• Travel Alert – Malaria in DRC

    Malaria – Congo Dr: (Haut-Uele Province)

    Malaria in eastern Democratic Republic of Congo (DRC) is “out of control” with many parents letting their sick children die at home because they cannot afford treatment, a medical charity (MSF) said as it ramps up its emergency response.

    Children under 13 [years of age] made up 80 per cent of the 45 000 malaria outpatients Medecins Sans Frontiers (MSF) has treated in the last 4 weeks in Haut-Uele Province in north eastern DRC.

    “The situation is definitely out of control,” MSF’s emergency coordinator for DRC, Stephane Reynier de Montlaux, told the Thomson Reuters Foundation in a telephone interview. “Many people are dying. It is children that are the 1st victims.”

    The government asked MSF to step in after recording more than 93 000 malaria cases in 4 health zones in the province in the 1st 16 weeks of 2016 – almost 4 times the figure for 2015.

    Malaria is the leading cause of mortality in DRC, with 21 million cases in 2013,

    Malaria is the leading cause of mortality in DRC, with 21 million cases in 2013, the 2nd highest globally after Nigeria, World Health Organization data show.

    MSF said it was unclear what has caused the outbreak and is providing medicines and support, including latrines and chlorine to keep overcrowded hospitals clean.

    Most patients in eastern DRC seek treatment at health posts where malaria drugs are supposed to be free. But patients end up paying for a prescription if the drugs are out of stock and are also charged for further tests and treatment as required, Reynier de Montlaux said.

    “They cannot go to the hospital just because they cannot afford the price (of treatment) and whole logistics (of getting there),” he said.”So they go back to the village and the kid dies in the village. It’s a very recurrent story.”

    There have been reports of numerous burials since the surge in malaria cases was recorded, Reynier de Montlaux said. “I met a mother in a health centre. A village she was visiting 2 days before lost 10 children in 1 week which is really enormous,” he said.

    DRC is one of the poorest countries in the world, lacking basic infrastructure like roads and health posts. Eastern Congo, home to numerous militias, is plagued by bouts of volatility following a regional conflict between 1996 and 2003, which sucked in more than half a dozen countries.

    Out of 10 children diagnosed with malaria by MSF, 4 also had severe malnutrition, complicating their treatment. MSF has admitted 1600 malaria patients to hospital over the past 4 weeks because they required intensive care, such as blood transfusions and oxygen therapy.

    Communicated by: ProMED-mail

    As discussed in our comment to another report of malaria in the Democratic Republic of Congo (DRC), government funding for malaria control is negligible. The situation as described here is a supposedly public health care system providing free treatment, but without drugs and a private sector with unaffordable drugs.

    According to UNICEF the under-five mortality in DRC is 15 per cent and the maternal mortality is 1.3 per cent of pregnant women giving birth. These numbers are probably an underestimation, especially in a situation of an acute surge in malaria cases, which also contribute to maternal deaths, as well as deaths for premature and small newborn babies


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