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IMMC
Integrated Malaria Management Consortium
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Africa fooled on Mosquito/Malaria Control?
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Hamisi Malebo to kishimba, me, afro-nets, gbamwenda ...
Oct 18 ... From: Hamisi Malebo
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Aide Memore for Discussion from 1988
Date: Oct 18, 2005 6:17 AM
Subject: Re: Africa fooled on Mosquito/Malaria Control?
Dear Prof. Kishimba and All,
Thanks a lot for throwing light on this issue. Just few months ago, I asked
Peter Burgess on economic aspects of malaria control and he sent me one of
his presentations, self-explanatory and for those interested to look at, I
have attached it herewith.
Dr. Kitua has put it right, for Tanzania, we need to study the documents
Prof. Kilama is referring to and see ways to re-implement mosquito control
approaches in the country.
There is an important lesson in the Americas approach to mosquito and
malaria for our malaria control programs in Africa. Recently, health
officials in the US raised concern over the brackish, polluted water in the
Katrina affected areas and worried that, such waters could be fertile
breeding grounds for trillion of mosquitoes which could transmit
encephalitis, malaria and yellow fever. In this regard, they have already
launched a C-130 hercule aircraft capable of spraying 60,000 acrea a day
with Dibrom insecticide, which is safe for humans and the environment but
extremely effective for mosquito control.
In 1999 three C-130 hercules sprayed Dibrom for 22 days in the wake of
hurricane Floyd. It is reported that, they killed 99% of all mosquitoes
across 1.7 million acres in Virginia and North Carolina. This has further
complicated my worry, as if we could spray and kill 99% of all mosquitoes in
su-Saharan Africa, what will be the impact to malaria? Furthermore, as to
why, when US is threatened by malaria outbreaks they quickly resort to
killing mosquitoes and to to ITNs?
Dr. Mboera has elaborated on the fact that, effective malaria control tools
are known and available today, the only snags are with the decision makers
at the global level.
Why can’t we use the American way in controlling malaria in Africa? Is
WHO, Roll back malaria and other stakeholders are advocating effective
malaria control approaches for Africa? and to Prof. Kilama, could you
through AMANET Trust organise a meeting to discuss and articulate the
African voice on effective means to control malaria in Africa?
It is high time for African scientists to have a refined thinking and take a
lead on malaria control.
With best regards,
Hamisi Masanja Malebo
Research Scientist (Medicinal & Bio-Organic Chemistry),
National Institute for Medical Research (NIMR)
P.O. Box 9653, Dar es Salaam, Tanzania
Mobile: +255 744 383 143
Fax: +255 22 2121360/380
Email:Malebo@hotmail.com,
From: 'Prof. M.A. Kishimba'
Subject: Re: Africa fooled on Mosquito/Malaria Control?
Date: Mon, 17 Oct 2005 18:53:26 +0300
Aide Memore for Discussion from 1988
Dear Hamisi,
Please refer to your most 'provocative' e-mail - thought provocative that is. I was
once told - and do not quote me - that in 1960, after successful eradication of Malaria
by insecticides in the US, the US volunteered to do the spraying to eradicate the disease
in Africa as well.
WHO, I was told, strongly dis-recommended the move - and 45 years later,
here we are. Remember, those were days before Rachel Carson's Silent Spring.
Guess for yourself what the reason(s) were! I hope this is not true.
ANCAP deliberated on the issue last year in Kampala and the declaration of the w/shop
are worth viewing at www.ancap.org/DDT.htm
Best regards,
Michael Kishimba
From: Hamisi Malebo
To LIST
Sent: Saturday, October 15, 2005 9:18 AM
Subject: Africa fooled on Mosquito/Malaria Control?
Dear All,
The recent and 1999 choice of extensive insecticide spraying by health officials in the US as a robust method for the control of disease transmitting mosquitoes, creates suspicion that Africa could be fooled on mosquito/malaria control approaches. The message pasted below is self explanatory.
Air Force Reserve Sprays Mosquitos Over Louisiana
by Staff Sgt. Jennifer Gregoire
9/13/2005 - DUKE FIELD, Fla. (AFPN) --
The Air Force Reserve continues to save lives in Hurricane Katrina's aftermath by conducting the first of many aerial spray missions that began Sept 12 over Louisiana in an attempt to reduce mosquito and filth fly populations.
The Department of Defense's only fixed-wing aerial spray unit, the 910th Airlift Wing, and its C-130 Hercules were requested by the Federal Emergency Management Agency and the Centers for
Disease Control and Prevention to spray until the threat of disease subsides.
FEMA officials are assessing how many acres need to be sprayed as a result of Katrina.
'The elimination of disease-carrying insects is a vital part of ensuring public health and safety in the aftermath of Hurricane Katrina,' said Lt. Col. Steve Olson, a 910th AW medical entomologist. 'The targeted insects are capable of transmitting diseases such as Eastern Equine Encephalitis, West Nile virus and malaria. If not controlled, the probability people will contract these diseases, either in single incidents or in widespread outbreaks, increases greatly.'
Planes spray insecticide
Two US Air Force C-130 planes, specially equipped to carry out low-altitude spraying, treated parts of New Orleans late Monday with an insecticide to kill adult mosquitoes, Air Force spokesman Master Sergeant Paul Fazzini told AFP.
'They started their first mission yesterday and the next flight is probably going to be today,' Fazzini said on Tuesday. 'The target zones are put together by the FEMA and the CDC,' he said, referring to the Federal Emergency Management Agency (FEMA) and the US Centers for Disease Control (CDC).
Dibrom, the insecticide being used, is very heavily diluted and sprayed in an ultra-fine mist so that it adheres to the bodies and hairs of mosquitoes, Fazzini said. The chemical is dangerous for humans at high doses, but for these operations it is so heavily diluted that it is safe, he said.
AFP
Why can't we have similar spraying operations in Africa?
Regards,
Hamisi Masanja Malebo
Research Scientist (Medicinal & Bio-Organic Chemistry),
National Institute for Medical Research (NIMR),
P.O. Box 9653, Dar es Salaam, Tanzania
Mobile: +255 744 383 143
Fax: +255 22 2121360/380
Email:Malebo@hotmail.com,
From: Charles Obonyo
'African Networks for Health Research and Development (AFRO-NETS)'
To: LIST
Subject: RE: [afro-nets] Mosquito/Malaria Control (41)
Dear Dr. White,
Reading your opinion on malaria/vector control I would like to add some important data based observations obtained over the last 4 years in the highlands of W. Kenya:
- Larval habitats of malaria vectors can be localized and classified according to their productivity of malaria mosquito larvae, thus source reduction is possible.
- Not only seasonality but also the proximity of larval habitats to nearby homesteads needs to be considered.
- Man-made larval habitats seem to take a key position within the list of all habitats, particularly disturbed habitats (Carlson et al, 2004).
- Source reduction of malaria vectors through water-management and environmental friendly larviciding are a realistic and cheap approach by which the communities are getting involved and become owner of both the problem and the intervention.
I would like to suggest that for proper malaria vector control as a tool of malaria prevention
we shouldn't consider one single approach but rather put our complementary activities into an
integrated framework. Not making competition but rather working together and exchanging our data
and strategies for obtaining significantly reduced malaria prevalences in a given intervention
setup is my personal 'malaria philosophy'.
We would be happy to show you our integrated approach in Nyabondo of Nyando district and in
Kisii and Gucha districts, respectively.
Please let us know if you are interested in and what date/time would be suitable for you.
Thank you.
With kind regards,
Francois X. Omlin
Environmental Management Programme Leader
ICIPE-Kisii
-----Original Message-----
From: Chris White
Sent: Friday, September 23, 2005 4:12 PM
Subject: RE: [afro-nets] Mosquito/Malaria Control (41)
My response to an argument sent out through AFRO-NETS.
Chris
To Whom It May Concern
I'm afraid that the argument for adopting certain methods for vector control
currently in use in the USA to the sub-Saharan Africa context is weak to say the
least.
To understand the reasons for different approaches being used in
these settings one has to understand something of the ecology and behaviour
of various disease vector species (which differ markedly both across and
within these geographical ranges in terms of breeding site preferences, feeding location
preferences, host species preferences, biting times, transmission efficiency, disease
organisms carried and so on).
One should also remember that the main threat being addressed through aerial
spraying in the southern USA is that of yellow fever (YF), dengue and west nile
virus (WNV) - not malaria.
Each of the arbo-viruses listed are not actually carried by potential human malaria
vectors (in fact they are carried by an entirely different Genus altogether - Aedes).
It is important to understand too that the predominant malaria vector species in
middle Africa - Anopheles gambiae s.s. (which is widespread south of the Sahara
and north of South Africa) can easily breed in small, transient, rain-fed pools
such as hoof prints and tyre ruts, feeds mainly on human hosts and feeds and rest
indoors.
Considering the sheer number of suitable breeding sites in places such as Uganda and Tanzania for example and the resulting vector population densities in such areas and the housing conditions of the human host population, it soon becomes very clear as to why vector control through larval site sprayingis both physically unrealistic and economically unsustainable. A treated insecticide-treated net on the other hand can provide protection for the users (2 or more people) for up to 5 years and when significant coverage is achieved in any one community actually result in a 'mass-killing' effect on the vector population, resulting in a reduction in malaria transmission and subsequent malaria-related morbidity for the community. Also, it is important to realise that the human population in Africa is largely rural (and frequently remote). The logistics involved in getting millions of nets to these communities is difficult enough (although significant strides are being made), but the idea of spraying tiny pools of water every time it rains in tropical areas is obviously ludicrous.
Some suggested further reading on this subject:
Essential Malariology by Warrell and Gilles (eds) - chapter 4, the Anopheles vector (by M.W. Service and H. Townson)
The Biology of Disease Vectors by Beaty and Marquardt
Medical Entomology by M.W. Service
Chris White Programme Leader Malaria African Medical & Research Foundation (HQ) PO Box 00506-27691, Nairobi, Kenya, Tel: +254-20-699-3215 (direct line) http://www.amref.org
AMREF - Winner of the Gates Award for Global Health 2005
---------- Forwarded message ----------
From: Andrew Kitua
To: afro-nets@healthnet.org
Date: Fri, 21 Oct 2005 18:16:11 +0200
Subject: [afro-nets] Africa fooled on Mosquito/Malaria Control? (3)
Africa fooled on Mosquito/Malaria Control? (3)
Dear Wiketye,
This is brilliant thinking and we should keep this in mind so
that we can actually implement it through any new projects and
while contemplating new interventions. Could I suggest that we
form a small team to actually analyse the policy formulation and
evidence for the current policies so that we can critically ar-
gue for the environmental component. Who would be interested?
Dr. Andrew Y Kitua MD, PhD
Director General
National Institute for Medical Research
Ocean Road, P.O.Box 9653, Dar es Salaam, Tanzania
Tel: +255-22-2130-770/2131-864
Fax: +255-22-2130-660/2131-864
mailto:akitua@hotmail.com
Profitinafrica@aol.com to me
More options 1:42 pm (27 minutes ago)
---------- Forwarded message ----------
From: Victor Wiketye
To: afro-nets@healthnet.org
Date: Fri, 21 Oct 2005 18:12:07 +0200
Subject: [afro-nets] Africa fooled on Mosquito/Malaria Control? (2)
Africa fooled on Mosquito/Malaria Control? (2)
Last year I attended an international training course on tropical diseases
control. The course was conducted in China. It is
sad to learn that while several other countries have succeeded
to eliminate (or almost eliminate) malaria and maintain that
status for years, we in Africa are virtually accepting the dis-
ease as ineradicably in our environment. We have accepted the
targets set for us by WHO reducing malaria to certain preva-
lence, reducing child/infant mortalities to so and so... preva-
lence by year so and so. They have declared eradication or
rather elimination to be impractical and we have bought the
idea. We remain to be inexhaustible market for therapeutic anti-
malarials made elsewhere!
I totally agree with the senior scientists that revisiting our
previous efforts (in 1970s) will shed light to the way forward.
Elimination of malaria needs integrated approach. Vector control
mainly through environmental modification coupled with the use
of safe insecticides should be central to parasite clearance
through prophylactic and therapeutic treatments. The major challenge thrown to us, especially with the issue of environmental
modification has been the huge costs involved. Moreover, despite
elimination programmes being such capital intensive, maintaining
the controlled area free from re-invasion is another big challenge. India once (in early 1960s) eliminated malaria but then
took no further efforts to sustain the situation. Just in three
year there came re-invasion, which exploded with prevalences and
mortalities far higher that those experienced before the elimination was launched.
Community sensitization, I believe is the key to successful sustainability of elimination programmes. To help overcome the challenge of intensiveness of the required capital, it would be of use if we think of integrating the components of environmental modification (aiming at communicable disease control), to all construction projects. Currently we have many such projects in our country which include road constructions, residential area constructions (e.g. mradi wa viwanja elfu ishirini in Dar), schools renovations, rehabilitation of tape water systems in urban area etc. We would benefit a lot if all these would seriously include elements of environmental modification to discourage mosquito breeding and propagation of other disease causing microbes.
Sincerely,
Victor Wiketye
mailto:wikeetye@yahoo.co.uk
From: Hamisi Malebo
To: afro-nets@healthnet.org
Date: Fri, 21 Oct 2005 18:20:01 +0200
Subject: [afro-nets] Africa fooled on Mosquito/Malaria Control? (4)
Africa fooled on Mosquito/Malaria Control? (4)
Dear Dr. Kitua,
I applaud the proposal. I will be glad to participate. In the
year 2002 I attended an International training course on malaria
control in China, whereby China was sharing experience on its
success on control towards eradication of malaria. I hope I will
be able to share the knowledge and practicals in this area.
With best regards,
Hamisi Masanja Malebo
Research Scientist (Medicinal & Bio-Organic Chemistry)
National Institute for Medical Research (NIMR)
P.O. Box 9653, Dar es Salaam, Tanzania
Mobile: +255-744-383-143
Fax: +255-22-2121-360/380
mailto:Malebo@hotmail.com
mailto:hmalebo@nimr.or.tz
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