By Yacine Djibo
President, Speak Up Africa*
The malaria elimination project currently being implemented in Richard-Toll in the northern part of Senegal aims to put an end to the local transmission of malaria in the district. The National Malaria Control Program (NMCP) picked this specific zone as it already has very low malaria incidence, less than 5 cases per 1,000 residents. For reasons including population density, rainfall, and geographical and financial access to health facilities, the malaria burden is much lower in the northern region of the country. With the help of MACEPA, the NMCP intensively monitors reported malaria cases. Once a malaria case is confirmed by one of the heath posts attached to the health district, a mission to investigate the case is planned. A handful of volunteers made up of community workers, medical students, or health district officials organize a visit to the household of the person sick with malaria.
During these investigative missions all the members of the household take a rapid diagnostic test to determine if anyone else has contracted malaria. If any member of the household tests positive for the disease, they are immediately treated with an antimalarial. Residents in the nearest five households are also tested for malaria at the same time. The goal of this effort is not just to treat malaria cases, but to stop all local transmission of the disease.
In November 2012, I was part of an investigation in which we visited the household of Mrs Aby Bineta Ba. Her 18-year-old grandson had contracted malaria and the diagnosis was confirmed by the health center. Aby Bineta was very impressed with all these strangers who were all concerned about the health of her family. Gnagna Dieng Sow, the MACEPA focal point in charge of the investigation, took time to explain to Aby Bineta the purpose of our visit so that she would agree to take the test and allow the rest of her family to do so as well.
To my surprise, despite the fact that she had no symptoms whatsoever, Aby Bineta’s test turned out to be positive. As a result, Aby Bineta was given the necessary medication and therefore did not have to go to the health center to get treated. This experience proves how essential this close malaria case surveillance is. It allows the NMCP to find and treat asymptomatic cases as early as possible, thus reducing the chances for affected individuals to serve as a vector for transmission. Aby Bineta fully understood this as she was very grateful to be cured immediately without getting sick and so she would no longer pose a risk to her family.
“Thanks to this project, the usual procedures are reversed, and we are closer to our community. The project enables us to realize the true meaning of our job and, most importantly, it allows us to ensure the health of our communities,” Gnagna Dieng said.
Aby Bineta received the necessary instructions to follow her treatment correctly in the presence of her sister who was visiting from Dakar, the capital of Senegal. Full of emotions, her sister told us how much she was grateful for our actions. She noted that this program would change the lives of many people in her neighborhood if it were implemented there as well.
Our visit with Aby Bineta has allowed me to truly understand the importance of the strategy behind the malaria elimination project. Beyond working to end the disease, it shows how community health workers are a significant force in the expansion of health services throughout the most remote communities.
*Speak Up Africa is a Dakar-based health communications and advocacy organization whose goal is to engage all sectors of African society in the fight to eliminate malaria.