Prevention
Although adults and children cannot be vaccinated against malaria, the disease can still be prevented in more ways than one.
Tackling the mosquito's living environment
Mosquitoes breed in stagnant water. Drying out these sources of water or covering them up prevents mosquitoes from multiplying. Mosquitoes can also be fought with so-called IRS (Indoor Residual Spraying), which consists of spraying the walls and ceilings of houses with pesticides such as DDT. This approach once formed the basis of the fight against malaria and was successful as part of the control strategy that was applied in areas where malaria is less common (such as in Washington DC). For the last 30 years, IRS has been discouraged because of the mosquito’s increasing resistance to insecticides and concern about the effect insecticides have on the environment and people's health. Based on scientific research, the World Health Organization (WHO) declared in September 2006 that they would again recommend IRS as an effective intervention against malaria. A prerequisite is, of course, that the intervention is carried out correctly and that only the recommended and authorized pesticides are used. The WHO helps countries gather and analyse data so they can determine whether IRS would be an effective measure within their national context and then helps them plan and carry out the spraying.
Reduce the chances of exposure to infected mosquitoes
This preventive measure consists of using mats, hanging up curtains in windows and doors and sleeping under mosquito nets that have already been impregnated with a recommended insecticide. One mosquito net can protect the lives of three children.
If these measures are not available, people are encouraged to cover their arms and legs (by wearing long sleeves and trousers) as soon as the sun starts setting.
Education
It is crucial that people are well informed and educated in the application of these preventive measures so they not only continue applying them, but apply them in the right way. It has been proved that behavioural change does not occur without awareness raising and that mosquito nets remain unpacked or are used as fishing nets.
Prophylaxis
Prophylaxis consists of giving medicine to people without having determined whether they are really sick. This preventive measure proved to be effective in pregnant women, one of the largest risk groups. Treating them preventively protects them against the effects of malaria. This so-called Intermittent Preventive Treatment (IPT) is carried out in the second and third trimester of pregnancy, i.e. between months 3 and 6 and months 7 and 9. This is an effective way of preventing the onset of symptoms should a pregnant woman have malaria without knowing it. Such symptoms are, for example, anaemia in the mother, low birth weight, stunted growth or stillbirth. Not all countries, however, have formulated an IPT policy.
Travellers who are exposed to malaria-infected mosquitoes are also prescribed antimalarial drugs as prophylaxis. But were the drugs taken at the community level, the parasite would develop resistance, making it difficult to treat malaria when the disease manifests itself. This is why it is important that experts supervise IPT in pregnant women and ensure the correct dose of the correct drug is taken at the right times during the pregnancy.
Preventive measures work!
The WHO World Malaria Report 2010 indicates that access to preventive measures has hugely increased. 42% of African households had at least one mosquito net in mid-2010, and 80% of the available mosquito nets were actually used. 35% of the children slept under a mosquito net. In 2009, 75 million people were protected by IRS, and 95% of the people were protected by a combination of mosquito nets and IRS.
This increase in preventive measures combined with increased access to drugs has led to a huge decrease in both the number of deaths and cases of malaria.
