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Prevention and Control

In areas where malaria is endemic, the threat represented by the disease has, for many people, grown. There are many reasons for the continuing high endemicity and the reappearance of the disease in malaria-free zones. The most important are:

  1. Malaria parasites are survival artists (based on antigenic diversity and antigenic variation)
  2. The resistance of the anopheline mosquitoes against the effective insecticides in use, especially DDT
  3. The rapid spread of parasites resistant to the drugs currently used for therapy and prophylaxis
  4. Health systems which in many areas cannot guarantee rapid diagnosis and effective treatment of patients because the necessary peripheral structures of the healthcare services are not in place or are not functioning optimally
  5. The lack of a vaccine, due, again, to the complexity of the malarial parasite
  6. The greatly increased mobility of population groups (due to urbanisation, wars etc.) has intensified the problems with malaria

The currently most effective strategies for control are:
Early identification of cases and treatment of malaria episodes

  • Exposure prophylaxis: provision of insecticide-treated mosquito nets to exposed populations
  • Promotion of appropriate information and communication campaigns to raise the awareness of affected population groups
  • Vector control is undertaken using insecticides against adult mosquitoes, changes in the environment (e.g. drainage) or biological measures (e.g. larva-eating fish)
  • Vaccines are not yet available but are under development
  • For travellers to endemic countries: the most important prophylactic measures are malarial chemosuppression together with adequate protection against exposure (repellents, clothing, etc.)