AHAPN Celebrates 2019 World Malaria Day; Screens Lagos Residents, Donates Antimalarials To Health Facility

It was a gathering of eminent pharmacists, medical practitioners, other health care professionals and members of the public at the Bariga Local Government Area Secretariat to mark the 2019 World Malaria Day,  organized by the Association of Hospital and Administrative Pharmacists of Nigeria (AHAPN) National body in collaboration with the Lagos State branch.

The World Malaria Day is celebrated on April 25th every year and the theme of the 2019 celebration was “Zero Malaria starts with me.” This year’s celebration had as sub theme “Continued relevance of Artemisinin based Combination Therapies (ACTs) in the treatment of Malaria.”

In his opening remark, the Chairman of the occasion and former President of the Pharmaceutical Society of Nigeria, Pharm. Olumide Akintayo FPSN, FPCPharm, FNAPharm, FNIM who was ably represented by Pharm. Tony Oyawole FPSN, FNAPharm commended AHAHN for their decision to mark this year’s World Malaria Day in Lagos. He lamented a situation whereby 65 per cent out of a population of 180 million Nigerians expended about 120 million naira daily on the average to treat malaria; which transcends to over 43.8 billion naira annually on just an antimalarial drug. He added that the trend could hit the 100 billion mark if the situation was not adequately addressed. He revealed that almost 20 per cent of the entire value chain that symbolizes the pharmaceutical market is dedicated to drug treatment with antimalarials, assuming the total value of the pharmaceutical sector is put at 2 billion dollars. Pharm. Akintayo challenged hospital and administrative pharmacists to align with other stakeholders to reengineer the approach to malaria treatment if we truly want to achieve zero prevalence of malaria.    

The chairman of Association of Hospital and Administrative Pharmacists Lagos State branch, Pharm. Titilayo Onedo while welcoming the guests, described malaria as a life-threatening scourge that should be eradicated. She said “Recent research shows that environmental degradation added to the spread of malaria, hence, we are mobilizing the people to ensure a clean environment as well as the use of preventive anti-malaria measures and appropriate diagnosis cannot be overemphasized.” 

The state chairman further said the screening conducted by the association to commemorate the day cut across kidney disease, sugar level and high blood pressure. She stressed the need for more of such awareness programmes in the country, saying that when the populace is well informed on the causes of malaria, they would likely make efforts to prevent it.

Also speaking, the chairman of the Pharmaceutical Society of Nigeria (PSN) Lagos State Branch, Pharm Bola F.O.Adeniran FPSN said the malaria scourge calls for concerted efforts by governments, communities, non governmental organizations and individuals. She emphasized on the need for preventive measures, including provision of long lasting insecticide treated nets, and encouraging residents to sleep under these treated nets.

The Special Guest of Honour and Honourable Commissioner of Health, Lagos State, Dr. Olajide Idris who was ably represented by the Director of Pharmaceutical Services at the Ministry of Health, Dr. Moyosore Adejumo FPSN, commended AHAPN for using the occasion to draw national attention to the malaria scourge.

Delivering the Key Note Address, the Guest Speaker and Director, Pharmaceutical Services, Lagos State Ministry of Health, Dr. Moyosore Adejumo FPSN said the theme of this year’s celebration is apt in view of the collective responsibilities of all stakeholders including governments at all levels, professional bodies, healthcare workers at all levels, civil society organizations, communities, corporate organizations and individuals to reduce the scourge of malaria.

Dr. Adejumo traced the history of malaria to ancient times, adding that malaria has plagued humanity since ancient times and continues to haunt nearly 50% of the world’s population. She said that globally, an estimated 3.4 billion people are at risk of being infected with malaria and developing the disease while 1.1 billion are at high risk of getting malaria annually. She said Nigeria suffers the world’s greatest malaria burden with 97% of the total population (approximately 173 million people) at risk of malaria infection.

She said that according to the World Malaria Report 2018, there were 219 million cases of malaria globally in 2017 and 435,000 malaria deaths. She further added that in Lagos State, malaria is responsible for more than 70% of the out patient attendance in public health facilities, stating that more than 400,000 cases are reported annually. Dr. Adejumo said more cases are reported in children under 5 years and in pregnant women where the infection can be very serious, due to the very vulnerable nature of this segment of the population.

In the area of control of malaria, the Director of Pharmaceutical Services reiterated that all malaria elimination interventions have been fully implemented in the state. She mentioned that emphasis is now placed on environmental management (such as effective refuse management,  dredging of canals  and channels) and Integrated Vector Control including operational research for evidence based programming  and informed decision making, noting that some of the researches conducted have brought out key findings which shall be used for policy decisions and programme designs. According to her, anopheles mosquitoes that cause malaria which hitherto used to breed in clean stagnant water, have been discovered to breed in dirty  and polluted water.

In an address of welcome, the national chairman of AHAPN Dr. Kingsley Chiedu Amibor FPCPharm  informed the audience about the paradigm shift globally in pharmacy practice from the traditional focus on dispensing to pharmaceutical care. “Pharmaceutical care is a total shift from drug focus to patient focus. It is the responsible provision of drug therapy by pharmacists to achieve definite outcomes that improve or maintain the quality of life of patients.”   He pointed out that pharmaceutical care is patient centered and seeks to prevent drug related problems before they occur. “Some of these drug related problems include adverse drug reactions, drug drug interactions and drug overdose. This innovation has resulted in prevention of several patient deaths worldwide, including Nigeria.” Dr. Amibor used the opportunity to call on the Nigerian government at all levels to give the necessary legal backing to the Association’s efforts at adoption of pharmaceutical care as their new brand of philosophy of practice, for the overall good of the Nigerian people. “We also appreciate the current and all past presidents of the Pharmaceutical Society of Nigeria for their huge sacrifices in taking the Pharmacy profession to great heights” he said.  

Dr. Amibor also touched on the issue of consultancy circular for consultant pharmacists practicing in Lagos State. “While thanking the Lagos State Government for her support to Pharmacy practice over the years, AHAPN hereby calls on the state government to release the Consultancy Circular earlier issued to consultant pharmacists practicing with the Lagos State Government which was withdrawn.”

In his address, the President of the Pharmaceutical Society of Nigeria (PSN) Mazi Sam Ohuabunwa FPSN, MON, OFR ably represented by the Deputy President South, Pharm. Ejiro Foyibo FPSN, commended AHAPN for their decision to mark the World Malaria Day, saying that the PSN was fully involved in efforts to find a lasting solution to the malaria scourge, adding that the Society was ready to partner with the federal government and other stake holders to eradicate malaria from the shores of Nigeria. He assured all pharmacists to keep hope alive in his administration, adding that the transformation agenda for the society was on course.

In a paper presented on “Continued Relevance of Artemisinin based Combination Therapies (ACTs) in the treatment of malaria,”  Dr. Amibor Kingsley, a Consultant Clinical Pharmacist and Fellow of the West African Post Graduate College of Pharmacists (FPCPharm) described  Malaria as a serious and life- threatening disease caused by parasites transmitted to humans through the bite of infected female Anopheles mosquitoes,  adding that there are 5 Plasmodium species that cause malaria infection in humans- P. falciparum, P. malariae, P. vivax, P. Ovale, P. knowlesi, with  P. falciparum and P. vivax posing the greatest threat. He said P. falciparum is more common in Nigeria.

Dr. Amibor who is also a Public Health Expert, stated that currently 5 Artemisinine based Combination Therapies (ACTs) are available for use against P. falciparum malaria and that the choice of ACT should be based on results of therapeutic efficacy studies against local strains of P. falciparum malaria.

Quoting the World Health Organization (WHO), Dr. Amibor stated that an estimated 409 million treatment courses of ACTs were procured by countries in 2016, an increase from 311 million in 2015.  He said a study carried out on ACT use among patients being treated for malaria by clinical pharmacists at the Federal Medical Centre Asaba revealed that about 70% of patients completed their doses of ACTs, 25% went back to the hospital within 4 weeks to complain of same symptoms of malaria, adding that the  Study was still ongoing.

Dr. Amibor also revealed that ACTs are rendered less effective if taken with multivitamins containing Vitamin C, adding that a Nigerian study involving 80 malaria infected adult patients showed that co-administration of orange juice, grapefruit juice or vitamin C concomitantly with artesunate or amodiaquine severely diminished the efficacy and potency of the drugs.

According to the Consultant Pharmacist, “Despite reported cases of relapse with use, ACTs remain the mainstay of treatment for P. falciparum.  Since there are no alternatives to artemisinin derivatives for now, efficacy of ACTs must be preserved. Artemisinin and its derivatives must not be used as oral monotherapy as this promotes development of artemisinin resistance.”

The Clinical Pharmacist said “For continued relevance of ACTs in the treatment of malaria, all hands must be on deck,” adding that “it is important for all to employ the principle of rational use of medicines which requires that the right ACT be used for the right patient with the right diagnosis at the right dose for the right duration at the right cost via the right route.”

The highlight of the celebration was the donation of antimalarial drugs to the Bariga Local Government by the National Chairman of AHAPN flanked by other dignitaries. Receiving the drugs, the Medical of Health, Bariga Local Government, Dr. Owoyele Abdulwasiu commended AHAPN for the gesture, adding that the drugs would be put to judicious use.

Other dignitaries at the event included the Chairman of Bariga Local Government, Honourable Kolade Alabi ably represented by the Vice Chairman, Honourable Adeola Kuponuyi; the Head of Pharmacy Department at the National Orthopaedic Hospital, Igbobi Lagos, Pharm. Margaret Obono FPCPharm, FPSN; Pharm. Bisi Opanuga FPCPharm, FPSN Director Pharmaceutical Services, Lagos University Teaching Hospital (LUTH); Pharm. Lawunmi Peters FPCPharm, FPSN, Director Pharmaceutical Services, Federal Neuro Psyschiatric Hospital, Yaba, Lagos and Pharm Ezeugwu, South West Coordinator of Pharmacists Council of Nigeria (PCN)  medical practitioners, directors of pharmacy and other distinguished personalities. The head of disease control services was represented by Dr. Osinowo.

In all, over 200 residents of Bariga were screened for malaria, while about 1000 doses of antimalarial drugs were donated to the health facility for use by children and adults diagnosed with malaria.

Dr. Kingsley Chiedu Amibor  PharmD, MPH, FPCPharm

National Chairman AHAPN

Pharm. Titilayo Onedo

Chairman AHAPN Lagos State