AMAZIGH, Guinea-Bissau — Despite preventative measures, malaria continues to be the leading cause of death among pregnant women as well as children under five in Guinea-Bissau, a small nation on the west coast of Africa. Although Guinea-Bissau only has a population of 1.84 million, approximately 70 percent of those residents live below the poverty line, contributing to the prevalence of malaria in the nation. The inclusion of digital technology is revolutionizing the response to malaria in Guinea-Bissau and may be successful in significantly reducing malaria in the nation.
insecticide-Treated Mosquito Nets
Malaria is prevalent in Africa, with more than 90 percent of all malaria cases and deaths occurring on the continent. Malaria still accounts for 18 percent of all deaths in health facilities in Guinea-Bissau, and it is the leading cause of death for pregnant women and children under five. Since 2000, global organizations and governments have been working to reduce malaria across Africa. One of the UNDP’s Sustainable Development Goals is to end the malaria epidemic by 2030.
One of the main ways to prevent malaria is to sleep under insecticide-treated mosquito nets (ITNs). In this regard, Guinea-Bissau is ahead of many other African countries since, as of 2016, 80.6 percent of children were already sleeping under ITNs and 90 percent of households had at least one ITN. This is likely a direct result of the nation distributing free ITNs since 2005 in order to decrease the infections rates.
Intermittent Preventative Treatment
Pregnant women are at increased risk of malaria because they have weakened immune systems. If infected during pregnancy, they are more likely to give birth to babies with low-birthweight or who are stillborn. For this reason, it is imperative that pregnant women sleep under ITNs. It is also important, however, that they receive intermittent preventive treatment during pregnancy (IPTp). IPTp includes administering sulfadoxine-pyrimethamine at antenatal care visits and has been used to prevent malaria in Guinea-Bissau since 2005.
Unfortunately, only 18.6 percent of women between the ages of 15 and 49 received IPTp during their last pregnancy in Guinea-Bissau, according to UNICEF. This may, in part, be a result of inadequate antenatal care rates, as only 65 percent of women in Guinea-Bissau attended the recommended four antenatal care visits. Increasing the administration of IPTp involves both making antenatal care more accessible to women and ensuring all health facilities have the supplies and training necessary to administer the treatment.
Malaria Cases and Deaths
Data on malaria in Guinea-Bissau, and other African nations, is difficult to compile because not all cases are confirmed and not all deaths are reported. For example, in 2010, WHO noted that there were 89,784 cases of malaria confirmed at one health facility. However, it estimated that there was actually a total of 108,000 cases that year. Similarly, there were 296 reported deaths from malaria, but WHO estimated that there were approximately 688 in total.
These discrepancies make it difficult to track progress; however, reported malaria deaths have decreased by 105 cases between 2010 and 2016. Because preventative action had also increased during this time, it is unlikely that the reported deaths decreased as a result of an inability to report accurate data.
Between 2010 and 2015, there was also a 23 percent increase in people sleeping under ITNs. By 2016, the reported deaths had been reduced to 191, indicating progress in preventing malaria and malaria deaths. Paulo Djata, The coordinator of Guinea-Bissau’s National Program to Combat Malaria, noted that the cases of malaria, as well as deaths from the disease, had decreased significantly by 2016.
Digital Technology To Track Malaria
To further decrease the prevalence of malaria in Guinea-Bissau, UNDP partnered with the Global Fund, the World Bank and the government in 2017 to digitize malaria data. Currently, mobile tablets are being used to upload data from 136 facilities, and they plan to expand this to all 169 health facilities by 2020.
Guinea-Bissau is one of many African nations that suffer from limited access to the internet. That, in combination with long distances to travel, has made it difficult to gather and compile data. Digitizing the malaria response improves the accessibility of the data since all data is sent to the National Institute of Public Health.
The inclusion of new technology decreases the amount of time it takes to compile and analyze data, allowing the Ministry of Health to coordinate quick responses to areas with outbreaks. Health professionals can also more easily receive data about what areas are short on resources in order to better respond to the need.
A Decrease in Malaria Cases
This new digitized reporting system contributed to a 16 percent decrease in malaria deaths from 2017 to 2018, and the hope is to continue this progress over time. In addition to malaria, the National Institute of Public Health is collecting data on other diseases, including polio, yellow fever and cholera, to improve overall health in the nation.
In addition to this new digitization of the data, the Global Fund and UNDP are continuing to work with the government to ensure that everyone at risk of malaria receives free prevention and treatment measures, recognizing that those who live in poverty often have increased difficulties accessing the necessary medical care and supplies.
It remains to be seen whether the use of new technology will significantly decrease malaria in Guinea-Bissau. If the initiative is successful, it will likely be implemented in other African nations, helping to end the malaria epidemic by 2020.