The battle against malaria in Africa has stalled. Can research in Mozambique explain why—and how to get it back on track? LongReads
, which can bite indoors or out, is the most plentiful. In Gaza and Inhambane provinces, where indoor spraying has not been used, the team still finds lots ofCelso Melembe suctions out lab-reared mosquitoes to test for insecticide resistance, recording the number that survive exposure.There are other reasons why mosquito control alone may not be enough to end malaria. Bed nets work very well—when people are sleeping under them.
Celso Melembe, a technician at the Manhiça Health Research Centre, uses a filtered tube to transfer mosquitoes in a study into the efficacy of insecticide-treated bed nets . In the same lab, microscopist Leonisia Mahumana identifies mosquitoes collected during a field trip .So why did cases continue to surge? The study Colborn and colleagues just finished for the Global Fund mentioned several possible reasons.
Health workers in Nampula province mark a house where they have given children prophylactic drugs during peak malaria season. Early results suggest seasonal chemoprevention sharply reduces incidence.That’s why on a hot spring day a religious leader in Nampula province, Juma Alberto Munlela, is talking about malaria with a group of about 15 men in a straight row of plastic chairs under the span of a huge tree.
PIRCOM staff will return to Namaita in a few weeks to see whether the community is following their leader’s advice, for instance by seeking care when they feel ill. “Changing behavior is not something you say today and it happens tomorrow,” says Herminio Rafael Guitutela, PIRCOM’s provincial coordinator in Nampula. “It’s a process.”for answers to Mozambique’s malaria puzzle, one thing is abundantly clear: New strategies and tools are needed if the country is to bring down its sky-high burden.
But the malaria burden remains so stubbornly high that in 2020 NMCP decided to give the strategy a try in two districts in Nampula province. The first phase, last year, showed seasonal chemoprevention is safe, feasible, and widely accepted, says Maria Rodrigues, Mozambique country director of Malaria Consortium. Now, the collaborators are testing its effectiveness.
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