Programs
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Mozambique
Malaria
Malaria is the most common cause of death in Mozambican children. UNICEF and WHO have recently estimated that, every year, this mosquito-transmitted parasitic infection kills about 45,000 Mozambican children under 5 years of age.
Children are not the only group affected by malaria. Over 5 million cases of malaria, affecting persons of all ages, were reported in Mozambique in the year 2003 alone. The growing problems of anti-malarial drug resistance and HIV/AIDS (HIV infection places affected adults at higher risk of infection) threaten to exacerbate the malaria problem in Mozambique in coming years, unless effective campaigns are conducted very soon.
The Mozambican Ministry of Health (MOH), in its current strategic plan, lists the fight against malaria as the first of its five highest-priority campaigns to reduce death from all causes in Mozambique.
HAI, with support from the University of Washington, the Centers for Disease Control and Prevention (CDC), the Association of Schools of Public Health, and USAID, have collaborated with the MOH in its anti-malaria campaign since 2000.
HAI's Main Activities Have Been
Promotion, Sale, and Re-treatment of Insecticide-Treated Bed Nets (ITNs).
Studies have shown that regular use of ITNs can prevent about 20% of all childhood deaths in malaria-ridden regions. Since 2000, HAI –
- Sold 32,771 ITNs in 26 separate sites in Sofala and Manica Provinces
- Re-treated 7930 nets, through mass re-treatment campaigns conducted at the community level
The overall poverty of the local residents has been one of the major obstacles to our bed net campaign. We are now lobbying major donors in favor of a policy of free treated bed nets for residents of the poorest communities.
Prevention of Malaria in Pregnancy
Pregnant women are at high risk of malaria, especially during their first pregnancies and/or if they are infected with HIV. Malaria in pregnancy causes anemia in the mother, and may even lead to the death of the mother.
When pregnant women are infected with malaria, the baby is at risk of –
- miscarriage
- still-birth
- low birth weight.
The risks to the lives and health of pregnant women and their infants can be reduced remarkably by provision of insecticide-treated bed nets to pregnant women, and by intermittent preventive treatment (IPT) with anti-malarial medication given to the mother during the last 5 months of pregnancy.
Major Accomplishments
2003 - HAI and the University of Washington helped the Mozambican MOH to establish its first IPT pilot project in 10 prenatal clinics in central Mozambique.
By March of 2005, this project had made IPT available to 17,691 pregnant women. In a study we conducted, we confirmed that pregnant women in our IPT program were significantly less likely to suffer severe anemia or to give birth to low birth weight babies. We are now working with the Mozambican MOH to make IPT available nationwide in Mozambique.
HAI's Intermittent Preventive Treatment (IPT) Team
Other projects
Anti-Malarial Drug Resistance
In 2001 and 2003, we helped the Mozambican MOH conduct studies of anti-malarial drug resistance in central Mozambique. Through these studies, we confirmed that levels of drug resistance to chloroquine (then, the most commonly used malaria medication in Mozambique) had become dangerously high. Our studies, along with several others conducted in Mozambique, were used by the MOH to justify a change to use more effective medications to treat malaria in Mozambique.
HAI's lab coordinator reading malaria slides.
Operations Research Training Program
In 2002, we started a training program on operations research for 21 mid-level Mozambican health officials. The trainees spent weeks in Maputo, learning research methods at the Centro Regional para Desevolvimento em Saude (Regional Center for Health Development). They then returned to their home districts to conduct practical research on local MOH programs.
Evidence-Based Patient Management
Finally, we are now working with the MOH to define evidence-based policy for management of patients who are simultaneously infected with HIV and malaria, with the aim of treating both infections effectively while avoiding toxic medication combinations.