Interview

Malaria must be diagnosed & treated

- Dr. Denis Nsame, Director Limbe Regional Hospital

                Cameroon on 25 April 2018 joined the rest of the world in commemorations marking World Malaria Day, celebrated under the theme: “Ready to Beat Malaria”. Malaria is one of the deadliest diseases affecting Cameroon with a death toll of about 3000 people annually. It is for this reason that the ministry of public health disbursed 40 billion for the national fight against malaria in March 2018. The commemoration of world malaria day by stakeholders is important because it provides an occasion to highlight the need for continued investment in the fight, prevention and control of malaria. In this exclusive interview, The Median’s Ticha Melanis, caught up with the Director of the Limbe Regional Hospital, Dr. Denis Nsame, who gave answers to questions on the spread, prevention, treatment and control of malaria. Read on!

              

Dr. Denis Nsame, Director Limbe Regional Hospital

  **What is malaria and how is it contracted?

                --Malaria is a chronic infectious disease caused by a parasite called plasmodium which has about 5 types in humans and with the most dangerous being Plasmodium Falciparum.

                **How does the parasite find itself in humans?

                --This parasite has a vector which is the female Anopheles Mosquito. People get malaria by being bitten by an infected Anopheles Mosquito that must have been infected through a previous blood meal taken on a person who is infected. Since the parasite is found in the red blood cell of an infected person, malaria can be transmitted through blood transfusion, organ transplant and from a mother to her unborn baby {congenital malaria}.

                **When does one suspect he has malaria?

                --It can take close to two weeks for one to have signs and symptoms of malaria from the time the female anopheles mosquito bites you. This is because the parasite has a circle (incubation period) to go through before it develops to malaria. Early symptoms are fever, headache, body pains and joint pains. Signs for complicated malaria include digestive problem, vomiting and loss of consciousness. If you have these complicated symptoms it means the malaria disease is severe. Malaria is classified into two types: simple and severe malaria which is very dangerous.

                **How is malaria cured?

                --It is interesting to note that Malaria is one of the parasitic diseases that have a cure. Before talking of the cure, I want to let you know about the preventive method called ATCs which are first line drugs like Quaterm. When it is severe we give the patient antimonite injections or quinine injections.

                **So how has the Limbe Regional Hospital been tackling the incidence of malaria?

                --The regional hospital Mile 1 Limbe being a reference hospital handles complicated cases because of the health system. We have very severe cases of malaria from the health centers and districts hospitals transferred to the regional hospital. It is difficult to find cases of simple malaria in the regional hospital because we have a community action that provides malaria treatment on the field. The statistics of simple malaria received by the regional hospital from 2015- 2017 are 1716, 2367, 3048 cases respectively. For severe cases from 2016 -2017 we had an increase of 227 cases. Actually malaria is always on the increase. We are happy because malaria in pregnancy dropped from 404 in 2016-217 in 2017 and this is very encouraging to the pregnant mothers and the hospital. The regional hospital sensitizes patients on the causes, prevention and proper case management of malaria in the hospital premises since we don’t do outreach programs.

                **How can malaria be prevented?

                --Prevention is at the level of the vector that is, preventing the mosquitoes from biting us by using long lasting insecticides treated bed nets. Surveys were carried out to find out how many houses have mosquito net and statistics show that 69% of households in the Southwest have bed nets. A survey was also done to see the usage of these nets which stands at 59% showing that the population needs to sit up. Preventive treatments mostly target pregnant women and infants because they constitute the population at risk of getting malaria and dying from it. Preventive treatment is equally given to people who come into the country from areas where malaria is not prevalent. A good preventive strategy is to drain all standing water around your environment. This prevents the breeding of mosquitoes. 

                **What are some of the worst malaria cases that the RH has received?

                --We had a pregnant woman of about 26 years with severe malaria who gave up the ghost after few days of admission and a 27-year-old boy who went into coma due to severe malaria but thanks to God he is responding to treatment. We have had other complicated cases of malaria in children which leads to convulsion and more. As I speak the pediatric ward is full with malaria cases.

                **Can one be re-infected with malaria after receiving treatment?

                --Yes, because when you take treatment there is no vaccine that can produce anti bodies against the disease. So when you expose your body to the mosquito bite, you get re- infected. The mosquitoes bite mostly during dusk and dawn.

                **What are some of the things the Regional Hospital plans to do to step up the fight against malaria?

                --We will continue carrying sensitization on prevention; case management that is appropriate treatment, monitoring and equation of cases of malaria etc. We will use the press to educate and sensitize population on the causes, prevention and treatment of malaria and equally put posters everywhere for people to read and know what to do when they have the symptoms. We advise people to avoid buying drugs from the roadside. When you have signs and symptoms of malaria, rush to the hospital for proper diagnosis and treatment. People should sleep under treated mosquito bed nets. The nets are not meant for fishing or the protection of smoked fish.

                We will continue with regularly surveys to gather reports on cases and treatment of malaria from all approved health facilities and report to the ministry of public health for better management of the disease in the country. We have partners like the global fund which is the main partner in the country, dialogue structure, health committees and voluntary people in the society that works with us.

                **What are some of the challenges faced by the Regional Hospital in the fight against malaria?

                --We have shortage of staff from the human resource department which leads to the staff being over worked, shortages of blood ban; children carry the highest burden of complicated cases of malaria that often need blood transfusion but are faced with shortage of blood because people don’t donate and at times have stock out of the free drugs of malaria.            

  **What do you think can be done to solve some of these challenges? 

                We appeal to the population to come freely and donate blood that will save a life; voluntary donors from 20-50years. We need to recruit more personnel to engage in fight against the disease. Concerning the stock out of drugs, the minister is doing his possible best to always make sure the regional fund is having these drugs so that we always have enough stock. We make our request early enough. If all these are taken into consideration then we will be moving toward to eradicate malaria in our community.

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Dr. Denis Nsame, Director Limbe Regional Hospital