What's new in malaria control ?

Abstract

Malaria remains a significant health problem in many tropical areas but the main impact of the infection is felt in sub-Saharan Africa, where malaria continues to cause many deaths and much morbidity. Recently, several new initiatives to improve malaria control in Africa have been started. Control is difficult to achieve in areas with very high levels of transmission but something can be accomplished with existing tools, which include provision of good treatment facilities, chemoprophylaxis in pregnancy and use of insecticide-treated materials. In some areas, especially on the fringes of sub-Saharan Africa, households spraying may also have a role. Use of insecticide-treated materials has had a major impact on child mortality in several countries in Africa, although there are concerns that the dramatic effects achieved initially may not be sustained. A major constraint on malaria control in Africa has been poor organization of malaria-control programmes. New approaches that combine elements of vertical and of horizontal control systems are being tried. Malaria control, even when carried out efficiently and cost-effectively, is relatively expensive. New ways of financing malaria control in the countries where it is needed most must be found.