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Malawi

Malawi's fight with bilharzia

Malawi has a high rate of bilharzia infections. Half of its 14 million people require treatment for the water-borne disease. Chimwemwe Padatha reports.

The country has embarked on a massive national campaign aimed at eliminating bilharzia by the year 2020. 

In 1985, the Lake Malawi region was considered free of schistosomiasis (bilharzia or bilharziasis). But the disease has since returned and is expanding rapidly. At least seven million people in Malawi live in bilharzia-prone areas. The country's Ministry of Health attributes this to lack of information. Hence, people easily expose themselves to the risk. "Many people have it. They know it but not everyone appreciates it as a disease," said Dr Benson Chilima, acting director for Preventive Health Services in Malawi's Ministry of Health. The government has also developed information packages for schools and the public in order to increase awareness of symptoms and available treatment, Chilima added.

At Kawale Primary School, children play and bask in the sun, while parents and guardians take turns to stand in long queues. A mass campaign was launched to give drugs to people affected by bilharzia with the aim to reduce infections by the year 2020. This is one of the centers where the drug administration program on bilharzia is taking place. Most of these centers have been established in schools since they mainly target children from ages five to 14. About three million children - half of the infected population - are receiving treatment for the disease.

Bilharzia is spread through use of contaminated water. The risk of getting the disease among those in remote areas is especially high. Access to drinking water in Malawi is still very low in rural areas.

A study conducted in 2014 on the schistosomiasis prevalence in Zomba, southern Malawi, revealed that 40 percent of children from five villages surrounding the Lake Chilwa Basin were infected with the parasite. A high prevalence was also observed among fishers and farmers.

Prevention and awareness priority

school children in Malawi

The campaign is aimed mostly at children

The Praziquantel drug which is used to treat bilharzia, used to be administered to children with empty stomachs. As a result, the minors often fell unconscious, which created fear of the treatment. This is not happening anymore. Praziquantel is a strong drug with side effects including dizziness, stomach cramps, diarrhea and vomiting. Treatment of young children has resulted in satisfactory cure rates. Bilharzia is an infection caused by parasitic flat-worms in the urinary tract. Awareness campaigns have been running through the media, urging parents to take their children for treatment.

Due to financial constraints the campaign used to target only people from the most affected areas. This time, the medication is being given to all individuals in areas alongside water bodies. Those who do not live in the affected districts, especially children from ages five to 14, will also receive the drugs as a preventive measure.

Saving tourism

A boat and a fisherman on Lake Malawi

Overfishing in Lake Malawi is said to have increased bilharzia flat-worm parasites.

About 20 percent of Malawi's population live in bilharzia-affected areas, making them more vulnerable than the rest of the population. Health rights activist Maziko Matemba said it is high time that Malawi stamps out the disease completely to avoid affecting tourism. The country's sector is under threat, as international travelers have been shying away from Malawi because of the disease. About seven percent of the country's gross domestic product comes from tourism.

Matemba said awareness needs to be increased. She called for authorities to strengthen their efforts.

"The most important thing that the government needs to do is to invest into publicizing some of these important messages, because they are going to help the country, more especially in the tourism sector," Matemba said. 

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