Date: Mon 10 Apr 2017
Source: The Southern Times [edited]
<https://southernafrican.news/2017/04/10/bots-malaria-death-toll-rises-as-drugs-run-out/>

The recent heavy rains which pounded most parts of Botswana resulting in the outbreak of malaria are likely to reverse the gains that the southern African nation had achieved in the fight against the scourge.

Recently, a release from the African Leaders Malaria Alliance (ALMA) stated that Botswana was among 8 other African countries that have shown commitment and innovation in the fight against the disease and were honoured by ALMA. "The progress in Botswana shows what is possible when a country and its leaders make malaria a priority," the release quoted Joy Phumaphi, executive secretary of ALMA as saying.

However, assistant minister of health and wellness, Phillip Makgalemele, told the parliament last week [3 to 9 Apr 2017] that due to the heavy rains, Botswana is experiencing an increase in the number of reported malaria cases. In February this year [2017], Botswana had recorded 5 cases of malaria deaths. But Makgalemele stated that the number has risen to 7. "By the beginning of this month [March 2017], we had recorded 627 cases and 7 deaths. About 60 per cent of these cases are from Okavango District," he said, adding that the country has also recorded sporadic cases from non-endemic malaria districts in southern Botswana.

According to Makgalemele, malaria transmission period runs from around October to early May. "Annually, in preparation for this season, my ministry conducts integrated vector control interventions, public education, community mobilisation and capacity building. Drug and commodity availability are also ensured," he said. He explained that, based on the early warning of normal to above normal rainfall this year [2017] by the Meteorological Services, his ministry intensified its efforts to prepare for the eventuality of a possible outbreak.

"We have been monitoring stock levels of our anti-malarials at both Central Medical Stores (CMS) and our health facilities. Most of our health facilities have adequate stock levels of 1st line anti-malarials," said the assistant minister. However, Makgalemele said a few District Health Management Teams (DHMTs) have recently reported shortage of quinine injection, which is used for severe cases. He further added that they are expecting a 2nd consignment and additional stocks of this drug and other anti-malarials were expected in the coming weeks to cater for the increase in cases.

"Central Medical Stores is monitoring the situation by contacting DHMTs on a daily basis to monitor anti-malarials and anti-diarrhoeal. There has been no staff redistribution based on the outbreak. The National Malaria Control Programme has trained trainers of trainers from all our health districts on malaria case management to train the rest of the staff in their respective districts," he said. Makgalemele said the country-wide training was to strengthen case management of health care workers in both Malaria and non-malaria endemic areas.

"Specifically for this particular outbreak, national teams have been dispatched to monitor the situation in the affected districts. Our entomologists are also on the ground supporting the case investigations," he said. He highlighted that all DHMTs have malaria epidemic response teams. "During outbreaks, as is the case, these teams have been reactivated and are meeting on a weekly basis to assess the situation," he said.

He said due to high population mobility and standing water pools, sporadic cases of malaria can occur in non-endemic areas. My ministry has bought 2325 long lasting insecticidal mosquito nets (LLINS) which continue to be distributed in malaria endemic districts," he said. In addition he commented that all these nets have and were being distributed in the endemic areas adding that for the quarter ending December 2016, the average drug availability was 86.5 per cent.  [byline: Mpho Tebele]
================
[There has been an increase in malaria cases in South Africa, Botswana and Namibia in recent months following heavy rains (see ProMED-mail reports). These do strain drug supplies where artemisinin-combination therapy is the key treatment, acting rapidly and administered orally. Insecticide treated nets (ITNs) have been a huge success throughout Africa and their introduction is believed to be the main intervention responsible for the decrease in malaria mortality observed over the past 2 decades. - ProMED Mod.EP]

[A HealthMap/ProMED-mail map can be accessed at:
<http://healthmap.org/promed/p/169>.]
Date: Mon, 3 Apr 2017 22:44:47 +0200

Gaborone, Botswana, April 3, 2017 (AFP) - A strong earthquake with a magnitude of 6.5 struck the southern African nation of Botswana on Monday, US seismologists said, with the tremor felt in several neighbouring countries.    The epicentre of the quake, which hit at 7:40 pm (1740 GMT), was in a sparsely populated area 238 kilometres (about 150 miles) northwest of Botswana's capital Gaborone, the US Geological Survey said.

It struck at a depth of 29 kilometres, and rumbled throughout the capital for about 30 seconds, an AFP correspondent said.   In a statement published on social media late Monday, the government of Botswana said no deaths had been reported.   "We felt the house was vibrating, all the window and door panels shaking heavily. We went outside and felt the same," a resident of Letlhakane, a village in Botswana near the epicentre, told the Earthquake Report website.   The quake was also felt in several cities in South Africa as well as in Swaziland and Zimbabwe, several hundreds of kilometres from the epicentre,
witnesses said.

In central Johannesburg, two buildings were evacuated as a precaution, according to media reports.   "My whole bed was shaking. It was so scary. I didn't know what was happening," a resident of Durban, on the southeast coast of South Africa, told the News24 agency.   Earlier Monday, a smaller quake with a magnitude of 4.6 was recorded in north-western South Africa.   Strong earthquakes are rare in southern Africa, though in 2006 Mozambique was hit by a 7.5-magnitude quake that killed four people and injured 29.
Date: Mon 20 Mar 2017, 10:45 AM
Source: News24, a Traveller24 report [edited]
<http://traveller24.news24.com/News/Alerts/alert-limpopo-on-high-alert-as-botswana-issues-malaria-warning-20170320>

Travellers heading to Botswana or those who find themselves in Limpopo need to ensure they take the correct preventative measures as a warning have been issued for high levels of malaria in both of these regions.

The Ministry of Health and Wellness for Botswana has issued a warning that the country is experiencing high levels of malaria, following the recent heavy rains. "There have been increases in the number of cases in Okavango, Ngami, Chobe, Boteti, Tutume and Bobirwa. Travel agents are advised to warn their clients to seek medical advice 2 weeks before travelling to malarial areas."

The Limpopo Health Department [South Africa] has also announced an increase in the number or reported malaria cases in the province, particularly around Lephalale and Thabazimbi [both in Limpopo District, South Africa].

News24 reports the Limpopo health department on [Tue 14 Mar 2017] confirmed at least 46 cases of malaria had been reported in the western Waterberg district around Lephalale and Thabazimbi. The department's spokesperson Thabiso Teffo stated no fatalities had been reported. "It is an area that does not normally have malaria mosquitoes. We also worried that 70 percent of the cases reported were people who had not travelled. It means they had contracted malaria in the area they stay." Teffo said the department started spraying insecticide and informed residents and doctors.

However it is important to note that the department says it is "not an outbreak. It's malaria season". The concern is that the cases are uncommon because it's an area where we don't expect malaria.  [Byline: Selene Brophy]
======================
[The report mentions districts in both Botswana and South Africa. The main increase in the number of cases is in the Limpopo District, South Africa. The Limpopo District is bordering Botswana explaining the alert from the Botswana health authorities. The report also mentions the recent heavy rains in the region and ProMED has recently reported increased number of cases in northern Namibia as well as 3 fatal cases of malaria in Gauteng Province, South Africa. - ProMED Mod.EP]

[A HealthMap/ProMED-mail map can be accessed at:
<http://healthmap.org/promed/p/169>.]
Date: Tue 9 Aug 2016, 3:06 PM (GMT +2)
Source: MmegiOnline [edited]
<http://www.mmegi.bw/index.php?aid=62146&amp;amp;dir=2016/august/09>

Botswana will continue with its ongoing measles/rubella (MR) vaccination campaign, despite reports from Namibia of deaths among some children injected with the vaccines.

Yesterday [Mon 8 Aug 2016] assistant health minister Alfred Madigele said the campaign was going well and had not resulted in any deaths or serious challenges. "The campaign is going very well. We have not registered any deaths associated directly with the vaccination and de-worming. In fact, the only challenge we encountered was a shortage of de-worming tablets at some point in some districts, but that has since been rectified," he said.

Madigele said government is happy with the number of those bringing their children forward for vaccination. "The interim reports show promising numbers. We are also happy that private schools have also been working with us in addition to public schools," he said.

The campaign, which started on 25 Jul [2016], ends on 12 Aug [2016]. The campaign is targeted at children aged between 9 months and 14 years.

Namibian newspapers last week reported that parents whose babies died after they were vaccinated have approached that country's Legal Assistance Centre for help to sue the Ministry of Health and Social Services. According to The Namibian newspaper, 21 babies countrywide have died since 2006 after receiving the vaccines, which are normally administered to children at 6 weeks and 12 weeks [This seems unlikely -- too early. Our previous posting (Measles update (35): Ireland (GY), Botswana vaccine shortage http://promedmail.org/post/20160730.4382060) said the campaign was "targeting children aged 9 months to 14 years of age". Clarification from an informed source would be welcomed. - ProMED Mod.SH]. The deaths have been termed sudden infant death syndrome. "A total of 5 of these cases recorded in July this year [2016] in Windhoek alone were caused by complications arising from the ongoing MR vaccination exercise," the paper reads.

According to the newspaper, Dr Theopolina Tueumuna, a veteran Namibian medical doctor with expertise in public health, specialising in maternal and child health, defended the campaigns, saying in Namibia's case, most children are malnourished and when they get the vaccination there is a likelihood that some might die. She compared Namibian children to those she attended to in London, whom she said were well nourished, lived in good houses, had access to supportive treatment, and plenty of nutritious food.

Madigele said in districts where there is malnutrition, parents are requested to bring the children back for check-ups so they can be helped on time if there is a problem.  [byline: Innocent Selatlhwa]
===================
[Common side effects from the MMR vaccine include low-grade fever, skin rash, itching, hives, swelling, reddening of skin, and weakness. Serious adverse events following MMR vaccination include seizures, severe headaches, double vision, vomiting, joint pain, or pain in the digestive system.

There have also been 397 deaths reported to Vaccine Adverse Events Reporting System (VAERS) in association with the MMR vaccine. However, the numbers of vaccine-related injuries and deaths reported to VAERS may not reflect the true number of serious health problems that occur develop after MMR vaccination.

Even though the National Childhood Vaccine Injury Act of 1986 legally required paediatricians and other vaccine providers to report serious health problems following vaccination to federal health agencies (VAERS), many doctors and other medical workers giving vaccines to children and adults fail to report vaccine-related health problem to VAERS. There is evidence that only between 1 and 10 per cent of serious health problems that occur after use of prescription drugs or vaccines in the United States are ever reported to federal health officials, who are responsible for regulating the safety of drugs and vaccines and issue national vaccine policy recommendations. Excerpted from <http://www.nvic.org/vaccines-and-diseases/measles/measles-vaccine-injury-death.aspx>.

It is not clear whether Nambia and Botswana have the same reporting requirement in place as the US, so the total number of deaths following vaccination may be higher. It is likely that malnutrition and consequent poor health contributed to the children's deaths following vaccination in Nambia.

See ProMED-mail: Measles update (35): Ireland (GY), Botswana vaccine shortage http://promedmail.org/post/20160730.4382060 reporting vaccine shortage in Botswana, although that is not mentioned in this current report.

A map of Botswana may be accessed at
<http://healthmap.org/promed/p/169>.

A map of Nambia may be found at
<https://www.expertafrica.com/namibia/google-map> - ProMED Mod.LK]
Date: Fri 29 Jul 2016
Source: The Voice [edited]
<http://www.thevoicebw.com/shortage-measles-vaccine-hits-moh/>

Shortage of measles vaccine hits MoH [Ministry of Health, Botswana]
-------------------------------------------------------------------
Hardly a week after the Ministry of Health (MoH) [Botswana] launched the measles/rubella (MR) campaign, shortage of the life saving vaccination has been reported in different parts of the country. In this year's campaign, the MoH introduced measles/rubella (MR) vaccine, targeting children aged 9 months to 14 years of age.

This week some members of teams that have been dispatched at various health posts across the country told of how they spent most of their time idling as they had run out of the vaccine. Some of the affected areas are said to include Tutume District Health Management Team (DHMT), Ngamiland DHMT and Boteti DHMT.

"Honestly I don't know what we are doing here because there are no vaccines. We were dispatched with full knowledge of the anticipated turn out of the children, but the medication did not tally with the numbers of the children. In some instances we are forced to give children either the injection or pills and that doesn't complete the whole vaccination process," said a team member who preferred anonymity. Measles is a highly contagious disease caused by a virus.

In 1980, before widespread vaccination, measles caused an estimated 2.6 million deaths each year. The disease remains one of the leading causes of death among young children globally, despite the availability of a safe and effective vaccine.

Approximately 114 900 people died from measles in 2014 -- mostly children under the age of 5. According to a savingram that was sent to DHMT heads in all districts from the Ministry of Health, the measles/rubella campaign is scheduled for 25 Jul to 12 Aug 2016.

The communique further indicates that after the campaign, the measles/rubella vaccine will be introduced into the routine immunisation schedule and will be administered to babies aged 9 months and 18 months. "Post measles campaign coverage survey will be conducted within 10 days following the campaign and it is planned for 22 to 26 Aug 2016," read part of the savingram.

The savingram further revealed that the Ministry of Health has successfully conducted measles follow-up campaigns every 3-4 years as per the World Health Organisation recommendation. The last measles campaign was conducted in 2013, hence the next campaign taking place in 2016. Attempts to reach Chief Public Relations Officer at the Ministry of Health, Doreen Motshegwa, were unsuccessful as she was said to be attending meetings on Wednesday [27 Jul 2016].

Key facts about measles
----------------------
Measles is one of the leading causes of death among young children even though a safe and cost-effective vaccine is available.

- In 2014, there were 114 900 measles deaths globally -- about 314 deaths every day or 13 deaths every hour.
- Measles vaccination resulted in a 79 percent drop in measles deaths between 2000 and 2014 worldwide.
- In 2014, about 85 percent of the world's children received 1 dose of measles vaccine by their 1st birthday through routine health services -- up from 73 percent in 2000.
- During 2000-2014, measles vaccination prevented an estimated 17.1 million deaths, making measles vaccine one of the best buys in public health. [Byline: Leonard Matota]
=======================
[Measles, mumps, and rubella are serious diseases. Before vaccines they were very common, especially among children. To prevent disease, children should get 2 doses of MMR vaccine: 1st dose at 12-15 months of age, 2nd dose at 4-6 years of age (may be given earlier, if at least 28 days after the 1st dose). A map of Botswana may be accessed at <http://healthmap.org/promed/p/169>. - ProMed Mod.LK]
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