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article imageQ&A: How Mozambique is preparing for the malaria threat Special

By Tim Sandle     May 12, 2019 in Health
As the floodwaters recede after Cyclone Idai, Doctors Without Borders' response to the natural disaster is preparing for the next health threat in Mozambique: malaria. To gain an insight of what is happening on the ground, we spoke with a malaria expert.
As the malaria season approaches—and considering mosquitoes breed in stagnant and standing water and the fact people are sleeping in open areas and without mosquito nets— Doctors Without Borders / Médecins Sans Frontières is working to combat what we expect to be an abnormally large peak of malaria through preventative measures like distributing mosquito nets.
Typically, after a disaster hits a malaria-prone area, as with Mozambique and Cyclone Idai, the mosquitoes will wash away at first and cases will be low for the first few weeks, but then there's typically a surge in cases once the mosquito population re-establishes itself. The rate of that differs depending on the species.
With Mozambique it is excepted that mosquitoes that transmit Dengue Fever will recover to the stage where they can transmit the disease again a couple weeks—slightly sooner than the mosquitoes that transmit malaria.
To gain an insight into what needs to be done, Digital Journal spoke with Dr. Tomas Jensen, Doctors Without Borders / Médecins Sans Frontières' Tropical Medicine Advisor.
Digital Journal: What are the current trends with incidences of malaria globally?
Dr. Tomas Jensen: Overall the number of cases has been decreasing over the last decade, but unfortunately we are now seeing that this positive trend is stalling and that the burden has plateaued. There are also some pockets of worsening trends, in particular in places where conditions are already difficult due to conflict or other causes of poor access to the populations.
DJ: How effective are preventive action proving?
Jensen: We have some quite effective preventive tools like mosquito nets that have been treated with insecticides, and preventive distribution of antimalarials. How effective they are often depends on how easy access we have to the population targeted.
DJ: Is there any evidence of the parasites gaining resistance to anti-malarials?
Jensen: Yes. All of the antimalarials that have previously been used have eventually become ineffective due to the emergence of resistant parasites. The current artemisinin-based combination therapies, or ACTs, are still effective in most of the world, but there are some worrying indications that resistance is again starting to emerge in parts of South East Asia.
DJ: What are the concerns specifically for Mozambique?
Jensen: The main issue is that flooding leads to more stagnant water which provides breeding ground for mosquitos and therefore a risk of much more cases of malaria (and other mosquito-borne infections).
DJ: What measures need to be taken specifically for Mozambique?
Jensen: For malaria we need to prepare ourselves for an increase in cases. Making sure that a good surveillance system is in place so that we can detect if there is a sudden increase. Making sure that preventive tools such as mosquito nets are used. And ensuring that the population have access to testing and treatment.
More about Malaria, Environment, Mosquito, Global warming, Cyclone
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