Malaria: Prevention, vector control

Mosquito control is a speciality in itself and includes the use of insecticides, treatment control of breeding grounds and biological control. Each ecological region requires its own individual approach: savannah, primeval forest, agricultural areas with or without irrigation systems, the margins of uplands, desert margins and oases, city environments, coastal and marsh regions. There are many difficulties: interventions need to be maintained over large areas for very long periods of time, mosquitoes quickly become resistant to insecticides, many people will not allow their houses to be sprayed, high costs, shortage of staff, ecological collateral damage due to insecticides, political instability which interferes with long-term planning. Border regions with rapid expansion and unstable social situations, e.g. mining (precious stones, gold), as in Thailand or Brazil, have their own specific problems. An exclusively technical approach will not be possible without simultaneous improvement in the social and economic conditions of the population at risk.

Genetic basis of insecticide resistance

There are three major enzyme families implicated in insecticide resistance: (1) carboxylesterases, (2) glutathione transferases and (3) cytochrome P450s. Genomic analysis of Anopheles gambiae reveals a considerable expansion of these supergene families in the mosquito.

Category: Medicine Notes