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Malaria
Control
The goal
of malaria control in malaria-endemic countries is to reduce as much as
possible the health impact of malaria on a population, using the resources
available, and taking
into account other health priorities.
Malaria
control does not aim to eliminate malaria totally. Complete elimination
of the malaria parasite (and thus the disease) would constitute eradication.
While eradication is more desirable, it is not currently a realistic
goal for most of the countries where malaria is endemic.
Malaria control
is carried out through the following interventions, which are often combined:
- Case management
(diagnosis and
treatment) of
patients suffering from malaria
- Prevention
of infection through vector
control
- Prevention
of disease by administration of antimalarial drugs to particularly vulnerable
population groups such as pregnant
women and infants.
Case Management
Persons who
are sick with malaria should be treated promptly and correctly. Malaria
is often a debilitating disease that, when caused by Plasmodium falciparum,
can be fatal. In addition, treatment eliminates an essential component
of the cycle (the parasite) and thus interrupts the transmission
cycle.
The World
Health Organization recommends that anyone suspected of having malaria
should receive diagnosis
and treatment with
an effective drug within 24 hours of the onset of symptoms. When the
patient cannot have access to a health care provider within that time
period (as is the case for most patients in malaria-endemic areas), home
treatment is acceptable.
Prevention
of Infection
Infection
is prevented when malaria-carrying Anopheles mosquitoes are prevented
from biting humans.
Vector
control aims to reduce contacts between mosquitoes and humans. Some
vector control measures (destruction of larval breeding sites, insecticide
spraying inside houses) require organized teams (for example, from the
Ministry of Health) and resources that are not always available.
An alternate
approach, insecticide-treated
bed nets (ITNs) combines vector control and personal protection. This
intervention can often be conducted by the communities themselves and
has become a major intervention in malaria control.
Prevention
of Disease
Administration
of antimalarial drugs to vulnerable population groups does not prevent
infection, which happens through mosquito bites. But drugs can prevent
disease by eliminating the parasites that are in the blood, which are
the forms that cause disease. Pregnant
women are the vulnerable group most frequently targeted. They may
receive, for example, "intermittent preventive treatment" (IPT)
with antimalarial drugs given most often at antenatal consultations
during the second and third trimesters of pregnancy.
Partnerships
for Malaria Control
Successful
malaria control activities require coordinated actions by:
- National
authorities (especially the Ministry of Health)
- International
organizations (such as the World Health Organization and UNICEF)
- Governmental
and nongovernmental agencies
- The private
sector
- The communities.
To enhance
coordination, various partnerships have formed, the most prominent being
the Roll Back Malaria
global partnership.
Activities
for Malaria Control
The main
activities necessary for carrying out malaria control interventions are:
- Health
education (also called Information-Education-Communication, IEC), where
the communities are informed of what they can do to prevent and treat
malaria.
- Training
and supervision of health workers, to ensure that they carry out their
tasks correctly.
- Provision
of equipment and supplies (e.g., microscopes, drugs, bed nets) to allow
the health workers and the communities to carry out the interventions.
Barriers
to Malaria Control
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A patient ward at Mandla District Hospital, India. Inadequate health
infrastructures and resources are often a barrier to malaria control.
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Malaria control
is made difficult by several technical and administrative problems.
- Drug-resistant
malaria parasites hinder case management by decreasing the efficacy
of antimalarial drugs and by requiring the use of alternate drugs that
are often more costly, less safe and less easy to administer.
- Insecticide
resistance decreases the efficacy of interventions that rely
on insecticides such as insecticide-treated bed nets and insecticide
spraying.
- Inadequate
health infrastructures in poor countries are unable to conduct the recommended
interventions.
- The people
most exposed to malaria are often poor and lack education. They often
do not know how to prevent or treat malaria. Even when they do know,
they often do not have the financial means to purchase the necessary
products, such as drugs or bed nets.
Page last modified : January 8, 2009
Content source: Division of Parasitic Diseases
National Center for Zoonotic, Vector-Borne, and Enteric Diseases (ZVED)
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