KABUL, 25 April 2008 (IRIN) - Over half of Afghanistan's estimated 26.6 million population – and especially pregnant women and children - are vulnerable to malaria, according to Afghanistan's Ministry of Public Health (MoPH).

MoPH says that 14 of the country's 34 provinces are identified as "high risk" areas where, plasmodium vivax, a malaria parasite, is prevalent.

"About 14 million people across the country are at risk of malaria," Najibullah Safi, programme manager for National Malaria and Leishmaniasis Control (NMLC) at MoPH, said in Kabul.

Landlocked Afghanistan has the second highest number of malaria cases in the Eastern Mediterranean region [http://wwwlive.who.ch/about/regions/emro/en/index.html], according to the UN World Health Organization (WHO).

The MoPH and WHO estimate that every year up to 1.5 million cases of malaria occur throughout the country, but most go undiagnosed.

Figures verified by the Health Ministry indicated that only 433,412 malaria patients received treatment from March 2006 to March 2007.

"Up to 98 percent of malaria cases were plasmodium vivax – a less life-threatening form of the disease - and only two percent were falciform, the most life threatening form of the disease," Safi said.

While malaria kills over one million people in Africa and Asia, according to WHO [http://www.who.int/malaria/faq.html], just 25 malaria-related fatalities were confirmed in Afghanistan in 2007[http://www.rollbackmalaria.org/worldmalariaday/index.html].

Weak diagnosing capacity

Only about 20 percent of the total 443,412 patients who received malaria treatment last year were clinically diagnosed malaria-positive, NMLC reported.

"About 80 percent of all malaria patients who were treated last year [over 350,000 patients] were suspected cases and were not confirmed through laboratorial tests," the manager of NMLC said.

While malaria treatment is included in MoPH's basic health services package, which reaches up to 85 percent of the population through 1,429 health facilities nationwide, there are not enough facilities to diagnose the disease.

"We do not have laboratories in all our health facilities in the country and therefore cannot do proper laboratory tests to confirm every suspected malaria case," Safi said. "It's a huge problem," he added.

Health specialists warn that any use of anti-malarial drugs such as chloroquine and hydroxychloroquine can badly affect the health of a person not suffering from malaria.

"If you give anti-malarial drugs to a pregnant woman or a child it can seriously put their health at risk," warned Abdul Karim Norzai, a paediatrician in Kabul.

Eradication impossible?

Ranked the fifth least developed country in the world, Afghanistan does not have adequate resources, or the technical capacity to wipe out the parasite in the foreseeable future, health officials say.

The country is trying to control malaria within five years (2007-2012) with a US$28.3 million fund from the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria.

To control the parasite the MoPH plans to distribute 1.2 million insecticide-treated bed nets to vulnerable communities, particularly in high-risk provinces, in 2008.

Immunised children and pregnant women will receive bed nets for free, while others will have to pay a subsidised price, MoPH said.

Malaria is a major public health problem in Afghanistan, which not only threatens the health of millions of people but also affects human productivity and development, and traps vulnerable communities in continuing poverty, experts say.

Afghanistan is acutely prone to malaria due to its tropical climate, paddy fields, poor waste management and other environmental factors, MoPH said in a statement.

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