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At least 19 recordsLinked to original sources
PubMed1998

Process indicators for malaria control.

Malaria Control efforts are existing in India since antiquity. Organised malaria control interventions were initiated in 1953 by launching of National Malaria Control Programme (NMCP) which was soon converted to eradication in 1958. The initial success achieved was short-lived as malaria resurged in sixties. In 1977, Modified Plan of Operations was launched and the malaria decreased to 2-3 million cases in 1984 and was maintained at the same level. In 1994, after large scale epidemics were experienced, deaths due to malaria increased. WHO recommended a process-based approach to malaria control involving community with decentralized planning in the Global Malaria Control Strategy. Decentralised requires redefining the role and responsibilities at each level of implementation. To facilitate this and monitor the implementation of malaria control detailed process indicators have been developed.

Humans↗
PubMed1997

What's new in malaria control?

Malaria remains a significant health problem in many tropical areas but the main impact of the infection is felt in sub-Saharan Africa, where malaria continues to cause many deaths and much morbidity. Recently, several new initiatives to improve malaria control in Africa have been started. Control is difficult to achieve in areas with very high levels of transmission but something can be accomplished with existing tools, which include provision of good treatment facilities, chemoprophylaxis in pregnancy and use of insecticide-treated materials. In some areas, especially on the fringes of sub-Saharan Africa, households spraying may also have a role. Use of insecticide-treated materials has had a major impact on child mortality in several countries in Africa, although there are concerns that the dramatic effects achieved initially may not be sustained. A major constraint on malaria control in Africa has been poor organization of malaria-control programmes. New approaches that combine elements of vertical and of horizontal control systems are being tried. Malaria control, even when carried out efficiently and cost-effectively, is relatively expensive. New ways of financing malaria control in the countries where it is needed most must be found.

Africa South of the Sahara↗
PubMedDate not supplied

[Armenia: implementation of national program of malaria control].

Malaria has been existing in Armenia since antiquity. In the 1920"s to 1930s, thousands of people suffered from this disease in the country. Enormous efforts were required to prevent further spread of the disease. A network was set up, which consisted of a research institute and stations. A total of 200,000 cases of malaria were still notified in 1934. Rapid development of the health infrastructure and better socioeconomic conditions improved the malaria situation and reduced the number of cases in 1946. Malaria was completely eradicated in Armenia in 1963, and the malaria-free situation retained till 1994. During that period, comprehensive activities were undertaken in the country to prevent and control malaria. Since 1990, following the collapse of the Soviet Union, the situation became critical in many newly independent states. Economic crisis, human migration, worsening levels of health services, and the lack of necessary medicines, equipment, and insecticides significantly affected the malaria epidemiological situation in the country. Malaria cases started to penetrate into Armenia from neighboring countries. In 1994, a hundred ninety six military men contacted malaria in Karabakh, which was unfavorable in terms of malaria, as well on as the border with Iran and along the Araks river. The first cases recorded in Armenia were imported, afterwards they led to the incidence of indigenous cases, given the fact that all the prerequisites for malaria mosquito breeding and development were encountered in 17 regions and 3 towns of the country. In 1995, there were 502 imported cases and in 1996 the situation changed: out of 347 registered cases, 149 were indigenous. The Ministry of Health undertook a range of preventive measures. In 1997 versus 1996, the total number of malaria cases increased 2.3-fold: 841 registered cases of which 567 were indigenous (a 3.8-fold increase). The overwhelming majority of cases were recorded in the Ararat and Armavir marzes. In 1998, there were a total of 1156 cases, of them 542 being locally contacted. The situation became stable thanks to joint efforts of WHO, IFRX, the Armenian Red Cross Society, UNICEF, the Ministry of Health of Armenia and its Government. Under Minister's Decree No. 292 of May 17, 1999, a malaria project implementation office was established in the Masis Sanitary and Epidemiological Surveillance Center of Hygienic and Antiepidemic Surveillance to improve progress of the malaria control programme in Armenia. WHO allocated some 7,700 USD for 5-month maintenance and work of the office. Thus, analyzing the malaria cases registered in 1999 and 1998 indicates a 1.9-fold decrease (616/77). The setting up the malaria programme field office under the Minister's decree was instrumental in planning and implementing activities in situ. In 1999, four cases of tropical malaria were recorded in Armenia. The patients were Armenian pilots who contacted malaria during duty travels: 1 in Sudan and 3 in Congo. The list of pilots making flying to endemic countries was submitted to the Republican Center to implement preventive measures in the future. In Armenia malaria surveillance has been improved to ensure timely detection of all suspected cases and to carry out malaria control activities. In this regard, a seminar was held for 21 entomologists and 12 parasitologists. UNICEF and WHO Armenian offices provided a substantial support to organize seminars. To facilitate the seminars, the manual "Malaria parasitology and entomology" was published and distributed among their participants. On April 19, 1999, the session of the Ministry's Executive Board (Collegium) gave recommendations to reinforce malaria control activities in the country. Decrees No. 256 of May 31, 1999, No. 47 of May 29, 1999, and No. 245 of April 30, 1999, "On malaria and preventive and control activities" were issued by the Ministry of Health, the Ministry of Defense, and the Ministry of Internal Affairs and National Security to serve as a guideline for planning and implementing activities. The Ministry of Agriculture undertook to clean the collective irrigation (drainage) system covering 102 and 77 km in the Ararat and Armavir marzes, the Ministry of Health provided a list of endemic foci where cleaning was a priority. Taking into account the importance of the people's participation in ensuring effective prevention and control, emphasis was laid on health education activities: publication of leaflets, as well as articles in local newspapers, radio broadcasts and TV shows. Throughout the season, the early detection of malaria cases, timely hospitalization (in no later than 1-3 days) for at least 5 days and subsequent treatment under direct supervision of a physician were successfully carried out due to home-to-home visits. Entomological studies conducted in the malaria foci show an increase in the presence and density of a malaria vector in the buildings. As far as treatment is concerned, the overall surface of stagnant waters comprised 2642 ha in 1999 (2733 ha in 1998), including 1285 ha of anophelogenic stagnant waters (2276 ha in 1998). The biggest stagnant water surfaces were in the Ararat and Armavir marzes--2209 ha, where the majority of malaria cases were recorded. A total of 1,283,111 and 559,213 sq. m. of constructions were treated in 1999 and 1998, respectively, out them there were 1,259,637 sq. m. in 5 endemic regions. Stagnant water surfaces were treated with bacticulicides on 250.7 and 743.8 (almost 3 times more) in 1998 and 1999, respectively. In 1999, 740 ha of surface were biologically treated using Gambusia compared to 900 ha treated in 1998. There is no highly qualified diagnostic specialists in many regions of the country, which necessitates the holding of further seminars involving relevant specialists, in all malaria regions. There is a tendency of geographical spread of malaria: malaria cases occur in new regions and dwellings. A country-wide action plan was drafted for 2000, mainly focusing on staff training. With WHO assistance, a seminar was held for 324 specialists from endemic regions. During the first quarter of 2000, 13 cases of tertian malaria were recorded as compared 59 cases during the same period of last year. All these patients contacted malaria in the previous season and demonstrated long incubation periods. Thus, the malaria control plan recommended by WHO and the rational and targeted use of its assistance has shown a 2-fold decrease in the incidence of malaria.

Armenia↗
PubMed2004

Urbanization in sub-saharan Africa and implication for malaria control.

Malaria not only remains a leading cause of morbidity and mortality, but it also impedes socioeconomic development, particularly in sub-Saharan Africa. Rapid and unprecedented urbanization, going hand-in-hand with often declining economies, might have profound implications for the epidemiology and control of malaria, as the relative disease burden increases among urban dwellers. Reviewing the literature and using a modeling approach, we find that entomologic inoculation rates in cities range from 0 to 54 per year, depending on the degree of urbanization, the spatial location within a city, and overall living conditions. Using the latest United Nations figures on urbanization prospects, nighttime light remotely sensed images, and the "Mapping Malaria Risk in Africa" results on climate suitability for stable malaria transmission, we estimate that 200 million people (24.6% of the total African population) currently live in urban settings where they are at risk of contracting the disease. Importantly, the estimated total surface area covered by these urban settings is only approximately 1.1-1.6% of the total African surface. Considering different plausible scenarios, we estimate an annual incidence of 24.8-103.2 million cases of clinical malaria attacks among urban dwellers in Africa. These figures translate to 6-28% of the estimated global annual disease incidence. Against this background, basic health care delivery systems providing early diagnosis and early treatment and preventive actions through mother and child health programs and the promotion of insecticide-treated bed nets for the rapidly growing numbers of the urban poor must be improved alongside well-tailored and integrated malaria control strategies. We propose environmental management and larviciding within well-specified productive sites as a main feature for such an integrated control approach. Mitigation of the current burden of malaria in urban African settings, in turn, is a necessity for stimulating environmentally and socially sustainable development.

Africa South of the Sahara↗
PubMed2002

Genetic transformation of mosquitoes: a quest for malaria control.

Malaria inflicts an enormous toll in human lives and this burden is increasing. Present means to fight the disease, such as drugs and insecticides, are insufficient. Moreover, an effective vaccine has not yet been developed. This review examines an alternative strategy for malaria control, namely the genetic modification of mosquitoes to make them inefficient vectors for the parasite. The article summarises progress made toward the development of transposable element vectors for germ line transformation and the search for mosquito markers of transformation. Also reviewed is the search for anti-malarial effector genes whose products can inhibit development of the parasite in the mosquito with minimal fitness burden. While much progress has been made, much work remains to be done. Future research directions are discussed.

Animals↗
PubMed2003

Anopheles gambiae genome: perspectives for malaria control.

Malaria, a disease that infects 300 million people throughout the world and kills more than a million people, mostly children in sub-Saharan Africa, involves three organisms. The human host where the disease is seen, the protozoan Plasmodium parasite and the mosquito. The parasite is transmitted to humans only by the mosquito vector, which in sub-Saharan regions is generally Anopheles gambiae. Malaria along with AIDS and tuberculosis are killing large numbers of people and crippling the economies of the affected African countries. Though an enormous effort has been made during the past twenty years to develop vaccines to block malaria in humans, the incidence of the disease is increasing in Africa. The reasons for this development include a breakdown in mosquito control related to increased insecticide resistance, as well as increased parasite resistance to antimalarial drugs. It is clear that new methods of Anopheles mosquito control are needed to ameliorate the medical and economic situation in sub-Saharan Africa. As a step toward new malaria control methods, the international Plasmodium falciparum and Anopheles gambiae consortia have carried out the full genome sequencing of the most deadly malaria parasite and the most efficient vector. These, combined with the human genome sequence, provide the genomic infrastructure for a better understanding of the complex interactions within the malaria triad. This essay discusses possible strategies as to how the Anopheles genome can contribute to malaria control.

Animals↗
PubMedDate not supplied

[Vector control and malaria control].

Vector control is an integral part of malaria control. Limiting parasite transmission vector control must be considered as one of the main preventive measure. Indeed it prevents transmission of Plasmodium from man to vector and from vector to man. But vector control must be adapted to local situation to be efficient and feasible. Targets of vector control can be larval and/or adults stages. In both cases 3 main methods are currently available: physical (source reduction), chemical (insecticides) and biological tolls. Antilarval control is useful only in some particular circumstances (unstable malaria, island, oasis...) Antiadult control is mainly based upon house-spraying while pyrethroid treated bed nets is advocated regarding efficiency, simple technique and cheap price. Vector control measures could seem restricted but can be very efficient if political will is added to a right choice of adapted measures, a good training of involved personal and a large information of the population concerned with vector control.

Africa↗
PubMed2002

Integrated approach to malaria control.

Malaria draws global attention in a cyclic manner, with interest and associated financing waxing and waning according to political and humanitarian concerns. Currently we are on an upswing, which should be carefully developed. Malaria parasites have been eliminated from Europe and North America through the use of residual insecticides and manipulation of environmental and ecological characteristics; however, in many tropical and some temperate areas the incidence of disease is increasing dramatically. Much of this increase results from a breakdown of effective control methods developed and implemented in the 1960s, but it has also occurred because of a lack of trained scientists and control specialists who live and work in the areas of endemic infection. Add to this the widespread resistance to the most effective antimalarial drug, chloroquine, developing resistance to other first-line drugs such as sulfadoxine-pyrimethamine, and resistance of certain vector species of mosquito to some of the previously effective insecticides and we have a crisis situation. Vaccine research has proceeded for over 30 years, but as yet there is no effective product, although research continues in many promising areas. A global strategy for malaria control has been accepted, but there are critics who suggest that the single strategy cannot confront the wide range of conditions in which malaria exists and that reliance on chemotherapy without proper control of drug usage and diagnosis will select for drug resistant parasites, thus exacerbating the problem. An integrated approach to control using vector control strategies based on the biology of the mosquito, the epidemiology of the parasite, and human behavior patterns is needed to prevent continued upsurge in malaria in the endemic areas.

Animals↗
PubMed1993

A malaria control trial using insecticide-treated bed nets and targeted chemoprophylaxis in a rural area of The Gambia, west Africa. 1. A review of the epidemiology and control of malaria in The Gambia, west Africa.

Malaria was recognized as an important cause of death among early European visitors to The Gambia, but the infection was first studied systematically in the local population only in the 1950s. Studies undertaken in the village of Keneba at that time showed that nearly all children under the age of 5 years had parasitaemia throughout the year. More recent surveys in rural areas of The Gambia have shown much lower levels of parasitaemia, probably as a result of a decline in rainfall in The Gambia during the past 30 years and because of an increase in the availability of anti-malarial drugs. Nevertheless, community surveys and reviews of hospital statistics show that malaria is still one of the most important causes of death among Gambian children; about 1 in 25 rural Gambian children die from malaria before reaching the age of 5 years. Until recently, malaria control in The Gambia relied upon prompt treatment of clinical attacks, first with quinine and more recently with chloroquine, and upon some limited vector control in the capital, Banjul. However, during the past few years, it has been shown that mortality in rural children can be reduced substantially by means of chemoprophylaxis given by village health workers. Bed nets (mosquito nets) are used widely in The Gambia and epidemiological surveys have shown an association between the use of bed nets and protection against malaria. This observation led to a series of small scale intervention trials.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1993

Global malaria control. WHO Malaria Unit.

The four basic elements in the global malaria control strategy are described. The objectives of this strategy are to prevent mortality and to reduce morbidity and social and economic loss due to disease through the progressive improvement and strengthening of local and national capabilities. The strategy does not propose a single solution but gives broad lines of approach to achieving a common aim. The approaches are to be adapted by the countries concerned according to the structures of their health systems and existing control operations, their resources, and a realistic assessment of the control needs and risk factors.

Adolescent↗
PubMed2004

Rationalizing historical successes of malaria control in Africa in terms of mosquito resource availability management.

Environmental management of mosquito resources is a promising approach with which to control malaria, but it has seen little application in Africa for more than half a century. Here we present a kinetic model of mosquito foraging for aquatic habitats and vertebrate hosts that allows estimation of malaria transmission intensity by defining the availability of these resources as the rate at which individual mosquitoes encounter and use them. The model captures historically observed responses of malaria transmission to environmental change, highlights important gaps in current understanding of vector ecology, and suggests convenient solutions. Resource availability is an intuitive concept that provides an adaptable framework for models of mosquito population dynamics, gene flow, and pathogen transmission that can be conveniently parameterized with direct field measurements. Furthermore, the model presented predicts that drastic reductions of malaria transmission are possible with environmental management and elucidates an ecologic basis for previous successes of integrated malaria control in Africa before the advent of DDT or chloroquine. Environmental management for malaria control requires specialist skills that are currently lacking in sub-Saharan Africa where they are needed most. Infrastructure and human capacity building in clinical, public health, and environmental disciplines should therefore be prioritized so that growing financial support for tackling malaria can be translated into truly integrated control programs.

Animals↗
PubMed2003

Effect of insecticide-treated bednets for malaria control in Southeast Anatolia-Turkey.

Deltamethrin is one of the most effective insecticides for vector control, already widely used for bednet impregnation to control malaria. To evaluate the efficacy of deltamethrin-impregnated bednets in malaria control and in reducing the biting nuisance caused by Anopheles sacharovi, field trials were carried out in an endemic area of malaria in the surrounding rural settlements of Sanliurfa City, SE Anatolia, Turkey. Preliminary studies commenced in August 1999 with pre-intervention house-to-house surveys to identify villages outside of Sanliurfa City with high malaria incidence, to collect socio-economic, epidemiological and entomological data, and to determine physical properties of the study areas. An intervention field trial promoting the use of K-OTAB (deltamethrin-tablet formulation) impregnated bednets by local inhabitants of four villages was performed between July 2000 and July 2001. Its aim was to examine the monthly and annual efficacy of such bednets in controlling malaria and to compare the effect of impregnated bednets (IB) with non-impregnated bednets (NIB). The experimental design consisted of four villages. Gedik was selected as the intervention area using IBs, Orgulu served as the control area, and in Persiverek and Sandi NIBs were implemented. All 1,406 inhabitants of the 146 households were recruited for the study. Results showed significant (P < 0.05) reduction in malaria incidence in Gedik from 8.29% in the pre-treatment year to 1.57% in the post-treatment year. In contrast, malaria incidence slightly increased in Orgulu from 6.55% to 7.58%. Similar results were obtained from the other two villages where NIBs were used; malaria incidence rates increased from 2.16% to 6.77% (Persiverek) and from 1.9% to 9.8% (Sandi). Entomological surveys, employing different techniques, were carried out randomly at selected collection sites within the intervention and control settlements every month from June 2000 to June 2001 to determine the fluctuation of seasonal population sizes and compare the monthly density of malaria vectors between intervention and control areas.

Animals↗
PubMed1996

Permethrin-impregnated bednets are more effective than DDT house-spraying to control malaria in Solomon Islands.

A field trial compared DDT house-spraying with permethrin-impregnated bednets for malaria control in Solomon Islands from 1987 to 1991. Mortality-rates of malaria vector Anopheles farauti in exit window traps were 11.6% from an untreated hut, 10.1% from a hut sprayed with DDT 2 g/m2, and 98% of those from a hut in which the occupants used bednets treated with permethrin 0.5 g/m2. Since bioassays of the DDT-sprayed walls (15 min exposure in W.H.O. standard test cones) gave 77% mortality of An.farauti, it was concluded that the insignificant impact of DDT could be explained by the exophilic behaviour of endophagic vectors, whereas the greater impact of permethrin was attributed to the more effective exposure of An.farauti females to the impregnated bednets-attracted by the occupants. The parous rate was higher indoors, except in the area with permethrin-impregnated bednets. It was therefore concluded that permethrin-impregnated bednets reduced the mean longevity of An.farauti and hence its vectorial capacity. The circumsporozoite (CS) antigen positivity rate of An.farauti in the DDT area was 0.18% outdoors, significantly less than 1.42% indoors. In the comparison area CS rates were 0.65% outdoors and 0.75% indoors. CS antigen was not detected in An.farauti from the bednet area, indicating the apparent prevention of malaria transmission. As DDT spraying was so much less effective, it was discontinued in 1993 and permethrin-impregnated bednets are now the principal malaria control method in Solomon Islands.

Animals↗