More than 400,000 people in the world die of malaria every year – and, although it is a preventable and treatable disease, two-thirds of the deaths are among children under the age of five, according to a report by the World Health Organisation (WHO) published last year.

It said malaria accounted for 50% of total consultations in health facilities in northeast Nigeria. In Borno and Yobe states, the WHO estimated that more than half of the morbidity and mortality were due to malaria, a proportion that was higher than all other causes combined, including measles, cholera and hepatitis E.

The WHO said malaria killed almost 100,000 people each year in Nigeria. Nearly one out of every three of these deaths occurred in an emergency setting within populations displaced by violence, struggling to get the food, water, shelter and security they need to live.

Because of the recent uptick in the number of cases of malaria, the Borno State Primary Health Care Development Agency in the Maiduguri Metropolitan Council and Jere Local Government Area started a house-to-house campaign to vaccinate all children aged five and under against malaria.

The campaign started on Saturday, August 14.

The Jere focal person, Wakil Bukar, told RNI reporter Nana Hadiza Mustapha that there had been an upsurge in the number of cases of malaria and the campaign was intended to vaccinate children aged five and under because they were the most vulnerable.

Fatima Muhammad, a resident of Maiduguri, said she was grateful for the initiative and would cooperate fully with the healthcare agency. “We need to do whatever we can to protect our children. There has been an increase in the number of cases, so the campaign is timely and we should all support it.”

Bukar said most parents in Maiduguri and the Jere Local Government Area were happy about the initiative and pledged their support en masse and had welcomed the healthcare workers into their homes.

But not everyone was happy. A few parents considered the vaccine “a conspiracy”. They had doubts about it and some said even if they were paid to get their children vaccinated, they would not allow it. They did not say why they were so doubtful about the vaccine or what harm it would cause.

“The parents will not cooperate with you sometimes but as a health worker you need to be patient with them and continue to educate them on the importance of the vaccine as well as the consequences of rejecting it. Once they know all the facts they often approach you to get the vaccine. We are hoping the parents will come round to our way of thinking. It is very important that children, especially, get the vaccine,” Bukar said.

The vaccinations would be given by Community Oriented Persons (CORPs), who were community-based healthcare providers, and who had been trained, certificated and engaged by the WHO to provide comprehensive healthcare interventions at home to children, including malaria, pneumonia and diarrhoea.

The CORPs would be going from house to house in the two local government areas to educate parents about the importance of the vaccine. The aim was to make Borno State malaria-free.

Yagana Abatcha, a resident of Jere Local Government Area, said that her 29-month daughter had been vaccinated. “I did not even have to take her anywhere. They came to our house and gave her the vaccination. I am very grateful.”

Médecins Sans Frontières (MSF) – also known as  Doctors Without Borders – said the rainy season in northeast Nigeria brought a huge uptick in rates of malaria. The geographic location of Nigeria made it suitable for malaria transmission throughout the country. Although the rainy season was the time more infections occurred, in most parts of the country it was all year round.

WHO Key Facts

• Malaria is a life-threatening disease caused by parasites that are transmitted to people through the bites of infected female Anopheles mosquitoes. It is preventable and curable.
• In 2019, there were an estimated 229 million cases of malaria worldwide.
• The estimated number of malaria deaths stood at 409 000 in 2019.
• Children aged under five years are the most vulnerable group affected by malaria; in 2019, they accounted for 67% (274 000) of all malaria deaths worldwide.

The WHO African Region carries a disproportionately high share of the global malaria burden. In 2019, the region was home to 94% of malaria cases and deaths.

The WHO described malaria as an acute febrile illness. In a non-immune individual, symptoms usually appeared 10 to 15 days after the infective mosquito bite. The first symptoms – fever, headache and chills – could be mild and difficult to recognise as malaria.

Children with severe malaria frequently developed one or more of the following symptoms: severe anaemia, respiratory distress in relation to metabolic acidosis, or cerebral malaria. In adults, multi-organ failure was also frequent. In malaria endemic areas, people could develop partial immunity, allowing asymptomatic infections to occur.