Malaria: Obstacles and Opportunities (1991)

Chapter: Appendix A: Paradigms

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Previous Chapter: 12. Social and Behavioral Aspects of Malaria
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Suggested Citation: "Appendix A: Paradigms." Institute of Medicine. 1991. Malaria: Obstacles and Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/1812.
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Appendix A

PARADIGMS

TYPES OF MALARIA

  1. African wet savannah

  2. Forest

  3. Irrigated agriculture

  4. Highland fringe

  5. Desert fringe and oasis

  6. Urban malaria

  7. Plains—traditional agriculture

  8. Coastal

DETERMINANTS

  1. Level of endemicity

    • Highly endemic: perennial transmission

    • Moderately endemic: perennial transmission

    • Modestly endemic: seasonal transmission

    • Highly endemic: seasonal transmission

    • Low endemicity: seasonal transmission

    • Epidemic transmission

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Suggested Citation: "Appendix A: Paradigms." Institute of Medicine. 1991. Malaria: Obstacles and Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/1812.
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  1. Parasite species

    • Plasmodium falciparum

    • P. vivax

    • P. malariae

    • P. ovale

  2. Population characteristics

    • Immune status (high, low, none)

    • Movement (settled, resettled, transient); if transient: organized, nomads, random

    • Population density and settlement patterns

  3. Social, behavioral, and economic characteristics

    • Housing

    • Occupation

    • Water utilization

    • Health-seeking behavior

    • Sleeping habits

    • Customs and taboos

    • Income and wealth

    • Local understanding of malaria

    • Access to health care

  4. 5. Health infrastructure

    • National health budget

    • Status of governmental health care delivery system

    • National malaria control program (type, budget, and efficiency)

    • Importance of non-governmental services (i.e. missions, private voluntary organizations)

    • Availability of private health care

    • Importance of health care delivery by family, market, etc.

  5. Use of drugs

    • Cost

    • Availability

    • Drug-use patterns

    • Effectiveness (degree of resistance)

  6. Vector considerations

    • Behavior (breeding, feeding, resting)

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Suggested Citation: "Appendix A: Paradigms." Institute of Medicine. 1991. Malaria: Obstacles and Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/1812.
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  • Susceptibility to insecticides

  • Cost, safety, and acceptability of effective insecticides

  • Availability and cost of bed nets

  • Feasibility of bed net impregnation with insecticides

  • Availability and cost of repellents and fumigant coils

  1. Development projects

    • Government development projects (dam construction, road building)

    • Unofficial or illegal activities (mining, gemming)

      • organized

      • random

TOOLS

  1. Vector control

    • Personal protection

      • nets or curtains with or without insecticide

      • screens

      • house siting (where the house is physically located)

      • repellents

      • smoke coils

    • Environmental management

      • source reduction

      • flushing, sluicing

      • clearing vegetation

      • water management

      • reforestation

    • Larvicides

      • chemical

      • mechanical

      • biological

    • Adulticiding (killing the adult forms of the mosquito)

      • residual spraying

      • fogging

      • largescale ULV (ultra low volume spraying)

    • Zooprophylaxis

  2. Medical resources

    • Diagnosis

      • clinical

      • microscopic
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Suggested Citation: "Appendix A: Paradigms." Institute of Medicine. 1991. Malaria: Obstacles and Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/1812.
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  • Treatment facilities

    • inpatient

    • outpatient

    • market

  • Prophylaxis

  • Mass chloroquineprimaquine administration for epidemics

  1. Information, education, and communication

    • Public

      • individuals, households, and communities

      • school curricula

      • radio

      • newspapers

      • television

      • local media (songs, theater, etc.)

    • Health care providers

  2. Surveillance

    • Diagnosis and treatment

      • morbidity

      • incidence of severe malaria

      • mortality

      • prevalence of parasitemia

    • Epidemic early warning

    • Vector information

      • insecticide resistance

      • behavioral changes

    • Antimalarial drug resistance
Page 279 Cite Bookmark
Suggested Citation: "Appendix A: Paradigms." Institute of Medicine. 1991. Malaria: Obstacles and Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/1812.
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Page 279
Page 280 Cite Bookmark
Suggested Citation: "Appendix A: Paradigms." Institute of Medicine. 1991. Malaria: Obstacles and Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/1812.
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Page 280
Page 281 Cite Bookmark
Suggested Citation: "Appendix A: Paradigms." Institute of Medicine. 1991. Malaria: Obstacles and Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/1812.
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Page 281
Page 282 Cite Bookmark
Suggested Citation: "Appendix A: Paradigms." Institute of Medicine. 1991. Malaria: Obstacles and Opportunities. Washington, DC: The National Academies Press. doi: 10.17226/1812.
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Page 282
Next Chapter: Appendix B: Dissenting Opinion
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