Pausing the Fight Against Malaria to Combat the COVID-19 Pandemic in Africa: Is the Future of Malaria Bleak?

Nora Nganyewo Nghochuzie; Charles Ochieng' Olwal; Aniefiok John Udoakang; Lucas Naam-Kayagre Amenga-Etego; Alfred Amambua-Ngwa

doi:10.3389/fmicb.2020.01476

Pausing the Fight Against Malaria to Combat the COVID-19 Pandemic in Africa: Is the Future of Malaria Bleak?

Front Microbiol. 2020 Jun 18:11:1476. doi: 10.3389/fmicb.2020.01476. eCollection 2020.

Authors

Nora Nganyewo Nghochuzie^{1

2}, Charles Ochieng' Olwal^{1

2}, Aniefiok John Udoakang^{1

2}, Lucas Naam-Kayagre Amenga-Etego^{1

2}, Alfred Amambua-Ngwa^{3

4}

Affiliations

¹ West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Accra, Ghana.
² Department of Biochemistry, Cell and Molecular Biology, College of Basic and Applied Sciences, University of Ghana, Accra, Ghana.
³ Medical Research Council Unit The Gambia at LSHTM, Banjul, The Gambia.
⁴ London School of Hygiene and Tropical Medicine, University of London, London, United Kingdom.

Abstract

Malaria remains a major global health burden, killing hundreds of thousands annually, especially in sub-Saharan Africa. In 2019, a Phase IV Expanded Programme on Immunization (EPI)-linked malaria vaccine implementation was underway. However, in December 2019, a novel pneumonia condition termed coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with many clinical, epidemiological, and biological parallels to malaria, was reported in Wuhan, China. COVID-19 is spreading rapidly, and, as of the 3rd of June, 2020, more than 382,507 persons had died from COVID-19. Children under 5 years who suffer high malaria-attributable mortalities are largely asymptomatic for COVID-19. Considering that the malaria burden is highest in low-income tropical countries with little capacity to fund malaria control and eradication programs, the fight against malaria in these regions is likely to be hampered. Access to healthcare has generally been limited, while malaria interventions, such as seasonal malaria chemotherapy and distribution of insecticide-treated bed nets, have been suspended due to lockdowns. Likewise, the repurposing of antimalarials for treatment of COVID-19 shared symptoms and the shift in focus from the production of malaria rapid diagnostic tests (RDTs) to COVID-19 RDTs is a cause for concern in malaria-endemic regions. Children are less affected by the COVID-19 pandemic compared to the elderly. However, due to the fears of contracting SARS-CoV-2, the elderly who are worst affected by COVID-19 may not take children for malaria medication, resulting in high malaria-related mortalities among children. COVID-19 has disproportionately affected developed countries, threatening their donation capacity. These are likely to thwart malaria control efforts in low-income regions. Here, we present perspectives on the collateral impact of COVID-19 on malaria, especially in Africa.

Keywords: ACE2; COVID-19; SARS-CoV-2; coronaviruses; malaria; plasmodium.