Eritrea: Combat to Eradicate Communicable Diseases

By Semhar Mebrahtu

Good state of health is indispensable in human life as it is a fundamental necessity to lead a settled life. For this reason people struggle to maintain a stable health condition. Countries invest vast amount of money to safeguard their populations’ health status. A nation Eritrea has come a long way in health related endeavors. The issue of controlling communicable diseases has been a main concern of the Ministry of Health (MOH). Communicable diseases are contagious and infectious diseases which must be prevented and instantly controlled before they spread to all communities. Therefore, the MOH is putting so much efforts towards awareness raising and controlling such dangerous diseases.

Dr. Araya Brhane, Director of Communicable Diseases Control in the Ministry of Health, said that the efforts to control communicable diseases is the main target of the MDG (Millennium Development Goals) program. Dr. Araya underlined that although controlling and reducing the number of infections caused by communicable disease is the main concern of this program, the ultimate goal of the program remains eradicating these diseases. The health center’s main focus is on identifying communicable diseases, controlling them, and totally eradicating them by providing sufficient treatment through medications.

There are five units engaged in combating communicable diseases. These are the controlling unit for HIV, tuberculosis, malaria, tropical diseases like Bilharzia and other communicable diseases controlling units. These health units also make checkups every two to three weeks and conduct research on other related communicable diseases which are internationally common.

The MDG program has been in operation for a long time and tremendous results have been achieved in controlling communicable diseases. Combating communicable diseases is the third goal of the eight goals of MDG which started with significant targets of controlling HIV by 50% and eradicating malaria and TB infections by the same percentage. The units have exerted efforts in controlling and treating these diseases having strong integration and commitment of the health workers. So far over 50% of these diseases have been eradicated which is more than what had been initially planned. Eritrea has made tremendous progress in the reduction of HIV, Malaria and TB.

Eritrea made a fine progress in combating HIV up to 2015. HIV incidence reached its peak in 1996. As a result of coordinated efforts of multi-sectorial partners under the leadership of the MOH, the incidence showed marked decline over the last 20 years from 1.15 per 1000 in 1996 to 0.16 per 1000 at the end of 2015 a reduction of 86%. According to the 2010 Eritrea Population Health Survey (EPHS), HIV prevalence in women is 2.3 times higher than in men. The incidence also showed a reduction of 88.5% from that of 1996. HIV incidence also showed a reduction of HIV infections in adults and young people aged 15- 24 from 0.29% in 1996 to 0.03% at the end of 2015, a reduction of almost 90%.

There were important achievements aimed at combating HIV. The number of HIV counselling and testing sites increased 13 fold from 19 in 2001 to 255 at the end of 2015, increasing access to HIV testing. Testing of pregnant women for HIV increased from 2.45% in 2004 to 89% in 2015. Facilities that provide anti-retroviral therapy increased from five in 2005 to twenty eight in 2015 with more than 8000 people living with HIV AIDS receiving anti-retroviral therapy, contributing to the marked reductions in AIDS related deaths.

Eritrea’s progress in controlling malaria up to 2015 was also satisfactory. Malaria infections have

declined from 157 in 1998 to 12 cases per 1000 population in 2015. Similarly death rates sloped down from 0.2 in 1998 to 0.002 per 1000 population in 2015, a decline of 90% is registered. The methods employed to eradicate malaria were environmental management of mosquito breeding sites through public participation, larviciding, use of insecticide treated bed nets(mosquito Nets), indoor residual spraying, early treatment of suspected malaria cases and routine health education.

Dr. Arya Brhane

Sustainable environmental sanitation and usage of anti-mosquito nets as well as visiting medical centers for screening at times of new infections are prerequisites to combat the prevalence of communicable diseases particularly in the Southern, Gash-Barka, Anseba and Northern Red Sea regions which are known for recurring malaria cases. 1.5 million Anti-mosquito nets were distributed last year and research has been underway to study the nature of the mosquito species that are recurring in the country so as to take preventive measures to control them. As a result, Eritrea received the 2016 African Leaders Malaria Alliance Award for Excellence for achieving the MDG (Millennium Development Goals) target. The award was given to countries that have reduced malaria by over 75% by December 2015.

Similarly, according to the 2015 World Health Organization (WHO) estimates, Eritrea has achieved MDG targets for the prevention of TB before the year 2011. The incidence of TB had begun to reverse in the early 90s with a reduction of above 68% and the mortality has been reduced to above 60% from that period onwards.

Tuberculosis incidence showed marked decline of 243 per 100,000 population to 92 per same population within 25 years (1990-2015). The prevalence showed a decline of 478 per 10,000 population to 153 per same population within these years. Similarly, mortality due to TB has reduced from 12 to 4.7 per 100,000 population.

There were important achievements in tuberculosis prevention services. The opening of a tuberculosis treatment hospital at Merhano has helped in healing 75% TB patients. The introduction of 13 Gene/Xpert machines in referral hospitals is contributing to the early diagnosis of susceptible and resistant tuberculosis. The success rate of drug sensitive pulmonary treatment for is TB sustained at 90%. The active surveillance done in TB prevalence especially for high risk populations such as prisoners, diabetics, miners, etc. And locations such as slums and rural areas, showed many TB cases.

Dr. Araya underlined that the achievement registered in the eradication and control of the communicable diseases should be maintained through integrated, popular and administrative efforts. He also pointed out that their reduction doesn’t mean that they have totally vanished.

Commitment and working together is the major powerful weapon in controlling and eradicating communicable diseases. Society’s awareness and cooperation with the Ministry of Health has a tremendous role in eradicating communicable disease.

 Malaria incidence per 1000 population, 1998-2015

HIV incidence per 1000 population, 1991-2015

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