• Malaria and Covid-19 share symptoms such as fever, headache, body aches and weakness.
• Malaria drug, widely touted as a potential cure for Covid-19, has shown no benefit against the virus.
Image: MAGDALINE SAYA
Suspected or confirmed Covid-19 patients in malaria-endemic areas might be required to receive a malaria diagnostic test should the government adopt WHO requirements.
Similarly, those confirmed to be having malaria infection will have to undergo Covid-19 tests.
As the world marks World Malaria Day on Saturday, the World Health Organization, in the new regulations, says malaria can coexist with many other infections, hence confirmation of malaria infection does not rule out the possibility that a patient might also be suffering from Covid-19.
This is because malaria and Covid-19 share some symptoms such as fever, headache, body aches and weakness.
This comes even as a malaria drug, widely touted as a potential cure for Covid-19, has shown no benefit against the disease over standard care, and is in fact associated with more deaths.
In a study conducted by the US government on how American military veterans fared on hydroxychloroquine, researchers looked at the medical records of 368 hospitalised veterans who either died or were discharged by April 11 across the country.
The death rate for patients on the drug was 28 per cent compared to 22 per cent when it was taken in combination with azithromycin, an antibiotic by French scientist Didier Raoult. On the other hand, the death rate among those who were receiving standard care only stood at 11 per cent.
The combination of the two among patients with severe illness was found to have no impact, as mortality persisted even after doctors adjusted the dosage to higher rates.
Previous research had shown that the drug was risky for patients with certain heart rhythm problems and can cause blackouts, seizures or at times cardiac arrest.
Hydroxychloroquine and related compound chloroquine have been used for decades to treat malaria.
On Wednesday, Health CS Mutahi Kagwe said the country’s Covid-19 response is premised on a five-year public health security framework. He urged the counties to keep an eye on other healthcare services.
“I, therefore, want to call on all counties to ensure the continuity of health services, without losing sight of the coronavirus. We should, therefore, be prepared in the coming days to share our county health service delivery scorecards,” Kagwe said.
Malaria eradication is among the services that are likely to be hurt by disruptions in the healthcare systems as a result of the virus. Malaria remains a major public health problem in Kenya and accounts for about 16 per cent of outpatient consultations.
About 70 per cent of the population is at risk of contracting malaria, with 14 million in endemic areas and another 17 million in areas of the epidemic and seasonal malaria.
According to the Kenyan National Bureau of Statistics, malaria is still the second major cause of death after respiratory infections, with nearly 70 per cent of the country’s people at risk.
The WHO now says that should exceptional situations arise in the context of Covid-19, it may be necessary to assume that fever cases are associated with malaria, and all febrile individuals should receive antimalarial treatment.
“Given that Covid-19 also leads to fever, these individuals should also be assessed for possible Covid-19 illness,” the UN agency says.
Malaria is widespread, endemic and causes illness in about 230 million people and kills about 430,000 people globally each year.
Given the grim picture of its prevalence, the ministry has also been tasked with encouraging early care-seeking for fever and suspected malaria by the general population to prevent a spike in severe malaria cases and deaths.
“Exceptional measures to control malaria, including mass drug administration or presumptive treatment, may be required to minimise increased disease and death arising from the Covid-19 pandemic,” the WHO states.
In addition, it is required that an official from the National Malaria Control Programme be part of Covid-19 response team to ensure malaria policies and practices are coordinated along with the larger health system changes going into effect due to Covid-19.
The global health agency says that even though the entire population is at risk of infection and illness, with an elevated risk of severe disease among the elderly and those with underlying health conditions, it is possible but currently unknown whether malaria and its consequences, especially severe anaemia, may increase severe Covid-19 risk. Research on the same is ongoing.
In settings where malaria is not endemic, potential Covid-19 patients are advised not to go to health facilities for fear of infecting health workers.
However, in malaria-endemic settings, it is important that patients who may have malaria access a parasitological diagnostic test and receive early treatment with an effective antimalarial drug.
According to the WHO, testing should emphasise the use of Rapid Diagnostic Tests, as these tests allow for simple procedures, limited person-to-person contact and rapid results.
“To facilitate patient flow in health facilities and ensure physical distancing, testing could be conducted in a special area away from other patients and done by staff using appropriate protective measures.”
Under the guidelines, pregnant women who experience a febrile illness or suspected malaria should be encouraged to seek care and be tested for malaria and other potential causes of the fever, including the coronavirus disease if need be.