Visiting a clinic in Binji Local Government Area of Sokoto State Nigeria today we saw the attached poster.Â In fact there were three copies posted on walls in the public waiting areas. It was not clear whether this poster was intended as a job aid (reminder) for the health staff or a public education poster. If the latter, there is too much happening on the poster for it to be a good BCC material.
The main concern about this poster is that it implies that all mosquitoes are responsible for malaria. The pictures in fact implicate other mosquitoes such as the culicine species and Aedes aegypti.Â Covering pots and getting rid of old cans and bottles will prevent mosquito breeding, but more than likely will prevent yellow fever, not malaria.
Clearing dirty gutters can prevent breeding of culex and the various viral diseases they carry, but not malaria. Yes, we want people to prevent mosquito breeding generally, as there appear to be no ‘good’ mosquitoes, but promising that preventing breeding of non-anophelene species will prevent malaria is misinformation.
We can be straightforward with the public and say there are many types of mosquitoes, and they carry many different diseases. It helps to prevent the breeding of all, but as different ones breed in different places, we can not expect every action will result in the prevention of malaria. We also need to stress that not all fevers are malaria, and we need testing to ensure the right medicine is given, not ACTs for dengue or west nile virus (which are carried by the other mosquitoes – adding to the public’s confusion).
At present there are two major vector control measures recommended by the RBM community – insecticide treated bednets and indoor residual spraying.Â A few places have been successful with limited larviciding, but since breeding sites are ubiquitous, this is an almost never ending activity.Â Lets focus on what is feasible.
Finally we need to recall that when we talk to local people about mosquito breeding, they may not understand what we mean by mosquito larvae.Â Among the Yoruba, for example, these larvae are called tanwiji and are thought to be a different animal from actual mosquitoes themselves.Â People have been confused by attempts at BCC on larval control thinking that health workers are saying that swallowing the tanwiji causes malaria.
Again, for now lets make headway with our treated nets and appropriately targeted IRS.Â If we can achieve those coverage targets, the 2015 Millennium Development Goals will be achievable.