By Omair Ali

Source: J. Bavier, Voice of America

Niger experiences extremely high mortality rates related to disease outbreaks, which are rooted in poor access to sanitation, lack of prevention, and limited treatment options. According to the Institute for Health Metrics and Evaluation, malaria is Niger’s leading cause of death[1]; however, this summer will be especially challenging as the global COVID-19 outbreak will coincide with malaria season.

Malaria is a protozoal infection that is caused predominantly by a parasite, Plasmodium falciparum, the most lethal of all Plasmodium species, in Niger[2]. The parasite is transmitted by Anopheles mosquitoes, which can acquire or transmit malaria through contact with human blood during its nocturnal feeds. Once malarial parasites enter human blood, they infect liver cells and multiply; the parasites then leave to infect red blood cells, where they multiply further and cause symptoms[3].

Common symptoms of malaria are very similar to COVID-19 and include fever, chills, nausea, fatigue, and headache[4]; this makes having tests for COVID-19 and malaria essential for appropriate diagnosis and treatment. Complications from unresolved malaria are severe bleeding, organ failure, seizures, severe hypoglycemia, and death. Pregnant women and children shoulder the highest burden of vulnerability to malaria. Additionally, widespread anti-malarial drug resistance has also challenged the effectiveness of existing treatment options. Compounding the problem is the fact that Niger does not have access to the malaria vaccine, Mosquirix, which is being tested in pilot programs elsewhere[5]. These shortcomings in medical management have made it exceedingly difficult for vulnerable populations in Niger to battle malaria.

According to the Centers for Disease Control and Prevention (CDC), methods that effectively reduce malarial transmission involve the use of chemicals in high-risk wet areas to kill mosquitoes during the larva stage and the implementation of insecticide-treated nets, repellants, and window screens to prevent mosquito bites[6]. Implementing these strategies is critical during the rainy summer months when Anopheles mosquitoes use the newly formed wet areas as breeding grounds for rapid population growth[7]. However, as a disease of poverty, malaria has its most significant impact on Niger’s low-income families, whose access to prevention and treatment is at the mercy of the government and humanitarian aid.

As of June 17, there are 1016 total cases and 66 deaths from COVID-19 in Niger, but the worst is yet to come[8]. The World Health Organization’s models predict that the COVID-19 outbreak has negatively impacted malarial prevention strategies[9]. In Niger, the response to COVID-19 has led to lengthy lockdowns and other restrictions that have slowed down the distribution of anti-malarial treatments and preventive measures and has further endangered many communities.

Another reason that prevention is so critical is that malaria is challenging to treat because it frequently occurs with other health conditions. One study found an association between severe malaria and diarrhea-causing bacterial infections[10]. The rainy season also coincides with the “hunger gap” period, when many Nigeriens run out of stockpiled food from their previous harvest and are at risk for starvation[11]. When malnourished individuals have malaria, their weakened immune systems are less able to fight off infections, which leads to worse health outcomes.

Water scarcity compels Nigerien women to travel for several hours daily to find water, which also leaves them vulnerable to mosquito bites around the water sources they locate. But when people are desperate for basic needs, they don’t have the luxury to avoid high-risk areas where they can contract malaria.

Wells Bring Hope’s efforts are crucial to the survival and success of Nigerien communities, as we drill wells that ensure sustainable access to clean water. Giving people access to clean water frees people from the burden of relying on open water sources, allows them sufficient water for planting starvation-preventing gardens, and allows them to focus on critical issues like malaria prevention.