The Manson Oration, May 1979. Man against malaria: conquest or defeat.
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Biomedical subjects
Publications and source records attributed to L J Bruce-Chwatt.
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Research on malaria, which was endemic in several parts of Portugal at the beginning of this century, was intensified in the 1940's and led to the development of better control methods, especially in the rice-growing areas of the country. In the 1950's residual DDT spraying was introduced and followed by extensive detection of cases of malaria and their treatment. Plans for eradication of the disease were made, and by 1958 the transmission of the infection was interrupted in nearly all areas of European Portugal. The country was placed in the maintenance phase of malaria eradication and the certification of malaria eradication was confirmed by the WHO in 1973. The political and military events of the past five years greatly increased the number of cases of malaria imported into Portugal from tropical Africa and indicated the need for much vigilance to prevent the resumption of transmission by the local vectors. It appears that the measures put into action have succeeded in this respect. This was due to the high degree of effective surveillance and also to the fact that Anopheles atroparvus does not readily transmit the exotic strains of Plasmodium falciparum and P. vivax. However, further vigilance must be maintained and intensified.
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Chloroquine and amodiaquine are demonstrably still the most reliable drugs for the treatment of malaria, except in the south east Asia area, and in parts of south and central America where an altered sensitivity of falciparum plasmodia has been confirmed. The present position of malaria prophylaxis is, unfortunately, anything but satisfactory. But there are already some good preparations which, if correctly used with consideration of all available information, contribute considerably to the prevention of an infection.