By JOHNSON KANAMUGIRE

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The flooding from the unusually heavy rains in the country in recent months is likely to increase the risk of waterborne diseases like malaria and cholera.

This is because sanitation and hygiene may quickly deteriorate as sewage contaminates drinking water.

In addition, hectares of stagnant water will become breeding grounds for mosquitoes that spread and transmit malaria.

The government recently issued an alert following a cholera outbreak in neighbouring Uganda.

The Ministry of Health has asked citizens travelling to Uganda and those living along the border to be vigilant and maintain high levels of hygiene.

Cholera is an acute diarrhoeal disease that is contracted by ingesting food or water contaminated with a bacterium carried in human faeces and spread through poor sanitation and dirty drinking water.

It can kill within a few hours if not treated.

Symptoms

The signs and symptoms of cholera include abdominal pain, severe diarrhoea, vomiting and dehydration.

“We urge all Rwandans in general and those residing in sectors bordering Uganda to be careful about taking food, drinks or fruits that are unhygienic while in Uganda,” Health Minister Diane Gashumba said in a statement issued last week.

She also urged the public to report any suspected cholera case and to take appropriate prevention measures like ensuring proper hygiene at homes, washing hands with soap, drinking boiled water and maintaining clean toilets.

Now, the Ministry of Health says it is monitoring the health situation and preparing to intervene specifically regarding malaria.

According to the ministry, cases of malaria may rise to levels above the usual trend this year, mainly due to the huge amount of stagnant water as a result of the floods. These water bodies are now potential breeding sites for mosquitoes.

There is concern that people living in high-risk areas like urban areas with poor drainage could be the most affected.

People are being urged to take preventive measures such as sleeping under mosquito nets and seeking timely medical care for malaria.

Interventions

Patrick Ndimubanzi, the State Minister of Public and Primary Health Care said the government is already in the process of deploying special control interventions for high-risk regions for malaria.

But, he emphasised that efforts were needed at the community level to deal with stagnant water left behind by the floods.

Mr Ndimubanzi added that the government will ensure sufficient drugs and diagnostic testing systems aredeployed to all regions and especially those most affected by the disease.

“We cannot afford to lose more people to malaria on top of those who recently died due to the devastation caused by the heavy rains. We encourage people to take precautions, but also seek the help of community health workers who are currently well-equipped to respond to malaria cases,” he told Rwanda Today.

The recent heavy rains and resultant floods and landslides that killed hundreds of people and caused damage to property, came at the same time when the country was entering the peak time for malaria, which is expected to go on until July and another period to start from November to December.

Report

A 2017 World Health Organisation report put Rwanda among the countries experiencing an increase in malaria cases, having registered more than one million new cases of malaria between 2015 and 2016.

While the Ministry of Health did not respond to our request for new data by press time, figures shared during a joint meeting on firming up malaria prevention efforts held in May, which brought together heads of health facilities, local officials and Rwanda Biomedical Centre officials, show that malaria incidence is still on the rise.

They showed that malaria cases rose from 112 per 1,000 people between 2013 and 2014 to 198 per 1,000 people in 2014/2015; rising further to 418 per 1,000 people in 2016/2017.

Malaria incidence were at a low of 48 per 1,000 people in 2012. This implies an increase in malaria cases from 567,407 in 2012 to 4,794,778 in 2016, according to data from the health management information system for 2016.

The system regularly tracks nationwide trends in malaria prevalence and deaths attributed to the disease from health facilities.

Data shows the largest increase in malaria cases was registered in 10 districts in the Eastern province, where the number of cases tripled, while they doubled in Southern province.

Experts attribute the rise to inconsistent vector control activities, increased rainfall, mosquito resistance to insecticide and increased rainfall as well as rice cultivation, among other factors.

Better turn up

But, the Ministry of Health attributes the increase to a better turn up of people to health facilities as well as improved availability of rapid diagnostic tests in these areas.

However, despite this increase in cases, the ministry showed it managed to reduce malaria-associated mortality by 48 per cent as at 2017.

The data, which was reported through the health management information system between 2009 and 2016, showed the deaths from malaria stood at 489 in 2015 and had increased to 715 in 2016.

For the past couple of years, five malaria-prone districts namely Gisagara, Kirehe, Bugesera, Nyagatare and Gatsibo have been targeted for malaria control interventions like the spraying exercise, but with the general increase in rainfall nationwide the disease burden is expected to extend to more districts.