Malaria interventions and control programes in Sub-Saharan Africa: A narrative review

Malaria transmission and prevalence involves a triangular web of interactions between man, vector, and the environment. Any meaningful effort in malaria control, elimination and or eradication should target weakening and or breaking the forces of interactions within the triangle. In sub-Saharan Africa, effective malaria control programme is encumbered by myriad of challenges. The unabated burden of malaria could be ascribed to efficient malaria vectors with strong niche for ecological expression that maintain high levels of transmission at all seasons. Parasite genotypic heterogeneity, multiple expressions of traits of adaptations to parasitism and unpredictable behavioural changes are the smart ways the infectious agent thrives, persists and expresses ecological niche with scaring symphony. Environmental factors and climatic changes, population movement, deteriorated socioeconomic situation, lack of access to effective and timely antimalarial treatment, use of sub-standard and or fake anti-malarial drugs, self medication and non-compliance to drug dosage are the galvanizing factors to poor intervention outcomes. Above all, for ages, in most settings and communities, there is lack of knowledge regarding the causative agent of malaria. Diversionary factors and misconceptions such as eating too much palm oil, standing in the sun, drinking too much of alcohol, jinxing and witchcraft attacks are brands of porous perceptions on causes and risk factors of malaria. And if a thousand and one sophisticated strategies are put in place to eliminate malaria in sub-Saharan Africa where indigenous and factorial perceptions with rhetorical contrast of ideas hold sway, then, a predictable defeated performance is the expected result. For the sustenance of the gains already recorded in the fight against malaria in sub-Saharan Africa, the role of the community as a strong partnership for change cannot be underestimated.