AFRO 2: the malaria project changing African lives

APA-Windhoek (Namibia)

About ten kilometres on the eastern outskirts of Rundu is the Mayana village, an area characterized by flood plains. In fact, Mayana means flood plains in the local dialect and is named after the low-lying ground surrounded by water.

“We have a lot of water bodies down here and mosquitoes breed everywhere,” explains Johannes Lipayi, the AFRO 2 Malaria project coordinator for Mayana and Sikondo villages, situated in the Kavango East and West regions. 

The village is in one of five districts among the five regions selected to participate in malaria cases reduction study because of the high number of malaria cases and deaths in those areas. The other districts are in Omusati, Oshikoto, Ohangwena, and Kavango West. The study was part of the World Health Organization's (WHO) continuous efforts to support Namibia in its fight against malaria. 

This three-year pilot project was implemented in 2018 with the aim to reduce malaria transmission through larviciding while also using environmentally friendly chemicals. 

“We were trying to see if the water bodies where mosquitoes are breeding if treated with a biological agent would contribute to reducing the mosquitoes transmitting malaria,” explains Dr Florence Soroses, the Malaria National Project Coordinator with the WHO.

“Before the implementation of the project in this village we had a lot of malaria cases and deaths. But as soon as the program started the cases started to decrease,” explained Lipayi. 

The community has always been open to the initiative. When word of the project spread, the community gathered in large numbers at the house of the headman to enquire how they could be involved, explained Lipayi. 

“When we compare this village to others where this project has not been implemented you can tell the difference,”said Lipayi. 

In 2020, 13,633 malaria cases were recorded in Namibia. Out of this number, 40 people died from malaria. In 2021, 13,740 malaria cases were recorded in the country. The number of deaths decreased to 15. 

“Even when we were reporting the data, we could see a decrease in malaria cases compared to previous years before the project was implemented,” said Lipayi. Meanwhile, Markus Kamburu is a 42-year-old father of five children. For the past three years, Kamburu was employed as a Field Operator on the malaria project in Mayana village. His work schedule started as early as 6 in the morning, and sometimes, he would need to work night shifts depending on the labour. 

Kamburu’s duties included larval habitat mapping, larviciding as well as setting up the CDC light traps for adult mosquito collection. In addition, Kamburu and two other teammates also had the responsibility of conducting larval surveys, a process which includes the monitoring of mosquito larvae activity and density in the breeding sites. They started by counting the number of households in the village and found the village has 3,365 houses. Out of these 20 houses were randomly selected to be part of the study.  The team identified 65 breeding sites. These breeding sites hold water during the rainy season which can be anywhere between December and May. Some breeding sites have water throughout the year. 

“These are the breeding sites that we always monitor to see if there are some larvae. If there are larvae, we larvicide. At the very beginning, however, we started with the mapping process and then we did the larviciding for the breeding site which we identified if there were some larvae there,” explained Kamburu. 

Kamburu says he had no prior knowledge of identifying larvae and neither did he have any technical knowledge of malaria. He was appointed by the village headman in 2018 when the project started. 

“The chemicals we use for larviciding were very impressive because when we use them, we expect to find larvae in two to three days when we get back. We will find the larvae floating already. We were also collecting adult mosquitoes. Even while the mosquitoes are adults, we still collect some. So, this process was really fighting the mosquitoes at all the stages of their lives and therefore reducing malaria,” explained Kamburu. 

In addition to larviciding, Kamburu says the team also uses the prokopack aspirators, which operates as a vacuum to collect outdoor resting adult mosquitoes. This process is usually conducted in the early morning hours. For indoor resting mosquitoes, they use the CDC light trap to catch the adult mosquitoes overnight. 

“These are the methods we use to collect the mosquitoes in the village,” he explained.  After collecting the data, the team records and sends samples for further analysis to their supervisor, Dr Soroses in Windhoek. “We have an organised system that we use to record and send the data to Dr Soroses,” explained Lipayi. 

The WHO injected N$1 million towards the project. In May, the funding for the project officially came to an end, with the community and the WHO hailing it as a success. The Country Representative, Dr Charles Sagoe-Moses said the difference the project has made in the community shows that “the biological agent used works in malaria control”. 

Joseph Mbamba says the knowledge and experience he has gained from the project are invaluable. “I go out in the community to raise awareness on malaria. I also take the equipment to demonstrate how we do our work,” he added. The project also helped him financially because he was able to pay for his son’s higher education. 

“The WHO invested a lot in these people. My hope is that the Ministry of Health and Social Services or the private sector will take over the project so that their knowledge will not be wasted,” said Lipayi. He also fears that malaria cases will increase again.

 “These people know the methods that are used in malaria control, and they are very well informed about that. They attended annual workshops and training and now it’s up to the government to look at their plight and take over,” said Lipayi.  Echoing similar sentiments, the headman of Mayana village, Berthold Shinimbo called for investments in the malaria project. “This will enable the community to take over. As you can see, we have a high unemployment rate,” said Shinimbo. The AFRO 2 project was implemented with the goal to strengthen national capabilities for the implementation and scaling up of evidence-based, innovative, diversified and environmentally friendly malaria vector control interventions with a particular focus on winter larviciding as an additional vector control tool to achieve malaria elimination by 2022. The project was also implemented in Botswana and Eswatini. 

Courtesy of the WHO

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