Malaria N° 5 - Subject N° 4

CONTROL OF MALARIA IN AFRICA
J.H. Ouma

SUMMARY
Malaria remains among the top devatating diseases occuring in the world today. The majority of estimated annual incidence figures of 300-500 million clinical cases and mortality of 1.5 - 1.7 million malaria deatgs occur in Africa.
Earlier efforts to control and/or to eradicate the disease failed. WHO has initiated new efforts aimed at reducing morbidity and mortality due to malaria significantly by strengthening the capabilities for malaria control at all levels in endemeic countries. For Africa, this is crucial since most cases of malaria morbidity and mortality occur in Africa. The strategy for malaria control in Africa will focus on strengthening case management as well as prevention of malaria through personal protection measures. Prevention involves chemoprophylaxis and reduction of human-mosquito contact. Chemoprophylaxis is to be limited to the high risk groups. Reduction of human-mosquito contact involves use of insecticide treated material, vector control mainly useing residual sprays. Vaccine would present additional tools but we still do not have one which meets the criteria for a good vaccine.
Outbreaks of epidemics are usually treated as emergency situations. In addition to the measures outlined, there is usually needs for mobilization of all concerned to ensure availability of guidelines and supplies needed to contain epidemics.
Given that past efforts to control and/or to eradicate malaria have failed, the current strategy of reducing morbidity and mortality as much as possible is feasible if control approaches can be strengthened in a co-ordinated manner at all levels and within the existing health systems in endemic areas.