The Kheda malaria project: the case for environmental control

Abstract

In 1984 the Department of Health and Family Welfare in Gujarat state in India and the Malaria Research Center launched the Kheda control project to develop a model that replaces insecticides with bioenvironmental methods to control breeding of mosquitoes. The project began in 7 villages in Nadiad the worst affected subdivision in Kheda district (API 51). In 1986 it expanded to all Nadiad. In 1987 it began in both rural and urban Kapadwanj subdivision. Project workers used health education to promote community participation. They set up health camps where microscopes allowed the people to see aquatic and adult stages of mosquitoes and malaria parasites. Staff also pointed out breeding areas in both house and village. Another component of the integrated disease vector control strategy included reducing the number of breeding sites such as draining stagnant water and digging soakpits. They bred mosquito larvae feeding P. reticulata fish in water that could not be drained. The number of breeding ponds jumped from 6-100. Health workers collected blood samples from those with fever or a history of fever. They administered chloroquine and primaquine to adult confirmed Plasmodium vivax cases and P. falciparum cases. Staff also promoted sanitation. The Department of Social Forestry encouraged the planting of saplings in waste land and marshy areas. Another income generating program included fish farming. Profits went to building underground drainage systems and source reduction work. In control villages the man hour density of Anopheles culcifacies in human dwellings ranged from <5-<30% compared to 0-about 7% in the study villages. In 1983 the average slide positivity rate in Kheda stood at 6.2 and stabilized roughly at 1 for the next 4 years. In 1988 canal irrigation increased in areas bordering control districts so the SPR increased to 3.2.