Toutes les deux minutes, le paludisme ôte la vie à une personne. Le Niger, est particulièrement touché. Selon le ministère de la Santé nigérien, du mois de janvier au mois de novembre 2020, 3 193 598 cas de paludisme ont été confirmés avec 3 861 décès, soit une augmentation de plus 40% des cas de paludisme et 1932 décès de plus par rapport à 2019, année durant laquelle 1 884 477 cas ont été enregistrés avec 1929 décès au cours de la même période. La majorité de la population est exposée à la maladie et plus de la moitié des habitants vivent dans des zones où le risque de transmission est élevé. Pour des jeunes engagés, comme Zeinabou Idé, à la lutte contre cette maladie, l’implication de tout un chacun est nécessaire. Par ailleurs, le Niger accomplit des progrès remarquables contre la maladie, malgré de multiples difficultés, au rang desquelles on retrouve les attaques djihadistes récurrentes, l’insécurité alimentaire chronique.
Zeinabou Idé est une jeune Nigérienne, elle est chargée de programme pour Impact Santé Afrique (ISA), une ONG à vocation continentale basée au Cameroun dont l’objectif principal est de lutter contre le paludisme. Elle fait savoir que l’augmentation des statistiques liées aux décès dus au paludisme au cours de l’année 2020 devrait « tous nous interpeller ». C’est bien évidemment qu’elle s’intéresse à la situation paludique dans son pays natal. Selon elle, le système de santé nigérien est bien « enroué mais malgré les efforts consentis par l’Etat, le chemin est encore long » tout en soulignant que l’ONG travaille « de pair avec l’Etat en tant que Société Civile pour demander une augmentation des ressources domestiques allouées à la santé et nous faisons aussi de la sensibilisation auprès des communautés afin qu’elles prennent vraiment conscience que le paludisme est un véritable problème de santé publique ».
En effet, le Niger est un pays fortement endémique du paludisme, « nous faisons partie des High Burden High Impact Countries, signifiant qu’il fait partie des 11 pays les plus exposés au paludisme dans le monde » souligne Zeinabou.
Ayant un lien très étroit avec le paludisme, dont elle a souffert et qui lui ont valu un absentéisme à l’école et la perte de proches des suites du neuropaludisme qui est « une forme de paludisme encore peu connue chez nous » ; Zeinabou juge que le travail doit s’effectuer à deux niveaux concernant les facteurs qui défavorisent les prises en charges des maladies comme le palu au Niger. Ces niveaux sont notamment « celui des décideurs et également celui des populations ».
En effet, plusieurs mesures de prévention du paludisme ont été mises en place par l’Etat, dont entre autres, des distributions gratuites des moustiquaires imprégnées à longue durée d’action, dons de ces moustiquaires pour les femmes enceintes lors des consultations prénatales « car elles font partie des cibles les plus vulnérables, campagnes de chimio prévention du paludisme saisonnier pour les enfants de moins 5 ans… ». « Si l’Etat met en place ces mesures et que les populations ne suivent pas, les résultats escomptés ne seront pas atteints. Il est impératif que nous en prenions conscience. Dans les zones reculées, les gens utilisent les moustiquaires comme filets de pêche ou pour protéger les plants de rizières au lieu de les utiliser à bon escient » explique Zeinabou Idé.
Malgré les graves conséquences que peut engendrer cette maladie, la grande majorité de la population la néglige. « Il n’y a pas de petit palu ! Un paludisme simple peut se transformer en 3 jours en paludisme grave et entraîner la mort. Nous ne prenons pas le paludisme au sérieux parce qu’il nous côtoie tous les jours et à force, nous le banalisons. Savez-vous qu’au Niger, le paludisme tue 35 fois plus que la COVID-19 ? Nous l’avons tous constaté, l’année dernière, le paludisme a sévèrement sévit au Niger et entraîné de nombreux décès » rappelle Zeinabou.
La jeune engagée dans la lutte contre le paludisme, n’hésite pas de souligner qu’il urge d’agir face à cette situation inquiétante. « Pour commencer, il faudrait que nous puissions injecter plus de fonds dans le secteur de la Santé, la recherche et développement et l’innovation. Pendant que nous cherchons des solutions, le moustique ne nous attend pas, il mute et évolue. Une résistance aux insecticides qui servent à imprégner les MILDA est observée » dit-elle tout en ajoutant qu’ « ensuite, il faudrait que nous en tant que population jouons notre rôle. Nous ne pouvons plus nous permettre cette désinvolture face au paludisme. Cette maladie tue réellement. Si vous remarquez, nous constatons aussi de plus en plus une résistance à certains médicaments antipaludéens et que l’automédication est en partie responsable ».
Pour le moment, à titre préventif la solution la plus efficace est la moustiquaire imprégnée. « Protégez vos familles, et insistez pour que les femmes enceintes et les enfants de moins de 5 ans dorment sous moustiquaire car ils sont les plus vulnérables » insiste Zeinabou. A titre curatif, la jeune dame suggère que « si vous avez des symptômes de paludisme tels que la fièvre, faites toujours un test avant traitement, faites un traitement adéquat dans un centre de santé pour vous soigner car à force de faire de l’automédication sans être sûr que ce soit le paludisme, votre organisme s’habitue aux médicaments qui deviennent moins efficaces quand vous avez réellement le paludisme ».
Par contre, il est à noter que le Niger accomplit des progrès remarquables contre la maladie, malgré de multiples difficultés. Parmi ces progrès, peuvent être cités : « le principe de gratuité dans la prise en charge des enfants de moins de 5 ans qui a récemment été mentionné par le Ministère de la Santé Publique et une note de service a circulé à ce sujet. La communication pour informer les populations lors des programmes des campagnes de distribution des moustiquaires et de la CPS est assurée par le Ministère de la Santé Publique et par le Programme National de Lutte contre le Paludisme et ce, en plusieurs langues locales et en utilisant différents supports de communication. La formation du personnel de santé à tous les niveaux de la pyramide sanitaires. Le dépistage systématique des cas et la bonne disponibilité en test de dépistage rapide dans les formations sanitaires et au niveau communautaires. La mise en œuvre de la prise en charge communautaire des cas de paludisme par les relais communautaires. Le couplage de la chimio prévention du paludisme saisonnier au dépistage de la malnutrition. La bonne disponibilité des moustiquaires pour la distribution chez les femmes enceintes et les enfants de moins d’un an venant à la vaccination ».
Tout en rappelant que la santé est un droit, un droit pour tous, Zeinabou Idé conclut en appelant l’implication de tous les acteurs, « je me suis engagée parce que je crois qu’il est véritablement possible qu’en joignant nos efforts pour cet objectif commun, nous parvenions à l’élimination de ces maladies qui tuent les plus vulnérables d’entre nous. Pour faire notre travail et pour qu’il ait l’impact nécessaire, nous avons besoin les uns des autres. Nous devons travailler main dans la main : société Civile, Communautés, Gouvernement et services administratifs et de santé. Nous avons besoin de tous : vous, moi, NOUS. Personne d’autre que nous, ne pourra prendre à bras le corps ces problèmes de santé et les résoudre véritablement à la source ».
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