Thursday, April 25, 2013

World Malaria Day …………. Invest in the future: defeat malaria

The malaria story starts with a painless bite on any exposed part of the skin that mostly occurs between dusk to dawn as she plunges her mouthpiece into the skin. The only inking you have of her presence is the annoying sound when she hovers around your ears looking for a suitable point of contact. The mosquito has long, filament-thin legs and dappled wings; she's of the genus Anopheles which is fatal, the only insect capable vector of the human malaria parasite. The female anopheles depends on protein rich hemoglobin to nourish her eggs; she drills the outer skin, through layer of fat then into the network of capillaries to drink blood with the capacity to drink up to 2.5 times her body weight. They carry the blood in the salivary gland and enter another individual through worm like structures called plasmodium. The parasites remain in the blood stream for a few minutes then flow through the circulatory system to the liver. Inside the liver cells the malaria parasite Plasmodium falciparum eats and multiply then eventually burst to be released into the blood stream that is when the feverish condition and symptoms become apparent. Mosquitoes have an incubation period of 9-14days and usually transmit the malaria parasite when they feed on an infected human. Typically, symptoms may include Fever, headache, sweats & chills, pain in the back & limbs, exhaustion, coughing, diarrhea, nausea & vomiting etc.
Today 25th April, marks the commemoration of “Malaria Day” globally and the theme for the 2013 celebration is “Invest in the Future…….defeat malaria”. It is a call for all to take part in a wide range of activities and assess the remarkable progress made in combating malaria. It is a time for the global community to look ahead and continue to work towards total eradication malaria. Investments in malaria control have significantly reduced malaria deaths by one quarter within the last decade with overall child mortality rates reduced by approximately 20 percent.
By following the ABCD of malaria prevention we can break the malaria cycle.  The ABCD is:
A: Awareness- you need the knowledge and understanding of the malaria cycle.
B: Bite prevention- if you do not get bitten by an infected anopheles mosquito, you cannot get malaria.
C: Chemoprophylaxis- use of preventive anti malaria medication.
D: Diagnosis- should be early enough to ensure treatment is administered immediately.                                                                                          
This includes providing information on malaria and education of the public on the prevention and control of malaria.
Bite Prevention:
This is most effective when a combination of preventive measure are used to prevent being bitten by the parasite. The two major lines of defense against mosquito bites are Mosquito control programs and Personal protection.
Mosquito Control programs aims at reducing the mosquito population by destroying larvae in mosquito breeding areas and by killing adult mosquitoes. These measures include:
          Draining of swamps, gutters, ditches and depressions
          Eliminating stagnant water: such as remove, destroy or cover outside containers that can hold water, keep plants away from vicinity of patios and doors
          Preventing mosquito access to living quarters (window and door screens, seal cracks, gaps and other openings around doors, plumbing fixtures, vents, AC’s).
          Residual spraying of housing & buildings
          Insecticide fogging around dwellings and living quarters.
          Spraying of open water with larvicide’s chemicals.
          The use of larvae eating fish in ponds & lakes.
Personal Protection aims at minimizing being bitten by mosquitoes. Measures include:
          Avoid mosquito-prone areas by avoiding dark, shady or bushy areas and outdoor night activities (even environments that mimic dusk and dawn)
          Stay in well-screened, mosquito-free accommodation during the dusk to dawn period.  Keep windows and doors screened and in good condition.
          Use insect skin repellents at least 20% DEET:  These come as lotions, sprays, and balms and should cover every exposed area of your body including the back of your neck and ears. It can also be used for children as well but not on babies younger than 2 months. 
          Clothing: When you have to go out between dusk and dawn, wear long sleeve shirts and trousers or clothing reduce exposed skin
          Mosquito bed net: Is very effective and can reduce infant mortality by at least 20% for children that sleep under insecticide treated net. It can be washed and used again without losing their effectiveness as per instructions.
          Curtains can also be impregnated by the same insecticide solution used on mosquito bed nets. 
 This means taking a small quantity of medication as a preventative measure against a specific disease. Taking anti-malarial medication on a regular basis to prevent or suppress malaria symptoms.  This means that the dose is lower than what is used for treatment, but high enough to create an antagonistic environment for malaria parasites that have entered the body after a bite.  This minimizes the tissue and organ damage that the malaria parasite can cause. Some chemoprophylaxis kills the Malaria parasite when it is present in the blood, whilst other chemoprophylaxis will attack the malaria parasite in the liver therefore it should be taken exactly as prescribed. These medications are to be taken by the non-immune (those that were not born in malaria zone or lived there between 0-5years) and pregnant women.
Early Diagnosis: 
The most common form of detection is microscope observation on a Giemsa-stained (a blue/purple stain) thick and thin blood film or rapid diagnostic test (RDT). All personnel should seek medical attention anytime you have such symptoms and think “malaria first”. Studies have shown that most Nigerians (semi-immune) treat malaria at home.  Some years ago, the Federal Ministry of Health, Nigeria adopted artemisinin based combination therapy (ACT) as the first line drug for uncomplicated malaria but recently, resistance to artemisinin has been identified in some parts of the world therefore the World Health Organization (WHO) launched an emergency response to artemisinin resistance containment.
This campaign “Invest in the future: defeat malaria” will help strengthen the focus on malaria control globally and contribute to increase the funding needed in endemic countries for total eradication of this disease.

Written by O’ Reese of En-pact Solutions Limited, 2013
Twitter: @O Reese2

Sunday, April 21, 2013

Earth Day 2013…..the face of climate change

Earth the third of the nine planets, surrounded by an atmosphere is the only planet in the universe that supports life, therefore, there is a need to conserve it to ensure it remains sustainable. The concept of Earth Day was first initiated during a UNESCO conference in San Francisco, USA by John McConnell in 1969 where he proposed the first day of spring in the northern hemisphere on 21st March referred to as Vernal Equinox the time when the Sun crosses the equator making the length of night and day equal in all parts of the be commemorated. A month later a separate Earth Day was founded by United States Senator Gaylord Nelson as an environmental teach-in first held on April 22, 1970 which was thereafter launched internationally as a day to create awareness and focus on combating environmental issues.

Earth Day as an environmental movement has been celebrated globally on 22nd April for over 40 years now with a variety of activities to promote environmental awareness and identify ways to improve our environment and make a difference. This is now coordinated globally by the Earth Day Network. The global theme for this year 2013 is “The Face of Climate Change".
Earth Day
Climate change is of growing concern globally. There is a call for all Government, non-governmental organizations, civil society, private sector, charity organizations to work together to ensure the protection of the environment.
The Globe
Theme: The face of Climate change
Every day should be set out by people all over the world as a day of action to positively influence human attitudes and provoke policy changes with regards to effects of climate change and control measures to mitigate them.
The climate plays such a major part in our planet's environmental system that even minor changes have impacts that are large and complex.
Climate change refers to the changes in the statistical distribution or properties of the climate system when considered over a long period of time. The major concerns of climate change are not the natural earth processes causing changes in the atmosphere but man’s activities that alter the environment bringing about changes in the ecosystem.
Plant a tree
Studies over the last 30 years has shown that climate change affects people and the environment in various ways with an increasing threat to extinction of the natural habitat. This change in nature has very serious implications for the people, the environment and economic system.

Climate change and its impacts:
Global Warming: Increasing temperature of the earth surface (average air) and water system (ocean temperatures) due to green house gases and depletion of the ozone layer leading to melting of the polar region and Arctic sea ice. Studies since 1961 show that the average temperature of the global ocean has increased to depths of at least 3000m and that the ocean has been taking up over 80% of the heat being added to the climate system.

Unpredictable effects on the world's water systems: Due to the increasing levels of seas, a lot of areas are now prone to floods. In Nigeria for examples the northern states that are normally drier are experiencing floods leading to displacement of residential home, destruction of farmland, erosion. Increasing extremes of drought and flooding have become very common, causing displacement, erosion and conflict and less fresh water means less agriculture, food and income.
Deforestation: Trees help to purify the air, improve water quality, keep soils intact, provide a source of food, wood products, livelihood, medicines, and a habitat to most of the world’s most endangered species. Forests also help protect the planet from climate change by absorbing massive amounts of carbon dioxide (CO2), a major source of pollution that contribute to climate change. The increasing rate of deforestation by logging and burning to clear land for agriculture, livestock and construction releases huge amounts of carbon dioxide and other harmful greenhouse gases into the atmosphere (estimated at 20 percent of global emissions).

Food security: There is a significant risk of increased crop failure, loss of livestock and local food security. In some areas with extreme drier/warmer or wet conditions predicted, inconsistency of these changes will affect agriculture practices thereby affecting agricultural production, human health and livelihoods, as well as people’s purchasing power, food markets and food security on a household level.

How Can I participate?
This is a clarion call for all. As individuals; adopt more sustainable lifestyle, monitor your carbon footprint, purchase greener alternative products, use sustainable transportation, reduce human emissions of green house gases, plant trees to expand forests (reforestation), use renewable energy sources and promote energy efficiency. As government or inter-government, adopt cleaner technologies, set temperature targets, emissions tax, carbon trading, and implement environmental strategies and policies.

What action plan do we have as individuals, organization or the government to combat these imparts, are there are controls we can use to minimize the effects of climate change? Take an action today! The earth is our heritage, let us ensure we adopt greener lifestyles and sustainable activities to ensure we conserve the environment for future generations.

Written by O’ Reese of En-pact Solutions Limited, 2013
Twitter: @O Reese2


Saturday, April 13, 2013

High Blood Pressure…………the silent killer

The World Health day was recently celebrated globally on 7th of April to commemorate the origin of the World Health Organization, founded 65years ago as a specialized agency for the United Nations to champion health related issues. This year’s celebration focuses on creating awareness on HIGH BLOOD PRESSURE as a public health concern globally and the promotion of healthy living, early and improved detection and management of high blood pressure. The objective was to raise awareness on the causes, consequences and prevention of high BP to then reduce the incidence of heart attacks, strokes and such cardiovascular events. The prevalence of high blood pressure is increasing globally with highest incident rates found in low-income developing countries.

High blood pressure medically referred to as Hypertension is popularly called the silent killer because people who have the disease remain unaware until their blood pressure is measured. The Blood pressure is recorded as two numbers: the systolic (pressure in the arteries when heart contracts) and the diastolic (when the heart relaxes) e.g. 120/80mmHg (measured in millimeters of mercury). Uncontrolled high blood pressure is indirectly responsible for many deaths and disability resulting for heart attack or stroke. It is particularly dangerous because it is asymptomatic (no warning signs or symptoms) and can affect anyone regardless of race, gender or age. Once high blood pressure develops, it usually lasts for a lifetime (it is a chronic disease), you can only control or manage it.
Chronic hypertension most often leads to organ damage such as kidney failure, liver damage, stroke, eye damage that could lead to loss of vision, blocking of blood vessels or heart attack and often death.

Types and Causative factors:

There are two basic types of High BP: Primary and Secondary hypertension but other forms of high BP exist.
Primary hypertension occurs in majority of cases and is caused by risk factors such as age, family history, gender, being overweight, sodium sensitivity (high salt content from fast food, processed food or some over the counter drugs), socio economic status, alcohol use, smoking, injudicious use of birth control pills, lack of exercise and use of certain drugs (such as stimulants, allergy and cold drugs) to mention a few.
Secondary hypertension is caused by an underlining disease such as pregnancy, thyroid dysfunction or alcohol addiction.
Malignant hypertension is a severe condition where the diastolic blood pressure (lower number) often exceeds 140mm Hg. This high blood pressure requires emergency hospitalization in order to lower the blood pressure to prevent stoke or brain hemorrhage.

Diagnosis: High blood pressure   can be measured with a blood pressure cuff or sphygmomanometer. Blood pressure (BP) is classified as follows:
Systolic (top number)

Diastolic (bottom number)
Less than 120
Less than 80

 Stage 1(mild)
  Stage 2(mod - severe)
160 or higher
100 or higher

The ranges in the table apply to most adults (aged 18 and older) who do not have short-term serious illnesses.

Management: There is no definitive treatment for high blood pressure, it can only be managed therefore the means of control is by lifestyle modification and the use of medication. It is important to have your blood pressure checked regularly by a trained medical professional with a machine that is known to be accurate to ensure efficiency of treatment and monitor your progress.
Lifestyle modifications: includes maintaining a healthy diet, regular exercise and increase of your physical activity; quitting smoking; moderating alcohol consumption; achieving healthy stress control and maintaining a healthy weight / Body Mass Index (BMI); reduce intake of salt and oral contraceptives to mention a few. You can incorporate physical exercise into your daily routine: use of stairs instead of the elevator, getting off the bus /car one or two stops early and walking the rest of the way, park farther away from destination, ride a bike, practice brisk walking or go dancing.

Medical Treatment: Medication can be used to manage high BP and most often will be taken for a lifetime. It is advisable to take these medications at all times as prescribed by the health care provider. The medications have been proven to reduce the risk of stroke, heart disease, and kidney problems.

Therapy: Alternative therapies may be helpful to people trying to control their blood pressure e.g. acupuncture. Techniques that induce relaxation and reduce stress are recommended. These include mediation, yoga, relaxation training or use of dietary supplements such as garlic, vitamins, fish oil or herbs. These techniques alone will not keep the blood pressure in the healthy range for many people, discuss with your Doctor to get a better picture.
High blood pressure can go unrecognized for years due to the asymptomatic nature but could ultimately cause damage to vital organs and eventually lead to death or a reduced quality of life. Promoting a healthy lifestyle is key in preventing hypertension. Ensuring regular blood pressure check, taking of medication and follow-up doctor’s visit to monitor organs is vital in management of high BP.
The role of government, individuals, civil society, health care providers and private sector in promoting lifestyle modifications is vital in promoting the objectives of the 2013 celebration therefore all should play their role in creating awareness on the causes and prevention of high BP so that the incident of strokes and heart attacks can be eradicated drastically.

Written by O’ Reese of En-pact Solutions Limited, 2013
Twitter: @O Reese2

Saturday, April 6, 2013

April Tips: Here comes the rains, flood awareness

 The month of April comes with the anticipation of the rainy season. Ideally, Nigeria has two distinct seasons: rainy and dry  (harmattan) season. The seasons are normally distinct with the period of April to October for rainy season with a break in August and the dry season from November to March. In recent times, with the emergence of climate change, there have been a lot of concerns ranging from inconsistent seasonal changes, extreme weather conditions, increased sea levels to flooding which has left several parts of Nigeria including the Northern parts dealing with the aftermath of these climatic changes. At times like these, alerts on the likelihood of the intensity of the rains and flood prone areas are issued in different states to create awareness among the public and provide information on the impacts of flooding.

Flood can pose risks which could lead to exposure to hazardous substances, health hazards and contamination of public water supply, just to mention a few. All these can lead to drowning, electrocution, outbreaks of water borne diseases, and destruction of agricultural products, residential and commercial buildings. Other impacts of flooding include: shortage of food supply due to delayed harvest of some crops, leading to inflation of food price indices, increased cost of transportation and housing due to reinforcement works required to prevent flooding of residential areas.
The negative impacts of flooding can be minimized if certain control measures are taken and awareness is created to ensure people know what to do prior, during and after the flood.
The purpose of this article is to enlighten the public about the measures to be applied to mitigate the impacts of flooding in Nigeria.
In the last 2-3 years, Lagos, the Niger-Delta and some southern part of Nigeria has experienced torrential rainfall lasting for days during the rainy season with highest peak in July causing devastating effects and massive destruction of lives and properties. This has forced the State Governments to proffer solutions on combating flooding and advising residents in flood prone areas to relocate.

Contributing factors: The following are causative factors to flood risk
   Poor sanitation of surrounding environment.
   Dumping of household waste in drains or gutters.
   Improper disposal of waste in drains and gutter.
   Climate change leading to extreme weather conditions.
   Poor drainage facilities.
   Inadequate construction and planning of residential areas.
   Volume and run-off of storm water.


Prior to a flood

    Identify if you are in a flood prone area then provide reinforcements for your house.
   Ensure the surrounding environment is always clean; observe state and personal environmental sanitation.
   Proper disposal of waste should be maintained; always use a covered bin.
   Ensure prompt and regular collection of waste e.g. by Private Sector Participation (PSP).
   Take out an insurance cover for flood risk for your car, house and other valuable properties.
   Prepare an emergency plan and share with family and neighbours in case of evacuation.
   Ensure you have enough supplies of food, water and medications.

During a flood

   Turn off all electrical appliances.
   Ensure all windows and doors are closed to prevent water from entering the house.
   Stay indoors and only evacuate if it is safe.
   Have an emergency bag ready containing bottled water, canned food, medicines etc.
   If outdoors, seek shelter; minimize contact with electrical cables to prevent electrocution.
   If in a car, remain inside until it is safe to come out then look for a higher plane to take shelter.
   Avoid contact with floodwater to reduce exposure to health hazards and being swept away by flood.

What to do after a flood
   Start clean up of the affected area using appropriate Personal Protective Equipment such as gloves, boots and water resistant coverall.
   Do not eat or drink any edible items contaminated by the flood.
   Ensure building is assessed to determine the integrity before you re-occupy the house.
   Adequate repairs should be undertaken prior to moving back to reside in the affected home.
   Take photographs of damage(s) prior to clean up, for insurance claims.
   If injured during the flood ensure you get proper medical care in a hospital.
The health of individuals and the state of the environment after a flood are of concern to both the government and individuals therefore preventive measures should be put in place to ensure adequate controls are adopted.

In anticipation of the rains, individuals should invest in quality raincoats, umbrellas and wellington boots. They should always avoid exposure to rains and cold by keeping warm during the rainy season especially for children, elderly and immune-compromised people. The environment should be clean and clear of waste at all times to prevent over flow of the drains leading to floods where stagnant water which can be breeding grounds for vectors and other disease breeding organisms.

Climate change is a global concern that various organizations are working together to combat. The recent seasonal changes in Nigeria pose a great challenge in dealing with the impact of global warming. Is the government adequately equipped to deal with these problems? Are there enough resources to address these issues? How can we as individuals contribute to solving these problems? These are all unanswered questions that are lingering as State Governments set up committees to solve the problems and individuals reinforce their surroundings to ensure their safety in anticipation of yet another looming adversity.

 Written by O’ Reese of En-pact Solutions Limited, 2013

Twitter: @O Reese2