Enhancing Malaria Prevention in Cameroon Through Community Participation: An in-Depth Review

Jato Denis Mbako

doi:10.11648/j.cajph.20170306.12

Abstract

Despite 66 percent reduction in mortality between 2000 and 2015, malaria remains a major global public health problem, affecting mostly Sub-Saharan Africa. Cameroon remains endemic to malaria, with about 41 percent suffering at least one episode of malaria, annual overall mortality of 30 to 35 percent and 67 percent childhood mortality. Cameroon government’s subsidy on artemisinin combination therapy (ACT) for uncomplicated malaria, intermittent preventive treatment for pregnant women (IPTp), free distribution of insecticide treated bed nets (ITNs) to pregnant women and under-fives have been more of a top-down approach, with the affected communities mainly at the receiving end. Challenges of failed adherence to test results, drug and insecticide resistance, substandard and self-medication, low ITN ownership and utilisation have been identified, especially in the rural areas. This study reviews malaria prevention in Cameroon and proposes community based context-specific complementary interventions strategies that will promote community participation in prevention and mitigate the effects of poverty towards achievement of the sustainable development goals targets for malaria. The study involved an in-depth review of secondary data from electronic and non-electronic documents. Electronic search was done in Global Health, PubMed, governmental and non-governmental organisation websites, journals and google scholar. Non-electronic documents from the University of Leeds and World Health Organisation (WHO), Geneva libraries were also used. A conceptual framework on integrated community-based approach on intervention to prevent neglected tropical diseases and infectious diseases of poverty was adapted and used, while different intervention strategies were analysed. A total of 96 publications were eligible for inclusion. Analysis of the factors influencing malaria prevention in Cameroon, reveals that current measures alone are insufficient. Therefore, a combination of multiple delivery strategies using an integrated community-based approach is likely to be more effective in breaking the transmission cycle than single programme interventions. Concurrent implementation of community mobilisation through social groups and Village Development Committees, education on house screening, training of mothers and caregivers and health promotion through environmental management were recommended as the best and most feasible strategies to complement current interventions in Cameroon.

Highlights

Despite 66% reduction in mortality between 2000 and 2015, [1] malaria remains a major global public health problem, [2] with an estimated 214 million new cases and 438,000 deaths in 2015
[17] This calls for education of target groups like school teachers, students and pupils, mothers, caregivers, and households to enhance community acceptability and promote behaviour change. [18] b) Community Mobilisation on malaria prevention Community mobilisation involves the formation of support groups, motivating and engaging whole communities to get involved in health interventions
Case Management Failed adherence to malaria test results had been reported in Cameroon, with about 45% of rapid diagnostic tests (RDT) in Cameroon poorly adhered to, and 70% of malaria negative febrile patients treated with artemisinin combination therapy (ACT)

Summary

Introduction

Despite 66% reduction in mortality between 2000 and 2015, [1] malaria remains a major global public health problem, [2] with an estimated 214 million new cases and 438,000 deaths in 2015. [5] About 41% of the population suffers at least one episode of malaria each year, [4] with the highest mortality among women and under-fives. [2] Of the most malaria-endemic countries, Cameroon is ranked third in Central Africa and eleventh in Africa, [8] with a prevalence of 71 and 29 per 1000 in high and low transmission areas respectively. Despite setbacks with current interventions (more of a top-bottom approach), and the continuous high prevalence of malaria, the role of affected communities seems virtually ignored. This study had as aim to review malaria prevention in Cameroon, analyse existing gaps and propose interventions strategies that would promote community participation to complement current preventive measures towards achievement of the sustainable development goals (SDGs) targets for malaria

Methods

Results

Conclusion