Bernard P M
Bull World Health Organ. 1998;76(1):3-10.
Although spraying with insecticides has caused a spectacular regression in malaria in many parts of Africa, it cannot be said that the transmission of the disease has been definitely interrupted in any large area on the mainland. There is therefore some uneasiness regarding the methods so far adopted and doubts as to whether the very considerable expenditure involved is justified. There is, moreover, acute anxiety about the possible development of resistance to insecticides by the vector anopheles. Fortunately, so far there does not appear to be any in Africa, and the author considers that logical aim should be complete eradication of malaria before resistance does appear to the powerful insecticides now available. Control measures must inevitably be continued indefinitely, but if the aim of eradication is achieved, operations could cease and it would be possible for anopheles to co-exist with man without transmitting malaria. The author points out that before any continent-wide campaign can be begun, there are, in addition to the problem of funds, a number of other problems which must be carefully studied. Among these are the lack of trained specialized staff at all levels, transport difficulties, shortage of water over vast areas in the dry season and floods during the rains, the differing habits of the various African populations, and the biology of the vector mosquitos. Despite these problems, however, the time for concerted action to achieve eradication in Africa draws nearer with each succeeding day.
尽管在非洲许多地区喷洒杀虫剂已使疟疾疫情显著消退，但在非洲大陆任何大片区域都不能说疾病传播已被彻底阻断。因此，人们对迄今采用的方法感到有些不安，并且怀疑所涉及的巨额开支是否合理。此外，人们还对疟蚊媒介可能产生抗药性深感忧虑。幸运的是，目前在非洲似乎尚未出现这种情况，作者认为合理的目标应该是在对现有强效杀虫剂产生抗药性之前彻底根除疟疾。控制措施必然要无限期持续下去，但如果实现了根除目标，行动就可以停止，疟蚊也有可能与人类共存而不传播疟疾。作者指出，在启动任何全洲范围的运动之前，除了资金问题外，还有许多其他问题必须仔细研究。其中包括各级缺乏训练有素的专业人员、交通困难、旱季大片地区缺水以及雨季洪水泛滥、非洲不同人群的不同习惯以及疟蚊媒介的生物学特性。然而，尽管存在这些问题，在非洲采取协同行动实现根除疟疾的时刻日益临近。
