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Resurgent Malaria at the Millennium

Control Strategies in Crisis

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Abstract

Completion of the Panama Canal in 1914 marked the beginning of an era of vector control that achieved conspicuous success against malaria. In 1955 the World Health Organization (WHO) adopted the controversial Global Eradication Campaign emphasising DDT (dichlorodiphenyltrichloroethane) spraying in homes. The incidence of malaria fell sharply where the programme was implemented, but the strategy was not applied in holoendemic Africa. This, along with the failure to achieve eradication in larger tropical regions, contributed to disillusionment with the policy. The World Health Assembly abandoned the eradication strategy in 1969. Aresurgence of malaria began at about that time and today reaches into areas where eradication or control had been achieved. A global malaria crisis looms. In 1993 the WHO adopted a Global Malaria Control Strategy that placed priority in control of disease rather than infection. This formalises a policy that emphasises diagnosis and treatment in a primary healthcare setting, while de-emphasising spraying of residual insecticides. The new policy explicitly stresses malaria in Africa, but expresses the intent to bring control programmes around the world into line with the strategy.

This review raises the argument that a global control strategy conceived to address the extraordinary malaria situation in Africa may not be suitable elsewhere. The basis of argument lies in the accomplishments of the Global Eradication Campaign viewed in an historical and geographical context. Resurgent malaria accompanying declining vector control activities in Asia and the Americas suggests that the abandonment of residual spraying may be premature given the tools now at hand. The inadequacy of vector control as the primary instrument of malaria control in holoendemic Africa does not preclude its utility in Asia and the Americas.

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References

  1. Harrison G. Mosquitoes, malaria and man: a history of the hostilities since 1880. London: John Murray, 1978: 314

    Google Scholar 

  2. Krogstad DJ. Malaria as a reemerging disease. Epidemiol Rev 1996; 18: 77–89

    Article  PubMed  CAS  Google Scholar 

  3. Mouchet J, Manguin S, Sircoulon J, et al. Evolution of malaria in Africa for the past 40 years: impact of climatic and human factors. J Am Mosquito Control Assoc 1998; 14: 121–30

    CAS  Google Scholar 

  4. World Health Organization. Implementation of the global malaria control strategy. WHO Technical Report Series no. 839. Geneva: WHO, 1993

    Google Scholar 

  5. World Health Organization. Malaria fact sheet no.94. Geneva: WHO, 1998

    Google Scholar 

  6. Nye ER, Gibson ME. Ronald Ross: malariologist and polymath. London: Macmillan Press, 1996: 316

    Google Scholar 

  7. Boyd MF. Historical review, In: Boyd MF, editor. Malariology. Philadelphia: WB Saunders, 1949: 3–25

    Google Scholar 

  8. Ross R. On some peculiar pigmented cells found in two mosquitoes fed on malarial blood. BMJ 1897; ii: 1786–8

    Article  Google Scholar 

  9. Grassi B, Bignami A, Bastianelli G. Ulteriori ricerche sul ciclo dei parassiti malarici umani nel corpo del zanarone. Atti Reale Accademia dei Lincei 1899 S.5; 8: 21

    Google Scholar 

  10. James SP. Malaria in Mian Mir. In: Jennings WE, editor. Transactions of the Bombay Medical Conference, 1909. Bombay: Bennett, Coleman, 1909: 84–9

    Google Scholar 

  11. McCullough D. The path between the seas: the creation of the Panama Canal, 1870–1914. New York: Simon & Schuster, 1978: 698

    Google Scholar 

  12. Reed W, Carroll J, Agramonte A. Experimental yellow fever. Trans Assoc Am Physicians 1901; 16: 45–70

    Google Scholar 

  13. Packard RM. Malaria dreams: postwar visions of health and development in the third world. Med Anthropol 1997; 17: 279–96

    Article  PubMed  CAS  Google Scholar 

  14. Beadle C, Hoffman SL. History of malaria in the United States navalforces atwar: World War I through the Vietnam conflict. Clin Infect Dis 1993; 16: 320–9

    Article  PubMed  CAS  Google Scholar 

  15. Coatney GR. Pitfalls in a discovery: the chronicle of chloroquine. Am J Trop Med Hyg 1963; 12: 121–8

    PubMed  CAS  Google Scholar 

  16. Russel PF. Man’s mastery of malaria. London: Oxford University Press, 1955

    Google Scholar 

  17. Zucker JR. Changing patterns of autochthonous malaria transmission in the United States: a review of recent outbreaks. Emerg Infect Dis 1996; 2; 37–43

    Article  PubMed  CAS  Google Scholar 

  18. Faust EC, Debakey L. Malaria mortality in the Southern United States for the year 1940, with supplementary data on malaria in other states. J Natl Malaria Soc 1942; 1: 125–31

    Google Scholar 

  19. MacDonald G. The epidemiology and control of malaria. London: Oxford University Press, 1957

    Google Scholar 

  20. United States Agency for International Development. Malaria: meeting the global challenge. AID science & technology in development series. Boston: Oelgeschlager, Gunn, & Hain Publishers, 1985

  21. Jukes TH. Insecticides in health, agriculture and the environment. Naturwissenschaften 1974; 61: 6–16

    Article  PubMed  CAS  Google Scholar 

  22. Sharma VP. Re-emergence of malaria in India. Indian J Med Res 1996; 103; 26–45

    PubMed  CAS  Google Scholar 

  23. Atmosoedjono S. Malaria control in Indonesia since World War II. Wageningen Agricultural University Papers 1990; 90-7: 141–54

    Google Scholar 

  24. Curtin PD. Malarial immunities in Nineteenth Century West Africa and the Caribbean. Parassitologia 1994; 36: 69–82

    PubMed  CAS  Google Scholar 

  25. Baird JK, Sismadi P, Masbar S, et al. Afocus of endemic malaria in Central Java. Am J Trop Med Hyg 1996; 54: 98–104

    PubMed  CAS  Google Scholar 

  26. Lepers JP, Fontinille D, Rason MD, et al. Transmission and epidemiology of newly transmitted falciparum malaria in the central highland plateau of Madagascar. Ann Trop Med Parasitai 1991; 85: 297–304

    CAS  Google Scholar 

  27. Reynolds DJ. The Demerara doctor. Perspectives in Health 1996; 1 (2) [online]. Available from: URL: http://www.paho.org/english/DPImag/Number2/dpi2pdemerara.html [Accessed 2000 Feb 29]

  28. Cruz MA. Human migration and the spread of malaria in Brazil. Parasitai Today 1987; 3: 166–70

    Article  Google Scholar 

  29. Trigg PI, Kondrachine AV. Commentary: malaria control in the 1990s. Bull WHO 1998; 76: 11–6

    PubMed  CAS  Google Scholar 

  30. Packard RM. ‘No other logical choice’: global malaria eradication and the politics of international health in the post-war era. Parassitologia 1998; 40: 217–29

    PubMed  CAS  Google Scholar 

  31. Butler D, Maurice J, O’Brien C. Time to put malaria control on the global agenda. Nature 1997; 386: 535–6

    Article  PubMed  CAS  Google Scholar 

  32. Campbell CC. Malaria: an emerging and re-emerging global plague. FEMS Immunol Med Microbiol 1997; 18: 325–31

    Article  PubMed  CAS  Google Scholar 

  33. Kondrachine AV, Trigg PI. Global overview of malaria. Indian J Med Res 1997; 106: 39–52

    PubMed  CAS  Google Scholar 

  34. National Academy of Sciences (US). Vaccines Against malaria: hope in a gathering storm. Washington: National Academy Press, 1996

    Google Scholar 

  35. Greenberg AE, Lobel HO. Mortality from plasmodium falciparum malaria in travelers from the United States, 1959 to 1987. Ann Intern Med 1990; 113: 326–7

    PubMed  CAS  Google Scholar 

  36. World Health Organization. World malaria situation in 1994: Part II, the Americas. Wkly Epidemiol Rec 1997; 72: 277–84

    Google Scholar 

  37. World Health Organization. World malaria situation in 1994: Part III. Wkly Epidemiol Rec WHO 1997; 72: 285–90

    Google Scholar 

  38. Feighner BH, Pak SI, Novakoski WL, et al. Reemergence of Plasmodium vivax malaria in the Republic of Korea. Emerg Infect Dis 1998; 4: 295–7

    Article  PubMed  CAS  Google Scholar 

  39. Roberts DR, Laughlin LL, Hsheih P. DDT, global strategies, and a malaria control crisis. Emerg Infect Dis 1997; 3: 295–302

    Article  PubMed  CAS  Google Scholar 

  40. Sharp BL, le Sueur D. Malaria in South Africa: the past, the present and selected implications for the future. S Afr Med J 1996; 86: 83–9

    PubMed  CAS  Google Scholar 

  41. Lepers JP, Deloron P, Andriamagatiana-Rason MD, et al. Newly transmitted plasmodium falciparum malaria in the central highland plateaux of Madagascar: assessment of clinical impact in a rural community. Bull WHO 1990; 68: 217–22

    PubMed  CAS  Google Scholar 

  42. Malakooti MA, Biomndo K, Shanks GD. Reemergence of epidemic malaria in the highlands of western Kenya. Emerg Infect Dis 1998; 4: 671–6

    Article  PubMed  CAS  Google Scholar 

  43. Shukla RP, Pandey AC, Mathur A. Investigation of malaria outbreak in Rajasthan. Indian J Malariol 1995; 32: 119–28

    PubMed  CAS  Google Scholar 

  44. Martens WJ, Niessen LW, Rotmans J. Potential impact of global climate change on malaria risk. Environ Health Perspect 1995; 103: 458–64

    Article  PubMed  CAS  Google Scholar 

  45. Baird JK, Basri H, Jones TR, et al. Resistance to antimalarials in northeastern Irian Jaya, Indonesia. Am J Trop Med Hyg 1991; 44: 640–4

    PubMed  CAS  Google Scholar 

  46. Baird JK, Leksana B, Masbar S, et al. Diagnosis of resistance to chloroquine by Plasmodium vivax: timing of recurrence and whole blood chloroquine levels. Am J Trop Med Hyg 1997; 56: 621–6

    PubMed  CAS  Google Scholar 

  47. Hogh B, Gamage-Mendis A, Butcher GA, et al. The differing impact of chloroquine and pyrimethamine/sulfadoxine upon the infectivity of malaria species to the mosquito vector. Am J Trop Med Hyg 1998; 58: 176–82

    PubMed  CAS  Google Scholar 

  48. Rieckmann KH, Davis DR, Halton DC. Plasmodium vivax resistance to chloroquine? Lancet 1989; II: 1183–4

    Article  Google Scholar 

  49. Schwartz IK, Lackritz EM, Patchen LC. Chloroquine-resistant Plasmodium vivax from Indonesia. N Engl J Med 1991; 324: 927

    Article  PubMed  CAS  Google Scholar 

  50. Baird JK, Basri H, Subianto B, et al. Treatment of chloroquine resistant Plasmodium vivax with chloroquine and primaquine or halofantrine. J Infect Dis 1995; 171: 1678–82

    Article  PubMed  CAS  Google Scholar 

  51. Than M, Kyaw MP, Soe AY, et al. Development of resistance to chloroquine by Plasmodium vivax in Myanmar. Trans R Soc Trop Med Hyg 1995; 89: 307–8

    Article  Google Scholar 

  52. Garg M, Gopinathan N, Bodhe P, et al. Vivax malaria resistant to chloroquine: case reports from Bombay. Trans R Soc Trop Med Hyg 1995; 89: 656–7

    Article  PubMed  CAS  Google Scholar 

  53. Phillips EJ, Keystone JS, Kain KC. Failure of combined chloroquine and high-dose primaquine therapy for Plasmodium vivax acquired in Guyana, South America. Clin Infect Dis 1996; 23: 1171–3

    Article  PubMed  CAS  Google Scholar 

  54. Baird JK, Wiady I, Fryauff DJ, et al. In vivo resistance to chloroquine by Plasmodium vivax and Plasmodium falciparum at Nabire, Irian Jaya, Indonesia. Am J Trop Med Hyg 1997; 56: 627–31

    PubMed  CAS  Google Scholar 

  55. Baird JK, Leksana B, Masbar S, et al. Whole blood chloroquine concentrations with Plasmodium vivax in Irian Jaya, Indonesia. Am J Trop Med Hyg 1997; 56: 618–20

    PubMed  CAS  Google Scholar 

  56. Wolff MS, Toniolo PG, Lee EW, et al. Blood levels of organochlorine residues and risk of breast cancer. J Natl Cancer Inst 1993; 85: 648–52

    Article  PubMed  CAS  Google Scholar 

  57. Krieger N, Wolff MS, Hiatt RA, et al. Breast cancer and serum organochlorines: a prospective study among white, black, and Asian women. J Natl Cancer Inst 1994; 86: 589–99

    Article  PubMed  CAS  Google Scholar 

  58. Hunter DJ, Hankinson SE, Laden F, et al. Plasma organochlorine levels and risk of breast cancer. N Engl J Med 1997; 337: 1253–8

    Article  PubMed  CAS  Google Scholar 

  59. Longnecker MP, Rogan WJ, Lucier G. The health effects of DDT and PCBS and an overview of organochlorines in public health. Ann Rev Public Health 1997; 18: 211–44

    Article  CAS  Google Scholar 

  60. Institute of Medicine. Malaria: obstacles & opportunities. In: Oaks Jr SC, Mitchell VS, Pearson GW, et al, editors. Washington DC: National Academy Press, 1991

  61. World Health Organization. Four international organizations unite to roll back malaria, World Health Organization Press Release WHO/77 of 30 October 1998. Accessed at http: http://www.who.ch/

  62. World Health Organization. Multilateral perspective on malaria begins to take shape: tropical diseases newsletter no. 55, February 1998. Geneva: WHO, 1998

    Google Scholar 

  63. Fontinille D, Lepers JP, Campbell GH, et al. Malaria transmission and vector biology in Manarintsoa, high plateau of Madagascar. Am J Trop Med Hyg 1990; 43: 107–15

    Google Scholar 

  64. Pan American Health Organization. Status of malaria programs in the Americas. XLII Report. Washington, DC: Pan American Health Organization, 1994

    Google Scholar 

  65. Pan American Health Organization. Report on the status of malaria programs in the Americas. HCP/HCT/149/99, August 1999

  66. Brogdon WG, McAllister JC. Insecticide resistance and vector control. Emerg Infect Dis 1998; 4: 605–14

    Article  PubMed  CAS  Google Scholar 

  67. Roberts DR, Andre RG. Insecticide resistance issues in vector-borne disease control. Am J Trop Med Hyg 1994; 50 Suppl.: 21–34

    PubMed  CAS  Google Scholar 

  68. Bangs MJ. Doctoral dissertation. Bethesda (MD): Uniformed Services University of the Health Sciences, 1998

    Google Scholar 

  69. World Wildlife Fund News. WWF urges World Health Assembly delegates to phase out deadly DDT pesticide (May 21 1999) [online]. Available from: URL: http://www.worldwildlife.org [Accessed 2000 Mar 3]

  70. Beadle C, McElroy PD, Oster CN, et al. Impact of transmission intensity and age on Plasmodium falciparum density and associated fever: implications for malaria vaccine trial design. J Infect Dis 1995; 172: 1047–54

    Article  PubMed  CAS  Google Scholar 

  71. Jones TR, Baird JK, Bangs MJ, et al. Malaria vaccine study site in Irian Jaya, Indonesia: plasmodium falciparum incidence measurements, epidemiologic considerations in sample size estimation. Am J Trop Med Hyg 1994; 50: 210–8

    PubMed  CAS  Google Scholar 

  72. Pan American Health Organization. Status of malaria programs in the Americas. XLV Report. Washington DC: Pan American Health Organization, 1997

    Google Scholar 

  73. Baird JK. Age-dependent characteristics of protection vs. susceptibility to Plasmodium falciparum. Ann Trop Med Parasitol 1998; 92: 367–90

    Article  CAS  Google Scholar 

  74. Baird JK. Host age as a determinant of naturally acquired immunity to Plasmodium falciparum. Parasitol Today 1995; 11: 105–11

    Article  PubMed  CAS  Google Scholar 

  75. Snow RW, Omumbo JA, Lowe B, et al. Relation between severe malaria morbidity in children and level of Plasmodium falciparum transmission in Africa. Lancet 1997; 349: 1650–4

    Article  PubMed  CAS  Google Scholar 

  76. McElroy PD, Beier JC, Oster CN, et al. Dose- and time-dependent relations between infective Anopheles inoculation and outcomes of Plasmodium falciparum parasitemia among children in Western Kenya. Am J Epidemiol 1997; 145: 945–56

    Article  PubMed  CAS  Google Scholar 

  77. Baird JK, Hoffman SL. Prevention of malaria in travelers. Med Clin North Am 1999; 83: 923–44

    PubMed  CAS  Google Scholar 

  78. White NJ, Nosten F, Looareesuwan S, et al. Averting a malaria disaster. Lancet 1999; 353: 1965–7

    Article  PubMed  CAS  Google Scholar 

  79. White N. Antimalarial drug resistance and combination chemotherapy. Phil Trans R Soc Lond B Biol Sci 1999; 354: 739–49

    Article  CAS  Google Scholar 

  80. Price R, van Vugt M, Phaipun L, et al. Adverse effects in patients with acute falciparum malaria treated with artemisinin derivatives. Am J Trop Med Hyg 1999; 60: 547–55

    PubMed  CAS  Google Scholar 

  81. Nosten F, Hien TT, White NJ. Use of artemisinin derivatives for the control of malaria. Med Trop (Mars) 1998; 58 Suppl. 3: 45–9

    CAS  Google Scholar 

  82. Price RN, Nosten F, Luxemberger C, et al. Artesunate/mefloquine treatment of multi-drug resistant falciparum malaria. Trans R Soc Trop Med Hyg 1997; 91: 574–7

    Article  PubMed  CAS  Google Scholar 

  83. Van Vugt M, Brockman A, Gemperli B, et al. Randomized comparison of artemether-benflumetol and artesunate-mefloquine in treatment of multi-drug resistant falciparum malaria. Antimicrob Agents Chemother 1998; 42: 135–9

    PubMed  Google Scholar 

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Acknowledgements

The author is grateful to Stephen L. Hoffman, Donald J. Roberts, James R. Campbell and Michael J. Bangs for their thoughtful reviews of this manuscript. The views of the author are his own and are not to be construed as representing those of the US Department of Defence or of the US Navy.

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  1. Parasitic Diseases Program, US Naval Medical Research Unit No.2, American Embassy, Jakarta, Indonesia, 96520-8132, FPO AP, USA

    J. Kevin Baird

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Baird, J.K. Resurgent Malaria at the Millennium. Drugs 59, 719–743 (2000). https://doi.org/10.2165/00003495-200059040-00001

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