Malaria Control Strategy in Shell Companies in Nigeria—The Health Issues

Abstract

Abstract Malaria is a major public health problem worldwide. It is estimated that 500 million clinical cases of malaria are recorded yearly resulting in about 3 million deaths. Malaria transmission is very high in the Niger Delta region where Shell Nigeria (SCiN) operates. The disease is listed as the most frequent cause of mortality and morbidity among the population of this region. The non-immunes among Shell hospitals eligible population (expatriate staff and their families, Nigerians returning from overseas postings, children under 5 years of age, Sicklers and pregnant women) are all prone to severe forms of malaria. Malaria control is therefore one of Shell's topmost health priorities as it is a high health risk that also has the potential to impact on reputation and profit. SCIN has developed an integrated and highly effective malaria control program to checkmate the malaria scourge among staff and their dependants. A Malaria Working Group coordinates this program. The programme has proven to be very effective at reducing malaria morbidity and mortality. Our overall case fatality rate (CFR) of 0.00005% (i.e. 1 in 20,000) over the last 10 years compared with 1 to 5% in the Nigerian population is a highly commendable achievement. The CFR among Shell Nigerian expatriate staff and their dependants is 0%. The national CFR target is <0.5%. External assessors have described the control programme as "world-class". This paper outlines the critical components in the Integrated Malaria Control Program and their interaction. It also addresses our approach to best-practice sharing, managing recurrent issues including inconsistent or inappropriate chemoprophylaxis advice, compliance with advised and mandatory prophylaxis and malaria occurring in non-immunes after departure from Nigeria. The application of a well-designed malaria control and recovery strategy is highly effective in controlling malaria even in hyper-endemic regions.