Environmental Management and Sanitation as a Malaria Vector Control Strategy: A Qualitative Cross-Sectional Study Among Stakeholders, Sunyani Municipality, Ghana

Current Status of Malaria Control and Elimination in Africa: Epidemiology, Diagnosis, Treatment, Progress and Challenges

The African continent carries the greatest malaria burden in the world. Falciparum malaria especially has long been the leading cause of death in Africa. Climate, economic factors, geographical location, human intervention and unstable security are factors influencing malaria transmission. Due to repeated infections and early interventions, the proportion of clinically atypical malaria or asymptomatic plasmodium carriers has increased significantly, which easily lead to misdiagnosis and missed diagnosis. African countries have made certain progress in malaria control and elimination, including rapid diagnosis of malaria, promotion of mosquito nets and insecticides, intermittent prophylactic treatment in high-risk groups, artemisinin based combination therapies, and the development of vaccines. Between 2000 and 2022, there has been a 40% decrease in malaria incidence and a 60% reduction in mortality rate in the WHO African Region. However, many challenges are emerging in the fight against malaria in Africa, such as climate change, poverty, substandard health services and coverage, increased outdoor transmission and the emergence of new vectors, and the growing threat of resistance to antimalarial drugs and insecticides. Joint prevention and treatment, identifying molecular determinants of resistance, new drug development, expanding seasonal malaria chemo-prevention intervention population, and promoting the vaccination of RTS, S/AS01 and R21/Matrix-M may help to solve the dilemma. China's experience in eliminating malaria is conducive to Africa's malaria prevention and control, and China-Africa cooperation needs to be constantly deepened and advanced. Our review aims to help the global public develop a comprehensive understanding of malaria in Africa, thereby contributing to malaria control and elimination.

Mathematical Assessment of the Role of Intervention Programs for Malaria Control

Malaria remains a global health problem despite the many attempts to control and eradicate it. There is an urgent need to understand the current transmission dynamics of malaria and to determine the interventions necessary to control malaria. In this paper, we seek to develop a fit-for-purpose mathematical model to assess the interventions needed to control malaria in an endemic setting. To achieve this, we formulate a malaria transmission model to analyse the spread of malaria in the presence of interventions. A sensitivity analysis of the model is performed to determine the relative impact of the model parameters on disease transmission. We explore how existing variations in the recruitment and management of intervention strategies affect malaria transmission. Results obtained from the study imply that the discontinuation of existing interventions has a significant effect on malaria prevalence. Thus, the maintenance of interventions is imperative for malaria elimination and eradication. In a scenario study aimed at assessing the impact of long-lasting insecticidal nets (LLINs), indoor residual spraying (IRS), and localized individual measures, our findings indicate that increased LLINs utilization and extended IRS coverage (with longer-lasting insecticides) cause a more pronounced reduction in symptomatic malaria prevalence compared to a reduced LLINs utilization and shorter IRS coverage. Additionally, our study demonstrates the impact of localized preventive measures in mitigating the spread of malaria when compared to the absence of interventions.

Updates on traditional methods for combating malaria and emerging Wolbachia-based interventions

The escalating challenge of malaria control necessitates innovative approaches that extend beyond traditional control strategies. This review explores the incorporation of traditional vector control techniques with emerging Wolbachia-based interventions. Wolbachia, a naturally occurring bacteria, offers a novel approach for combatting vector-borne diseases, including malaria, by reducing the mosquitoes' ability to transmit these diseases. The study explores the rationale for this integration, presenting various case studies and pilot projects that have exhibited significant success. Employing a multi-dimensional approach that includes community mobilization, environmental modifications, and new biological methods, the paper posits that integrated efforts could mark a turning point in the struggle against malaria. Our findings indicate that incorporating Wolbachia-based strategies into existing vector management programs not only is feasible but also heightens the efficacy of malaria control initiatives in different countries especially in Pakistan. The paper concludes that continued research and international collaboration are imperative for translating these promising methods from the laboratory to the field, thereby offering a more sustainable and effective malaria control strategy.

Assessment of the Knowledge, Prevalence, and Control Strategies of Malaria Among Households in Sunyani Municipality, Bono Region, Ghana

Background

Malaria remains a global public health concern for centuries. The study assessed the knowledge, prevalence and control strategies of malaria among households in the Sunyani Municipality, Bono Region, Ghana.

Method

A simple random sampling method was used to administer semi-structured questionnaires to the respondents (n = 422). STATA version 14.0 was used to analyse the data and the results were presented in charts, graphs, and tables.

Result

The study shows that the knowledge level of malaria, its vector of transmission and mosquitoes breeding sites among the respondents was quite high. Among the respondents, 43% reported to have been infected by malaria once in a year and 94% indicated that, their relatives have been infected with malaria parasites previously. Also, majority, 65% of the respondents selected environmental management and sanitation (EMS), followed by settlement (building houses) away from wetlands, 20.0% as alternative vector control methods to be employed to supplement the core vector control methods in the Municipality. Further, majority, 69% of the respondents indicated that enforcement of environmental sanitation bye-laws will compel residents to clean their environment, and this is likely to eliminate most mosquito breeding sites, whiles 46% called on Government to support, and employ more Environmental Health Officers and Sanitary Labourers, and adequately resource them to work effectively.

Conclusion

Health authorities in the Sunyani Municipality must intensified education on malaria at all levels with the aim to influence the attitudes of households towards its prevention and control. Central and Local Government must employ more Environmental Health Officers, and empower and adequately resourced them to strictly enforce the environmental sanitation bye-laws. Malaria control authorities in the study area must consider employing environmental management and sanitation (EMS) and application of larvicides for mosquito larval control as alternative/supplementary malaria prevention and control methods to compliments the current core vector control methods.