Bruce-Chwatt L J
Bull World Health Organ. 1984;62 Suppl(Suppl):19-29.
The Malaria Conference in Equatorial Africa, convened by the World Health Organization in 1950 in Kampala, Uganda, was a milestone in the history of modern malaria control activities on the continent of Africa. It presented and assessed the available international information on epidemiological aspects of this disease and attempted to coordinate the various methods of research and control of malaria. Its two main recommendations were that malaria should be controlled by all available methods, irrespective of the degree of endemicity of the disease, and that the benefits that malaria control might bring to the indigenous population should be evaluated.The first period of field research and pilot control projects in Africa was between 1950 and 1964. A large number of studies in several African countries showed that the use of residual insecticides such as DDT and HCH might decrease, at times considerably, the amount of malaria transmission, but interruption of transmission could not be achieved, except in two relatively small projects in the forest areas of Cameroon and Liberia. During the second period, from 1965 to 1974, the difficulties of malaria eradication and control in Africa became more evident because of the development of resistance of Anopheles gambiae to DDT, HCH, and dieldrin; moreover administrative, logistic, and financial problems had emerged. It became clear that the prospects for malaria control (let alone those for eradication) were related to the availability of a network of basic health services. A number of "pre-eradication" programmes were set up in order to develop better methods of malaria control and to improve the rural health infrastructures. Much field research on the chemotherapy of malaria was carried out and the value of collective or selective administration of antimalarial drugs was fully recognized, although it became obvious that this could not play an important part in the decrease of transmission of malaria in Africa.The role of research as one of the ways of solving the technical problems of malaria control in tropical Africa was stressed from the early days of the global malaria eradication programme; the past ten years have seen an immense expansion of this activity.
1950年，世界卫生组织在乌干达坎帕拉召开了赤道非洲疟疾会议，这是非洲大陆现代疟疾防治活动史上的一个里程碑。会议展示并评估了关于该疾病流行病学方面的现有国际信息，并试图协调疟疾研究和控制的各种方法。其两项主要建议是，应采用一切可用方法控制疟疾，而不论该疾病的流行程度如何，并且应评估疟疾控制可能给当地居民带来的益处。
非洲实地研究和试点控制项目的第一阶段是1950年至1964年。在几个非洲国家进行的大量研究表明，使用滴滴涕和六六六等残留杀虫剂有时可大幅减少疟疾传播量，但除了喀麦隆和利比里亚森林地区的两个相对较小的项目外，无法实现传播的中断。在第二阶段，即1965年至1974年，由于冈比亚按蚊对滴滴涕、六六六和狄氏剂产生抗性，非洲疟疾根除和控制的困难变得更加明显；此外，还出现了行政、后勤和财政问题。很明显，疟疾控制的前景（更不用说根除的前景）与基本卫生服务网络的可用性有关。为了开发更好的疟疾控制方法并改善农村卫生基础设施，设立了一些“根除前”计划。对疟疾化疗进行了大量实地研究，抗疟药物集体或选择性给药的价值得到了充分认可，尽管很明显这在非洲疟疾传播减少方面无法发挥重要作用。
从全球疟疾根除计划早期开始，就强调研究是解决热带非洲疟疾控制技术问题的途径之一；在过去十年中，这项活动有了巨大的扩展。
