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Public health infrastructure, disease surveillance, and both indoor residual spraying and insecticide treated nets are needed
| The first 150 words of the full text of this article appear below. |
About 40% of the world's population, most of whom live in the poorest countries, are at risk from malaria. In Africa alone, malaria kills nearly a million children each year.1 Although we have the tools to fight malaria, such as insecticides for indoor residual spraying, environmentalist campaigns and some ill conceived decisions on public health policy have limited their use.
A renewed effort is under way to control malaria in sub-Saharan Africa. While heartening, the lead agencies have neglected to rebuild the technical expertise necessary to run effective vertical malaria control programmes. Still cautious of DDT (dichlorodiphenyltrichloroethane) and indoor residual spraying, such programmes have focused on the distribution of bed nets impregnated with insecticides. In their randomised controlled trial on bmj.com, Hill and colleagues assess the effect of combining an insect repellent with insecticide treated bed nets on Plasmodium falciparum or P vivax malaria in Bolivia.2 The trial found that
Donald R Roberts, professor emeritus
Uniformed Services University of the Health Sciences in Bethesda, Bethesda, MD 20814, USA
droberts@usuhs.mil
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