How mosquito nets are being misused

Shamiso Yikoniko
Zimbabwe has made significant strides in fighting malaria but these gains risk being reversed due to the non-usage and mis-usage of treated mosquito nets. The country, which is standing very proud, reached a pre-elimination stage after reducing the malaria incidence rate to 4,9 percent and surpassing the Abuja 2010 target of 6,8 percent.

However, the gains achieved in the fight against malaria are now in a reverse mode as individuals in some malaria-endemic areas are misusing treated mosquito nets by turning them into fishing nets, fowl runs nets and for granary purposes.

Malaria endemic areas in Zimbabwe include Gokwe, Kariba, Rushinga, Muzarabani, Centenary, Mbire, Matebeleland North, Guruve, Mt Darwin, Mazowe,Zambezi Valley, Triangle, parts of Chipinge and Matebeleland South.
Gokwe South district medical officer, Dr Takunda Sola expressed concern on the misuse.

“Though, it’s difficult to quantify how many mosquito nets are being misused, it’s a pity that people aren’t taking heed of their health safety,” he said.

“Our health promotion officers educate the community on the importance of sleeping under treated mosquito nets but the final decision lies with the user.”

“In Gokwe South district, we are entering into a pre-elimination stage for malaria and it’s worrying when we have some people not using the mosquito nets or misusing them,” he added.

Malaria is caused by plasmodium parasites. The parasites are spread to people through the bites of infected anopheles mosquitoes called “malaria vectors”.

In an individual with compromised immunity, symptoms of malaria appear seven days or more (usually 10-15 days) after the infective mosquito bite. These include fever, headache, chills and vomiting. If not treated within 24 hours, malaria can progress to severe illness often leading to death.

Children with severe malaria frequently develop one or more of the following symptoms: severe anaemia, respiratory distress in relation to metabolic acidosis or cerebral malaria.

Of the country’s 62 districts, 45 are malaria-prone, with 33 categorised as high burden malaria areas.
People who shy away from using treated mosquito nets claim that the nets make them itchy. Dr Sola, however, explained that people feel the itchiness because they do not follow instructions for the usage of mosquito nets.

“Before using the treated mosquito nets, they are supposed to be washed. And due to the fact that some people don’t follow specified instructions, they then feel the itchiness,” he explained.

The Government’s vision is to have a malaria-free Zimbabwe and the goal is to reduce malaria incidence from 95 per 1 000 in 2007 to 10 per 1 000 by the end of this year as well as to reduce malaria deaths to near zero.

In Zimbabwe, the malaria burden has decreased significantly over the past decade from an average of two million and 5 000 deaths per year in the early 2000s to below 400 000 cases and less than 300 deaths per year.

In 2013, 326 people died from malaria while 386 505 cases were reported countrywide.
For the year 2014, 518 030 cases were recorded with 717 deaths.

About 90 percent of the population that is at risk of contracting malaria is protected by indoor residual spraying while 83 percent use nets.
The distribution of treated mosquito nets and the spraying is usually carried out before the rainy season. The Ministry of Health and Child Care’s malaria control manager, Dr Joseph Mberikunashe said the Government is prepared for the upcoming season.

“We are prepared for the upcoming season in terms of prevention and treatment,” he said.
“We are anticipating to be carrying out spraying and distribution of nets in the third week of September until the end of December.”
Nevertheless, Dr Mberikunashe cited some challenges in the malaria programme.

“The malaria programme faces some challenges such as the timely response to outbreaks due to resource constraints and also lack of personnel due to competing programmes such HIV and TB,” he explained.

“However, despite these challenges, we have managed to realise significant reduction in malaria morbidity and mortality.”
According to the Zimbabwe National Statistics Agency (ZimStat), over 50 percent of the country’s population is at risk of contracting malaria despite the introduction of several measures to combat the disease.