Nation keeps up guard against malaria

UAE leads region in efforts to eradicate disease-carrying mosquito, and now Oman is ready to join list of malaria-free countries.

A member of a mosquito control team uses thermal fogging to kill larvae at a farm at Al Ain.
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ABU DHABI // Efforts to protect the UAE's malaria-free status in a region still grappling with the deadly disease may be buoyed this year, as Oman edges towards eradication. Long considered a leader in the fight against malaria in the Arabian Peninsula, the UAE has reduced the presence of disease-carrying parasites by more than 36 per cent from 1985 to 2008, according to new figures from the national Malaria Control Department.

The last locally transmitted case of the mosquito-borne killer was recorded in July 1997, said Dr Abdul Aziz al Muthanna, the director of the department. "Since then, we detect cases coming from abroad, mainly from the Indian subcontinent and tropical Africa." The GCC Technical Committee for Malaria has met annually for several years, with the aim of wiping out the problem regionally. "There are efforts to clean all the Arabian Peninsula from malaria," Dr al Muthanna said.

Exchanging information was vital in combating the problem, he added. "Activities are undertaken by the malaria teams from Oman and the UAE." Four mobile spray teams targeting "nuisance mosquito" breeding sites in Al Ain routinely inspect the septic tanks of old and abandoned homes, - as well as "any place that has dirty water or maybe an area that's not linked with the sewage system," said Mohammed Aziz, the contract manager who handles pest control for the emirate's Centre of Waste Management.

Demand for pest control increases as the weather cools. "We have received concerns from residents about a general trend of pests in the winter, because we find the [mosquito] life cycle is extended up to four weeks from two weeks," he said. "So we deal with this by looking for the source in bush areas, palms, marshlands and manholes." A separate special team roams mountains and wadis in search of stagnant pools, where malaria-carrying Anopheles mosquitoes can lay eggs. The Anopheline strain had been reduced to "almost zero per cent", Mr Aziz said.

"We don't have any malarial problems in the UAE or Al Ain. When we find someone is in the hospital for [malaria], they're imported cases." However, he noted that "Al Ain is situated on the brink of the border of Oman", which has not yet been certified by the World Health Organisation (WHO) as malaria-free. "Along that jebel area with mountains, and those wadi terrains, they don't have control," he said.

"They suffer, but we have control. So those [mosquito eggs] are imported in our country sometimes because it's on the edge." Oman had been poised for malaria-free certification, but outbreaks in 2007 and 2008 set the process back. At the time, the WHO's Roll Back Malaria partnership required three years without a locally transmitted case before certification could be awarded. But there is optimism as the capital, Muscat, is considered malaria-free and Qatar has been malaria-free for years, according to Dr Hoda Atta, the adviser for the Roll Back Malaria campaign's 22-nation eastern Mediterranean bloc.

Morocco, Oman and Syria are among nine countries that have "interrupted transmissions and are in the phase of preventing re-introduction of malaria", according to the 2009 World Malaria report. The prevention phase is the last before a country may be certified. Another representative with Roll Back Malaria said last week that "Oman is on the way to becoming certified". Saudi Arabia, which shares a border with the UAE, as well as Iraq, Iran, Pakistan, Afghanistan and Yemen, continue to struggle with eliminating the disease. Political upheaval and conflict in some of those countries could exacerbate the rates of infection, Dr Atta said.

The UAE maintain the targets of its malaria programme through high living standards and co-ordination with municipalities and the private health sector, Dr al Muthanna said. The country is further reducing the larval populations of the Anopheles mosquito as part of a post-elimination plan. It is extremely rare for adult Anopheles mosquitos to be found locally. Breeding grounds are also rare. Dr Mohammed Fikri, the Ministry of Health's executive director for health policies, said spraying was only one part of the "multi-disciplinary" antimalarial effort.

"This is a national programme that we've been working on for more than 30 years," he said. "If you set a national programme with a strong political commitment and budgeting, personnel, strategic plan, and include different sectors the environmental sector, agricultural, education and health all of this effort can achieve this." Farms account for more than 65 per cent of the mosquito breeding sites. Dr al Muthanna said the programme had identified 14,000 farms in the Northern Emirates that kept water basins potential breeding sites for irrigation.

In 2008, the malaria teams visited and treated 140,229 farms and other sites including basins, shallow wells and drums. If a patient was found to have malaria, his history would be recorded. Blood samples from family and neighbours would also be taken to check for the presence of mosquito breeding.