Alarming spike in childhood malaria admissions in South Sudan

Malaria admissions to the children’s ward began to increase in June, and by September, up to 400 children were being admitted to the pediatric department with severe malaria each week—more than double the numbers seen in September last year, and cause for serious concern.

“Every year, there is a surge in malaria cases during the rainy season in Aweil and we conduct seasonal preventive activities for tens of thousands of children,” said Mamman Mustapha, MSF’s head of mission in South Sudan. “We opened testing and treatment centers so people can quickly be diagnosed and receive treatment, and we established a malaria ward inside the hospital with 72 beds. However, this year we have faced an exceptional situation and the hospital has been completely overwhelmed.”

Even though MSF increased the number of beds in the malaria ward to 94 in September, it was not enough to cope with the surge in admissions, and many patients were  treated in the corridors. Over the past month alone, MSF has admitted an average of 43 children suffering from severe forms of malaria each day, with many requiring blood transfusions. Since September, MSF has carried out an average of 14 blood transfusions for malaria each day, and at any one time, there have been an average of 140 children admitted in the hospital suffering from severe malaria.

“These are terrible statistics,” Mustapha said. “It should not be the case that so many children are ending up in the hospital with advanced forms of malaria when it can so easily be treated at a health clinic.”

Earlier and more intense rains are fueling malaria

Malaria cases have also surged in other areas of South Sudan due to the earlier arrival of the rainy season this year, which has led to extensive flooding over many more months than usual. Over a million people have been impacted by flooding in South Sudan this year, and Northern Bahr el Ghazal is one of the states most affected. However, it is the near collapse of the primary health care system in Northern Bahr el Ghazal and the ensuing lack of access to take-home treatments that has led to so many more children than usual requiring hospitalization to save their lives.

Over the past two years, many primary health care clinics in Northern Bahr el Ghazal have been impacted by funding cuts that have left them without medicines and staff. Ongoing reforms to the health funding system also mean that available supplies in the handful of facilities that remain open have been quickly used up over the past few months due to the unexpected surge in malaria cases and delays in restocking facilities.

Early diagnosis is key to avoiding hospitalization

“While efforts have been made to replenish supplies in health clinics in Northern Bahr el Ghazal over recent weeks, the delays have cost lives and, with the malaria season not yet over, many more children are going to become sick and end up in the hospital unless urgent action is taken to improve people’s access to simple treatment,” Mustapha said. “In the past week, we have added even more beds in the hospital to try and reduce congestion in the corridors, and we’ve opened a seventh testing and treatment center that operates 24/7. But far more are needed in the most at-risk communities so that children can be treated on the spot before their condition deteriorates and hospital treatment becomes the only option that will make it possible to save their lives.”

This year, South Sudan received its first doses of the R21 malaria vaccine, marking a major milestone in the country’s fight against the disease. MSF is supporting the South Sudanese Ministry of Health in the rollout of this vaccine, and is hopeful that with increased coverage it will help to control the impacts of the disease in years to come.