SCALE UP ‘INDOOR RESIDUAL SPRAYING’ NATIONWIDE TOWARDS ATTAINMENT OF 2030 MALARIA ELIMINATION TARGET-OBUASI HEALTH OFFICIALS TO GOV'T.

 

Mad.Yaa Manu-Obuasi Municipal Director of Health during the interview

The Obuasi Municipality in the Ashanti region is making substantial gains in the effort toward the target of eliminating malaria by the 2030.  The municipality has seen consistent reduction in both reported and confirmed cases across all registered healthcare facilities since 2018.

Data obtained from major hospitals sampled and the Municipal Health directorate have showed that, not only has Malaria lost its unenviable long standing record as the number one cause of hospital attendance and admission during the four-year period, but has not led to the death of either an infant or woman.

Health experts in the Municipality are convinced that elimination of the disease by the target date is highly feasible if the ‘Indoor Residual Spraying’ IRS intervention would be scaled up across the country since it is the main factor in the successes achieved in the municipality. 

 

OPD attendance and hospital admissions due to malaria have dropped significantly

Obuasi, made up of the Municipality and Obuasi East district, is a well-known gold mining hub, which has for years not only attracted an influx of people from across Ghana and even beyond, but also, created fertile environment for mosquitoes to breed because of the numerous pits dug for gold and other factors.

This means, the few healthcare facilities within the enclave were continually kept under severe pressure with malaria as the main cause of hospital admissions while the main corporate employer in the area, Anglogold Ashanti, bore the brunt of high incidence of absenteeism and low productivity among its workforce.

Mr. Samuel Asiedu Agyei-Director of AGAMAL

This necessitated the establishment of AGAMAL, a charity set up purposely to plan, implement and coordinate to fight the disease and its high burden. This drive, according to the Director of AGAMAL, Mr. Samuel Asiedu Agyei, led to the introduction of the Indoor Residual Spraying or I.R.S., first on a small scale using the mine and immediate surrounding communities for its pilot.

“The initial objective of this programme was to reduce malaria incidence by 50% in the first 2 years. But due to the strategy and other interventions that were put in place, we were able to record 74% reduction in malaria incidence in the first two years. That made it very successful and then it was recommended to the National Malaria Control Programme at that time and with the support of the government, we had some resource from the Global Fund to expand beyond what the mine was doing”, Mr. Agyei explained.

 But over time and based on the huge success rate at the pilot level, with the coming on board of the Global Fund support by Anglogold Ashanti, the Indoor Residual Spraying intervention was scaled up to all communities in the Obuasi enclave.

Ashanti Today therefore went on a mission to ascertain the level of this intervention’s impact in Ghana’s malaria elimination efforts in the next seven years.

Scientist at work at the AGAMAL laboratory

Even though the people know the Indoor Residual Spraying intervention is about only the spraying of approved chemicals in rooms and walls conducive for mosquito breeding, Ashanti Today learnt that, scientists at the Entomology Laboratory at AGAMAL have to first go through mosquito breeding from the vector stage to adulthood to study their characteristics as well as determine the chemical with the best efficacy to destroy the malaria causing vector. And when satisfied, the gang of sprayers set off for the main activity which is, to spray homes, open places, churches, mosques among other identifiable spots throughout the communities.

 At Domeabra, one of the beneficiary communities in the Obuasi East district, a beneficiary landlord, 57-year old Mr. Ahmed Nkrumah, in sharing his experience with the intervention so far narrated what motivated him to embrace the intervention.

“I’d a catastrophic experience with malaria about 20 years ago when four of my when the Indoor Residual Spraying had not started when four of my children were all down with malaria. When they were sent to the AGA Hospital, three of them were admitted while one was treated and discharged. The doctors were very much annoyed with me that I was not taking good care of my kids. But, by God’s grace, the 3 who were admitted were also treated and discharged. And a year later the mine introduced the IRS and extended to the community. I must say, since that time, as a family, none of us has gone to the hospital for malaria treatment”, he noted.

On her part, Mrs. Tabi Amponsah, amidst giggles said “for about five years now, anytime I attend hospital, the doctors diagnose and treat me for other ailments but not for malaria. Apart from addressing malaria, when they spray, insects like cockroaches and reptiles like wall gecko which are a major bother also vanish.”

 With a population of more than 104 thousand and 12 approved public and private healthcare facilities, Ashanti Today then followed up to the two major referral hospitals in the area. These are the AGA Hospital now AGA Health Foundation, and the Obuasi Government Hospital.

Dr. Kwadwo Anim using graph to demonstrate the downward trend of malaria cases at the AGA Health Foundation(formerly AGA Hospital)

Using a graph, a chart and data, the Executive Director of the AGA Health Foundation, Dr. Kwadwo Anim, and the Medical Superintendent of the Government Hospital, Dr. Kwadwo Asamoah Nyarko-Jeckey, traced the trend and history of malaria cases at their respective facilities from before introduction of the I.R.S. to date showing that consistently for some time, malaria no longer tops the list of five causes of OPD attendance or admissions.

Referring from his computer, Dr. Nyarko-Jeckey said “when we look at our four year trend from 2018, malaria complications dropped from top of the list to 3rd instead of the usual unenviable 1^st position and from 2020, malaria dropped to 6^th among the top list of attendance and this position has been maintained and we believe that it will drop further.”

“In the past few years, malaria is no more a headache. Out of an attendance of a minimum of 12, 000 and a maximum of 17, 000 in a month, and you’re looking at a maximum of 400 cases of malaria, that is significant”, the AGA Health Foundation Executive Director used a chart to explain.

The Municipal Director of Health, Mad. Margaret Yaa Manu, disclosed that, since 2018, there has not been any infant or maternal mortality due to malaria within her jurisdiction and attributed the record largely to impact of the Indoor Residual Spraying as an intervention.

Just like the two medical doctors had said, Mrs. Manu is convinced that elimination of malaria in Ghana by the 2030 national target is feasible.

“They should scale up the I.R.S. and at the tail end, we add other interventions to complement it so we can reach our target. It’s very feasible if we put all hands on deck”, the Municipal Health Director noted.

Director of AGAMAL, Mr. Samuel Asiedu Agyei, assured that with sustained support of the Global