Malaria N° 10 - Subject N° 2

MALARIA IN AN URBAN ENVIRONMENT IN AFRICA
F.J. Louis, G. Martet, M. Morillon, J-E. Touze and D. Baudon

SUMMARY
Urbanisation today affects 40 % of Africans and this development will expand to the point where it will become one of the major preoccupations of the third millennium. Urbanisation will necessitate major change in most fields and pathology will not escape this process. In this particular ecosystem of the African township, characterised by an often explosive growth, extreme population density, underemployment and widespread poverty, a lack of cleanliness and a very low level of individual and collective hygiene, malaria can take on a markedly original appearance, to the point that today we can speak of “malaria in an urban environment”. The main characteristics of this malaria are the growth in domestic anopheline species, a considerable variation in anopheline density and levels of infecting bites, the loss of relative immunity in inhabitants with, as a corollary, the occurrence of severe bouts of malaria in adults, close proximity to health care organisations and the availability of antimalarials, counterbalanced by enormous financial difficulties, which hinder access to health care facilities and encourage a return to traditional medicine and even recourse to charlatans. The entire situation is complex and varies from town to town and from one district to the next, suggestive of an epidemiological patchwork.

KEY WORDS
Africa, Malaria, Urbanisation