A Successful Malaria Reduction Initiative in Eritrea
Control of malaria
Control of malaria is not a simple matter of treatment. Multiple control methods, such as treated bednets, residual spraying, reduction of mosquito breeding places and the training of community health agents are also are needed to be used in conjunction with effective treatments.
You may be interested in a free access paper from 2006 in the Malaria Journal which documents A steep decline of malaria morbidity and mortality trends in Eritrea between 2000 and 2004. It documents the successful implementation of a combination of control methods.
In the period 2000–2004, approximately 874,000 ITNs were distributed and 13,109 health workers and community health agents were trained on malaria case management. In 2004, approximately 81% households owned at least one net, of which 73% were ITNs and 58.6% of children 0–5 years slept under a net. The proportion of malaria cases managed by community health agents rose from 50% in 1999 to 78% in 2004. IRS coverage increased with the combined amount of DDT and Malathion used rising from 6,444 kg, in 2000 to 43,491 kg, in 2004, increasing the population protected from 117,017 to 259,420. Drug resistance necessitated regimen change to chloroquine plus sulfadoxine-pyrimethamine. During the period, there was a steep decline in malaria morbidity and case fatality by 84% and 40% respectively. Malaria morbidity was strongly correlated to the numbers of ITNs distributed (β = -0.125, p < 0.005) and the amount (kg) of DDT and Malathion used for IRS (β = -2.352, p < 0.05). The correlation between malaria case fatality and ITNs, IRS, population protected and annual rainfall was not statistically significant.