December 22, 2020
By Elizabeth A. Kaine
The World Health Organization’s (WHO) World Malaria Report 2020, which is posted on their website, reveals that Sierra Leone in recent times has one of the world’s highest burdens of malaria cases – accounting for an estimated 6,824 deaths (or roughly 2% of all malaria deaths recorded globally) in 2019.
According to the Government of Sierra Leone’s own ‘Malaria Control Strategic Plan (2016-2020)’, malaria is endemic in Sierra Leone and transmission has been recorded in all areas of the country. At the time of the plan’s publication (in late 2015), malaria accounted for 40.3% of outpatient morbidity for all ages, and it accounted for 37.6% of all hospital admissions in the country.
In 2020, the global COVID-19 pandemic became the world’s dominant health crisis – with COVID-19 already killing more than 1.6 million people across the globe as of December 18th, according to the Johns Hopkins Coronavirus Resource Center.
To try to ascertain whether COVID-19 has been killing more people than malaria in Sierra Leone, a Right to Access Information (RAI) request was submitted to the management of Connaught Hospital, the country’s main referral hospital, to know the number of deaths recorded at the institution this year (along with official causes) – but to date, the management has failed to provide a response.
To the National COVID-19 Emergency Response Centre (NaCOVERC), a similar request for information was sent, to find out the number and type of COVID-19 tests that have been conducted in Sierra Leone, including how many tests have been administered post-mortem (in other words, how many tests have been conducted on dead bodies). In their reply to the RAI request, NaCOVERC stated that there is no official “laid down policy for post-mortem COVID-19 analysis” in Sierra Leone – but that at least 47 individuals who died from COVID-19 were only diagnosed with the disease post-mortem. That is 47 out of a total 75 COVID-19 related deaths that have been recorded in the country, since the pandemic began (according to a December 16th Situation Report released by the Ministry of Health and Sanitation).
The NaCOVERC RAI reply, which was signed by NaCOVERC’s Chief of Staff, Lawrence L. Bassie, further stated that at least 79,626 RT-PCR tests have been conducted in Sierra Leone this year, as a result of which at least 2,451 cases of COVID-19 have been recorded in the country. Additionally, the response noted that among individuals who were officially quarantined during the pandemic, only one of the quarantined individuals died (with death occurring the same day the positive results were released).
Deputy Program Manager of the National Malaria Control Program at the Ministry of Health and Sanitation, Alhaji Sayni Turay, in an interview stated that – despite the ongoing COVID-19 pandemic – malaria is continuing to kill more people than any other illness in Sierra Leone.
“Malaria remains one of the prime causes of death among children and pregnant women, and one of the biggest causes for medical consultation and hospitalization,” he added.
Turay also noted that, every year a total of fifteen million dollars is given to Sierra Leone by partners as support towards the fight against malaria.
Harold Thomas is the communication pillar lead at NaCOVERC, and also works at the public education unit of the Ministry of Health. In an interview, Thomas made similar statements, sharing that that despite COVID-19, malaria still tops the list of highest killer diseases, and remains the country’s greatest health challenge.
“If we can handle and care for malaria properly, then it is halfway prevention for COVID-19 – as COVID-19 cases mostly come with signs and symptoms of malaria,” he explained, so proper identification and treatment of the two illnesses is often linked. He also said that, at this time, all suspected cases are tested for COVID-19 and if they prove negative, they are then further tested and treated for other ailments they test positive for.
Al-Hassan Bakar, who serves as program manager for All for Health Coalition (a health-focused civil society group), says that malaria has killed more people in Sierra Leone in 2020 than COVID-19.
“Malaria affects people in Sierra Leone more than any other illness, and it must be prioritized,” he said, adding his worry that, given the high profile of COVID-19 this year, continued efforts to combat malaria in the country may not have received as much ongoing support or attention as they should.
Bakar also stated that one of the biggest health challenges observed in some communities comes from the fact that signs and symptoms of COVID-19 are so similar to those of malaria.
“In some communities, people who were sick showed signs and symptoms that are related to both malaria and COVID-19 were afraid to go to the hospital,” he explained. “Some went to the pharmacy while some treated themselves, which led to the death of so many people.”
Leading Causes of Death in Sierra Leone, as published by healthdata.org