The 'coronavirus and malaria mix' in Anlokordzi

In the ghettos of Anlokordzi in the Volta Regional capital, Ho, a middle-aged man rejoices about a mix-up in his health issues.

Papavi's happiness appears interminable, after he was diagnosed with malaria and not COVID-19.

He had rushed to the Ho Municipal Hospital stealthily, presenting a history of high temperature, nausea, loss of appetite and chills, among others.

Petrified, lanky Papavi resigned himself to being diagnosed with COVID-19.

He was on tenterhooks as thoughts of him, being the next COVID-19 positive case in Ho, kept nudging.

The verdict, however, was malaria, and so, Papavi left the Hospital with smiles, clutching a cocktail of anti-malaria drugs.

It was his second time at the facility in a decade. The first, he accompanied an uncle, who later passed.

Papavi believes in herbs, and had used herbs all his life, occasionally offering herbal preparations to his children and neighbours who fall sick.

But in May this year, two gallons of malaria herbal preparations failed to cure him.

He says, the courage to sprint to the Hospital, was after he self-quarantined for two weeks with no relief, despite the gallons of malaria concoctions.

“It was God. I was almost gone. I saw my ancestors; my body was very hot, my eyes almost dropping and I said to myself, I'm the first Anlokordzi COVID-19 case and if not for the fear of losing my life to COVID-19, this malaria would have killed me,” he told the Ghana News Agency.

“I now know malaria can kill and testing and treating is the best,” he added.

Jane Azumah, a Senior High Student is also reliving her first malaria test in the wake of COVID-19.

“It is my first malaria ‘test and treat’ experience during this COVID-19 period and I’m happy, it feels good and I think it’s the best and I recovered very fast. I first thought it was Coronavirus. I was very sick,” the student, also a resident of Anlokordzi stated.

Anlokordzi is an inner-city of Ho. It is virtually without any spatial planning.

The suburb is a sanitation disaster with drains choked with rubbish.

The community is well known for hosting the Ho Children’s Park, which got engulfed in filth and rundown decades ago. It is also home to 'Asanyame' - a disfigurement of a car washing bay.

The area contributes a lot to the garbage problem in Ho with the popular ‘Amegashie Bridge,’-a dummy of “Odawna River” in Accra, remaining a headache, an engineering debacle, for the Ho Municipal Assembly.

This suburb’s state, could perhaps be attributed to the community’s proximity to the Ho main public transport terminus with a large transient population.

The insanitary conditions, give rise to high malaria cases in the catchment area and its environs; verdict from unscientific studies.

Over the years, Anlokordzi, Ho New Zongo and other highly populated areas in the Municipality were targets for malaria control programmes by the Ghana Health Service, the National Malaria Control Programme and Hope For Future Generation, a non-govermental Organization.

They benefitted from indoor residual spraying, distribution of insecticide treated nets, education on the need to test, treat and track and the use of ACTs for prompt and effective malaria treatment.

From my limited point of view, the sensitization on prompt and effective treatment with ACTs, is widely accepted and practiced by the people.

As a result, many go to pharmacies and drug stores for anti-malaria drugs, often, without testing, with a few still stuck to herbal preparations at home.

But in the wake of COVID-19, a cursory observation shows that many more people, not only from Anlokordzi, who would not have visited the hospital with symptoms of fever, do so to be sure they are Coronavirus-free.

Some people delay for the fear of contracting the virus at health facilities, but finally rush there, when symptoms persist.

Arguably, the fear of COVID-19 has enhanced efforts at sustaining gains made in malaria Test, Treat and Track campaign in the Municipality.

Records of malaria Test, Treat and Track reportedly went up slightly from 4067 in January to March, 2019, to 4680 in 2020, same period.

Checks from the Municipal Disease Control and Surveillance Unit also indicate that uncomplicated malaria cases tested negative but treated as malaria also went down drastically from 1708 in 2019 to 912 in 2020, from January to March.

The Ghana Health Service, during this year’s World Malaria Day, said between January to March, 2020, the country recorded 1,001,070 malaria cases - more than half of 2,346,677 suspected cases tested.

It also says there were 54 malaria deaths, 16 of them, being children under five.

A friend, Rafaella, from Italy described Ho years ago as, “haven of malaria” when 12 children reportedly died of malaria in 2015 and five in 2016.

But the Municipality is now quietly celebrating no under-five malaria deaths since 2017, with significant decline in malaria cases generally from 39.9 per cent in 2017 to 30.8 per cent in 2018.

Dr. Senanu Djokoto, Deputy Volta Regional Director of the Ghana Health Service, Public Health, says though malaria remains the number one Out Patient Department case, “we are inching towards 100 per cent Test, Treat and Track.”

This is against fears and warnings from the World Health Organization that efforts at containing COVID-19 in developing countries could make treatment of malaria take back seat at health facilities, with malaria related deaths skyrocketing.

Checks by GNA show that though general hospital attendance has slumped in the wake of COVID-19, malaria treatment did not backtrack in Ho.

This is largely because malaria drugs are available and other interventions such as general sensitization on the use of Long-Lasting Insecticide Nets, Indoor Residual Spraying and Intermittent Preventive Treatment with sulfadoxine-pyrimethamine for pregnant women have not been affected by COVID-19 activities.

Perhaps the biggest fear for many stakeholders in malaria control is the onset of the rainy season.

According to WHO, some species of mosquitoes, including those that cause malaria, prefer small shallow collections of fresh water such as ponds for breeding and these are abundant during the rainy season.

Already, there is mix feeling as the skies let loose with flood situations recorded after every downpour.

There is simply no preparation for the rains as used to be the case decades ago, where bushes are cleared and roofs repaired for rain harvesting among other precautions to avoid disasters and diseases.

Experts say wet seasons, simply mean more attention to hygiene, but unfortunately our drains are chocked leading to stagnation of water, which becomes breeding grounds for mosquitoes.

We have potholes and dugouts littering the communities, plantain leaves collecting rain water for days and water from bathhouses meandering through houses as Unit Committee Members, Assembly members, other political leaders and traditional authorities, look the other way.

Unfortunately, research has shown that coverage of Long Lasting Insecticide Nets is high, but usage very low in the Municipality.

Perhaps it is time we experimented Larval Source Management (LSM) to control malaria vectors and address challenges with Indoor Residual Spraying and Long Lasting Insecticide Nets to sustain gains made.

LSM will control mosquito population by targeting indoor and outdoor resting and biting mosquitoes - killing them young.

This calls for support and leadership from all - Chiefs, Unit Committee and Assembly Members to clear all breeding grounds for mosquitoes to make Ho, the “Oxygen City” of Ghana 'malaria-free' during and after COVID-19.