 Thank you for staying with us. Malaria is transmitted throughout Nigeria with 97% of the population at risk. According to the 2021 World Malaria Report, Nigeria had the highest number of global malaria cases, that's 27% of global malaria cases, and the highest number of deaths, 32% of global malaria deaths in 2020. The country accounted for an estimated 55.2% of malaria cases in West Africa in 2020, and the case numbers increased 5.3% between 2017 and 2020, from 298 to 314 per 1,000 of the population at risk. Debt also increased from 4.7% from 0.9 to 0.97 per 1,000 of the population at risk during that same period. Wow, these numbers are really daunting and we really want to know how we can eliminate malaria in Nigeria. Please just say what you have to say, remember you can join the Conversation Centers and SMS or WhatsApp to 0818384663. You could also Twitter us at WeshawAfrica1 with the hashtag Weshaw. I was saying that I heard, well, actually, I heard for the first time today that malaria kills. I didn't know people actually die from malaria. So that means that we actually take these things for granted. Yes, we do. Sometimes. Yes, we do. Okay, one of us are doctors but thank God that we have an expert in the house tonight who is actually going to talk to us and let us know how we can actually eliminate malaria because it's very disturbing when you see these numbers and see that Nigeria is even one of the countries, you know, the top countries in the world, you know, where people actually die from malaria. In the studio today, like we have Dr. Akinthi Miloluwa who is also known as Dr. Seven. She's a medical professional from the College of Medicine University of Lagos. She's also passionate about bridging the knowledge gap in the health sector and the general Nigerian populace through advocacy, particularly leveraging technology and social media. She currently corons an online platform that allows medical professionals the platforms to leverage technology to solve problems in the health sector. Dr. Temi is the co-founder of Kea Medicals, an online platform that is passionate about quick response to medical emergencies. Thank you for joining us, Dr. Temi. You look so beautiful by the way. I barely ever see doctors that look this way. Okay, so first thing's first. How is Nigeria or why is Nigeria one of the top countries costing debts. So I would say that we actually have a population that everybody knows of Malaria. So you go to the next one and your voice tells you that who I have Malaria. So you know that information about Malaria is quite widespread. But I feel like we are also in a nation where it's self-manecuting and not just self-manecuting, it's a lot of mysterious beliefs about health is like applauded. So it's like you are shocked that Malaria still kills people. But it's a thing because right now people come to the hospital, they are like in the end stages of Malaria. They've done everything they can do before they come to the hospital, they ask their neighbor, they've asked their friend, somebody has prescribed somebody has diagnosed, they've gone to a chemist, so they've exhausted all options for coming to the hospital. So I think that's one of the major reasons that Malaria is still such a thing in our nation. And also it's like an environment where we have a lot of people in this social economy class. So you can't ever remove the fact that hygiene, where you leave, all of that predispose people to Malaria. So definitely I think those are the top two reasons. Okay, so before I get the ladies go, let me also ask, because this is another question that has been in my head for a while, cerebral Malaria. So there's actually Malaria that affects the brain. How does that work? So cerebral Malaria is like when you have high levels, you know, Malaria is caused by parasites, you know, so plasmodium. So when the other parasites is, the numbers are quite elevated, it entices the brain and then you begin to see manifestations of cerebral, that's what we call cerebral Malaria. So basically it's Malaria in the brain. So you begin to see a lot of the scoma. Different people come differently. Some people may just be lethargic, some are responsive. I've seen it once in a friend and it's terrifying because it's like, it's, you are watching what is wrong, it's terrifying to say this honestly. But how do they get to that point? So like I said earlier, you know that we said Malaria is such a thing in our nation where everybody thinks they have Malaria. So if you sneeze, you are suspecting Malaria, you have a headache, you are suspecting Malaria. So you are self-treating, you are not going to the hospital to check whether you actually have Malaria. And oftentimes you have people use Malaria drugs to the point where they become resistant. So you've used the drug several even when you don't have Malaria. So when you actually have Malaria, the drug is not working. So the parasite is able to reach high levels such that it crosses the brain and you actually have to go to the hospital to get treated. And then the truth we are wondering, okay, is the parasite resistance to this drug? Is it resistant to that drug? What drugs have we used to treat this particular Malaria in this person? So yeah. What are the likely symptoms of cerebral Malaria? So we can see lethargy, we can see coma, unconsciousness. The person is saying things you don't, sometimes it looks like madness in fact. But then it's not. So one of the things, but one of the things that when he's an adult too, I said, oh, I had a person had fever for maybe a number of days, I was self-treating, I was sneezing, I used social and social drugs. And when a person comes to the hospital and says, oh, that person is not answering me anymore, I quote him, he's not responsive, he's not eating, he's just looking, he's just turning into thin space. And all of that. So you are thinking, oh, there are different differentials, but you are thinking first things first because of the, how endemic Malaria environment is your first thinking, okay, maybe it's a cerebral Malaria, then you check. So just a quick question, how many types of malaria do we have? So I do think there are types of malaria. So is it the advancements of the illness? Yes. Okay, so how does that, both at the stages? So there's malaria. The regular malaria. Regular malaria. Then the cerebral malaria, I think that cerebral malaria just has its own name because it is different from the regular malaria that we see. So there are not really stages of malaria. So there's the normal fever, the headaches, different symptoms for different folks. But the cerebral malaria is different because she's not the normal fever you are having, you are wondering what exactly is wrong with this person. Is there a, so like I mentioned earlier, the myth of AA. Is that really true? Because, yeah, so what's your take on that? Does it have to like, is it a thing that all AA's, if you are seeking malaria you are? So what I actually know of is the fact that something about the AA genotype gives you a resistance to malaria. So you are not easily predisposed to malaria as the normal person. So maybe the regular people are AA people, so they are less resistant to malaria than the AA genotypes. So is it reason why? I think it has to do with the shape of the red blood cells and all of that. So going into that deeply now, I mean going through pathophysiology and all of that. But I think he has, majorly has to do with the shape of the red blood cell because AA has a little bit of S. So that's why we advise AA not to get married. So they have something in the red blood cell that makes it difficult for the malaria parasite to easily enter and begin to light across all the symptoms that we see in malaria. So when people say AA are more predisposed, I think it's because they have, the AS has a higher level of resistance to coming down malaria. So that's what I know. I'm glad you said that because I was telling them yesterday that I literally get malaria every month and they were like, what are you talking about? But no jokes. Like, so I've noticed that maybe every month is a stretch. Let me say every other month. I just know that, okay, by the time I start feeling that weakness in my joints, please don't joke with me. It's because I know it's always been like that for me. So once I start to have a headache, because I barely get a headache. So once I start to get a headache and then I start to feel weak in my joints, I'm just like, okay, maybe it's time for me to go get malaria. Now that you've talked about drug resistance, I want to discuss that because I know that most times that's what happens to people. People, once you just have a headache or you just, there's just one slight fever. Sometimes even stress, maybe you just have a flu or something. The next thing they are jumping to the pharmacy to go and buy one at a whatever or once. Come or whatever, you know. So what would you say? What would you say about that? So I would say that the truth is that stress predisposes people to malaria. And in our climate, we're very stressed. We have ridden Nigeria. And in fact, if you're living in Lagos, you're already stressed. So definitely you have, most of the time, whenever you come down with something and there are different symptoms of different people. That's why we advise that you know your body. So you know that, okay, maybe when I have malaria that you've tested, I'm very sure I went to the hospital, I did the test, I did laboratory and everything came out with malaria positive and all of that. I had these symptoms. So when the symptoms are coming up, I'm beginning to, so in fact, oftentimes when people come to the hospital, we treat them symptomatically because we have a list of symptoms. When somebody is saying, oh, I have a fever, I have a headache. We're first giving malaria drugs. But the thing about resistance to malaria is that a lot of people abuse drugs. So you have to be very careful. You know that when you have a headache, you're already popping malaria pills. You have slight, you're feeling dizzy. Somebody is popping malaria. I feel like, apart from Parastomol, malaria drug is the next abuse, most abuse drug in Nigeria. It's crazy because I feel like one of the biggest, if I was going to open a pharmacy, I would just be selling malaria drugs. Anybody that comes here, even the pharmacist, the chemist tells you, oh, why won't you buy malaria drug just to prevent, but there's a place for prevention, you know. And we give anti-malarial to prevent, especially in pregnant women, because we know how bad malaria can be in pregnant women and it can affect their children. But when we are now seeing people who go into the chemist and we do outreaches, medical outreaches, right? And people are begging you for malaria drugs. Please give me, I need it. I'm having a headache. Just in case. In fact, so what you said is valid, but you also have to put in points that, okay, have I used Parastomol and it's not working? Have I rested and it's not working? Because the antidote to stress should be malaria drugs. It should be resting. It should be, okay, have I eaten properly? Am I well hydrated and all of that? And when all of that is not working, then you resort to malaria drugs. But I would always advise that if you can get a test done, or there is this thing we call rapid diagnostic tests, is very, I don't know whether pharmacy sell them now, but then you can self-test for malaria at home. I think that's one of the ways. When we're going to talk about elimination of malaria, one of the things we should advise is testing your house. So if it's positive, by the malaria, nobody's stopping you. But if it's not positive, it should be, you're not a doctor. So are you popping pills? Yeah. Okay. So another thing, people usually would say the climate in Africa, the tropical, it's a tropical climate and all of that. So do you think that has anything to do with the high level of malaria in our continent? Absolutely. I think especially because mosquitoes tend to thrive in that kind of environment. So that's why you want to travel out and then people are not coming. In fact, before a white doctor can think about malaria, it won't take a while because their climate doesn't allow for the growth of such insects, I guess. Mosquitoes are insects. Yes, but that is majorly why it's a problem in our environment. And the fact that we have a lot of people who are, like I said earlier, in the low social economic class. So you can't remove that because you can't, there are some things that hygiene can't take away. There are some things that are proper, you know, you are living right in front of a gutter, you are living in front of a canal, all of those, you know, you are breeding mosquitoes. So while our environment and our climate actually encourages the growth of mosquitoes, you are breeding, I would also say that in fact that we have a high level of uneducated people who are living below the poverty line that also really skyrockets the amount of malaria cases we have. So yeah, just a quick one. I wanted to just quickly find out, I mean, I know that there are symptoms, right? But there are also some people that their body doesn't really show symptoms in time. So you mentioned earlier that the hydration can cause headaches and a couple of other symptoms that could people could think of. So is there a particular way, like what are the things, if for instance, I'm the person, what do I need to pay attention to for my, I mean, to my body? What are the signs I need to pay attention to just so that am I stressed? Do I have malaria? What are the things I need to just focus on just to be able to determine? Do I need to go get tested? Do I need to just rest? What are the things that you would ask? So I would say that it varies because everybody is different. But there are some common things that we can see. So fever is one of them. So when you see fever and an adult in a climb, especially fever that is relapsing. So it goes today in the night, you are fine during the day and the night comes back and then you're not all of a sudden you are feeling like especially that's how my body works. So in the morning, I'm jumping in the night. I'm wondering what happened, what's going on? You are hot. Then headaches, requiring headaches that, okay, are you sparse and when I've rested, like I said, you have to go through, you have to know your body well enough. You're observant. Yes, you have to be observant. But then when you're thinking headaches, fever, then you're also looking at, okay, lots of appetite suddenly. I'm not eating properly. Food is irritating me. And then there's this thing for a lot of people about a bitter taste in their mouth. Oftentimes it's pointing at malaria. We are thinking, okay, most likely malaria. And then we're asking, when last do you use anti-malaria? Is it maybe three months or a go? Or are you resistant to malaria? How often do you use these drugs? So you're telling us every two weeks, I'm using malaria drugs. Okay. So there's off here. So I read that the World Health Organization, they recommended the use of a particular vaccine. I think RTS, and that's for children. How well is that going? Is that in full effect? Is it working? Have there been any good results from it? Or is it something that should be dropped? So if it is, the malaria vaccine was just recently signed by the, I think by the president, to allow the apprehendant to get in. But so I would say that so far, because it's just, I feel like it's not something that will be adopted quickly. So people, already we have a certain resistance and they believe, if you know the amount of stress like in with the COVID vaccinations, people are telling you that, oh, they want to implant something, something. So it's going to take a while before it's accepted. So we haven't really done testing and all of that. So we can't really say that this is the efficacy or this is how well the vaccine works because it is not yet well adopted. So it is something new. We are still looking at, okay, is it going to work? And in children, you can't really say because children can't tell you, oh, I'm feeling like this. So you have to be looking at them, okay, is she crying when I give the vaccination? How is she two hours after? Has the malaria fever dropped? Is there a spike? So you have to be, and it's going to take a while, maybe some years. So you can know, okay, this is how well the vaccine is going to be working. And should we adopt it? Should we drop it? It's still a new innovation. So I think it's something that we'll still be looking at for the time being. Have other countries adopted it, Ghana, Kenya? I'm not so sure about other countries, but I think for, I'm President, I think it is, I can't say for sure, but I think some African countries have adopted it, especially countries that are endemic because Africa has the highest rate of death, 95% of death from malaria. So I think several African countries are looking to adopt it, but some have already, but Nigeria's giant of Africa, if our country adopts it and it works, definitely all that African countries should be looking to. If you're just tuning in, we're discussing eliminating malaria in Nigeria with Dr. Akintemi Lolua, aka Dr. Seven. Please, let's hear what you have to say. Remember, you can join the conversation. You can also send an SMS or WhatsApp to 0818384663 or Twitter to us at Weshawafika1 with the hashtag Weshaw. So now let's get down to it. How can we eliminate malaria in Nigeria? So first things first, I think that we have to sit down to look at why is at the levels of malaria still high. If you do not know why there are still high, you can't talk about eliminating it. So we have to look at why are the people, is it that people do not have access to hospitals? Why are they always abusing malaria drugs? So I think one of the things we must do first is to evaluate the current system. Is it working? In my opinion, it's not because for us to be topping the charts of malaria globally as a 2021, it is bad. I don't know whether new research has been conducted, but we have to evaluate the system and say, okay, how can we better the systems? And then we can also ever take away the fact that political will comes in handy a lot. So I would say that if you're going to be doing anything, infrastructure, healthcare infrastructure will be playing a huge role. So we'll be looking at, okay, do we have public health centers that people can go to when I'm having it? So why do you have to come to Luth when you're having a headache or a fever? That's a tertiary health center. That should be the last resort. So why can't you go to the hospital, the primary health center next to you and then tell them that, oh, I'm having a headache. Please, can I get a rapid diagnostic test kits to check or can I walk into the next pharmacy next to me if I can afford it? Why can't I buy it? But we also have to look at the fact that people can afford a lot of things. So the primary health center should be able to have these things at snap of fingers. Okay, you know, we'll let us check. And then I think another thing which also do is that intersectoral and participation, you should encourage. So it is not just a healthcare problem. Obviously malaria cripples the economy. When someone is sick, it doesn't count function properly. So we should be looking at how can we bring, why can't we have financial institution, partner in the health institution? So, okay, you know, we'll let us fund innovations for combating malaria, malaria vaccination. I don't think, I don't, I'm not so sure now whether I was in Nigeria and I developed the vaccine, but we have the highest level of malaria globally. Why aren't Nigerians in discussions? Why aren't Africans talking about this? Why aren't we the ones innovating our way out of malaria? Why do we have to wait for the whites? And we'll hear people saying lack of funding, all of that. So when we have intersectoral partnership, so we are talking about, okay, malaria is our focus now, bring innovations that solve our problem. And then we'll be looking at, okay, how can we partner with you? How can we scale this? How can we make it affordable? How can we make it something that everybody has access to? How do we remove the stereotypes surrounding all of this? And then you also have to look at the fact that the doctors in Nigeria are not enough. So you can't ever say that until the doctor treats you. So we have to remove that and say, okay, how can we get people on board to actually combat this issue? So you can't be waiting for doctors to come and, okay, malaria has to be treated in the hospital, definitely. But then why can't we have people that, okay, we train them with skills, we equip them with skills to, you know, combat malaria. It's not, it's not, if it's, it's just like COVID, it wasn't medical practitioner, you gave the vaccine. So we should be looking at things like that. How can we get people to, you know, join the healthcare force just to equip them with skills to fight against malaria? I think there are so many ways to eliminate malaria, but I think it's a just field that come to mind now. This thing that you just said now, it takes a village. So imagine areas like Makoko, that these people are living in a swamp. So there's no way these guys will not have malaria. I'm sorry I'm being emotional, but you just have to say they'll keep going to the hospital every now and then. And for people like that, the drugs wouldn't work in their system anymore because they're going back to, it's a lot, it's a lot that Nigerians are basically going through. So if anybody, I mean, this, we need like people in the real estate sector to partner with the government in ensuring that this works because this is a healthcare problem. At the same time, it's also affecting every, like it's a, you're treating malaria today. You still go back to the house to go and sleep and you still get bitten by the malaria, by the mosquito again. I mean, you talked about doctors, you know, not being enough and living the country and training people who are not particularly medically inclined and bring them into the force. So they can also maybe administer, or you know, help people who have these conditions as well. But I would ask, do you think that's actually feasible in this country? Honestly, I think that if we come to a point where we realize that malaria is a national problem and drop all the, oh, okay, I mean, doctor, you are a nurse, you are a nursing assistant, all of that, and we realize that this is a problem. And if we do not enter, we'll still be topping the chart, come 2030. Of course. So all of that, so all of that has to come to play and we are thinking about this is something we have to join hands together. So if it's feasible currently, I would say to an extent, you already see people self-treating and they are not doctors. So why not just equip them, equip them, you know, give them, tell them, okay, these are the symptoms you should be looking out for. These are the things you should not do. These are what we advise you should do. You know, come get the vaccine and all of that, equip, not necessarily none. But if you already equip people with skills, you remove them from a place of not being ignorant to tell them, okay, if you do this, this has the side effect. If you do that, this can lead to this and all of that. You explain to people that this is what we are bringing you aboard. You know some, there's no how we cannot say that we know a family member who currently has malaria or a brother who is currently on, you know, there's always that in that coming to play. So I think that it is feasible if we all decide that, okay, this is a national problem and we have, we all have a role to play. Alira, you said something about the real estate guys partnering with the government and all that. I feel like that's hysterical because we know the country that we're in. But I was going to ask, do you think providing things like maybe insecticide-treated nets and maybe the insecticides itself, and do you think things like that can't work? I mean, actually for people living in those kind of unhygienic conditions, I think the best thing to provide for them is a vaccine. Because how many times, with outreaches provide, several times, you go for an outreach, giving you an exercise, you go for an outreach, giving you a mosquito net. You are wondering how many times, because how long will we continue to fight? Okay, let's prevent malaria. Let's permanently eradicate it. So the things we should be looking at is how can we subsidize the vaccination for people in this kind of environment, so that we go there and vaccinate them en masse. So it's not just giving them, because there's no how you want to give them. Definitely they will go to work and be beaten by a mosquito They are fishers Fishers are men They even live underwater They live right in the swamp They are not going to school People live in boarding schools My mother was born in 2010 But the mosquitoes in that my boarding school They were more than I said thank you They would pierce through Oh my God I get you I mean It's a sort of temporal Solution So the vaccine is more of a permanent Absolutely Anything even be done for The people that actually self-medicate Is it possible for instance These pharmacies I'm sure they are regulated So is there a regulation that can be passed That will make the pharmacies Not sell drugs without prescription I mean malaria is Just like a regular drug But people still have to go to the pharmacy And show a prescription to buy certain type of medication But to avoid self-medicating I feel like something has to be done What do you think? So the issue is that It's double It's like that sword So the moment you begin to ask a prescription To Get malaria drugs Somebody is going to start making drugs And selling it At the back of this house Making herbs And selling it back to this house So you are pushing people away from Okay this is a problem We accept it as a problem but we still know it's safer So it's safer It's like Between a D plus C I mean even the prescription That means you're asking people People have to go to the hospital Which a lot of people avoid them Because of the cost of seeing a doctor But the fact that the number has gone up You mentioned that before Is it 2021? Before then the number was not this high So what needs to be done To ensure that the number doesn't go up again Because it will go up again Something has to be done Even our environment Where we live in It's not exactly conducive The kind of mosquitoes I see in my house Allero Those things are like soldiers And they don't look small They are big So once you just see you I will not be able to sleep until I'm just looking If I catch you So just imagine In the kind of area where I stay Which of course is not exactly so clean It's not swampy But it's not exactly clean You get And you probably have They say Loma will come take up your refuse And stuff like that We are getting to rainy season And then sometimes Once there is a flood It doesn't go down to maybe two days after And which of course Exactly you have stagnant water You have mosquitoes coming in You see people always trying to change their nets There's a time See there's no insecticide that doesn't work anymore You know this Sorry that I'm digressing The advert that most of this mosquito Those When you see the animation Mosquito coming This is exactly what they do Because when you spray insecticide They still don't die They are becoming stronger by the day Mosquitoes are also building resistance They do See I wasn't wrong after all Because we advise you to change your insecticide Just shock them That's the one that lasts Mosquitoes I never experienced Today is one brand Next one is another brand If we hear you correctly You are saying that the permanent With eradicate or eliminate Malaria in Africa Is a vaccine Absolutely Honestly I think that's the best thing I heard the news and I literally jumped for joy Because there is no innovating Your way out of malaria Without getting a permanent solution Such as a vaccine So give people the vaccine And build permanent immunity No matter how many times It's probably the bites for people who have Those sensitive skin You have to be buying cream every now and then Because the vaccine doesn't cover that But at least you know that you are short Every month you will be at work You will not be down with malaria Alright ladies Anything else? I can't remember the last time I had malaria Are you AS? I'm AA But the reason why I'm saying I can't remember Who I'm feeling I feel feverish But what I do is take rest Because first of all I'm telling myself I'm stressed Because I know that I've stressed myself So I just go lay down The next day I wake up and I'm okay The last time I got sick was October Last year And it was malaria I said for my kid that I wouldn't lie See what comes next Because the way it came at me I feel feverish Like cold all of a sudden So I was like okay let me just rest for a bit I rested for like 30 minutes And by the time I woke up My body was hot And after a while It seemed like it was subsiding And in the next one or two hours It knocked me off And I was preparing to travel So I was just like If I go to the hospital Before my result comes out So I had to self-medicate For a few days For like two days and then I got myself back But by the time I traveled I had to go get tested Run a proper check to be sure that I'm actually fine Today I saw a video I mean it was malaria day yesterday And then there is this Medical hospital So this medical team They actually went to Makoko And they were testing them as usual Mosquito nets Insecticides and all of that And something one of the guys Who actually live in that area said And he said that there is a season for mosquito So there is a time When the water is salty There is no mosquito They won't breed but then It gets to the point where the water starts to become sweet Then the mosquito How do they even know? I'm sure they must There is something And they showed a child That was actually working inside The water You know where you see Gotta and there is like Refuse I think she went to buy something And she was coming back And she was working with her pants And I was looking at her like this And the guy said This is what you will see This is like a regular day So Giving them mosquito nets and insecticides Insecticides get more expensive By the day It's not 200, 300 like you used to buy It's not a 1.5 1.5, 1.8 almost 2,000 For you to actually buy insecticides So by the time you spray your room When you want to spray, I see they are spraying perfume You spray You spray very well So that means in a week or in two weeks You're done with one kind of insecticide And that's it So these people that have given it to I mean they've done a great job But in the next two weeks They're out of insecticide And there's nothing they can do about it So what happens then And there are lots of people living there People think they are not I think in the video they had mentioned About 200,000 or 400,000 people And that's a lot of people That's a lot of people I don't know what to say It's a very long way to go Eliminating malaria in our nation And by extension Africa And one thing we must also look at Is that Not everybody would have access To Getting tested For malaria So if we're going to be doing that We have to look for ways That people don't have to walk into the hospital To get tested And it has to be a 40% And malaria drugs should also be Needful to Until the vaccination is Gone round We should be seeing malaria drugs Almost free Because we know that a lot of times People can't afford it So I think that's it basically Okay They say if symptoms persist After two days After that Thank you so much It's been quite an insightful conversation The person that I have learned that So we should take this thing very seriously And I'm also going to appeal to the government as well I'm sure the government also has a role To play in terms of vaccine Helping to clean out the communities Making sure that people are living in more Hygienic conditions and all of that Thank you so much ladies It was great having you on the show tonight Thank you so much for having me Before we go to ensure you follow us on Instagram At Weshaw Africa Drop a comment and most importantly Follow all our social media Engagements And remember to like Share, comment and Invite your friends and family To watch us and follow us If you missed today's quotes here it is again It's not that easy living with malaria The reality of the high and all The toll should make that very obvious And this is by Tiki Naliaka See you tomorrow at 8pm Thank you so much for joining us on this screen