Keeping the country malaria-free is an ongoing battle

Transcription

1 Vocabulary Match the words in the left column to the correct meaning in the right column. You should find the words in the text (highlighted) to work out their meaning. WORD fluctuated constant vigilance to jeopardize to eradicate hot spots to come to pass painstaking persistent transmission abandoned MEANING lingering; won t go away to happen always on guard; always watching and checking to put in danger to get rid of; to eliminate difficult places of maximum activity changed a lot; went up and down spreading given up; quit Keeping the country malaria-free is an ongoing battle Original article by Jonathan Gornall The National, Feb 11, 2012 (adapted by Siobhan Flood) On January , UAE celebrated a remarkable achievement in the global fight against one of the world's most persistent diseases: United Arab Emirates was certified malaria-free. For the men and women of the Central Malaria Control Department, the Ministry of Health and the various municipal departments who had fought for 30 years to see this moment come to pass, it was a wonderful moment. Recent studies have suggested that the number of deaths worldwide from malaria could be almost twice the 655,000 estimated for 2010 by the World Health Organization (WHO). As such, malaria remains a serious threat. Even in Abu Dhabi, more than 2,000 cases were reported last year, nearly double that of Importantly, all of the cases were contracted in other countries.

2 Five years ago, the UAE was the first formerly endemic country since Singapore and Australia in the 1980s to be certified by the WHO as malaria-free. Malaria had been a major public health problem in the Emirates up to and throughout the 1960s, with hot spots including the east coast, Ras Al Khaimah, Al Ain and the central plateau. In the 1970s, international efforts to eradicate malaria worldwide were abandoned as impractical, but a few countries refused to give up the fight, determined to at least rid their own territory of malaria transmission. The UAE was one of them. Following major outbreaks in the 1970s, the Government set up a Central Malaria Control Department. It started work in 1979, with immediate positive results: the number of cases in the country fell from 22,791 in 1978 to 11,599 in It was a painstaking battle, and all about "vector control" - clamping down on the mosquitoes themselves, chiefly by destroying them at breeding sites while they were still in the larval stage, and by spraying insecticides in homes and communities at the centre of outbreaks. In addition, a chain of laboratories was set up to make sure that throughout the country cases of malaria were promptly detected, diagnosed and treated with the correct medicine, preventing the spread of the disease from one victim to another by the bite of a successive, previously uninfected mosquito. By 1968, the malaria infection rate in the UAE as a whole had been anything between 32 and 60 per cent of the population, with infants particularly vulnerable. By 1980, the transmission of the disease had been largely interrupted and the incidence rate had fallen to eight cases per thousand population. By 1985, incidence was down to 1.6 per thousand, and in 1990 the number of cases among Emiratis had fallen to down from 2,436 a decade earlier. The very last "home-grown" malaria case, recorded in Masfout village, was detected in July Since then there have been no more reported cases of locally transmitted malaria. However, although the UAE is itself clear of malaria, it must remain constantly on its guard. The UAE faces challenges in remaining clear because of its success as a tourism centre, shopping destination and trading centre, attracting many people from all over the world throughout the year. The key to success was early diagnosis and prompt effective treatment. For that reason, malaria diagnosis and treatment remains free of charge, while the effectiveness of anti-malarial drugs is constantly monitored. Meanwhile, travellers heading to infected countries are offered free health education and free prophylactic drugs at clinics throughout the Emirates. The UAE is surrounded by countries still plagued by high incidences of malaria - including Pakistan and Yemen - and others with limited problems, such as Saudi Arabia, Iraq and Iran. Four other countries in the WHO's Eastern Mediterranean region - Egypt, Morocco, Oman and Syria - are in the phase of preventing reintroduction of malaria. In the case of Egypt and Syria, it is not yet clear how the disturbance of the Arab Spring may have disrupted their malaria programmes. Malaria does continue to be found in the UAE, brought into the country by infected expatriate workers or residents returning from malarial countries, and containing these cases is vital to prevent the reintroduction of locally transmitted malaria. The disease is spread by one non-infected mosquito ingesting the blood of an infected carrier, and then biting, and infecting, another human host.

3 The number of cases has fluctuated over the years since eradication, "largely reflecting importation of malaria cases from abroad", but the need for constant vigilance was highlighted last month when Abu Dhabi - Health Authority (HAAD) announced that the 2,000 cases identified in the emirate in the first nine months alone of 2011 was double the number for the whole of HAAD is notified every time a case of malaria is identified. To make sure it is an imported case, the department conducts a rigorous epidemiological investigation, looking at the patient's travel history, the date they entered the country, the species of parasite involved and the timing of the first symptoms. The malaria parasites can lie low in the liver for months, or even years, and this is why it is essential to finish the free 14-day course of treatment. Some sufferers never start it, perhaps because they think that malaria is one of the deportable diseases, which it is not, and they are afraid to go to the public hospital or screening and prevention centres. Therefore, public awareness is important so that people know that malaria is a treatable disease and not a deportable disease. It is a labour-intensive operation: in 2003 alone, 42,600 blood samples were examined for malaria parasites, of which 1,796 cases (4.2 per cent) were positive for malaria. The recorded cases were found among people from 39 nationalities, though the vast majority per cent - were from the Indian subcontinent, predominantly Pakistan. Another vital line of attack is to deprive mosquitoes of their breeding grounds, and to destroy their larvae. The key to preventing mosquitoes breeding, in fact, is to intervene at the larval stage, and across the UAE entomology teams systematically check suspected breeding places and treat them with larvicides. Again, this is a labour-intensive activity. In 2003, for example, almost 130,000 sites were checked, of which just 1,565 came up positive. This vital work continues today in each emirate - while malaria thrives elsewhere in the region, the battle against the disease will never be over. In Abu Dhabi, HAAD's Communicable Diseases Section makes daily random visits to known mosquito breeding sites and, if they find larvae, the Centre of Waste Management dispatches private contractors to treat the area with larvicides - or even fish that eat the larvae. "We are moving towards implementing biological controls," says Dr Abdulla. "We are very concerned about the environment and instructing the service providers to cultivate fish in most of the places and we have intensified our efforts during the last two or three months." The UAE's achievement is an enormous one, and there is a constant challenge not to jeopardise this situation with any introduction of malaria. jgornall@thenational.ae

4 Keeping the country malaria-free is an ongoing battle QUESTIONS Circle the best answer to Questions Before being declared malaria-free in the UAE, the fight against malaria lasted a. 100 YEARS b. 50 YEARS c. 30 YEARS d. 5 YEARS 2. How many formerly endemic countries were declared malaria-free before UAE? a. None b. 1 c. 2 d Between 1978 and 1979, the number of cases of malaria approximately a. Remained the same b. Doubled c. Halved d. Increased slightly 4. Which group of people are most at risk from malaria? a. Men b. Women c. Children d. Babies

5 Questions 5-6: Complete the following sentences in no more than 2 words. 5. On 26 January 2007, UAE was declared 6. Malaria diagnosis and treatment costs 7. Name two countries near UAE that suffer from high numbers of malaria cases. 8. How many people were checked for malaria in 2003? 9. In 2011, the number of malaria cases in UAE was more/less/the same as (underline the correct answer) 10. Write a paragraph (in Pages) to describe how to control malaria in UAE. (100 words) to your teacher.