Scope for fly control as a diarrhoea intervention in Pakistan: a community perspective.

Clinic records show childhood diarrhoea to be an important health problem in the North West Frontier Province of Pakistan, particularly during the Spring months when the density of houseflies is highest. Fly control measures during this season may reduce the incidence of diarrhoea. By using participatory research tools during meetings with 61 mothers it was found that diarrhoea was perceived to be the biggest health problem faced by their young children and, after mosquitoes, houseflies were considered to be the biggest insect pest in the domestic environment. It was found, during in-depth interviews with a separate group of mothers, that flies were considered to be the principal cause of diarrhoea. If fly control is shown to reduce childhood diarrhoea then long term community based fly control may be feasible because the community is likely to support efforts resulting in reduced fly density. Treatment of diarrhoea, in the study area, was based on a combination of local remedies and commercially produced drugs. It was found that following an estimated average of 4.2 and 0.8 visits per child year to the local dispenser and specialist, respectively, an estimated average of $9.4 per child year was spent on diarrhoea treatment alone. A reduction in diarrhoea incidence as a result of fly control would result in economic gains over and above health gains. The preliminary results presented in this paper support the need to investigate the impact of fly control on childhood diarrhoea in Pakistan and this would have relevance for other developing countries.