Barai D, Hyma B, Ramesh A
Ecol Dis. 1982;1(4):243-55.
The resurgence of malaria in India began in 1966 and the states of Karnataka and Tamil Nadu were no exception to this phenomenon. In both states the peak occurrence came in 1976. Malaria was largely confined to highly vulnerable and receptive areas. The problem of increased incidence was particularly associated with the development of several irrigation and hydro-electric schemes. Improperly maintained irrigation systems and reservoirs provided ideal breeding grounds. The present paper examines the scope and limitations of a major anti-malaria activity, namely residual insecticide spraying as adopted and practised in rural vector control programmes in irrigation development project areas. Past experiences (as during the National Malaria Eradication programme, 1958-1965) and current practices are reviewed on the basis of selected examples. Eradication programme, 1958-1965) and current practices are reviewed on the basis of selected examples. In view of the current re-emergence of the disease, the states are faced with new obstacles to residual insecticide spraying such as (a) the development of resistance of malaria vectors to DDT and other alternative compounds like BHC (benzene hexachloride), changing vector behaviour with avoidance of contact with indoor insecticide deposits on walls, (c) environmental contamination (risks of chemicals), (d) extensive use of insecticides and pesticides for crop protection under an expanding green revolution agricultural technology, particularly in irrigated areas and (e) the existence of outdoor resting populations of the major vector Anopheles culicifacies and their role in extra-domiciliary transmission, making residual insecticide spray less effective. Spraying operations are also hindered by the persistence of certain social and cultural factors. The custom of mud plastering, white-washing and rethatching rural houses, for example, results in the loss of insecticide-treated surfaces. Other outdoor rural activities persist as obstacles in attempts to break the transmission cycle; washing, bathing and sleeping outdoors; illegal fishing and woodcutting at night; poorly constructed make-shift structures;housing project labourers near water sources; cattle grazing in nearby forests and human population movements related to seasonal migrants. The chain and extent of the transmission is dependent upon the malaria parasite carriers in the community (both indigenous and imported types) and the degree of contact of the community with those sites where people carry on the above activities, and on the effectiveness of surveillance operations.
印度疟疾的再度流行始于1966年，卡纳塔克邦和泰米尔纳德邦也不例外。在这两个邦，疟疾发病高峰出现在1976年。疟疾主要局限于高度脆弱和易感染地区。发病率上升的问题尤其与一些灌溉和水电项目的开发有关。维护不当的灌溉系统和水库提供了理想的滋生地。本文探讨了一项主要抗疟活动的范围和局限性，即在灌溉发展项目地区的农村病媒控制项目中采用和实施的残留杀虫剂喷洒。根据选定的例子回顾了过去的经验（如1958 - 1965年国家疟疾根除计划期间）和当前的做法。鉴于该疾病目前的再度出现，各邦在残留杀虫剂喷洒方面面临新的障碍，例如：（a）疟疾媒介对滴滴涕和其他替代化合物如六六六（六氯化苯）产生抗药性；（b）病媒行为改变，避免接触墙壁上的室内杀虫剂沉积物；（c）环境污染（化学物质风险）；（d）在不断扩大的绿色革命农业技术下，特别是在灌溉地区，大量使用杀虫剂和农药用于作物保护；（e）主要病媒库蚊按蚊存在户外栖息种群及其在户外传播中的作用，使残留杀虫剂喷洒效果降低。喷洒作业还受到某些社会和文化因素的持续影响。例如，农村房屋抹泥、粉刷和重新盖茅草屋顶的习俗导致经过杀虫剂处理的表面受损。其他农村户外行为仍然是试图打破传播循环的障碍；在户外洗涤、沐浴和睡觉；夜间非法捕鱼和伐木；建造简陋的临时建筑；靠近水源的住房项目劳工；在附近森林放牧的牲畜以及与季节性移民相关的人口流动。传播的链条和范围取决于社区中的疟原虫携带者（包括本地和输入类型）以及社区与人们进行上述活动的场所的接触程度，以及监测行动的有效性。
