Three hundred and fifty years of the Peruvian fever bark.
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Biomedical subjects
Publications and source records attributed to L J Bruce-Chwatt.
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The global program of malaria eradication coordinated and supported by the World Health Organization (WHO) since 1957 has been successful in most of the countries in the temperate climate zones of the globe. However, by the end of the 1960s it became evident that technical problems, such as resistance of mosquito vectors to insecticides and resistance of malaria parasites to drugs, presented serious obstacles to the pursuit of eradication programs in many tropical countries. Moreover, the administrative and financial difficulties of the developing countries were such that a revised strategy of antimalaria campaigns became necessary. In 1969 the World Health Organization recommended that although eradication of malaria should remain an ultimate goal, in countries where eradication does not appear to be feasible, malaria control operations may form a transitional stage. All effective methods of attack on the parasite and on the Anopheles vector should be employed according to epidemiological conditions of the area involved and in relation to their technical and logistic feasibility. Nevertheless, during the past decade the malaria situation has deteriorated in several countries, especially in southern and southeast Asia and some parts of Latin America. There has been no improvement in the highly endemic countries of tropical Africa. Since 1978 the concept of primary health care has been widely adopted, and antimalaria activities have become essential components of national health systems in many developing tropical countries. Malaria control within the orbit of primary health care aims first at the reduction of morbidity and mortality from malaria, although the decrease of the prevalence of this infection should also be an objective, whenever possible. This selective approach, based largely on chemotherapy, has been successful in a few countries, but in other areas the degree of integration of antimalaria activities with the primary health care system is less effective. Patterns of such integration depend on different epidemiological, socioeconomic, cultural, and other factors. Malaria control within the framework of primary health care demands full commitment by the government concerned, constant support of the community, and a close cooperation with all other sectors of the health system. Training of national professional and auxiliary staff and health education of the community are equally important.(ABSTRACT TRUNCATED AT 400 WORDS)
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According to the statistics provided by the World Health Organization in 1984, some 6.5 million cases of malaria were notified in 1982, an improvement in comparison with 1981, when the number of cases was 7.8 million. But these figures are incomplete and statistical data from sub-Saharan Africa are not included in the total. Out of the population of the world (in 1982) of 4,600 million about 2,100 million live in areas where malaria had never occurred or where indigenous malaria had disappeared. Some 2,100 million people live in areas where specific measures have greatly decreased the incidence of malaria. However, about 370 millions live in areas where no antimalaria activities took place, with the exception of some urban centres. On the African continent in countries north of the Sahara, out of the population of 100 million about 75 million are in areas, which were malarious 20 years ago, but today the amount of disease has been drastically reduced. The number of cases notified was 561 in 1982, against 482 in 1981, and most of them had been imported from tropical Africa. In Africa south of the Sahara out of 400 millions at least 350 million people live in malarious areas, where the prevalence of the disease has not changed for many years. The number of clinical cases of malaria has been estimated as between 70 and 100 million, with a mortality of about 1 million among small children.(ABSTRACT TRUNCATED AT 250 WORDS)
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