A mosquito. PHOTO/UGC.
By COLLINS O. OJIEHANOR
in Lagos, Nigeria
Mosquitoes are notorious for spreading malaria, however their position in transmitting different lethal ailments is much less well-known.
Past malaria, mosquitoes unfold Dengue fever, Zika virus, Chikungunya, and Yellow fever, impacting tens of millions globally, particularly in tropical and subtropical areas. These ailments are life-threatening, but their broader menace stays underappreciated.
In keeping with World Well being Group (WHO) report, every year, vector-borne ailments account for over 17 p.c of all infectious ailments, inflicting greater than 700,000 deaths worldwide.
Malaria alone accounts for round 219 million circumstances yearly and over 400,000 deaths, primarily amongst younger kids. Dengue fever, now endemic in over 100 international locations, impacts 3.9 billion individuals and leads to 40,000 deaths every year.
Current outbreaks spotlight the rising danger. In Nigeria, dengue fever has lately been reported in Sokoto State, with 71 suspected circumstances and 13 confirmed.
Excessive seroprevalence charges in several areas recommend dengue is turning into a major public well being concern. In the meantime, Yellow fever circumstances are additionally rising, with over 2,200 suspected circumstances reported throughout Nigeria in 2023 alone.
Regardless of the continued battle in opposition to malaria, public consciousness stays restricted. Many individuals are solely conscious of malaria’s connection to mosquitoes, leaving them susceptible to different mosquito-borne ailments.
Residents in Lagos, for example, expressed shock upon studying about ailments like Zika and Yellow fever, revealing a major hole in public well being training.
Different vectors, equivalent to aquatic snails, blackflies, sandflies, and ticks, additionally play vital roles in spreading ailments like schistosomiasis, onchocerciasis, leishmaniasis, and Lyme illness.
The impression of those ailments extends past the speedy well being penalties. They contribute to excessive ranges of morbidity, disrupt financial actions, and place a heavy burden on healthcare programs.
The Ongoing Battle In opposition to Mosquitoes and Malaria
Graph displaying yellow fever developments. GRAPH/CDC
In keeping with the 2019 World Malaria Report from WHO, Nigeria bears a good portion of the worldwide malaria burden. The nation accounted for 23% of the world’s malaria deaths, with over 88,000 fatalities, and 27% of the worldwide malaria circumstances, totaling over 61 million in 2019.
This has led to an intensified malaria prevention and management efforts in Nigeria, because the illness stays a significant public well being problem with devastating impacts on the inhabitants, significantly amongst kids beneath 5 and different susceptible teams.
Mosquitoes stay one of many deadliest animal on the planet, accountable for killing extra individuals yearly than another creature.
Among the many ailments they unfold, malaria is among the most devastating, significantly in sub-Saharan Africa, the place it stays the main reason behind outpatient visits, work and college absenteeism, and a significant contributor to under-five mortality in keeping with the Worldwide Society for Infectious Illnesses (ISID).
ISID highlighted that majority of malaria circumstances and deaths happen in low-resource settings. These areas are disproportionately affected by the illness’s morbidity and mortality resulting from restricted entry to preventive measures, well timed analysis, and efficient remedy.
For malaria, WHO recommends two key vector management interventions: indoor residual spraying (IRS) and insecticide-treated nets (ITNs).
Insecticide-treated nets present a bodily barrier that protects people from mosquito bites whereas they sleep, considerably lowering the danger of an infection.
In the meantime, indoor residual spraying entails the appliance of pesticides on the inside partitions of houses and different buildings the place disease-transmitting mosquitoes are prone to relaxation.
This methodology not solely kills Anopheles mosquitoes however will also be efficient in opposition to different disease-carrying bugs. Nevertheless, the effectiveness of those interventions is contingent on equitable entry.
Dengue fever: A Rising International Risk on Public Well being
An aged lady busy promoting meals in Wesley Shut, Lagos State, Nigeria, close to contaminated stagnant water with dangers of being uncovered to mosquito bites. PHOTO/ Collins Ojiehanor.
In keeping with WHO, dengue is a viral an infection transmitted to people by the chew of contaminated Aedes mosquitoes. The illness is now endemic in additional than 100 international locations, with Africa, the Americas, South-East Asia, and the Western Pacific areas being essentially the most severely affected.
Also known as “break-bone fever” as a result of extreme joint and muscle pains it causes, dengue is most typical in tropical and subtropical climates. It has grow to be an rising concern, significantly because it spreads to new areas and infects tens of millions every year.
In December 2023, the Nigeria Centre for Illness Management and Prevention (NCDC) confirmed an outbreak of dengue fever in Sokoto State, initially reported in November 2023. The report exhibits that 71 suspected circumstances had been recognized, with 13 confirmed by laboratory testing.
The virus was detected in three native authorities areas (LGAs): Sokoto South, Wamako, and Dange Shuni, with Sokoto South recording the best variety of circumstances at 60. Nearly all of the suspected circumstances fall throughout the age vary of 21-40 years, indicating that this demographic could also be significantly vulnerable within the outbreak.
The NCDC, in collaboration with its multisectoral companions by the Nationwide Rising Viral Haemorrhagic Illnesses Technical Working Group (NEVHD-TWG), performed a speedy danger evaluation to information the preparedness and response actions within the affected areas.
In keeping with a report within the Nationwide Library of Drugs, latest research point out that dengue viruses are rising as a major reason behind acute fevers in Nigeria.
Seroprevalence surveys performed in Maiduguri (Northern Nigeria) and Ilorin (Western Nigeria) revealed that 10.1 perecent and 30.8 p.c of individuals, respectively, examined constructive for dengue subtype-3 virus (DENV-3).
The report confirmed that in South-Western Nigeria, dengue IgM seroprevalence amongst febrile kids has been reported to be 17.2 p.c and 30.8 p.c.
These excessive prevalence charges of symptomatic dengue infections and IgM antibodies recommend that dengue may very well be turning into endemic in Nigeria, with many circumstances probably being missed by frontline well being staff.
Moreover, there may be proof of excessive vector density in densely populated Nigerian cities, additional indicating that dengue is an rising public well being concern within the nation. The state of affairs is sophisticated by the excessive charges of co-infection with malaria and dengue.
A latest report from Ibadan, South-Western Nigeria, revealed that 10% of confirmed malaria circumstances additionally had lively dengue co-infection. These findings underscore the necessity for extra centered consideration on dengue in Nigeria, as its true magnitude stays under-explored.
Whereas many dengue infections are asymptomatic or trigger solely gentle sickness, the virus can sometimes result in extreme circumstances and even demise, significantly in people who’ve been beforehand contaminated with a unique pressure of the virus. Most individuals contaminated with dengue will expertise gentle or no signs and can get better inside 1–2 weeks.
Nevertheless, signs that do seem normally start 4–10 days after an infection and might embody excessive fever, extreme headache, ache behind the eyes, muscle and joint pains, nausea, vomiting, swollen glands, and a rash.
In extreme circumstances, dengue can result in life-threatening circumstances equivalent to extreme belly ache, persistent vomiting, speedy respiratory, and bleeding gums or nostril.
WHO reviews that there’s presently no particular remedy for dengue or extreme dengue. Administration of the illness primarily entails relieving signs with ache relievers equivalent to acetaminophen (paracetamol) and making certain that sufferers keep hydrated. Early detection and entry to correct medical care drastically scale back fatality charges in extreme dengue circumstances.
Yellow Fever: A Excessive-Risk Illness with International Well being Implications
Map displaying areas with dangers of Yellow Fever in Africa. MAP/CDC.
Yellow fever, a mosquito-borne illness, continues to pose a major menace to international well being safety, particularly to international locations in Africa and the Americas.
Analysis exhibits that, the Aedes and Haemagogus mosquitoes that unfold yellow fever are day-biters and breed in varied environments, together with home areas round homes, forests, jungles, and semi-domestic habitats.
In keeping with a Yellow Fever state of affairs report by NCDC, from January 1 to September 30, 2023, a complete of two,203 suspected circumstances had been reported throughout 492 Native Authorities Areas (LGAs) in 36 states, together with the Federal Capital Territory (FCT).
The reported circumstances had been distributed amongst varied states: Abia (28), Adamawa (12), Akwa Ibom (9), Anambra (77), Bauchi (326), Bayelsa (39), Benue (54), Borno (157), Cross River (37), Delta (14), Ebonyi (16), Edo (26), Ekiti (34), Enugu (116), FCT (19) and Gombe (4).
Different circumstances exhibits; Imo (55), Jigawa (107), Kaduna (26), Kano (17), Katsina (190), Kebbi (85), Kogi (34), Kwara (37), Lagos (14), Nasarawa (47), Niger (97), Ogun (63), Ondo (79), Osun (19), Oyo (51), Plateau (80), Rivers (18), Sokoto (36), Taraba (112), Yobe (40), and Zamfara (28).
The gender distribution confirmed 1,157 males (52.5%) and 1,046 females (47.4%) among the many suspected circumstances. Notably, 76% of the circumstances occurred in people aged 30 years and beneath. Out of the two,203 suspected circumstances, 213 people (9.7%) had acquired a minimum of one dose of the yellow fever vaccine.
Equally, knowledge from WHO report exhibits that since September 2017, yellow fever circumstances have been reported throughout a number of states in Nigeria.
From January 1 to August 31, 2021, a complete of 1,312 suspected circumstances had been documented in 367 Native Authorities Areas (LGAs) throughout 36 states and the Federal Capital Territory (FCT).
Throughout this era, 45 blood samples had been despatched to Institut Pasteur in Dakar (IPD), and 31 samples examined constructive for yellow fever by the Plaque Discount Neutralization Take a look at (PRNT). Of those 31 PRNT-positive circumstances, twelve had a historical past of yellow fever vaccination.
Sadly, two deaths had been reported among the many 19 non-vaccinated PRNT-positive circumstances, leading to a case fatality ratio of 11%. These 19 circumstances had been reported from Enugu (7), Anambra (3), Benue (3), Delta (2), Oyo (2), Niger (1), and Osun (1).
Nigeria has recognized vital gaps in inhabitants immunity in opposition to yellow fever. In a 2020 UNICEF estimates, the nationwide immunization protection for yellow fever was 54%, which is beneath the 80% threshold vital to forestall outbreaks.
Within the 9 states reporting PRNT-positive circumstances, routine immunization protection declined between 2018 and 2020, falling beneath 80% in 2020.
These states embody Anambra, Benue, Delta, Enugu, Imo, Niger, Ondo, Osun, and Oyo, with six states reporting protection beneath 50% (Anambra, Delta, Enugu, Imo, Osun, and Oyo).
Data Hole Places Residents at Threat
A vendor sells meals subsequent to a pool of stagnant water oblivious of the well being dangers she poses to her purchasers in Ketu, Lagos State, Nigeria. PHOTO/ Collins Ojiehanor.
In a sequence of interviews with residents in Lagos state, Nigeria, many believed that mosquitoes are solely accountable for spreading malaria, a notion largely formed by the extraordinary international efforts and consciousness campaigns centered on eradicating the illness.
In a go to to Ketu market, Mrs. Adebayo Yinka, expressed her shock on the broader menace posed by mosquitoes,
“I’ve all the time identified mosquitoes trigger malaria, however I didn’t understand they might unfold different severe ailments too. Malaria is what we’ve been taught to worry, however now I’m listening to about dengue and Zika. It’s worrying as a result of we don’t have a lot details about these ailments right here,” Mrs Yinka mentioned.
Equally, Mr. Chinedu Emmanuel, in Mile 12 Market, shared his expertise with a lesser-known mosquito-borne illness.
“We’re used to coping with malaria, however I used to be shocked when my nephew was recognized with yellow fever after a go to to the village. We had no concept mosquitoes might trigger one thing so completely different from malaria. It’s clear we want extra training about these different ailments,” Mr Chinedu mentioned.
Fatima Ireti, a pupil, highlighted the gaps in public well being training, noting that most individuals she knew solely affiliate mosquitoes with malaria.
“Even in class, we primarily discovered about malaria prevention, however there’s little dialogue about different ailments just like the Zika or yellow fever. It’s as if malaria is the one factor mosquitoes could cause,” Ireti famous.
Mr. Ibrahim Ojo, a civil servant, recounted a troubling encounter with an unfamiliar sickness saying that at one time he travelled to his hometown in Ogun state, the place malaria is a standard drawback that everybody is aware of, however when his neighbour fell in poor health with extreme joint ache, they thought it was only a case of the farm work.
“It turned out to be yellow fever. I used to be so shocked after I heard it from the spouse. It made me understand how a lot we don’t know in regards to the risks mosquitoes can deliver,” Mr Ojo says.
In a go to to some secondary faculties in Kosofe Native Authorities Space, many college students weren’t conscious of the total vary of ailments transmitted by mosquitoes. Whereas most had been accustomed to malaria and its prevention, that they had restricted information about different severe mosquito-borne sicknesses equivalent to dengue, yellow fever, Zika, and chikungunya.
Mrs. Nneka Amadi, a secondary faculty instructor, emphasised the necessity for broader consciousness.
“We’ve been taught to make use of nets and sprays to guard in opposition to malaria, however I by no means knew mosquitoes transmit ailments like Zika. It’s scary as a result of we’re not outfitted to deal with these. There ought to be extra consciousness campaigns so individuals perceive all of the dangers, not simply malaria,” Mrs Amadi provides.
Skilled Highlights Key Challenges on the Combat In opposition to Mosquito-borne Illnesses in Nigeria
Residents Alapere, Lagos State, Nigeria are least involved in regards to the well being dangers posed mosquito breeding grounds. PHOTO/ Collins Ojiehanor.
Bukola Christiana Okusanya, a Public Well being professional, make clear the important obstacles hindering the battle in opposition to mosquito-borne ailments particularly in Nigeria.
Okusanya emphasised that points equivalent to poor sanitation, insufficient drainage, and ineffective mosquito management measures are exacerbating the unfold of those sicknesses in lots of households.
She defined that poor sanitation and waste administration create breeding websites for mosquitoes resulting from improper disposal of waste and particles.
“Insufficient drainage programs are one other concern,” Okusanya famous. “Clogged or non-existent drains result in standing water, which is good for mosquito breeding,” Okusanya says.
She additionally identified {that a} lack of entry to wash water forces individuals to retailer water in containers, offering extra breeding grounds for mosquitoes.
“Ineffective mosquito management measures are a major drawback as nicely. When pesticides and nets will not be correctly applied or maintained, mosquito populations can thrive,” she emphasised.
Behavioural Modifications and the Threat of Mosquito-Borne Illnesses in Nigeria
A few of the mosquito nets being utilized by residents in some houses in Nigeria as preventive and management measures in opposition to mosquitoes. PHOTO/ Collins Ojiehanor.
Okusanya outlined key habits that may improve the danger of mosquito-borne ailments and referred to as for important behavioural adjustments. She harassed that neglecting to make use of insecticide-treated nets, not carrying protecting clothes, and failing to use insect repellents considerably heightens vulnerability to mosquito bites.
“Failing to make use of handled mattress nets is a significant oversight in defending your self from mosquito-borne sicknesses,” she emphasised.
Each malaria, dengue and yellow fever are unfold by mosquitoes, and the prevention and management of those ailments closely rely upon vector management strategies. Though for malaria, WHO recommends two key vector management interventions: insecticide-treated nets (ITNs) and indoor residual spraying (IRS).
These strategies have been efficient in lowering the transmission of malaria, however their impression on dengue is restricted resulting from variations within the behaviour of the mosquitoes that transmit the viruses in keeping with WHO report.
Additional extra, the report exhibits that dengue-carrying mosquitoes, primarily Aedes aegypti and Aedes albopictus, are lively through the day, making ITNs much less efficient.
As a substitute, stopping dengue requires complete methods that embody environmental administration to get rid of mosquito breeding websites, using mosquito repellents, carrying protecting clothes, and making certain that houses have window screens or nets to maintain mosquitoes out.
At present, there isn’t any particular antiviral remedy for yellow fever. WHO advises that sufferers ought to relaxation, keep hydrated, and search medical recommendation. Remedy could differ relying on the severity of the illness; sufferers could also be managed at house, referred for hospital care, or require emergency remedy.
Managing dehydration, liver and kidney failure, and fever is essential for enhancing affected person outcomes. Moreover, related bacterial infections could be handled with antibiotics.
Yellow fever is notoriously tough to diagnose, particularly in its early levels, as its signs overlap with different ailments equivalent to malaria, leptospirosis, viral hepatitis, different hemorrhagic fevers, dengue, and even poisoning.
Polymerase chain response (PCR) testing of blood can typically detect the virus through the early levels, whereas later levels require testing for antibodies by enzyme-linked immunosorbent assay (ELISA) and plaque discount neutralization check (PRNT) in keeping with WHO report.
Okusanya emphasised the essential position that correct sanitation performs in controlling and stopping mosquito-borne ailments. She identified that sustaining a clear surroundings is vital to lowering the danger of those ailments.
“Correct sanitation helps by eliminating mosquito breeding websites,” she defined, noting that eradicating standing water and particles is crucial in stopping mosquitoes from multiplying.
The Want for Fairness and the Path Ahead
WHO estimates that 80% of the worldwide inhabitants is vulnerable to a number of vector-borne ailments. These ailments will not be restricted to malaria; mosquitoes, flies, bugs, and different vectors transmit a variety of viruses, parasites, and micro organism that result in lethal and debilitating circumstances.
Vector-borne ailments thrive in circumstances of poverty, the place entry to healthcare is usually restricted, and environmental circumstances present fertile breeding grounds for disease-carrying bugs.
The impression of those ailments is just not solely felt when it comes to mortality but in addition within the long-term penalties for survivors who could also be left completely disabled or disfigured, additional entrenching them in cycles of poverty and drawback.
Economically, these ailments place a heavy toll on affected communities, proscribing each rural and concrete growth.Urbanization, particularly unplanned city development, has additionally contributed to the unfold by creating environments conducive to mosquito breeding.
Excessive inhabitants density, insufficient waste administration, and unreliable water sources improve the danger of transmission. Group information, attitudes, and practices in direction of illness prevention are essential in controlling the unfold of those ailments.
By investing in vector management, enhancing group consciousness, and enhancing entry to healthcare, the world could make vital strides towards lowering the burden of malaria and dengue.
This battle is not only about controlling ailments; it’s about reaching well being fairness, selling sustainable growth, and defending the way forward for communities world wide.
Preventive measures for mosquito-borne ailments embody insecticide-treated nets and indoor residual spraying for malaria. For dengue, environmental administration and private safety are essential.
Yellow fever, which has no particular antiviral remedy, requires supportive care and vaccination, highlighting the necessity for improved immunization protection. As vector-borne ailments persist and unfold, particularly in impoverished and quickly urbanizing areas, addressing these challenges is crucial.
Investing in vector management, enhancing group consciousness, and enhancing healthcare entry are essential steps towards mitigating the impression of those lethal ailments and reaching international well being fairness.
