ETHIOPIA: Mosquito University

A couple weeks ago I got out of Addis again. This time it was a work visit to five malaria labs and a few health center posts in the East Shoa Zone. Since this work a work related excursion there was no need to take the bus. We had an SUV and a driver. We traveled down the road I described earlier as the “death triangle” or something similar, the most dangerous road in the world! It’s the road south of Addis and very crowded and hilly. It descends out of Addis and into the Rift Valley. I’ll talk more about the drive in a future post.

It was a fantastic experience to see the malaria labs. The labs are located in Debre Zeyit, Adama, Ziway, Shashemene, and Metahara. We didn’t get to the lab in Metahara but did see a sub-lab in Meki. I was able to see where all the data I have been looking at is coming from. I saw their bare-bones facilities usually consisting of a computer, a lab table, and a microscope, and a dedicated but understaffed crew of people actually doing the work. The five malaria labs in this district serves over 500 villages and 2 million people of which 95% of them are at risk for seasonal transmission of malaria. The labs are free for people with malaria symptoms to come and get checked out. A blood sample is taken and placed under a microscope and the trained technicians can determine a positive or negative for P. falciparum or P. vivax. If positive, treatment medication is dispensed also free of charge. During high transmission season the malaria labs do brisk business. They have been in existence for over 40 years so they are well known and the hospitals will charge for a visit. The lab in Adama has been doing some very interesting research on the main mosquito vector species in Ethiopia, Anopheles arabiensis: detecting biting rates and biting patterns. Great stuff. This was where Mosquito University was located.

In recent years Ethiopia has implemented a Health Extension Program where trained females from the villages go house to house to assist with health issues people may have and provide preventive measures to them. Among other responsibilities, this includes conducting a Rapid Diagnostic Test (RDT) for malaria and dispensing treatment as necessary and also giving out Insecticide Treated Nets (ITNs). This slows some traffic to the malaria labs and saves people the trouble of having to travel long distances. As there are only five malaria labs for the entire zone some people may have to travel a couple hundred kilometers to reach the closest one. One of the many positives of Health Extension Workers is that they bring the health care to the people.

As it is currently low transmission season for malaria (high transmission season begins in September or after the rainy season ends) the labs were averaging around 25-35 patients a day (as opposed to a few hundred/day during high transmission season) with anywhere from 3-10 coming up positive. Interestingly, the labs say that they have been seeing much more vivax than falciparum. This is part of my research also. I am looking at whether there has been a change in distribution of vivax or falciparum. We’ll see if the statistics prove out what is being seen anecdotally.

I was very glad not only to get out of Addis once again but to get to see where and how the data I have been working on comes from. It was great to talk to the people in the labs and a few health extension workers about their feelings about what they are doing. It is heartening to see people working hard to help others and attempt to improve the health of their fellow citizens.