

Highly affected areas include Shakawe, Xakao and Seronga in the Okavango District while in Ngami, Tsau and Mababe were the most affected.

Out of the affected people, it was reported that males were mostly affected as compared to females, and that more than 30 per cent of the affected were children. The most affected areas were said to be schools.

Dr Pusoentsi explained that malaria infection in humans was mainly transmitted through the sting of the female anopheles mosquito, adding that the disease in people could present clinically as either uncomplicated, complicated or asymptomatic, especially for people living in malaria endemic areas.

She stated that prevention of malaria remained a priority with strategies aimed at vector control. She said two strategies have been used to control mosquitoes in the area such as indoor residual spraying and the distribution of the long lasting insecticide treated nets. She added that 57 000 nets having been distributed across the country.

Regarding indoor spraying, Dr Pusoentsi revealed that for the transmission period of 2016/17, the district achieved an average of 69 per cent coverage as compared to the 85 per cent target.

Asked if the district was winning the battle, she said they were on the right track as health officials have doubled up efforts to tackle the epidemic.

She said social mobilisation was effective as the community and leadership were taught to make malaria a priority in their agenda, adding that if one member of a family was affected, chances were high that the rest of the family were also at risk.

Furthermore, Dr Pusoentsi explained that many opportunities still existed at community level to effectively control the spread of malaria, citing the cleaning of surroundings to minimise the breeding spaces for the mosquitoes.

Another strategy was to work collaboratively to ensure community knowledge and participation during the epidemic period. She urged the community to visit health facilities if they experience any symptoms of malaria so that they could be assisted on time.

She noted that common signs and symptoms include high temperature, headache and rigors, pallor and vomiting.

Dr Pusoentsi also noted that Botswana was among the countries which were aiming to eliminate malaria by 2018, adding that as part of the strategy, all efforts and investments had been put in place to control the spread.

Effective surveillance mechanism, she said had been put in place to monitor the disease burden and response efficiency at all times.

In addition, she pointed out that case management and drug supply had been strengthened to ensure quality management of cases of malaria to avoid deaths. (BOPA)

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