Profile - Dr Koffi Tsogbe

Dr Koffi Tsogbe is UNHCR's Senior Public Health Officer in Chad.

How would you rank malaria as a health problem among refugees in Chad?

Malaria is the first cause of morbidity in the camps in Chad, mostly in children under five and pregnant women. In the children, it is also the first cause of mortality. It is the result of a mosquito bite, in the night mostly.

How many people are affected?

From January to February 2008, we had 6,843 cases and 889 deaths - just in these two months - mostly children under five. Malaria is endemic in Chad but it is a particular problem in the south, particularly in the wet season.

How do you prepare for the wet season?

We do "collective prevention" that involves spraying once a year inside the huts or tents, mosquito nets and social mobilisation to prevent mosquito bites. We have to teach people not to leave water lying around. One container left outside a house in the rain is all the mosquito needs to breed.

Can you describe how malaria affects children?

It takes about a week from the mosquito bite to the appearance of symptoms. Then, in very young children, the fever is very quick – climbing to 39°- 40°. The child can have a convulsion and fall into coma. It is so quick that what we do with any child presenting with fever, is assume that it is malaria first. We run a Paracheck diagnosis – a diagnostic test that gives a very quick result. It is not accurate but it is usually enough to show that malaria is present. Then the treatment can follow straight away.

If the child is treated quickly, the recovery rate is very good – around 90-95%. It’s when they don’t come for treatment earlier that we have a problem. This is why we still have 13% of children with malaria dying.

Do you think UNHCR's programs have helped to reduce malaria deaths and suffering in the camps where you work?

Oh sure! We have certainly helped to reduce malaria infections. During the first emergency, the situation was much worse than now. Now - with us providing the mosquito nets and teaching people to use them, with the interior spraying, preventative treatment for pregnant women - the situation is becoming better.

As soon as the refugees arrive, they are screened for risk factors like malnutrition and pregnancy. We provide mosquito nets to all children under five years and to pregnant women and the pregnant women are also given medication to take. The problem we have now is getting people to use the nets correctly and to seek early treatment.