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Larval source management: a supplementary measure for malaria vector control. An operational manual.
Geneva, Switzerland, WHO, 2013.  p.Larval source management (LSM) refers to the targeted management of mosquito breeding sites, with the objective to reduce the number of mosquito larvae and pupae. When appropriately used, LSM can contribute to reducing the numbers of both indoor and out-door biting mosquitoes, and -- in malaria elimination phase -- it can be a useful addition to programme tools to reduce the mosquito population in remaining malaria ‘hotspots’. This operational manual has been designed primarily for National Malaria Control Programmes as well as field personnel. It will also be of practical use to specialists working on public health vector control, and malaria programme specialists working with bilateral donors, funders and implementation partners. It has been written by senior public health experts of the malaria vector control community under the guidance of the WHO Global Malaria Programme. The manual’s three main chapters provide guidance on: the selection of larval control interventions, the planning and management of larval control programmes, and detailed guidance on conducting these programmes. The manual also contains a list of WHOPES-recommended formulations, standard operating procedures for larviciding, as well as a number of country case studies.
Africa Renewal. 2005 Jan; 18(4): p..The Millennium Development Goals (MDGs), which include halving world poverty and slashing child mortality by two-thirds, are as challenging as they are ambitious, Mr. Sachs said at UN headquarters in New York in late September, in briefings on the work of the Millennium Project, which he directs. But meeting those goals, said Mr. Sachs, can be as simple as distributing a $1.50 mosquito net or providing a family farmer with a sack of fertilizer. "These are not metaphysical problems. These are not grand cultural problems.... These are practical problems, and they don't cost very much money." Mr. Sachs asserted that while substantial progress has been made in some regions of the world, "Africa on the whole has not achieved progress and has experienced significant regress in many areas." The continent is the epicentre of global poverty, he continued. World leaders are slated to review progress towards the goals in September 2005. The reasons for Africa's halting progress are numerous, he said, including poor soils, the effects of climate change and shortages of basic transportation and communications. But these problems have been worsened by the donor community's insistence on market mechanisms, inadequate and poorly targeted aid and a tendency to blame Africa. The continent's problems "cannot be folded under the rubric that poor Africa just doesn't govern itself properly," Mr. Sachs observed. "Blaming the poor will not solve the problem. Nor is it an accurate, analytical picture" of the obstacles to Africa's development. (excerpt)
Use of intermittent presumptive treatment and insecticide treated bed nets by pregnant women in four Kenyan districts.
Tropical Medicine and International Health. 2004 Feb; 9(2):255-261.The roll back malaria (RBM) movement promotes the use of insecticide-treated bednets (ITNs) and intermittent presumptive treatment (IPT) of malaria infection as preventive measures against the adverse effects of malaria among pregnant women in Africa. To determine the use of these preventive measures we undertook a community-based survey of recently pregnant women randomly selected from communities in four districts of Kenya in December 2001. Of the 1814 women surveyed, only 5% had slept under an ITN. More than half of the 13% of women using a bednet (treated or untreated) had bought their nets from shops or markets. Women from rural areas used bednets less than urban women (11% vs. 27%; P < 0.001), and 41% of the bednets used by rural women had been obtained free of charge from a research project in Bondo or a nationwide UNICEF donation through antenatal clinics (ANCs). Despite 96% of ANC providers being aware of IPT with sulphadoxine–pyrimethamine (SP), only 5% of women interviewed had received two or more doses of SP as a presumptive treatment. The coverage of pregnant women with at least one dose of IPT with SP was 14%, though a similar percentage also had received at least a single dose as a curative treatment. The coverage of nationally recommended strategies to prevent malaria during pregnancy during 2001 was low across the diverse malaria ecology of Kenya. Rapid expansion of access to these services is required to meet international and national targets by the year 2005. The scaling up of malaria prevention programmes through ANC services should be possible with 74% of women visiting ANCs at least twice in all four districts. Issues of commodity supply and service costs to clients will be the greatest impediments to reaching RBM targets. (author's)
Monday Developments. 2003 Sep 22; 21(17):8-9.At the end of June, the Zambian Red Cross in coordination with the Ministry of Health helped vaccinate five million children between the ages of six months to 15 years against measles. The integrated campaign delivered an unprecedented number of health interventions at the same time. To combat malaria, 75,000 insecticide treated bed nets were distributed to vulnerable families with children under five. Vitamin supplements and a de-worming medication called Mebendazole were also administered by some 1,800 Red Cross volunteers. (excerpt)
[Geneva, Switzerland], WHO, 2003. 69,  p. (WHO/CDS/MAL/2003.1093)This report is an initial effort to collect, analyse, and present information on the malaria situation. The report focuses on Africa and specifically on those African countries with the highest burden of the disease. These countries bear more than 90% of the global malaria burden. Emphasis is also given to the technical strategies for malaria control established by the Roll Back Malaria Partnership and the targets set at the Abuja Summit. In addition, with due regard to the importance of understanding the resource requirements of malaria control, a chapter on resource mobilization and financing is included. The data contained in this report have been drawn from a variety of sources in order to provide the most complete picture of the malaria situation in Africa. The UNICEF Multiple Indicator Cluster Surveys and the and Health Surveys, in particular, are national surveys that represent a major advance in collection of baseline data to provide benchmarks against which progress can be measured. It is fully expected that the recent consensus on core data needs, well coordinated efforts to collect data, and progress in solving methodological and other data collection problems will together fulfil the new demands for malaria information. (excerpt)
Africa Recovery. 2001 Jun; 15(1-2):42.On May 9, 2001, the UN Food and Agricultural Organization released a study which found that stocks of deadly, obsolete pesticides are five times larger than previous estimates and constitute a toxic "ticking time bomb" in Africa and other developing regions. The figures set the amount of prohibited and outdated pesticides at 100,000 tons in Africa and the Middle East, 200,000 tons in Asia, and 200,000 tons in eastern Europe and the former Soviet Union. These pesticides, including some of the most poisonous compounds ever made, are often stored in deteriorating and leaky containers without adequate safeguards for people and the environment. The WHO estimates that more than 1 million people are affected by exposure to pesticides worldwide, causing 20,000 deaths annually. The problem is particularly severe in sub-Saharan Africa, where farmers and government regulators often lack the financial resources and technical capacity to handle pesticides safely and screen out substandard, banned, and contaminated compounds. Although clean-up efforts are being started, the cost and difficulty of disposing of Africa's obsolete pesticide stocks have hampered such efforts. However, several international agencies are assisting African governments identify and respond to the toxic threat.
WORLD HEALTH FORUM.. 1998; 19(4):417-27.Ministers of Health sometimes cover up malaria epidemics. Then, when the epidemic is exposed, the entire government Cabinet falls. The case of Egypt and how malaria control remains political are noted. The World Health Organization (WHO) should not have disbanded its malaria control program. If malaria control programs are reinstituted, the control activities should not be integrated into primary health care work. To control malaria, the responsible vector must be stopped. While primary health care workers can treat malaria, they cannot handle the vector. Vector control is the military part of public health, with certain mandatory steps taken with military precision. The author responds to interview questions on the funding of a malaria control campaign based upon vector control, how people are born to lead rather than trained to lead, the role of the health care system in handling malaria, steps to take in Africa, and WHO's strengths and weaknesses.
Tropical Medicine and International Health. 1999 May; 4(5):319-21.The World Health Organization-led "Roll-Back Malaria" (RBM) initiative opens the possibility for malaria control programs to explore new and broader strategies against malaria. Through the RBM, there is closer collaboration with UNICEF, the World Bank, the UN Development Program, and other public organizations working in health, economic, and community development. The commercial sector can also be used by national malaria programs to broaden the scope and sustainability of preventative and curative services. This paper outlines a model for engaging the commercial sector in launching a nationwide insecticide-treated materials (ITM) initiative in Ghana, and how the model can be used with the pharmaceutical sector to promote a national malaria drug policy. The model described has been successfully used to promote contraceptives in Morocco, reproductive health products and services in Indonesia, hand washing with soap in 5 Latin American countries, and oral rehydration solution in Bolivia.
AFRICA HEALTH. 1998 Jul; 20(5):34.The African Initiative for Malaria Control in the 21st Century (AIM) will be launched in 1999 to cover all 46 countries of the Africa region of the World Health Organization (WHO), and will spearhead WHO's global program against malaria. Britain's Prime Minister, Tony Blair, has pledged to provide US$90 million from the Department for International Development (DFID) for the initiative. Malaria is sub-Saharan Africa's biggest health problem, attacking 270-480 million people and killing 1.5-2.7 million every year. Areas in which malaria was largely previously unknown are now experiencing epidemics of the disease, while the malaria parasite has developed resistance to some anti-malarial drugs and insecticides. Among the Bushmen of the Kalahari, malaria is the second most important cause of death after tuberculosis. Health Unlimited is helping to organize the distribution of bednets impregnated with pesticide in a bid to reach 80% of the population in Bushman land over the next 3-5 years.
TDR NEWS. 1996 Jun; (50):3.Malaria causes considerable morbidity and mortality in Africa, killing 1.5-2.7 million people on the continent annually. A meeting on insecticide-impregnated materials was held at the World Health Organization (WHO) Regional Office for Africa (AFRO) during March 18-20, 1996, to promote the use of insecticide-impregnated materials by communities in Africa, review and discuss the results of recently conducted studies in the Africa Region on the use of insecticide-treated nets (ITNs) in malaria control, examine the best ways of implementing the wide-scale use of insecticide-impregnated materials under differing epidemiological and socioeconomic conditions, discuss major operational research priorities, and make recommendations for the promotion and wide use of insecticide-impregnated materials by malaria control programs and communities. The meeting was jointly organized by the WHO Division of Control of Tropical Diseases (CTD), the UNDP/World Bank/WHO Special Program for Research and Training in Tropical Diseases (TDR), and AFRO, and attended by experts, malaria control program managers, private sector representatives, nongovernmental organizations, and technical and scientific institutions. Conclusions and recommendations include the need to assess whether pregnant women could benefit from the use of ITNs. Elements of the successful implementation of sustained malaria control activities involving the use of ITNs are listed. Problems encountered in the large-scale implementation of ITNs in Africa should be addressed collaboratively at the regional and global levels, and coordinated by WHO.
UN CHRONICLE. 1998; (1):12-3.Infection by onchocerca volvulus, a parasitic worm, causes onchocerciasis (river blindness), a debilitating and often blinding disease endemic to tropical areas of Africa and Central and South America. The adult onchocerca volvulus invades the human host where it lives and reproduces for up to 14 years, creating millions of infant worms which cause itching, loss of skin color, rapid aging, and disfiguring skin disease in the host. Onchocerciasis often causes blindness in the human host by approximately age 35 years, and is the third leading cause of blindness in Africa. Onchocerca volvulus is transmitted among humans through the bite of blackflies which breed in fast-flowing rivers. The Onchocerciasis Control Program (OCP) was formally launched in 1974 by the UN's Food and Agriculture Organization (FAO), the UN Development Program (UNDP), the World Bank, and the World Health Organization (WHO) in Benin, Burkina Faso, Ghana, Cote d'Ivoire, Mali, Niger, and Togo. Vector control is the central strategy of the OCP, consisting of weekly helicopter spraying of larvacide to prevent the blackfly from reproducing and transmitting the disease. In addition, Merck & Co. is providing drug therapy against the infant worms in the human host free of charge to 16 million people in endemic areas. Onchocerciasis has now almost been eradicated in the 7 original target countries. Also through the OCP, by 1996, more than 34 million people were protected against the disease, about 2 million who were seriously infected have fully recovered, and an estimated 600,000 people have been prevented from going blind. 12 million infants born since the launch of the OCP face no risk of contracting the disease, and approximately 25 million hectares of arable fertile riverine land has been opened for resettlement. Labor productivity has also increased.