Prompt distribution of bed nets could prevent hundreds of thousands of malaria deaths

The prompt distribution of mosquito nets could halve the number of deaths from malaria during the coronavirus outbreak in Africa, according to a new study.

The pandemic has severely disrupted malaria control activities and researchers writing in Nature Medicine have said there could be 779,000 deaths from the mosquito-borne disease in sub-Saharan Africa over the next 12 months.

Malaria remains humanity's most deadly infectious disease. There were 228 million cases of malaria and 405,000 deaths in 2018, the WHO estimated in its most recent assessment. African nations are home to 93 per cent of malaria cases and 94 per cent of malaria deaths.

But the researchers say that prompt action could reduce the burden of malaria and stop both it and Covid-19 overwhelming health systems.

While the pandemic has not hit Africa as hard as initially feared, the number of cases are rising exponentially and the continent hit one million infections on Thursday.

Okefu Oyale Okoko, deputy director of the National Malaria Elimination Programme in Nigeria, said: “In the face of Covid-19 it will still be important to ensure vector control interventions continue to be deployed as much as possible in order to not only sustain the gains already made in malaria elimination but ensure we do not have a resurgence in malaria.”

Treating children with fever as if they have malaria even though they have not been diagnosed with the disease could save nearly 200,000 lives, the researchers concluded.

Researchers considered four different models for the spread of Covid-19 in Africa to estimate the impact on malaria control programmes.

The researchers, from Imperial College, London, said that if malaria control programmes are halted the number of malaria cases could double in 2020, compared to 2019.

In Nigeria alone, one of the most affected countries on the continent, cutting treatment and delaying the distribution of bed nets could result in 81,000 additional deaths.

Distribution of insecticide-treated bed nets is vital to controlling the disease. These are currently the most effective tool to control malaria and are typically distributed at community gatherings which may be cancelled or poorly attended because of fears over coronavirus.

Other important measures such as the distribution of preventive treatments and the spraying of homes with insecticide may also be cut back, despite World Health Organization recommendation that they should continue.  The modelling found that provision of bed nets is critical to controlling the disease - the nets are treated with long-lasting insecticide whose effects go on for about three years.

More than half of the 47 countries most badly affected with the disease were due bed net distribution this year. Some 228 million nets were due to be handed out - the largest number ever.

James Whiting, executive director of Malaria No More UK, said: “This important modelling is a reminder that efforts to end malaria sit on a knife edge. Protecting people against Covid-19 cannot be pursued in isolation. Governments must see maintaining efforts against malaria as a core part of pandemic preparedness or risk a catastrophic domino effect.”

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