Date: June 20, 2008
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In Campaign Against Malaria-Carrying Mosquitoes, Ugandan Government Should Monitor and Guard Against Development of Resistance to Insecticides
As the Ugandan government continues its program, it should monitor mosquito populations to determine whether they are developing resistance, and manage insecticides in ways that minimize resistance, says a new report from the Uganda National Academy of Sciences. Resistance is inevitable if a single class of insecticide is used over a long period, noted the committee that wrote the report.
The report, produced by consensus from a committee of public health and malaria experts, is the first study to be issued by the Uganda National Academy of Sciences. The academy was launched in 2000 with the objective of providing an independent forum for the exchange of scientific knowledge.
To get a clearer view of mosquito resistance throughout
The Ministry of Health also should set up "sentinel" sites to monitor mosquito populations as the program continues, to determine whether the insecticides remain effective over time, the report says. Sites should be dispersed through the major ecological zones, and priority should be given to areas where insecticides have been used heavily in agriculture or past public health campaigns, which would increase the likelihood of resistance.
In addition, the ministry should develop a long-term strategy for minimizing the emergence of resistance and institute strict practices for use of insecticides. These chemicals should be used judiciously and applied using high-quality techniques, the report says. The ministry also should track the use and transport of insecticides, and ensure that they are not illegally diverted to agriculture.
Once an insecticide spraying program is started in an area, it must be sustained over the long term to be effective at protecting public health, the report says. Strong acceptance by communities is essential to the program's success, and the ministry should take steps to build awareness of the campaign and engage communities in dialogue about it. In addition, the ministry should evaluate the effectiveness of its program over time, which will involve collecting data on rates of malaria transmission, the size of mosquito populations, and the length of time insecticides are staying effective in homes, among other variables.
The Ministry of Health and other ministries also should support studies that monitor the concentrations of DDT and other insecticides in the environment and food chain. The same qualities that make DDT a powerful tool against malaria -- the chemical persists despite time and rains, and does not have to be reapplied often -- make it necessary to monitor in the environment for ecological and economic reasons, the report adds.
The Uganda National Academy of Sciences is a participant in the African Science Academy Development Initiative, a joint effort among several African academies and the U.S. National Academies to advance science advice and evidence-based public policy in
Committee on Assessing Malaria Vector Resistance to Insecticides Used for Indoor
Residual Spraying in
James Tibenderana (chair)
Nelson Musoba (vice chair)
Senior Health Planner, and
Focal Point Person
Public Private Partnerships in Health (PPPH)
Ministry of Health
Vector Control Reference Unit
National Institute for Communicable Diseases
Benson B.A. Estambale
University of Nairobi Institute of Tropical and Infectious Diseases (UNITID)
Jesca Nsungwa Sabiiti
Principal Medical Officer
Child Health-Ministry of Health
Charlotte Muheki Zikusooka,
John W. Bahana (consultant)
Chief of Party
Mary Hamel (consultant)
Malaria Branch Chief
KEMRI/CDC Research Station
Allan Schapira (consultant)
Department of Public Health and Epidemiology
Swiss Tropical Institute