Malaria cases have increased dramatically in the Democratic Republic of the Congo (DRC), leaving clinics and treatment centres unable to cope, Médecins Sans Frontières (MSF) has warned.
The number of people treated for malaria in MSF projects has soared by 250% since 2009 in six provinces — half of the vast African country — and accelerated even more sharply in recent months.
The reasons for the trend are not clear, although it is thought renewed fighting by militia groups has made it increasingly difficult for people to access prevention and treatment for the mosquito-borne disease.
The agency said the rise was particularly alarming because of a high number of severe malaria patients requiring hospital care and urgent blood transfusions due to anaemia. It has deployed additional emergency medical teams in four provinces but is unable to respond in all affected areas.
“Treatment outside the cities remains especially weak, due to unaffordability or geographic inaccessibility,” said Dr Jorgen Stassijns, a malaria specialist for MSF. “In some areas, healthcare is simply non-existent. Even when treatment is available, the drugs are sometimes inadequate or outdated.”
In 2009, MSF’s teams treated more than 45 000 people with malaria. In 2011, the total rose to more than 158 000. So far this year, more than 85 000 people have been treated.
Renewed fighting
Violence involving armed groups may be a primary cause of the increase. Villagers are sometimes too scared to sleep under anti-mosquito bed nets and leave them behind when they flee.
In North Kivu and South Kivu provinces, and recently in the northern area in Katanga province, insecurity and renewed fighting prevent people obtaining healthcare, MSF said.
In the Maniema, Orientale, Equateur and Katanga provinces, overstretched health systems also make it difficult for people living in endemic areas to access prevention and treatment for malaria.
MSF quoted an unnamed nurse at a clinic in South Kivu as saying: “Some of our patients come from 10km away to our health centre, on foot, bicycle, motorcycle or in a canoe if they live on the peninsula: most of them are ill with malaria.
“Each week we treat about 600 to 900 patients, often more than 100 patients per day. MSF distributes mosquito nets daily. They are given to pregnant women during their prenatal consultations, as well as to children who test positive for malaria and are under the age of five.
“Often people had used the mosquito nets at home but they lived in a conflict zone and, when they fled, the nets were left behind or were stolen. This is part of the reason why we have been seeing more people with malaria.”
‘Near-zero’ deaths
Malaria is the leading cause of death in Congo, killing about 300 000 children under five every year. Wednesday is World Malaria Day. The global campaign to fight malaria is appealing for $3.2-billion in a bid to reach the UN goal of “near-zero” deaths from the disease by 2015.
Alex Perry, author of a book about the international effort, Lifeblood: How to Change the World, One Dead Mosquito at a Time, said: “This latest news from Congo compounds a bad few months for the global campaign against malaria.
In February, a Lancet study said the number of deaths each year was 1.2-million, not 655 000 as the campaign claimed. Earlier this month, researchers found evidence that resistance to the main treatment, artemisinin, was rising in Asia. Now, despite earlier success in distributing nets, we have this unexplained spike in deaths in the DRC.
“It underlines how little [is known] about one of the world’s oldest diseases and how difficult, despite all the billions of dollars that have been thrown at it, it is to control. There is no doubt malaria deaths have come down dramatically in the past five years.
Equally, there is no doubt that this remains a formidable battle in which the lives of millions are at stake.” —