Malaria making a comeback

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A slow but sure increase being witnessed in the number of malaria cases within the first four months of 2022 has the Anti Malaria Campaign (AMC) concerned. As the Directorate continuously remind the public, the parasite may have been eliminated but the mosquito- Anopheles is still very much a live and very present.

According to the Centre for Disease Control and Prevention (CDC) an infected mosquito can carry the disease from one human to another, while infected humans transmit the parasite to the mosquito. But, “in contrast to the human host, the mosquito vector does not suffer from the presence of the parasites.”

 In 2019 the number of malaria cases in the country were 53. The cases reduced in 30 in 2020 owing to the Covid-19 situation. Numbers declined further by 2021 and dropped further 26 of malaria.

However, 2022 seems to be another ‘kettle of mosquitoes’ as within the first four months of this year a total 17 cases of the mosquito borne disease was identified by medical professionals.

Reduction in cases from Dambadiwa

The AMC Director, Dr. Prasad Ranaweera observed that with Covid the number of pilgrims to Bodhgaya had seen a decline. In contrast the number going to African countries during this period increased. A majority travelled to India for either studies or on pilgrimages to Bodhgaya.   

In 2020 the AMC detected only one case from among those who had travelled to Western Africa. While those remaining were those who had been to malaria endemic India. But tables turned as it may seem as the numbers to African countries have spiked since. 

Malaria from Africa

In 2021 the country only saw one malaria case from India while the remaining 25 persons were those who had flown to African countries.

Out of the 17 cases detected this year, seven persons have been to Africa, he pointed out. The concerned Director noted that previously majority of those who visited Africa were those who travelled for business purposes such as gem dealers, while there were members from the Sri Lankan Security Forces who travelled to African countries as UN Peace Keeping Forces.

Change of purpose

That trend too has changed since of late as a majority travelling to Africa now were illegal migrants.  Dr. Ranaweera said that illegal migration had become a challenge for the AMC. A large number of those who contract malaria once they return to the country don’t even want to reveal the fact that they have been to a malaria endemic African country. The numbers travelling to Africa has risen to about 30 persons a day. So much so that the AMC fears that there would be more cases hospitalised by September this year if timely precautions were not taken by creating more and more awareness among the general public.

Those who return after spending just three months in Africa are those who have been unable to gain passage to Europe.

At least, 30 locals travel to African countries daily, a majority of them stay for three months till they can obtain visas and then travel to Europe or Canada, he said. “Most of persons leaving for Africa say that they are going for employment purposes, but are not aware of which part of Africa they would be traveling to when asked.

The AMC is not bothered if their trip to Africa is legal or illegal, what matters is if they develop a fever after returning they should test for malaria,” he said. Dr. Ranaweera recently appealed to those travelling to Africa or any malaria endemic country to test for malaria should they develop a fever within one year of their returning.

Dr, Ranaweera said in December, last year, two cases had been detected from Jaffna, Also, there was another case detected from Mannar this year “twelve years after the detection of the last malaria case in the country,” he said.

Most travellers went to lesser-known countries in the African continent and were very vague about their travel history once they contracted the disease, leave alone when they come to obtain the medication given before traveling to a malaria endemic country. “Some of the don’t even want to own up to having a passport.”

The AMC Director said that the Northern Province health authorities whilst assisting largely to curtail the spread when cases were detected from Jaffna and Mannar had pointed out the increasing number of cases being detected from that director of the globe.

Call for support

Addressing a recent Media briefing the AMC Directorate said that it dispersed the necessary preventive drugs to those traveling to malaria endemic countries beforehand. Therefore, before giving them, those who are travelling should be able to produce their passport and any letter that they receive; be it a job offer or any such papers in this regard before obtaining the medication.

Economic crisis

The last case of indigenous malaria was reported in the island in October 2012. The country was well ahead of the targeted date of 2014 end. But the AMC’s worst fears may be realised owing to the current surge of people flying to foreign countries in search of greener pastures owing to the current economic crisis. According to Dr Ranaweera there were at least 30 persons flying to Africa. Therefore, not only the people and the AMC, but the hospitals too may have to be on guard for the possible cases of malaria. One case that is unidentified may lead to so many more cases of the mosquito borne disease. 

By Dilanthi Jayamanne