Operational and epidemiological field research activities for the implementation of malaria control through primary health care in Africa.

The magnitude of the malaria problem in tropical Africa has been a deterrent to a large-scale control effort as long as the aim was conceived to be only a reduction in transmission. The focus on local priorities brought about by the primary health care approach has resulted in the formulation of a strategy of malaria control that envisages the progressive incorporation of antimalaria activities as peripheral and supportive primary health care structures are developed.The local application of this strategy requires a new approach to the study of the epidemiology of malaria as a disease, with greater emphasis on the reasons for its focalization or intensification in space, time, and social groups and the implications for control measures.The primary health care approach opens up a wide area for field and health services research into the deployment of different technical resources for malaria control, as well as into the setting up of monitoring systems for the detection of technical problems, such as drug and insecticide resistance, or for the early recognition of epidemic outbreaks.