Scientists predict rise in severe malaria cases as schools reopen

Kampala, Uganda | THE INDEPENDENT | Experts are warning about an increase in not just malaria cases, but an increase in its severe forms in the coming weeks as students start reporting back to school.

Dr Richard Idro, a malaria researcher based at Makerere University says that the recent upsurge of malaria in many parts of the country has also seen the disease shifting from affecting very young children aged below five years to school-going children.

Previously, he says the bulk of severe malaria cases recorded had been among babies, a trend which is now changing, yet most public health interventions focus on children under five and pregnant women.

Idro, who is also a paediatrician at the Mulago National Hospital Acute Care Unit says that even during the school holiday, they have been seeing children present with kidney injury, abnormal bleeding and impairment of consciousness, yet for some time especially in Kampala, such hasdn’t been happening.

Dr Denis Rubahika, the Deputy Program Manager at the National Malaria Control Programme of the Ministry of Health says they are aware of the change in epidemiology and new interventions in especially treatment are being discussed.

He says that apart from a shift in most affected age groups, they are recording cases of treatment failure which are not entirely attributed to the bug resisting currently existing malaria treatments.

While not yet printed out, their new guidelines on severe malaria stipulate that in case all fail, health workers can give quinine, a drug that had been discontinued due to high toxicity without waiting for the patient to complete initial Artemisinin-based combination treatments (ACT) doses.

He says currently they are supposed to test all suspects and give adequate treatment however many health workers prefer using Rapid Diagnostic Tests (RDTs) that are not the gold standard which is microscopy. He says RDTs have a lot of shortcomings.

When it comes to areas like Kampala and Kigezi where prevalence was less than five per cent before the upsurge, the doctor says they had planned to start the elimination phase where they wanted to start an initiative to test contacts of cases and start them on treatment even before they have symptoms. This plan he says was halted because they had no funding for it.

By the end of last week, an upsurge in malaria cases had been reported in over fifty districts across the country.

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