Outbreak Reports Show Need for Vigilance in Malaria Fight

January 16, 2002
By Michelle Vachon
The Cambodia Daily

Malaria outbreaks in Indonesia and India clearly show how easily a country can lose ground in the battle against the disease if it's not constantly kept in check.

According to RC Dhiman and SK Subbarao of the Malaria Research Center in New Delhi, the situation has reached epidemic proportions in numerous Indian states due to unexpected heavy rains and a lack of adequate government monitoring.

In Rajasthan, the increase in malaria cases was linked to extensive canalization that turned the arid area into irrigated land, they said in the report they presented at the Mekong Malaria Symposium, which was held in Siem Reap last month.

This, added to deforestation and the construction of hydroelectric dams has transformed the area's environment, and created fertile grounds for malaria-carrying mosquitoes to breed, Dhiman and Subbarao said.
 
Man-made development also played a major role in malaria resurgence in Bukit Menoreh, said Bona Sianturi, who serves with the Malaria Sub-Directorate at the Indonesian Ministry of Health.

Political and social unrest in Indonesia forced about 800,000 people to move into malaria-prone areas, he said in the report he presented during the symposium.

"The situation was also worsened by inadequate housing and health protection measures provided by the government in new settlements," the report states.

The two countries might have been able to control malaria had there been uninterrupted surveillance, the three officials said.
 
In Bukit Menoreh, poor coordination among district health staff has hampered efforts to fight the disease, Bona Sianturi said. In the meantime, there has been a rapid spread of p falciparum malaria strains that have built drug resistance, he said.

It will take drug tests in the area and cooperation among health workers to find out the extent of the problem and come up with a solution, he said.

Facing an epidemic in some areas, the Indian government has now made it a priority to assess the situation and to study drug and insecticide resistance in the most-affected areas, Dhiman and Subbarao said.

During the symposium, which was attended by malaria experts and government officials from 24 countries, numerous speakers stressed the importance of ongoing malaria control programs in malaria-prone regions of the world.

Since there still is no vaccine against the disease and since mosquitoes continue to breed, countries risk outbreaks if they relax their efforts.

Some participants stressed the fact that, once a government control program has been successful in curbing the disease and reducing the number of fatal malaria cases, donor and international funding becomes harder to secure. Governments have to come up with new strategies to get support for malaria control, they said.