"I had always asked my family members to sit outside for one or two hours at night just before bedtime, when I usually spray the bedroom with indoor sprays," says Hajia Hauwa Abiso, who lives in the north-eastern Nigerian state of Borno. "Little did I know that mosquito bites during this period were enough to infect them."
When she learned about the danger of mosquito bites at night, she worried that her 3-year-old child might be infected with malaria. "Since my child received the antimalaria drugs given during the campaign, and I started to use lessons from the radio drama on household practices for malaria prevention, my children have hardly fallen ill of malaria," she explains, with great relief.
Hajia Hauwa is the mother of one of the 1.2 million children younger than 5 years reached in four cycles of house-to-house campaigns since 2017 by the World Health Organization (WHO) and partners in Borno State with the seasonal malaria chemoprevention.
WHO recommends the intermittent administration of full treatment courses of an oral antimalarial medicine to children in areas with high transmission rates during the malaria season.
Even though malaria control in Borno State remains a public health challenge, there are suboptimal availability and use of prevention and treatment interventions, such as insecticide-treated bed nets and accessibility to health facilities for diagnosis and treatment using quality-assured artemisinin-based combination drug therapy.
WHO estimates that more than half of the recorded deaths in Borno State in 2018 were due to malaria combined with malnutrition – more than all other causes of death combined, including cholera, measles and hepatitis E.
Seasonal malaria chemoprevention targets the protection of young children from malaria infection. A recent impact survey by WHO showed promising results on malaria morbidity and mortality in the state. Based on the incidence of malaria in children aged 3–59 months in 20 randomly selected clusters (using National Immunization Programme sample in 16 local government areas of Borno, the findings indicated fewer cases of malaria among children who participated in the seasonal malaria chemoprevention campaign, compared with children who did not receive the treatment.
The survey findings also showed that children living in areas where the campaign did not take place are at higher risk of malaria infection (at 16%), compared with children who received the treatment (at 5%).
"WHO is impressed by the results of the survey. It confirms our recommendation, and we urge health authorities to conduct seasonal malaria chemoprevention campaigns as a cost-effective and safe means to prevent malaria across the Sahel sub-region of Africa," emphasizes Dr Matshidiso Moeti, WHO Regional Director for Africa.
With assistance from WHO, the Borno State Ministry of Health developed a strategy for malaria control in north-eastern Nigeria, with the seasonal malaria chemoprevention treatment as a critical tool for rapidly reducing malaria death and disease among young children.
"In emergencies such as in north-eastern Nigeria, the most effective ways to reduce morbidity and mortality due to malaria among children living in vulnerable conditions is through preventive measures, such as use of insecticide-treated nets, seasonal malaria chemoprevention and the provision of real-time lifesaving messages for prevention," stresses Dr Clement Peter Lasuba, Officer in Charge for WHO Nigeria.
Borno State Malaria Programme Manager, Mala Waziri, agrees: "From the impact assessment of the seasonal malaria chemoprevention exercise in Borno State, it is evident that the intervention has helped to reduce the incidence of malaria in households, as less cases are reported in the clinics than previously."