Malaria control activities need to be planned with specific local conditions in mind. This is the lesson derived from three articles which appear in the January 2008 issue of Acta Tropica.
Reporting from Burkina Faso Ouedraogo et al. observed that, “The gametocyte prevalence was significantly higher at the start and peak of the wet season compared to the dry season when corrected for asexual parasite density and age.” In fact they estimated only one infective mosquito bite a month during the dry season. While malaria control programs must clearly have their major interventions in place before the rainy season, they should also educate people to be on their guard during the dry season when people traditionally slack off on ITN use because of heat.
The man-made environment was the focus of concern for malaria transmission in western Kenya. Howard and Omlin went searching for fish ponds and found that 29% of 261 in Kisi Central District of Nyanza Province had been abandoned. Without the fish these a unused ponds became better mosquito breeding sites. The link with economic development was important since access to markets and agricultural extension services may influence whether ponds are abandoned or stocked. Thus, sustaining efforts to improve economic development through aquaculture may help prevent mosquito breeding.
Meissner et al., looked at another geo-environmental concern, variations in chloroquine resistance in urban and rural areas of Burkina Faso. They propose that higher drug pressure in urban areas may explain greater chloroquine resistance in urban communities. This has implications for phasing in changes of national malaria drug policies and well as targeting health education about malaria drug regimen adherence.
These three studies show that one size does not fit all communities when it comes to malaria control. The economic, ecological and epidemiological characteristics of each location should be considered for optimal program implementation.