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Malaria resurgence and its control in a previously malaria-free island of Basilan, Philippines.


 White ME,
 Ento BS,
 Hugo CT,
 Brizuela MB,
 Sadang RA,
 Lofranco VS,
 Gavino RR,
 Dayrit MM


Review of previous surveillance records revealed that the first slide-confirmed case occurred in August 1988 and, subsequently, there was an average of 3 cases per month until December. The importation of a case who went back to Dassalan after seeking treatment at a malaria health post in August 1988 started the epidemic. During that time the vector density was probably high. This provided oportunities for the transmission of malaria to non-immune population. Sixteen malaria deaths were reported during the months of December 1988 and January 1989. Review of records of death during the same months of the previous year showed no deaths. Inteview of senior household members revealed that this was their first experience with this kind of illness
The January 1989 investigation showed the percent positive as 50% and a prevalence rate of 18%. The cases were given chloroquine and primaquine. Houses were sprayed with DDT. In the second visit on June 1989, the percent positive decreased to 15% and the PR was 9%. All the cases were treated and second cycle house spraying with deltamethrine was done. All household were given permethrin-treated bed nets. A third visit on February 1990 showed a percent positive of 4% and a PR of 2%. Cases were treated, bed nets were re-treated with permethrin, and temephos was applied to the four wells
Entomologic survey identified Anopheles litoralis as the potential vector
These data demonstrate that malaria was introduced into a previously malaria-free area. This study shows that when malaria outbreaks do occur, the application of appropriate and sustained measures will reduce malaria transmission. In non-malarious areas, vigilance and health education should be undertaken to ensure that malaria does not obtain a foothold. We recommend that a thorough entomologic surveys be performed in areas where potential vectors are undocumented so that vector control strategies can be appropriately targetted.(Summary)

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