THE Government of Zimbabwe, through the Ministry of Health and Child Care (MoHCC) in collaboration with the World Health Organization (WHO) and other stakeholders in malaria control is carrying out a study on a malaria prevention approach in Chiredzi district, Masvingo province, through a project called the AFRO II Project, a multi country initiative which aims at developing measures which are environmentally sound and effective for malaria vector control.
By Michael Gwarisa
The AFRO II Project is a research study that is aimed at gathering evidence for additional/alterative interventions against malaria vectors. In Zimbabwe, the study was launched in 2019 and is supposed to be carried over a five-year period
Speaking on the sidelines of a project field visit in Chiredzi, Mr Wilson Chauke, the National Vector Control Officer responsible for strategizing Malaria preventive interventions in the Ministry of Health and Child Care said the AFRO II Project was not replacing existing control measures as such but adding to existing Malaria prevention and control mechanisms.
The project has been here for about two and half to three years now but because of the COVID-19 pandemic, we couldn’t expedite the implementation but now we are almost getting to the implementation stage.
“Currently, Zimbabwe is using chemical based vector control interventions and the AFRO II project is going to assess effectiveness of house screening a non-chemical-based intervention. You know chemicals have an environmental impact which should be avoided at all costs. Should this project succeed, we look forward to having an additional intervention which is environmentally friendly,” said Mr Chauke.
He added that even though areas such as Chiredzi were still having high malaria disease burden, the country has undergone epidemiological improvement in as far as malaria control is concerned. Zimbabwe has moved from having 47 high Malaria burden districts to 29 districts, which are still classified as high burden with an annual parasite incidence of 5 per 1000 population. Twenty nine districts had since been rolled out to initiate Malaria elimination activities by December 2020.
Mr Casper Tarumbwa, the WHO National Coordinator for the AFRO II Project, said they would need an extension to fully implement and conclude the project as the project had been interrupted intermittently by the need to comply with COVID-19 control measures such as lockdowns and travel restrictions.
“This project is owned by the Ministry of Health and Child Care and WHO`s role is that of fund administrator and offering technical assistance. We first came here in Chiredzi to do community mobilization. We met the political and traditional leaders, local NGOs and even the security forces to sell the idea of the project. Following several other visits in 2020 to recruit and train data collectors we returned in May 2021 to do the baseline study of the project which was aimed at selecting 800 eligible houses,” said Mr Tarumbwa.
Due to increased irrigation activities in Chiredzi district coupled with high temperatures Malaria remains one of the leading causes of mortality and morbidity in the low veld.
Meanwhile, Dr Brian Dhlandhlara the District Medical Officer (DMO) for Chiredzi said the district records Malaria outbreaks almost twice every year and lives are lost especially among vulnerable groups such as pregnant women and children.
“So far, we have been doing Malaria vector control through Indoor Residual Spraying (IRS) which is done every year. We have also been distributing insecticides treated mosquito nets and this is also complemented by case management/treatment. We have also been engaging the community to ensure that there is social and behavior change to avert the scourge of malaria,” said Dr Dhlandhlara.
Vector control is either through IRS or larviciding. Larviciding is spraying of chemicals on the water bodies to destroy the larval stage before it develops into a full blown mosquito. IRS on the other hand is where a team visits a malaria hotspot to spray the inside walls to deposit chemicals which will kill the mosquitoes which cause malaria when they land on the walls. Case management is where all positive malaria cases will be treated using recommended medicine by trained health workers.
The results from the AFRO II Project are expected to assist in overcoming challenges such as reliance on chemical-based malaria vector interventions that are prone to resistance, scarcity of human and technical resources, and inadequate capacity for the enforcement of policies related to production and safe use of insecticides. The multi-sectoral approach to the implementation of the project will also enhance collaboration between the health and other relevant sectors with regards to developmental projects impacting on health.