Malaria in Madagascar Research Paper

Document Type:Research Paper

Subject Area:Health Care

Document 1

Geographical reasons such as heavy rainfalls and presence of dangerous malaria parasites like P. falciparum in the region mainly explains malaria prevalence. The importance of addressing the issue of malaria in Madagascar is that it affects most children below the age of five and is the major cause of mortality and morbidity in the country. The study recommends the use of long-lasting insecticidal nets together with indoor residual spraying to deal with malaria. The suggested strategy of intervention is expected to work because previous studies show the high effectiveness of these two interventions when combined. For about two centuries, the Malagasy people have suffered from malaria2 but at the beginning of the century, the rate has declined substantially. This rate seems to have skyrocketed once again, causing an overload in the available healthcare amenities.

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Research shows that despite the interventions that have been previously implemented to curb malaria in Madagascar, the rate is still remarkably high. Health Profile The health profile of Madagascar will be discussed in relation to the country’s nutrition profile among other things. Malnutrition is a major reason for disability and death in the world. million and is the fifth biggest island in the whole world. Forty-one percent of the whole population consists of individuals under the age of 15 and 64 percent of the entire population also reside in rural areas. The rate of fertility in Madagascar is said to have declined over the years but it is still evident that this rate is very high. By 2030, the population in Madagascar is expected to increase to about 34. million. The country has had decreased investment in its infrastructure and this has impacted negatively on the efforts towards curbing such diseases as malaria4.

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Therefore, malaria continues to be the major priority in the healthcare system in Madagascar. Physical Environment In relation to the environment or the climate in Madagascar, the country is highly vulnerable to climate-related hazards and climate change. In every year, the country is said to experience a minimum of three natural disasters. In the year 2017, the Enawo cyclone and delayed rain season led to damage that amounted to $400 million, which is 4 percent of the real GDP and about 20 percent decrease in the country’s agricultural activity. The level of inequality and poverty varies depending on the age, gender, place of residence and household structure. Between 2001 and 2001, the level of poverty and inequality increased to 75 percent from 71 percent. According to USAID, Madagascar is said to be at position 153 out of the total 157 countries in relation to the progress made towards achieving the Sustainable Development Goals.

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Different groups of individuals have different experiences related to health. In Madagascar, the health profile of the country in relation to inequalities shows a wide parity between the rich and the poor due to the high levels of individuals living under poverty. The infected female mosquitoes known as Anopheles mosquitoes are the carriers or malaria vectors and these bite humans, infecting them with malaria. The five common parasites are Plasmodium falciparum, Plasmodium vivax, Plasmodium ovale, Plasmodium knowledge and Plasmodium malaria. Of these five, P. vivax and P. falciparum are said to be the most dangerous and P. Fringe areas, also known as intermediate altitudes are said to have seasonal transmission pattern that lasts during the rainy season. There are major outbreaks in the South, Central and Fringe highlands. These are the regions that the intervention program should be focused more since they are said to be the regions with the majority of cases related to malaria.

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Socio-Cultural Factors Madagascar is among the poorest countries in sub-Saharan Africa where people die due to preventable and curable diseases like malaria. Poverty is one of the factors that are highly linked to the high rate of malaria in Madagascar. Appendix 2 shows the level of literacy in Madagascar from 2000 to 2015. The literacy level has been declining over the years and this may explain the high ignorance levels when it comes to some of the preventive measures against malaria such as the use of insecticidal treated nets. The low levels of education are generally poverty-related and therefore the preventive actions taken need to address such factors to be able to deal with malaria effectively. Biological Factors The major biological factors related to the issue of malaria in Madagascar is one of decreased immunity.

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Most of the individuals in high transmission regions have reduced immunity. Proposed Intervention In Madagascar, most of the interventions for malaria have relied on insecticidal nets, intermittent preventive treatment of the women who are pregnant, indoor residual spraying, campaigns known as an information, education and communication, treatment of the cases of non-complicated malaria by using artemisinin combination therapy and using microscopy to test for the fever cases. Most of these interventions require large sums of money or funding from international organizations since Madagascar has a poor economy with low GDP. Therefore, it is important to come up with an intervention or program that is relatively cost-effective. The recommended strategy for dealing with malaria in Madagascar involves the use of long-lasting insecticidal nets together with indoor residual spraying. These are some of the preventive measures that have been applied before and research shows that they have been highly effective in preventing malaria in Madagascar.

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Another research conducted by Kesteman et al11 indicates that the use of both insecticidal nets, as well as indoor residual spraying are highly effective in curbing malaria in Madagascar. The World Health Organization also claims that one of the most effective ways of preventing malaria is to use the long-lasting insecticidal nets, insecticide resistance, antimalarial drugs, and indoor spraying. In this case, it is highly important to ensure that the insecticide-treated nets are given freely to the already impoverished population in Madagascar. This is something that the international community has been very helpful in, thereby taking part in curbing malaria. The President’s Malaria Initiative is among the common strategies used to help prevent malaria in Madagascar. Furthermore, the economic outlook of Madagascar is not promising and therefore it is important to come up with other measures that are less costly but highly effective.

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This is a major problem because the suggested program is quite expensive to implement but is also considered highly effective. The alternative strategies may be cost-effective but may fail to eradicate malaria in Madagascar. Drug resistance is also another major problem expected in the implementation of the suggested strategy. Most of the malaria parasites have become resistant to the insecticides sprayed on them and this becomes a major comeback for the preventive measures. Looking out for the interest of the poor Malagasy people will be a great sacrifice that is pleasing to God. Therefore, more help from countries like the US is encouraged to make it possible for the efforts towards preventing malaria to be effective. Additionally, Matthew 5:42 requires people to give to whoever asks and not to turn away from anyone who wants to borrow.

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As research reveals, the poverty rate in Madagascar is high. One of the ways in which the rate of poverty can be reduced is through foreign aid. References Ihantamalala FA, Rakotoarimanana FM, Ramiadantsoa T, Rakotondramanga JM, Pennober G, Rakotomanana F, Cauchemez S, Metcalf CJ, Herbreteau V, Wesolowski A. Spatial and temporal dynamics of malaria in Madagascar. Malaria journal. doi:  10. s12936-018-2206-8 Randrianarivelojosia M, Raveloson A, Randriamanantena A, Juliano JJ, Andrianjafy T, Raharimalala LA, Robert V. A. Rabeza, V. R. Ramananjato, R. H. Howes RE, Mioramalala SA, Ramiranirina B, Franchard T, Rakotorahalahy AJ, Bisanzio D, Gething PW, Zimmerman PA, Ratsimbasoa A. Contemporary epidemiological overview of malaria in Madagascar: operational utility of reported routine case data for malaria control planning. Malaria journal. Dec;15(1):502. org/10. © World Bank. worldbank. org/handle/10986/18250 Kesteman T, Randrianarivelojosia M, Raharimanga V, Randrianasolo L, Piola P, Rogier C.

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Effectiveness of malaria control interventions in Madagascar: a nationwide case–control survey. Malaria journal. Malaria journal. org/10. s12936-016-1132-x Fullman N, Burstein R, Lim SS, Medlin C, Gakidou E. Nets, spray or both? The effectiveness of insecticide-treated nets and indoor residual spraying in reducing malaria morbidity and child mortality in sub-Saharan Africa. Malaria journal. doi:  10. MJHID. World Data Atlas. Madagascar - Adult literacy rate. com/atlas/Madagascar/Adult-literacy-rate  US Department of State, US Agency for International Development, Centers for Disease Control and Prevention.

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