In 2020, the number of malaria patients that were reported in Sri Lanka was 30, and in comparison to other diseases, that is a very low number, while for 2021, we have so far recorded only seven cases of malaria, the National Anti-Malaria Campaign revealed. However, authorities believe danger still lurks with the possibility of the disease being imported to the country.
The National Anti-Malaria Campaign also stated that every year the Ministry of Health allocates nearly Rs. 1 billion to prevent malaria from being reintroduced to Sri Lanka.
“Although we have a very few patients that have contracted malaria, we need to remember that these numbers could increase at any given time. All these cases of malaria that are getting reported are imported cases and are found to be in persons returning from countries in the African continent,” National Anti-Malaria Campaign Director Dr. Prasad Ranaweera explained.
Dr. Ranaweera noted that if these persons fail to inform the healthcare services about their travel history and if they have contracted malaria and do not take the necessary treatment, they are able to reintroduce the parasite through a mosquito to the community.
National Anti-Malaria Campaign Technical Support Team Member Prof. Anula Wijesundara recalled that Sri Lanka faced three malaria outbreaks which took place in 1935, 1970, and between 1986-1987, adding: “The most aggressive outbreak took place in 1935 where about 80% of Sri Lanka’s population at the time contracted malaria. Which means out of the six million people in Sri Lanka, about five million had malaria and about 80,000 persons had died due to malaria.”
Prof. Wijesundara noted that the number gradually decreased up until 1961 when the malaria patients dropped to 17 that year, after which Sri Lanka was recognised as the country that eliminated malaria. However, due to the lack of a proper surveillance mechanism at the time, the detection rates for malaria had dropped and even controlling the mosquito population had been ignored and the public had forgotten about the disease.
“That gave rise to the second outbreak of Malaria, where in 1970 we had 500,000 malaria patients in the country and the third outbreak which took place in 1986-1987 reported 600,000 malaria patients. With the gradual decrease in the number of cases reported, the last patient that contracted malaria in Sri Lanka was reported in 2011,” Prof. Wijesundara elaborated.
Present situation
It is estimated that about 30% of the monies budgeted for healthcare was allocated to eradicate malaria. With the country not reporting any indigenous cases of malaria in 2016, the World Health Organisation (WHO) declared Sri Lanka as a country free of malaria. Yet, the possibility of malaria spreading in the country is still high.
As Prof. Wijesundara noted, Sri Lanka’s weather is ideal for the Anopheles mosquitoes to breed. “The climatic conditions, the irrigation system that is established across the country is providing ample breeding grounds to these mosquitoes. Which is why we said that Sri Lanka still has a risk of getting malaria, as we could easily allow the vector to breed in the country.”
Sri Lanka recently detected the Anopheles stephensi mosquito breed which was found to be causing urban malaria in India. The vectors have been identified in Jaffna and Vavuniya. According to Prof. Wijesundara, at present, an eradication campaign has been launched in these areas, and as a first step, any wells that are not being used are being closed, and the team is also collecting vector samples to study whether they carry the parasite.
“This recent detection only proves that we might see an increase in cases of urban malaria in the Northern Province. In addition to that, malaria is easily contracted through travel, and we have a lot of foreigners travelling to Sri Lanka from countries like India and China to work at construction sites. These workers can easily bring malaria to the country,” Prof. Wijesundara elaborated.
She also pointed out that gem merchants of Sri Lanka who constantly travel to Madagascar and Mozambique are at high risk of contracting malaria and then importing the disease to the country. Apart from that, military personnel that go on United Nations Peacekeeping missions deployed to the Central African countries, such as South Timor and South Sudan, can also import the malaria parasite to Sri Lanka.
Side effects of malaria
Elaborating on the side effects of malaria, Prof. Wijesundara stated that they could fall ill constantly, experience anaemia, slow growth rate/loss of bodily strength, and mental instability.
Speaking about the groups that were vulnerable to malaria during the three outbreaks, Prof. Wijesundara explained that farmers, especially in the Anuradhapura and Polonnaruwa Districts, were among the highest number of cases that were reported.
“Since they had lost their bodily strength, they were unable to work the fields, and there were some unfortunate incidents where some farmers that could not pay off the loans they had obtained, had died by consuming poison,” Prof. Wijesundara noted.
She also noted that if pregnant women contract malaria, due to the high fever, there can be miscarriages or it could affect the growth of the foetus, cause congenital abnormalities, cause low birth weight, and anaemia in the newborn.
Dr. Ranaweera added: “Therefore, it is important that vulnerable groups seek medical advice and take chloroquine 10 days before travelling to a country where malaria is endemic. In addition to that, when a person returns from a country where malaria is endemic, they should keep their area’s medical officer of health informed and if they contract high fever and symptoms of malaria, they should seek immediate medical attention.”
When The Sunday Morning inquired on how the health authorities plan to control the reintroduction of malaria to the country, Dr. Ranaweera said that the present quarantine procedures in place for Covid-19 are assisting them to easily identify persons returning from countries where malaria is endemic.
“We collect blood samples from such individuals to run the necessary tests to detect whether they have been infected by the malaria parasite. In 2020, most of the detections of malaria cases took place at quarantine centres. In addition, our entomologists also collect vector samples in areas where malaria incidence has been reported. Following this, they will take the necessary steps to destroy the mosquito breeding grounds,” Dr. Ranaweera elaborated.
Dr. Ranawera also noted that any person that is tested for malaria is also prescribed the necessary medicines to kill the parasite that has entered their bloodstream.
Dengue on the rise
The Dengue Control Unit meanwhile has raised concerns over the increasing numbers of dengue cases getting reported across the country. The total number of cases between 1 January and 23 April was recorded at 6,389, with the highest number of cases reported from the Batticaloa Regional Director of Health Services (RDHS), which has reported 2,686 cases, and the Colombo RDHS, which reported 939 cases.
“Since the symptoms of Covid-19 and dengue are similar in nature, we urge the public to get tested for dengue as well if they are showing symptoms. We are also launching clean-up campaigns in public places, with priority given to schools and universities. We also request the public to keep their surroundings clean and destroy any potential breeding grounds in their homes,” Dengue Control Unit Director Dr. Aruna Jayasekara informed.
Meanwhile, Colombo Municipal Council Chief Medical Officer Dr. Ruwan Wijeyamuni stated that the Public Health Department had deployed 60 teams to carry out house inspections, especially in the Colombo Central and Colombo North regions.
“Our PHI teams had inspected 22,000 households and issued 440 red notices to premises that had mosquito breeding grounds,” Dr. Wijeyamuni added.
Speaking to The Sunday Morning on controlling the increasing dengue mosquito population, National Dengue Control Unit Director Dr. Aruna Jayasekara said: “Our entomological surveillance carried out across the country in the month of March had inspected 36,384 premises, out of which 2,534 premises had potential mosquito breeding grounds. Once such areas are recognised, we employ vector control measures such as indoor residual spraying (IRS) and space spraying to control a further increase of the dengue mosquito population.”
Dengue on the rise
The Dengue Control Unit meanwhile has raised concerns over the increasing numbers of dengue cases getting reported across the country. The total number of cases between 1 January and 23 April was recorded at 6,389, with the highest number of cases reported from the Batticaloa Regional Director of Health Services (RDHS), which has reported 2,686 cases, and the Colombo RDHS, which reported 939 cases.
“Since the symptoms of Covid-19 and dengue are similar in nature, we urge the public to get tested for dengue as well if they are showing symptoms. We are also launching clean-up campaigns in public places, with priority given to schools and universities. We also request the public to keep their surroundings clean and destroy any potential breeding grounds in their homes,” Dengue Control Unit Director Dr. Aruna Jayasekara informed.
Meanwhile, Colombo Municipal Council Chief Medical Officer Dr. Ruwan Wijeyamuni stated that the Public Health Department had deployed 60 teams to carry out house inspections, especially in the Colombo Central and Colombo North regions.
“Our PHI teams had inspected 22,000 households and issued 440 red notices to premises that had mosquito breeding grounds,” Dr. Wijeyamuni added.
Speaking to The Sunday Morning on controlling the increasing dengue mosquito population, National Dengue Control Unit Director Dr. Aruna Jayasekara said: “Our entomological surveillance carried out across the country in the month of March had inspected 36,384 premises, out of which 2,534 premises had potential mosquito breeding grounds. Once such areas are recognised, we employ vector control measures such as indoor residual spraying (IRS) and space spraying to control a further increase of the dengue mosquito population.”