Roll Back Malaria Partnership: Ghana Progress and Challenges towards SUFI

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Ghana: Progress and Challenges towards SUFI

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Ghana: Malaria Distribution Map

Survey-Based Progress Tracking

Indicator DHS 2003 MICS 2006
% of households with at least one mosquito net of any type 17.6 30
% of households with at least one insecticide-treated net (ITN) 3.2 19
% of children under five years of age sleeping under any type of mosquito net 15 33
% of children under five years of age sleeping under an insecticide-treated mosquito net (ITN) 4 22
% children under five years of age with fever receiving any anti-malarial medicines 63 61
% children under five years of age with fever receiving any anti-malarial medicines promptly (within 24 hours) 44 48
% of Children with fever receiving any anti-malarial medicines 63 61
% of women who received IPT (treatment with at least 2 doses of SP/Fansidar) during pregnancy 1 67
% of pregnant women aged 15-49 years sleeping under any type of nets 9.5 -
% of pregnant women aged 15-49 years sleeping under an ITN 2.7 -

Source: DHS 2003 and MICS 2006

I. Epidemiological background

Parasite (Plasmodium) types The crude parasite rates range from 10-70%, with Plasmodium falciparum accounting for 90-98% of all infections, P. malariae for 2-9%, and P. ovale for 1%.
Main Malaria vector (mosquito) types The predominant malaria vector species in the entire country is the Anopheles gambiae ss. which is indoor-biting (endophagic) and indoor resting (endophilic). In addition, Anopheles melas is found in the mangrove swamps of the southwest whilst An. Arabiensis (exophilic and exophagic) is in the savannah areas of northern Ghana. Anopheles funestus is another vector found in the tropical rainforest belt of the country and is also endophagic and endophilic in nature. Characteristically, these species are highly anthropophilic and bite late in the night, and are commonly found in the rural and peri-urban areas.
Total population 21,832,963(2007)
Population at risk 21,832,963(2007)
~ 100% of the Population lives in areas at risk of malaria.
Pregnant women at risk of malaria 873,319 (2007)
Children under five at risk of malaria 4,366,593 (2007)
Malaria Mortality and Morbidity
Reported malaria episodes per year 3,411,452 (2006)
Malaria deaths per year (all ages)(reported) 2,835 (2006)
Under 5 child mortality (per 1000) 111 (2006)
Infant mortality rate (per 1000 live birth ) 71 (2006)
II. Current Policy and Strategy

Anti-malaria Drug policy
In April 2004, Ghana changed its anti-malaria drug policy as follows: Chloroquine which was first-line drug for uncomplicated malaria was replaced with Artesunate-Amodiaquine (AS+AQ). Parenteral quinine was maintained for severe and complicated malaria whilst Sulphadoxine-Pyrimethamine (SP) was used for intermittent preventive treatment in pregnancy. (IPT). The change came about because there was evidence that malaria parasite had developed resistance to Chloroquine: treatment failure rates ranged from 8.6% to 26.6% in the different sites and 75.6% overall average adequate clinical response. Parasitological failure also ranged from 21.7% to 49.0% Anti-malaria Drug policy In April 2004, Ghana changed its anti-malaria drug policy as follows: Chloroquine which was first-line drug for uncomplicated malaria was replaced with Artesunate-Amodiaquine (AS+AQ). Parenteral quinine was maintained for severe and complicated malaria whilst Sulphadoxine-Pyrimethamine (SP) was used for intermittent preventive treatment in pregnancy. (IPT). The change came about because there was evidence that malaria parasite had developed resistance to Chloroquine: treatment failure rates ranged from 8.6% to 26.6% in the different sites and 75.6% overall average adequate clinical response. Parasitological failure also ranged from 21.7% to 49.0%.

Access to effective malaria case management using efficacious drugs
This strategy addresses malaria management at household level as well as health facility level. It seeks to ensure that caretakers/parents recognize symptoms and signs of malaria and respond appropriately and promptly within twenty-four hours of onset. Health care workers have been trained and provided knowledge and skills to manage all cases of malaria including complications promptly and appropriately in order to reduce morbidity and mortality due to malaria. Artesunate-Amodiaquine (AS+AQ), the treatment of choice for the management of uncomplicated malaria since 2005 has been available countrywide.

Ensuring multiple preventive interventions including Integrated vector control
The Integrated Malaria Vector Management Policy, developed by the NMCP in coordination with all key stakeholders places considerable emphasis on four primary intervention areas (environmental management, adulticiding and larviciding, biological control, and insecticide-treated materials). These interventions may be used singly or in combination, depending upon the epidemiological setting.

For more details see the National Strategic Plan.

III. Primary interventions

[+] Malaria mortality and morbidity

[+] ITN coverage

[+] Treatment of Under fives

[+] Intermittent Preventive Treatment and ITN use for pregnant women

[+] Drugs used to treat fibrils Under fives

Source: MICS 2006 report; NMCP Ghana

IV. Challenges and Priority support needs (2008 - 2010)

Information not available

V. Key RBM Partners in Ghana

For questions, contact:
Mrs Bart-Plange Constance, National Malaria Control Programme Manager
Dr Claude Emile Rwagacondo, RBM Partnership Focal Point for West Africa Regional Network
Dr B-B Udom, RBM Partnership facilitation
Dr James Banda, RBM Partnership facilitation Coordinator