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EDITORIALS: Donald R Roberts Preventing malaria in endemic areas BMJ 2007; 335: 1001-1002 [Full text]

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Insecticide impregnated nets in malarial control

John E Parry   (21 November 2007)

NMEP

Dr V Rama prasad, nil   (22 November 2007)

Insecticide impregnated nets in malarial control 21 November 2007
John E Parry, retired medical missionary/g.p. 3Portlands Oxford Rd Gerrards Cross Bucks SL9 7RH Send response to journal: Re: Insecticide impregnated nets in malarial control	Referring to BMJ 17 Nov 2007 Preventing malaria in endemic areas pp 1002/3 and Research pp 1023-5 “…insecticide treated bed nets..” A major concern is the abuse of gifts of impregnated nets for fishing to an extent that would affect aquatic life. (see Wilfred Zulu (2007) “Zambia: Malaria claims over 50,000 lives yearly in the average.” Africa Press International, (africanpress.com) November 14 2007 .) This raises the spectre of the loss of the fishing industry in the Lake Mweru area of Zambia, with a serious loss of protein in the diet. The staple diet is cassava, about 1% protein; compare rice which is about 8%. During my 20 years from 1949 as a doctor in the Luapula valley 30 miles south of the lake, I saw many children of just over 1 year old with kwashiokor and marasmus. Beans, fish and ground nuts were available but not always used. At our small hospital we were amongst the first to start a residential malnutrition programme in “the bush”. Malaria accounted for most deaths; mainly carried by falciparum mosquitoes and occuring all the year round, but survival was helped by a better diet. The fishing industry in the valley has always been crucial. The improvement in communications with tarmac roads to the Copperbelt has been an economic success, but local communities resent the whole catch going to the towns, leaving little or nothing for themselves. It is depressing to find that another potential improvement is hampered by lack of foresight and control. Impregnated nets are a proved antimalarila measure, and the free provision of them commendable. The fishmen have some reason for their abuse of the gifts, in that their families need fish and the nets are a highly efficient way to get them. What is needed is adequate supervision combined with education about reducing the enormous loss of life through malaria.. John Parry Competing interests: None declared
NMEP 22 November 2007
Dr V Rama prasad, Retired India 620001, nil Send response to journal: Re: NMEP	National Malaria Eradication Programmee (NMEP)was a prime programmee in India under WHO. DDT was used extensively in endemic areas. As other pestisides were also used in fields for cultivation DDT became in effective. NMEP was a failure in India. Competing interests: None declared