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MALARIA: Obstacles and Opportunities
Appendix A
PARADIGMS
TYPES OF MALARIA
African wet savannah
Forest
Irrigated agriculture
Highland fringe
Desert fringe and oasis
Urban malaria
Plains—traditional agriculture
Coastal
DETERMINANTS
Level of endemicity
Highly endemic: perennial transmission
Moderately endemic: perennial transmission
Modestly endemic: seasonal transmission
Highly endemic: seasonal transmission
Low endemicity: seasonal transmission
Epidemic transmission
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MALARIA: Obstacles and Opportunities
Parasite species
Plasmodium falciparum
P. vivax
P. malariae
P. ovale
Population characteristics
Immune status (high, low, none)
Movement (settled, resettled, transient); if transient: organized, nomads, random
Population density and settlement patterns
Social, behavioral, and economic characteristics
Housing
Occupation
Water utilization
Health-seeking behavior
Sleeping habits
Customs and taboos
Income and wealth
Local understanding of malaria
Access to health care
5. Health infrastructure
National health budget
Status of governmental health care delivery system
National malaria control program (type, budget, and efficiency)
Importance of non-governmental services (i.e. missions, private voluntary organizations)
Availability of private health care
Importance of health care delivery by family, market, etc.
Use of drugs
Cost
Availability
Drug-use patterns
Effectiveness (degree of resistance)
Vector considerations
Behavior (breeding, feeding, resting)
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MALARIA: Obstacles and Opportunities
Susceptibility to insecticides
Cost, safety, and acceptability of effective insecticides
Availability and cost of bed nets
Feasibility of bed net impregnation with insecticides
Availability and cost of repellents and fumigant coils
Development projects
Government development projects (dam construction, road building)
Unofficial or illegal activities (mining, gemming)
organized
random
TOOLS
Vector control
Personal protection
nets or curtains with or without insecticide
screens
house siting (where the house is physically located)
repellents
smoke coils
Environmental management
source reduction
flushing, sluicing
clearing vegetation
water management
reforestation
Larvicides
chemical
mechanical
biological
Adulticiding (killing the adult forms of the mosquito)
residual spraying
fogging
largescale ULV (ultra low volume spraying)
Zooprophylaxis
Medical resources
Diagnosis
clinical
microscopic
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MALARIA: Obstacles and Opportunities
Treatment facilities
inpatient
outpatient
market
Prophylaxis
Mass chloroquineprimaquine administration for epidemics
Information, education, and communication
Public
individuals, households, and communities
school curricula
radio
newspapers
television
local media (songs, theater, etc.)
Health care providers
Surveillance
Diagnosis and treatment
morbidity
incidence of severe malaria
mortality
prevalence of parasitemia
Epidemic early warning
Vector information
insecticide resistance
behavioral changes
Antimalarial drug resistance
Representative terms from entire chapter:
perennial transmission
