Impact of the malaria control campaign (1993-1998) in the highlands of Madagascar: parasitological and entomological data.

Malaria transmission in the central highlands of Madagascar was interrupted in the 1960s by a national control program that used DDT indoor spraying and mass treatment with chloroquine. At the end of the 1980s in this region, epidemic malaria reappeared. Italian health authorities provided technical assistance to the National Malaria Control Program since the beginning of the resurgence of malaria in the central highlands. Yearly residual house spraying performed for 5 years (1993-1998) and the availability of antimalarial drugs reduced malaria transmission to very low levels, with improvement in parasitologic and entomologic indexes. A significant reduction of malaria prevalence was observed in the villages located at altitudes of 1,000-1,500 m, corresponding to the stratum of unstable malaria that was the main target of the antivector interventions. A significant reduction of malaria prevalence was also observed in the villages located at altitudes of 900-1,000 m, where malaria transmission is stable. The main vector Anopheles funestus was dramatically reduced in abundance and distribution in the sprayed areas.

[Insecticide sensitivity in malaria vectors in high altitude Madagascar after five years of vector control]. / Sensibilité aux insecticides des vecteurs du paludisme sur les Hautes terres de Madagascar après cinq années de lutte antivectorielle.

In 1991, Anopheles gambiae and Anopheles funestus, the main malaria vectors in the Highlands of Madagascar, were reported to be fully susceptible to DDT; nevertheless a slight decrease in the susceptibility levels was recorded when compared with previous assays carried out in 1962. From 1993 to 1997, five cycles of indoor residual spraying have been carried out in the Highlands: a total of 1,482,000 kg of 70% wp DDT have been used for the treatment of houses and animal shelters. From 1996 to 1999, adult mosquito susceptibility tests to DDT and to some pyrethroids (lambdacyalothrine, deltamethrine, permethrine and cyfluthrine) have been carried out on samples collected in 20 areas of the Highlands. Bioassays were carried out following the WHO standard method. All tested populations of An. funestus showed a full susceptibility to DDT. An. gambiae showed a widespread decrease in the susceptibility to DDT, particularly marked in the region of the capital city Antananarivo. Both species were susceptible to pyrethroids.