Malaria cases among pregnant women and children aged under five have significantly declined, a report by the Roll Back Malaria Partnership (RBM) shows.

Malaria prevalence in children under five decreased from 2.6 per cent in 2008 to 1.4 per cent in 2010. Among pregnant women, malaria prevalence decreased from 1.4 per cent in 2008 to 0.7 per cent in 2010.

Malaria can cause stillbirth, preterm birth and low birth weight, all of which increase the risk of death for newborns.

The report, released yesterday, said 94,000 newborn deaths around the world were prevented between 2009-2012 because of more malaria intervention treatment.

Dr Corine Karema, director of the national malaria control programme, said the key to Rwanda’s success has been a mixture of prevention, treatment, and mosquito control as part of the government’s goal to strengthen the health system in the country.

"There is political commitment, countrywide vision, vigilant leadership from top to bottom, and inherent responsibility from the highest levels of the system down to the village level of volunteer community health workers,” Dr Karema said.

Rwanda ranked first out of 12 sub-Saharan African countries in reported use of treated mosquito nets, with 72 per cent of women using the nets during pregnancy in 2010. 

This was a big increase from 2005 where only 17 per cent of women used the nets during pregnancy.

 It was one of only five countries to note an increased use of treated nets during pregnancy above 60 per cent.

"The ownership and use of treated mosquito nets is the primary prevention strategy for reducing malaria transmission in the country,” Dr Karema said.

Free mosquito nets

Rwanda distributes free treated mosquito nets to children under five during vaccination campaigns, and to pregnant women during their first visit for antenatal care.

Between 2005 and 2010, Rwanda reduced its malaria mortality rate for children under five by 67 per cent.

Despite of a lot of success in recent years, the RBM report said there were still 10,000 women and between 75,000 and 200,000 newborns in Africa who die every year from malaria infection during pregnancy and is encouraging countries to keep improving prevention measures.

IPT paradox

The report points to Intermittent Preventative Treatment during pregnancy (IPT) as a highly successful tool to ensure the health of the mother and the baby. 

IPT requires pregnant women to receive two doses of medication in their second and third trimesters in order to prevent malaria.

The use of IPTs reduced severe maternal anemia by 38 per cent, low birth weight by 43 per cent and prenatal mortality by 27 per cent among women on their first or second pregnancies.

 However, Rwanda stopped using intermittent preventative treatment during pregnancy in 2008.

Dr Karema said the country discontinued the use of the treatment because more and more women started to become resistant to the medication. 

Instead, they are working on early detection of malaria cases and nationwide distribution of insectcide treated mosquito nets.

Dr Eric Mouzin, and editor of the RBM report, said Rwanda’s decision to stop using IPTs was appropriate because they have such a high prevalence of the use of treated mosquito nets.

"Rwanda has a strong national malaria control programme,” said Mouzin. 

"They have done an extremely good job and are on track to eliminating malaria deaths.”

He said Rwanda should keep going down the path to providing universal health care because it helps with economic development as well as health.

Rwanda is among seven African countries which were in January recognised for exceptional progress in scaling up malaria control interventions during the official opening of the African Union Summit of Heads of State in Addis Ababa, Ethiopia.

The African Leaders Malaria Alliance award recognises African countries with accelerated action in malaria prevention and control.