Literacy and malaria – a public health debacle


Being educated is not enough to prevent malaria – why is this so?

Earlier today, we reported that sub-Saharan Africa is going to benefit from the world’s first malaria vaccine. It is perhaps the epitome of decades of malaria research. Even as we await the roll-out of the vaccine, we need to contend with interesting yet sad malaria and other health statistics.

For instance, most deaths in children under five years and pregnant women are due to illiteracy and low socioeconomic status; it has also been revealed that education can have a positive impact on the malaria burden – yet a lot of educated folks are taking malaria for granted thus increasing figures and therefore the burden of malaria in Nigeria. In my clinical practice, I’ve encountered several of such. Let me introduce you to Mr. A. O.

He is a 36-year old engineer who brought in his 3-year old daughter to the emergency unit on a fateful Thursday evening. “Please help me, I don’t understand her again,” he yelled.

During resuscitation, history revealed that the girl experienced fever for over two weeks – more in the evenings as she still went to school during the day and she ate well until 2 days prior to the day of presentation when she was noticed to be too weak to go to school though she still managed to smile and play with her daddy.

But suddenly, that evening, her father noticed she was not responding to him again as she became restless and he could not understand what was happening. He said they gave her paracetamol every evening whenever the fever was up, since they had it at home and it always lowered  the fever, he said he thought of buying her an antimalarial drug but was busy shuffling between work and hospital, before he would get home, he would have forgotten.

The mother is a 31yr old pregnant woman admitted in the same hospital 4 weeks prior to the due period for adequate bed rest, thereby making her unavailable to cater for the girl; but she had people at home taking care of her.

Examination revealed a restless, severely pale (paper white), febrile (hot), moderately dehydrated girl.
Before resuscitation and preparation for blood transfusion could be completed, the young girl died, all effort to resuscitate and save her life proved abortive, it was a depressive situation.

“Don’t tell me my girl is no more, my happy, lively, active fine baby, no way,” the father lamented. “How will I face my wife, this is not good.”

This is a major problem no doubt

Malaria still kills Nigeria’s under 5 children somehow like the avian influenza kills chickens. Mr. A. O.’s daughter is just one of the several that die annually from malaria. A lot of work, researches and funds have gone into the development of malaria treatment from different organizations and bodies – some have worked on vaccines and prevention, and there have been improvements in the prevention and management of the disease worldwide which is why the mortality rate among children under five fell by 65% worldwide and by 71% in Africa between 2000 and 2015.

In Nigeria, we’ve been made to know that anybody with high body temperature has malaria until proven otherwise, so it’s not a matter of maybe people are aware of the signs and symptoms of malaria or not, but a lot will not present early in the hospital because they can easily get anti-malaria medications at the ubiquitous pharmacy stores around until it becomes too late. High body temperature is just one of the symptoms, there can be chills and rigor, loss of appetite, vomiting and feeling of sickness and if not taken care of can lead to loss of consciousness and death.

Not a hopeless case

Don’t get me wrong, malaria is not a hopeless disease as we are in the malaria endemic environment, it is both preventable and curable. It can be prevented by cutting bushes around the house, ensuring no stagnant water in the premises, preventing mosquitoes from entering the house by netting all the windows and doors.

You can also prevent bites from those already inside by using insecticide treated nets and insecticides for the whole house. Insect repellent creams can also be rubbed on the body to ward off the insects.

I strongly believe that early presentation is the most important aspect in the management of malaria to arrest the disease. We can stop the disease progression and ensure prompt recovery from malaria. We all need to work together to prevent untimely deaths in our communities, discourage self treatment and make our young ones survive.

“Global technical strategy for malaria is the new WHO agenda to combat malaria endorsed by the 68th world health assembly,” said Dr Tolu Arowolo on the occasion of the 2016 World Malaria Day. “It entail a lot of steps and we all need to put in our support in order to end malaria in Nigeria and live in a world free of malaria.”


About Author

Dr. Victoria Adepoju provides special insights into topical issues as they affect various stakeholders in the health sector with special emphasis on day-to-day operations of the various units in the hospital. She has vast experience reporting health and continues to cover major events for

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