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Should we broaden our attack on mosquitoes to maintain and improve national support?

July 2, 2014 - 10:53 -- William Jobin

One of the weaknesses in our fight against malaria is that we are missing the opportunity to attack other mosquito-transmitted diseases. It is the weakness of any "vertical" approach to disease control.

For instance, if people go to each house to spray the inside walls for anophelines, would it not be smart to have the same sprayers empty and spray the household and yard containers which contain Aedes or Culex larvae? It would save on cost of personnel and vehicles. Does it make sense to send two vehicles with two separate spray crews to the same houses to spray each species of mosquito? And if we send entomologists around to assess the impact of the indoor spraying, should they not check for other species at the same time? And if we monitor rainfall and temperature to predict mosquito breeding, should we not look at all the mosquitoes?

If we send out community education teams to prepare people for the annual spray against malaria, should we not also tell them about other mosquito or water-borne diseases, at the same time? And advise them of the health value in cleaning out roadside drains? In India this is already done.

In the future we all hope for, when malaria has been suppressed for years, there is the risk that local people and governments will lose interest in suppressing a disease that has receded in their conciousness. This happened during the waning years of the Global Malaria Eradication Program, just before it collapsed completely. If people in the Ministries of Health are cost conscious, they will recognize the advantage of broader approaches to these mosquito or water-associated diseases. If they knew this annual spray was also attacking dengue fever, filariasis, etc., it would make more sense and get better support.

This is especially true as malaria suppression becomes more and more successful. So we should think seriously about ways to broaden our attack on malaria now, especially to include the other diseases transmitted by mosquitoes.

Bill, an engineer