As countries in the Horn of Africa grapple with the ongoing heavy rains and widespread flooding attributed to El Nino, health experts are sounding the alarm about a potential surge in malaria infections across the region.

According to authorities at key public health agencies, including the United Nations, the World Health Organisation (WHO) and the Kenya Medical Research Institute (Kemri), the region should remain alert since the extreme weather conditions are predicted to last until early next year.

“Malaria cases are expected to spike in epidemic-prone areas in the Horn of Africa due to El Niño impacts while displacement, crowding and lack of access to vaccination are likely to increase the risk of diseases such as measles and meningitis,” said the UN Office for the Coordination of Humanitarian Affairs in an alert.

Cholera outbreak

While acknowledging that the El Nino conditions are likely to trigger an outbreak of multiple diseases, WHO has warned that malaria remains a major threat and a leading public health concern in East Africa. The region accounts for a quarter of global malaria cases, making it a critical area of focus in the fight against the disease.

The reason is an outbreak of new malaria cases in a region that is already grappling with outbreaks of cholera would be catastrophic.

“East Africa is already facing one of the worst cholera outbreaks in years, one of the longest ever recorded in the region. Heavy rainfall and flooding, often leading to increased water contamination, will likely exacerbate and further prolong this outbreak. Flooding will also provide ideal conditions for mosquito multiplication and the emergence and/or exacerbation of malaria,” read a WHO report on public health situation in the Horn of Africa.

According to Damaris Matoke-Muhia, the Principal Research Scientist at KEMRI, the looming wave of new infections may undo the progress made in malaria control in Kenya since transmission rate can go as high as 30-50 per cent during the rainy season.

Kenya has reduced malaria prevalence by over 50 per cent in the last decade and the number of new cases has also significantly decreased.

“Any change in climatic conditions, like the ongoing rains and floods, impacts public health. The current wetter-than-normal conditions are a favorable environment for the multiplication of vectors like mosquitoes. This will definitely result in a surge in cases of vector-borne diseases like malaria, chikungunya, dengue fever, leishmaniasis and yellow fever,” Matoke added.

According to Matoke there is need for coordinated response to the impending threat.

He said that concerned authorities should sensitize communities and individuals to cover all water containers and drain puddles of stagnant water to avoid mosquito breeding.

There should also be campaigns on using malaria control tools such as nets and spraying houses with insecticides or repellents. Mechanisms for early diagnosis and treatment can also go a long way.

“The country’s contribution to the fight against malaria cannot be gainsaid. In light of the ongoing heavy rains and widespread flooding, Kenya’s Ministry of Health has developed a comprehensive contingency plan to respond to health-related emergencies or disease outbreaks effectively, with the Division of Malaria Control actively involved,” says Matoke.

Loss of lives

The El Nino conditions have triggered flooding in most parts of the region, including Somalia, Kenya, Burundi, Ethiopia, Rwanda, South Sudan, Sudan, Tanzania and Uganda, leading to loss of lives and livelihoods and human displacement.

By November 15, according to OCHA, more than 3,100,000 people were affected by the heavy rains and flooding, with at least 772,000 displaced in Kenya, Somalia, Uganda, Burundi and Ethiopia.

The most affected countries include Somalia (1.7 million people), Ethiopia (760,000 people), South Sudan (450,980 people), Kenya (122,075 people), and Sudan (89,200 people).

According to Matoke though there are regional efforts that have been put in place to address cross-border malaria infections, such as the recent establishment of the Great Lakes Malaria Initiative (GLMI) by the East Africa Community secretariat, there is need for ramping up of treatment and control measures. The interventions should go beyond East Africa and cover the whole of sub-Sahara Africa.