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Malaria
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Public Health Multitasking: Measles and Malaria
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Public Health Multitasking: Measles and Malaria
Distribution of insecticide-treated bednets
during mass measles vaccination campaigns
in Africa aims at preventing two deadly
diseases.
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During the measles immunization campaign in Zambia (June 2003), children being immunized against measles also received insecticide-treated bednets (ITNs), vitamin A, and mebendazole (drug against intestinal worms). Such integrated approaches multiply the protection given to African children against deadly yet preventable diseases. |
Insecticide-treated
bednets (ITNs) are an important tool to fight death and disease
due to malaria, especially in Africa south of the Sahara, which accounts
for 90% of deaths due to malaria worldwide. One of the goals of the Roll
Back Malaria Partnership is that in Africa south of the Sahara,
60% of the people most at risk (young children and pregnant women)
will sleep under ITNs.
To date this target has not been met, because too often people who are
most in need of the ITNs do not know about them, do not have access
to them, or cannot afford them (even a unit cost of $5 is high for a
rural African family).
These obstacles may be overcome by piggybacking the distribution of
ITNs with another health intervention: immunization against measles,
another major killer of African children.
The Measles
Initiative, a partnership including the American
Red Cross, Centers for Disease
Control and Prevention (CDC), United
Nations (UN) Foundation, United
Nations Children’s Fund (UNICEF), World
Health Organization and International
Federation of Red Cross and Red Crescent Societies is a five
year commitment to eliminate measles in Africa by vaccinating 200
million children, saving 1.2 million lives. The partnership was created
in 2001 and as of June 2004 has vaccinated 120 million children.
The Measles Initiative strategy consists of mass vaccination campaigns
for children aged 9 months to 15 years during one week in a country.
Such campaigns draw mothers and children from wide areas and offer one-stop
shopping for free, much needed life-saving health opportunities. Recently,
ITNs have been successfully integrated in these campaigns:
In the Lawra district of northern Ghana,
the Ghana Red Cross and its local partners, with additional support
from other
partners, distributed 14,600 ITNs during a one-week immunization
campaign in December 2002. The ITNs were given free of charge to any
parent who accompanied a child under 5 years of age coming to the vaccination
post. Measles immunization and ITNs were delivered simultaneously to
achieve high coverage at a low cost. Prior to the campaign, only 7%
of the families in Lawra district had an ITN; after the campaign 80%
did.
In Zambia,
during one week in June 2003, the Measles Initiative vaccinated 5 million
children under 5 while the International Federation and the Canadian
Red Cross provided 90,000 ITNs in five districts. In these districts,
household ITN coverage increased from 29% (pre-campaign) to 85%, and
measles vaccine coverage reached over 95%. In addition to ITNs, the
Zambia campaign also delivered vitamin A and mebendazole (to treat intestinal
worms), addressing two other major health problems of children in Africa
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The logistical cost for delivering an ITN was US$0.32 and US$0.36 in
Ghana and Zambia, respectively.
The next step will occur in Togo in
December 2004. In the largest health intervention of its kind to date,
ITNs will be distributed nationwide: each of the 730,000 households
in Togo will receive an insecticide-treated bed net (ITN). Vitamin A,
albendazole (to treat intestinal worms) and the polio vaccine will also
be given. The intervention will be conducted by the Togo Red Cross and
partners that include the Canadian
International Development Agency and the Norwegian
Red Cross. The impact of this integrated intervention on mortality
will be measured.
(Contributed by the American Red Cross; images by Marko Kokic, Canadian
Red Cross)
Page last modified : June 22, 2004
Content source: Division of Parasitic Diseases
National Center for Zoonotic, Vector-Borne, and Enteric Diseases (ZVED)
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