RECENT SUCCESS WITH MALARIA CONTROL USING INDOOR SPRAYING OF HOUSES

ISEE-442 Malaria control on a large scale is essentially achieved through vector control using insecticides. The two main vector control tools currently available to control personnel are Indoor Residual House Spraying (IRS) and Insecticide-Treated Nets (ITNs). Larval control is used in a more focused manner, and on a small scale, as are personal protection measures, including insect repellents and improved housing. The insecticides available for use in vector control are limited and choice can be further limited by insecticide resistance in the target mosquito populations, by cost, residual life and toxicological considerations. Only pyrethroids are currently considered safe for use on ITNs. Only four groups of insecticides are available for use in IRS, fully evaluated by the WHO Pesticide Evaluation Scheme (WHOPES), namely, organochlorines, organophosphates, carbamates and pyrethroids. The choice of insecticide for IRS will be discussed in the context of insecticide resistance, cost, residual life and toxicity. In Southern Africa, over 13 million people are currently protected by IRS in 7 countries (SAMC 2001). A collaborative malaria control programme between the governments of South Africa, Mozambique and Swaziland, The Lubombo Spatial Development Initiative, has extended malaria vector control to a contiguous area greater than 100 000 km2 using IRS. The success of malaria control in South Africa and in the Lubombo Spatial Development Initiative area will be presented. The constraints on insecticide choice in this setting, as well as prospects for the future, will be discussed.