A Survey of the Incidence of Malaria among Vulnerable People of Luano District, Central Zambia Case Study Session Dr. Chileshe Benard, RCE Lusaka 9th African Regional RCE Meeting 5-7 August, 2019, Luyengo, Eswatini

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A Survey of the Incidence of Malaria among Vulnerable
People of Luano District, central Zambia
A Presentation made at the 9th African RCE Regional Meeting on ‘Accelerating
Progress towards the Achievement of Sustainable Development Goals in Africa’
Date: 5th - 7th August, 2019 at University of Eswatini, Luyengo Campus, Eswatini
RCE Lusaka
Bernard Chileshe
Mirriam Sampa Moonga
• RCE Name and Country: RCE Lusaka, Zambia
• RCE Challenge: Ill-health among vulnerable rural
communities in Zambia.
• RCE Educational Strategy and Response:
Sensitization Workshops.
• Link to SDGs and Targets:
• Goal 3: Ensure healthy lives and promote wellbeing
for all at all ages.
• Targets 3.1, 3.2 and 3.3: By 2030, reduce global
maternal mortality ratio, end preventable deaths of
infants and under-5 children, end among other
diseases, malaria, respectively.
Background
• Malaria is a parasitic disease that is transmitted
between humans through the bite of the female
Anopheles mosquito.
• In Zambia, the malria parasite Plasmodium
falciparum is by far the most deadly and common.
• Malaria is a major public health challenge in Zambia
and remains endemic across all ten provinces in the
country.
• In 2014, 5.8 million cases of malaria were reported
through the National Health Management Information
System (HMIS) and 4,000 deaths resulting.
• Morbidity and mortality are highest among pregnant
women (lowered immunity), under 5 children (have
not yet developed strong immune systems) and rural
populations = the most vulnerable groups.
Repercussions of ill-health
a) A disease-laden population is not a productive population
b) Lost years of healthy life.
c) Undermine socio-economic lives and destabilize societies
d) At home, economic burden related to direct medical costs. Diverting finances to
procuring treatment. Can lead to dissaving, borrowing and selling assets, and
falling into poverty.
e) Productive time is wasted on taking care of the sick.
f) At the work place, colleagues have to increase their workload to cover up work of
the ill colleague. Can lead to lose of employment.
g) Ultimately, death. May result in orphans and widows/widowers and attendant
problems.
• Scholars recommend that more research and surveillance is needed to improve the
understanding of the overall epidemiology of malaria in Zambia.
The Study Area: Luano District in Central Zambia
• Luano is a new district in the Central Province of Zambia (used to be
part of Mkushi District, until October 2012)
• 2019 population estimate: 36,082, rising rapidly from 13, 853 in
2000.
• 12,929 (50.6%) are male and 12,619 (49.4%) are female.
• Area: 9,211 km² – Density: 3.917/km² [2019], vast but sparsely
settled.
• The area is a hard- to-reach escarpment zone.
• Prone to both droughts and floods.
• Lagging behind in socio-economic development.
.
The location of Luano District in Zambia

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Objectives the study
a) To map the incidence of
malaria in six villages in the
region.
b) To establish the major
challenges to malaria control
in the area.
c) To hold malaria-prevention
sensitization workshops in the
area.
The UniversityTeachingHospital,Lusaka
Challenges identified
1. Settlements further away from the district admin
centre had higher incidence of malaria.
2. Age groups 5-15 years were more affected by malaria
(they did not receive insecticide treated mosquito
nets).
3. Pregnant women and chikdren were more favoured
to get insecticide treated mosquito nets.
4. Men rarely presented themselves for treatment;
therefore women appeared to suffer more from
malaria.
5. Unkempt surroundings (tall grass, maize fields,
puddles of water) contributed to prevalence of
malaria.
Challenges cont…
6. People spent time outside the house in the
evening exposing themselves to mosquitoes.
7. Hastily constructed dwellings let in
mosquitoes.
8. Mosquitoes used as fishing nets.
9. Some people did not like using mosquito nets
even if they had them.
10. Knowledge of malaria symptoms was very
high.
11. Knowledge-Action Gap (KAP)
Impacts of Malaria in Luano Area
• Impacts of having malaria
included:
• Children staying away from
school;
• Women who are home-minders,
failing to run homes;
• Men failing to till farmland;
• Household money spent on
procuring drugs.
Lessons learnt
• This study provided an insight into the challenges
facing rural communities concerning the disease
burden and how lack of amenities such as clinics and
insecticide-treated mosquito nets impacts on them.
• The study indicated the need to for two things:
(a) Providing education and sensitization to rural
communities (e.g. on residual spraying and use of
insecticide treated nets).
• This can help to them to respond appropriately to
malaria prevention, and, therefore, minimize loss of
lives and their disruptive consequences.
(a) Lifting rural people out of poverty(some people did
not use nets because they could not afford them). Or
used nets that they were given for fishing because
they could not afford fishing nets.
ECONOMIC EMPOWERMENT
Preventing malaria
• People in the area can take malaria
tablets to avoid catching the
disease.
• They can avoid getting bitten by
mosquitoes. Bed nets, insect
repellent spraying and long-sleeved
• Slash tall grass around the houses.
• Bury sites where stagnant water
collects. clothing are required for this purpose

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Conclusion
• There can be no accelerated
development towards meeting SDG 3
in Zambia if rural areas like Luano still
lag behind in accessing health care.
• Robust programmes needed in the
distribution of insecticide treated nets
and spraying for mosquitoes should
continue.
• This to go side by side with community
sensitization.
• Government constructing 650 health
posts, most of them in rural areas.
Long-lasting insecticide-treatednets (LLINs)
Indoor residual spraying (IRS)
Relationship to other RCE Activities
• This study essentially links well with other
projects that RCE Lusaka has undertaken in the
recent past:
1. Promotion of fish aquaculture to ensure
sustainability in fish production in the country
and among vulnerable communities;
2. Promotion of growing potted vegetables in
sacks for improved student diet at the
University of Zambia (and other communities
where people live in confined space);
3. Rainwater harvesting at the University of
Zambia
Thank you for listening!
Merci de votre attention!
Obrigado por escutar!
Siyabonga!
Salani kahle!!