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@ WORLD HEALTH ORGANIZATION ORGANISATION MONDIALE DE LA SANTE vBctgo.3 MAUgO.3 ENGLISH ONLY Distr.: LIMITED VECTOR BIONOMICS IN THEEPIDEMIOLOGY ANDCONTROL OF MALARIA PART II THEWHOEUROPEAN REGION j AND THEWFIO EASTERN MEDITERRANEAN REGION VOLUME II APPLIED FIELD STUDIES SECTION lll: VECTOR BIONOMICS, MALARIA EPIDEMIOLOGY AND CONTROL BY GEOGRAPHICAL AREAS (B) AS|AWEST OF rNDrA PREPARED BY A.R.ZAHAR
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@ WORLD HEALTH ORGANIZATION
ORGANISATION MONDIALE DE LA SANTE
vBctgo.3MAUgO.3
ENGLISH ONLYDistr.: LIMITED
VECTOR BIONOMICSIN
THE EPIDEMIOLOGY AND CONTROLOF MALARIA
PART II
THE WHO EUROPEAN REGIONj AND
THE WFIO EASTERN MEDITERRANEAN REGION
VOLUME IIAPPLIED FIELD STUDIES
SECTION lll: VECTOR BIONOMICS, MALARIA EPIDEMIOLOGYAND CONTROL BY GEOGRAPHICAL AREAS
(B) AS|A WEST OF rNDrA
PREPARED BY A.R. ZAHAR
@WORLD HEALTH ORGANIZATION
ORGANISATION MONDIALE DE LA SANTE
DISTR. : L IMITEDDISTR. : L IMITEE
wc/go.3MAL,/90.^3
ENGLISH ONLY
VECTOR BIONOMICS
THE EPIDEI,IIOLOGY AND CONTROL OF MALARIA
PART II
THE wlTO EUROPEAN REGION
&
THE WHO EASTERN MEDITERRANEAN REGION
VOLUME II: APPLIED FIELD STI,DIES
SECTION III: VECTOR BIONOI{ICS, I.{ALARIA EPIDEMIOLOGY AND CONTROL BY GEOGRAPHICAI AF'EAS
(B) ASIA !{EST OF INDIA
PREPARED BY
A.R. ZAHAR
FOR}IER }IHO ENTOMOLOGIST
*Literature search ceased at the end of Decenber 1990'
I N
This document is not issued to the general public. andall rights are reserved by the World Health Organization(WHO. The document may not be reviewed, abstracted,quoted, reproduced or translated, in part or in whole,without the prior written permission of WHO. No part
of this document may be stored in a retrieval system ortransmitted in any form or by any means ' electronic.mechanical or other - without the prior wiitten permissionot WHO.
The views expressed in documents by named authors are solelythe responsibility of those authors.
Ce document n'est pas destinC i Otre distribud au grand public
.i tout les droits y affdrents sont r6servds par l'Organisation
rnonJi.t. de la Santd (OMS). ll ne peut etre comment6'
rJsumd, citd. reproduit ou traduit. partiellement ou en totaliti'
..ni un. auioriiation pr6alable 6gite de I'OMS' Aucune partie
ne doit Stre chargde dans un systdme de recherche documen'
taire ou diffusie sous quelque forme ou par quelque moyen
que ce soit ' dlectronique, m€canique. ou autre - sans une
autorisation pr6alable icrite de l'OMS.
Les opinions exprimdes dans les documents par des auteur:
citds nomm6ment n'engagent que lesdits auteurs'
vBc/90.3t{AL/90.3Page 3
SECTION I I I :
VOLU}IE
VECTOR BIONOMICS
II APPLIED FIELD SIIJDIES (CONtd)
I,IALARIA EPIDEI'IOLOGY AND CONTROL BY GEOGRAPHICAL AREAS
(B) ASIA WEST OF INDIA
DETAILED TABLE OF CONTENTS
INTRODUCTION
ACKNOI{TEDGEMENTS
Subsect lon (1) : VECTOR BIONOMICS
l.An. sacharovl and 4g:-@ 8.8.
Page
5
7
l l
l l
2 42. An. superPlctus and An. f luv lat l l ls
2.L Vector lnpor tance2.2 Breedlng habltat2.3 Swarnlng and Datlng2 .4 D i spe rsa l2.5 Local spat la l and seaeonal d iEtr lbut lon2.6 [estlng behavlour e 2.7 Bltlng behavl.our2.8 Sanpl lng of nosqul toe ln f l lght2.9 l lost feedlng pat terne2.10 Longevi ty2.11 Natura l ln fect lon2.12 Vector res l .etance to lnsect lc ldee
3. &-Elcherrlnu6 and s}25g3g9 group
3,1 Vector lnpor tance3.2 Breedlng habl ts t3.3 Swanulng and natlng3 .4 D lepe rsa l3.5 Local epat la l and eeasonal d ls t r lbut lon3.6 Reetlng behavlour & 3.7 Bttlng behavlour3.8 Sanpllng of noequltos in fl lght3.9 l loet feedlng pat terng3.10 Longevl ty3. l l Natura l ln fect lon3.12 Vector reeietance to Lneect lc ldes
24252 72 7283436363 73739
39404 L4 L424 35 I5 15 l5556
vBc /90.3MAL/90.3Page 4
4. !g:_:Lglg.l .rd An. cul ic i fac les
4.1 Vector inpor tance4.2 Breeding habi tat4.3 Swarning and nating4 .4 D i spe rsa l4.5 Local sPat ia l and seasonal d is t r ibut ion4 .6 Res t i ng behav iou r & 4 .7 B i t i ng behav iou r4.8 Sanpl ing of rnosqul tos in f l ight4 .9 Hos t f eed ing Pa t te rns4 .10 Longev i t y4 . l l Na tu ra l i n fec t i on4 .12 Vec to r res i s tance to i nsec t l c l des
The $-3g!!g cornPlex
Secondary and susPected vectora
6 .1 An . d - tha l t6.2 G-Tffitor6.3 An. selgggg!!6.4 i;Fbp-
Subsection (11): EPIDEMIOLOGY Al{D CONTROL OF MALARIA
1. Epldenlo logical s tudles and contro l operat ions2. Reslstance of P. fa lc lParuao to chloroqulne ln Asla
west of India3. Malar ia and i ts contro l in water reaources
and other developrnent ProJects4. Al ternat lve methods of contro l5. Connunlty partlclPatlon
CONCLUSIONS: SECTION I I I (B)
SELECTED REFEFENCES
ANNEX I Documents of PART I eerles
AI{NEX 2 Selected referencea on oalarla quantltatlve epldenlology
AIINEX 3 Abbrevtatlons
AI{NEX 4 Corrlgenduro Eo Document VBC/90.2-UAL/9O.2
5 .
6 .
5 7
575 77 38 l85
1 0 7123123t29l 5 lr 5 5
r 6 6
r 6 6
1 6 6168r 6 9r69
1 7 0
1 7 0
293
35r
2963073 1 4
3 1 6
327
349
vBc/90.3l tAL/90.3Page 5
INTRODUCTION
The serles of VECTOR BIONOMICS IN THE EPIDEMIOLOGY AND CONTROL OF MALARIA has beenlssued ln two par t6:
PART I deals wl th the Afr t t roplcal Reglon and 1s ent l t led:Effibn BroNoMrcs rN THE EprDEnrot,ocy Al{D coNTRoL oF MALARTA rN THE mro AFRTcAN RxcroN AlrDTt{E SoUTIIERN llll0 EASTERN MEDITERRAIIEN{ REGIoN", the docuoents of whlch were lssued durlngf984-1985, and are l lsted ln Al.lNEX I at the end of the present docunent.
PART II deals wlth Europe and the Medlterranean Basln and Asla l{est of Indla up to andffiGEfng Paklstan (see Fig. l), the docunents of whlch have been leeued as follows:
Dgcument VBC/88.5-
vBc/90.3MAL/90.3Page 6
publ icat ions. For select ing the appropr late publ icat ions to be consul ted, or ientat ion toold and newer publ lcat lons deal ing wl th nalar ia quant l ta t ive epidenio logy have been l is tedin ANNEX 2 in the present document.
Sin i lar ly , sorne authors descr lbed the stat ls t ica l procedures used for analyz ing thei rdata. I t ls beyond the scope of th ls ser ies to conpl le such synbols and oethods, for whichthe or lg inal papers can a lways be consul ted. However, ln cer ta in instances, sone synbolsand thei r def ln l t ions had to be g lven in order to fac l l i ta te reading the g iven f ind lngs.
I t should be re-enphasized that the whole ser les is not designed to descr ibe theconvent lonal entonological technlques. For the descr lpt ion of such techniques, the reader1s referred to the WIIO Manuals on malaria entonology. However, infornation on thetechnlques enployed and thel r cr l t lca l appraisal as g iven by the authors are lncorporated.
As studies on specles A and BIndla, l t ls usefu l to inc lude th isgeographical area under review.
of the An. cu l ic l fac les conplexexpe r i6i'dll7@fr-Tndia doe s
have progressed innot fa1l wl th ln the
As rnent loned ln the PREFACE of VOL. I , resul ts of the recent prec ip i t in tests forL97L-L978 age quoted from the data annexed to the review of Garrett-Jones, Borehan EPant (1980)^. Regarding vector res ls tance to lnsect lc ldes, records are quoted f roro 11stsln the reporte of the l{ltO Expert Cornnlttees of Vector Blology and Control respectively,(wHo, 1980 - TRS. No. 655, and f t10, 1986 - TRS.No. 737) . More recent ln fornat lon ls addedfrorn reports of susceptlbll l ty test6 conounlcated to I 'HO/VBC by fleld lnvestlgators lnseveral countr ies dur ing f984-1988' .
Infornatlon on the recent rn:larla sltuatlon by country are obtalned nainly {ron WHOpubllcatlons and data comnunicated to WI|O/MAP by the WIIO Reglonal Offices (EMRO)-.Addi t lonal ly , country prof l les constructed ln a docunent ent i t led r rRegional Malar iaInforuat lont t by Dr G.A. Far i f , WHO Reglonal Malar ia Adviser , EMR0, are used for in format ionon countr les of that Region. ' Records of ch loroquine res is tance ln P. fa lc lparun ln theReglons under revlew as napped by I{Ito are reproduced. InnunologLcatEdEEETalarla arebeyond the scope of this cornpllatlon, but seroepldemlological surveys as part of nalariaepldenlologlcal studles are summarlzed.
At the end of th is docunent , se lected referencea are l ls ted. Since the a iu of th iseer les ls to aselst newly assigned malar la workers to t race the source of in fornat ion onthelr oltn or adJacent countriee of sinllar condltlons, the references are arranged bycountry in a lphabet lca l order . At the top of the l ls t , references deal lng wi th subJects ofgeneral nature or coverlng eeveral countrl.es are placed flrst.
Sone abbrevlatl.ons have been used ln thls docunent, the glossary appears ln AI{NEX 3.
As sone referencee were nlsprinted ln docunent VBC|90.2-l4AL/90.2, a corrlgendum hasbeen glven as AI{NEX 4.
Llterature eearch was nade through screening the abstracts published ln the TroplcalDiseaee Bulletln (TDB) of the Bureau of Hyglene and Ttoplcal Medlclne, London, [K, and theRevlew of Applted Entouology (RAE), Series B, of the Comonwealth Lnstltuce of Entonology,London, lK. The efforte nade by theee lnstltutlona are fully acknowledged and greatlyappreclated.
l. Pernlseion to quote these data was granted by the late Dr C. Pant and the CouoonwealthInst l tu te of Entonology (Dr J .U.B. l tar ley) in Apr l l 1983.2. A conputer prlntout of these reporta was provlded through the cooperatlon ofMr G. Shldrawl, OPR/qID.3. Coples of these data were provlded through the cooperatlon of Mr J. I lenpel, InfornatlonDocumentatlon/CTD.4. Permieslon to uee lnforDatlon Ln'thls docunent waa granted by the Reglonal Directort!|IIO/EMRO, Alexandrla
vBc/90.3MAL/90.3Page 7
ADDITIONAI ACKNOWLEDGEMENTS
In additlon to the Acknowledgements shown in VOL. I (docunents VBC/88.5-UAP/88.2 &
VBC/90.2-UAL/90.2) gratefu l thanks are expreased to the fo l lowlng col leagues ln var lous
lnstltutlons and WIIO for their valuable contributlon to the preeent and preceding lssuest
and to author6 and copyr lght author l t les for grant lng perniss lon to reproduce l l lust rat lons
and/or data f ron publ ished PaPers:
?rof . Ener l tue G. Davidson, forner Dlrector of the Department of Entonology, London School
of Troplcal l ted lc lne & Hyglene, and Dr Carolyn A. Brown, Edl tor /Assls tant Dl rector ' Bureau
of l tyg lene & Troplcal Diseases, London, for thei r cont inued lnterest In the ser ies and for
naking cooprehenslve abstracte of the prevlous lssues ln the Troplcal Dlseases Bulletln.
Mr N. Eshghy, c /o School of Publ lc Heal th & Inst l tu te of Publ lc l tea l th Research, Univers l ty
of Teheranr- ior provldlng explanatlone of the behavlour of certain vectors in Iran, as sell
as Daps of and notes on the dlstrlbution of vectors of nalarla and the nalaria eltuatlon ln
certal.n areaa of the countrY.
Dr M.A. Farld, forrner I{I iO Malarlologlet for glvlng infornatlon on the Dost recent nalarla
eltuatlon ln the Sultanate of Omanrand for grantlng perul.eelon to reproduce epldenlologlcal
data fron hls report on UAE ae eholtn ln the text.
The efforte of Mre Marl.anne Klng, former I|IIO Technlcal 0fflcer, in lndexing l lterature,editlng and correcttng the present text are gratefully acknowledged and fully appreclated.
Dr Marlo ltaffl, former l lttO tlatarfologlst, for dtrectlng the attentlon to an error that
occurred 1n the dletrtbutlon llap of An. fluvlatllls ln Yemen showr Ln documentVBC/90.1-MAL/90.1 and the ortglnal a6?udifff i6fiEdl89.967 ae explained ln the text ln
Subsect lon ( t ) under 2.1 below.
Dr Ronald A. Ward, Editor, Journal of the Aoerl.can Mosqulto Control Aseoclatlon'I{ashlngton, DC, USA for provldlng reprlnte of hle publlcatlons on vecEors of nalarla ln
northeaetern Afghanietan and on the Recent Changes ln the Epldenlology of Malarla Relatlng
to Hunan Ecology.
Dr Wlll lau K. Releen, Arbovirue Fleld Statl.on, Bakerefleld, Unlverelty of Callfornla,School of Publlc Health, Berkeley, USA for provldlng explanatlon and clarlf lcatlon ofcertaln statenente and data ln hia publlcatlons as ehorrn i.n the text.
To authore and/copyrlght authorlt lea (ae ehown ln the text).
Slncere thanke are expreased to all colleaguee who granted blanket Pernlsslon to uaelnfornatlon and/or reproduce data or f lgures froll their publtcatlona as followe:.
l lr N. Eahghy (addrees above)
Dr A.V. l lanoucbehrl, Prof. of Uedlcal Entonology & Vector Control, Teheran Unlversity ofHedlcal Sclencea, School of Publle Health & Instltute of Publtc ltealth Reeearch, Teheran,
Islaulc Republlc of Iran.
Prof. M. l lotabar, Profeseor of Epldenl.ology, School of Publlc l lealth, Unlverelty ofTeheran, Ielanic Republlc of lran.
Dr Wtll lan K. Reieen (addreas above) regarding hle varloue publlcatlons.
Dr Ronald A. I{ard (addreee above) regarding publlcatlons 1n the Journal of the AmerlcanHoequlto Control Aseoclatlon.
Speclal thanks are due to authors/Journale/Publlshere for grantlng pernieslon to use
lnfornatlon and/or reproduce data or f lguree as shown I'n the text:
D r J o h n R . B a k e r f o r p a p e r s p u b 1 1 s h e d 1 n t h e T ' . . . " ' cHedlcine and Bvglene.
vBc /90 .3MAL/90.3Page 8
Dr Ca ro l yn A . B rown , Ed i t o r /T rop l ca l D i seases Bu l l e t l n '
Dr W. crewe, Edi tor- in-chief for papers publ ished in the Annals of Tropical Medlc ine 6 '
Paras i to logY.
Mr Ray Everngam, Managing Edi tor , Entomological Society of Arner lca for papers publ ished ln
the Journal of L ledical Entomology '
I ,1r Br ian Furner , L ibrar ian/London school of l {yg iene & Tropical Medic ine ' for maps shown in
Macan ( 1950 ) .
p ro f . D r A . de Geus , Ed i t o r , f o r t he PaPers o f -Es -hgh i e t a l ' ( 1976 ) and Mo taba r ' Tab ibzadeh
& Manouchchr i (1975i in Tropical & 'GeograPhical l ' {ed ic ine '
Dr Hema Joshi for h is ar t ic le in the Journal of t \e Aner ican Mosqul to Contro l - ' ls rsOciat ion
( J o s h i e t a 1 . 1 9 8 8 ) .
Mr Kei th K.Leber, Assisrant Edi tor for a paper by Reisen, Azra & Mahrnood (1982) 1n the
Jgurgal of ltedlcal Entonology'
Dr Enninio onorl, former wlto Malarlologlst, for his PaPer ln the Transactlons of the Royal
Sociegr of Tropl-ca1 Mediglne & I{yglene'
The late Dr c . Pant /Dr J .M.B. Har ley, the comnonw: l l th Inst l tu te of Entornology ' London' uK'
for the paper by Garret t -Jones, p. r r i ' t Sor .han (1980) ln the Bul le t ln-of Entonologlcal
Resea rch .
Dr M.W. Serv ice/BlackwelL sc ient i f ic Publ lcat lons L in i ted '
Dr V.P. Sharna, Dtrector , (Edi tor in Chlef ) Malar ia Research Centre ( ICMR) ' Delh l for
publ icar lon of Dr-s.K. s ;bbarao in fhe l rd ian Journal of ualar to logy ' and a PaPer by Dhir &
i .ahin. (1957) ln the sane journal
Dr S.K. Subbarao for her publ icat lons in var ious journals '
Dr G.B. Whlte, Editor, for a PaPer publlshed in Medical & Veteilnary Entonology by Subbarao
e t a l . ( 1 9 8 8 ) .
Dr A. Zai r . , l led ical Entonologist , school of Publ ic l tea l th and Inst l tu te of Publ lc l tea l th
Research, univers i ty of Teheran, Is laro ic Republ ic of I ran ' for grant ing pernlss ion to use
lnfornation contalned ln hls recent working PaPer to the i"p"tt Coromtttee on Insectlcide
Resistance' Geneva, 5-12 March 1991'
& Shah (1980 )
World l lealth Organlzation
wtlo/EIIRO. Alexandrla
Thanks are exPressed to Dr M.H. I{ahdan, Director of Dlseaee Prevention and control '
for grantlrrg p..ri""lon on behalf of the nellonal Dlrector to use lnforrnatlon contalned in
unpublished rePorts of WHO Advisers and Consultants as shown Ln the reference llst ' and for
obtainlng permlsslon of Government6 concerned to reproduce certain maPs as sholdln 1n the
text. Thanks are also extended to Dr G.A. Farld, Reglonal l lalarla Adviser for provlding
copies of varlous unpubllshed reports'
WIIO. Geneva
Div ls lon of controL of Troolcal Djseases (CTD)
The wr l ter ls gratefu l to Dr N.A. Najera, Dl rector of cTD' for h is cont lnued interest
and usefu l d lscusslons as the work progressed'
orTr
tDr J. de Zulueta, former WI{O Malarlologist
in the Transactions of the Royal Soclety ofthe paper of Zulueta, MuJtaba
oical Medlcine q-lYglgne'.
col leagues ln cer ta ln unl ts ofdocunent as fo l lows:
vBc/90.3UAL/90.3Page 9
the Dlv ls lon for thel rGrateful thanks are also due tovaluable contr lbut ion to the presenc
Inf ornatlon documentat ion
Mr J. Henpel , Technical Of f icer , for prov ld lng coples of data on the nalar la s l tuat lon lncountr ies undertakLng ant inalar la actLv l t les ln Asia West of Indla as comrnunlcaEed by theWHO Reglonal Office (EMRO), as well as relevant lnfornatlon and a Dap showlng thedlst r ibut ion of ch loroqulne-res is tant P. fa lc lparun ln countr les of the preoentgeographical area.
Mrs P. Duchesne, Assls tant (Ltbrary) for prov ld ing copi .es of ass lgnnent repor ts of l { I tOAdvlsers/Consul tants and cer ta in publ lcat lons, and for organiz lng the d ispatch of coples ofthe docunents of the whole serles to appllcatlons withln and outslde WHO.
Operat lonal Research (OPR)
Dr L. Mollneaux, Chlef OPR, for checklng rnathenatlcal calculatlons nade by the wrlter andfor explalnlng sone nathenatical fornulae ueed by certaln authors.
Mr G. Shidrawl, Entonologlst, for provldlng computer prlntoute of the results ofconputerized reporte of euscepttbtl lty test6 communlcated to l{l lO durlng 1984-1988, and forueefu l d lecuselonE on aspecte re lated to vector res ls tance to lneect lc ldes.
INO LIBRARY
Thanks are extended to the l lbrary staff (notably Ur B. Blonda) for securing coples ofpubltcatlons and books on tellporary loan that are not avallable ln the mlO Llbrary.
DUPLICATING & BINDING
Thanks are due to thls service for expeditlously proceeslng the varlous documents ofthls eerles wlth utDost accuracy.
vBc/90.3MAr/90.3Page l0
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VOLU{E II APPLIED FIELD STUDIES (contd)
SECTIoN III: VECToR BIoNOMICS, MALARIA EPIDEMIOLOGY AND CoNTRoL BY GEOGR-APIIICAL AREAS
(B) ASIA I'EST OF INDIA
Thls area extends froro Iraq ln the north to the Arablan Peninsula in the south and tothe east uP to and ineludlng Pakistan (see Flg. l ) . As far as possib le th ls d l rect lon hasbeen followed ln conpll lng country lnfornation, noving fron the north to the south andeas tnard ly .
Subsect lon (1) : VECTOR BIONOUICS
Elght anophel lne species act lng as najor vectora and four specles act lng as secondaryor Euspected vectbrs ln the geographical area under revlew are dealt nlth here. Of thenembers of the An.- ragllg""lg cornplex only two specles are present naroely:nacul lpennls s .s . and sacharovl . The avai lable in fornat lon on these two vectors Ls notsuf f lc lent ly deta l led to warrant conpl l lng 1t under the standard subJect headlngs of vectorprofl le. Thus, the avallable knowLedge Is glven ln the forn of a slnple revlew. Thlsappl lee a lso to secondary and suspected vectors. Slnce the dtst r ibut lon of cer ta ln vectorsoverlap to a large extent, lt has been found Dore convenient to couplle the ava{lablelnformatlon on two of such vectors cooblned under standardlzed subJect headlngs, vLzzeuperp+ctE and 4uviatl l lsi Elcherrlnus and Ug; s.tephensl and _cullclfacies. Foroaps oE-tEe ai.strrEuEGn oT vE'irousTp-fes, sEffifr[r @;;enr vE'dlm:FidJ790.l)should be conaul.ted.
I . An. eacharovl and An. rnacul lpennls s .s .
Both sacharovl and rnaculipennleI{est of Indla, being conflned to thereference le Eade to thoge of Maeanextrene weatern deser t , and par ts ofaurveyed and, l ts c lass{ f lcatLon lntoln F lg . 2 (a ) ' and 2 (b ) '
s .s . have l ln t ted d ls t r lbut lon ln the area of Aslanor thern par ts of I raq and I ran. Of o ld s tudies,
(f950) who surveyed the whole of Iraq except for theIran adJolnlng Iraq durlng 1942-L944. The areaphyslogeographical reglons lrere napped as shown here
The physlogeographlcal reglons were descrlbed as surmarized ln the following:
(a) The Perslan plateau reglon: This ls bounded by the Zagros watershed, whlchdlvides those water courees whlch flow down to the Tlgrls ln Iraq fron those whlch flowtnto the varl.oue dralnage areaa ln lran. The plateau conslsts of rangee wlth long wldevalleys ln between, and the general level of the northern part, whlch naa surveyed, is overI50OD al t l tude.
(b) The escarpoent reglon: Thls was descrlbed as the rugged and steep eouthwesternelopee of the Zagroe range between the plateau and the foothll ls. In the extrene north, 1t1s about 500 n ' but t t fa l le s teadl ly ln the southeaster ly d l rect lon, and ln the la t l tudeof Baghdad lt ts about 300 n. fhe landscape of the escarpment 1s l lke that of the plateau,but lt is more rugged and the rellef 1s bolder.
(c) The foothll l reglon: Thla is conposed of low roll lng hll ls, wlth an occaslonalsharper rldge. Theee characterl.ze thls reglon and the boundary between lt and theunlfornly flat plateau. The reglon narrons betneen Khanaqln ln Iraq and the Perelan Gulf.To the 6outh of Khanakln, there ls a steep rldge known as Ilamrln h111s, whlch runs Ln anorthwest directlon to Fatha, where it ls dlvlded by a gorge cut by the Tlgrls river. Allthe wi.de area to the north of Hanrln hll ls roay be considered as belonglng to the foothlltreglon, although there are extenalve alluvial deposlts, especlally in the area bounded bythe Tlgrls, the Hamrln hil ls and the road connectlng Mosul and Klrkuk ln Iraq.
fftpr,;ff i i l-Uy perolsslon of the London School of Hyglene and Troplcal Medlclne.
v B c / 9 0 . 3t{a l /90.3Page L2
(d) The Arabian p lateau: This l ies to the southwest . The Parts surveyed aregeologlcal ly ident lca l , wl th the footh i l l region on the other s ide of the a l luv ia l p la in.
To the nor th of the a l luv ia l p la in, the footh i l l region and the Arabian p lateau nerge anda re t rea ted as one reg ion as shown i n F ig . 2 (b ) .
F iS . 2 (a ) Rou tes su rveyed March 1942 -Feb rua ty L944 .
KEYe--r--./ 'r l
1^"?*-^,.L
oN
I QN
i 8
l^F.ctsr'{--\
lYI
l-t"kil l
t ,
l>- iI tlvr i. ! t
" . t . .
36
3 4
i Srmk
,P.9
.il_
I
ROUTES
SURVEYED
Politicel Boundrry
30 ldt 20 f,n€l - - # . ,
aio Jao Km
A A-1-
I
:;:t*"{s,."j1
{ ta
ta
vBc/90.3UAL/90.3Page 13
Ffg. 2(b) Physlographical regl.one of the area surveyed
vBc/90.3MAL/90.3Page 14
, (d) The a l luv la l p la ln: This ls forned by the Tigr is and Euphrates and ls bounded by
the footh i l ls , Arabian p lateau and the Pers ian Gul f i t s lopes gent ly f rom an a l t l tude of
about 150 ro near the goig" fron l{arnrin hil ls down to sea 1evel.
As summarlzed by the author, notes on nembers of the An. maculipennis complex were
glven as f o l l 'ows:
An. sacharovl : This species is widespread and abundant ln the footht l ls and the
escarpment , and was recorded f rorn three t ta" ty separated ?: : t : : : - :T p lateau' I ! was a lso
encountered in one area in Shatt-Al-Arab' The season of its greatest abundance stas no!
d e t e r n i n e d . I t s h l b e r n a t l o n l s f r o n O c t o b e r t o M a r c h a n d w a s f o u n d t o b e i n c o n p l e t e .There was sone evrdence that a proport ion of l ts populat ion Day rest outs lde houses ' The
numbers caught lndoors lncreased "tt. ipfy
at the -beginnlng of hibernatlon' Its larvae were
found in poolsr ln s t reams and t f . r " . " , in r tce f te t t ls t t td i t t s in l lar large col lect ions of
c lean, s tagnant , or near ly s tagnant I 'a ter wl th vegetat ion. I t proved to be a ser lous
vector of nalarla in the foothll ls and escarpEent, and spleen rates of lo01^ were comnon in
i te area. I t a IEo t ransmlt ted ualar ia rn the shat t -Al -Aiab area, but on the p lateau, for
unknown reaaon', it was much less rrport"nt. ,Along shatt-Al-Arab, 185 specimens of
sacharovl were d issected dur ing Novernber, g lv lng a sporozol te ra le of ' 3 '87" (7/185
iiff i t.--i i i iy fenales and slx speclneis wtih gland r.nfecrlons cane froro rhe same
house. If these are excluded, the sporozolte rate aDong the renalnlng nosquitos comes Eo
O.7Z ( l /135 d lssected) . Dur lng Octo ler 1943, one sporo-o l te-posi t lve specinen was found
anong 353 feroales of aacharovl dlssected tn Kermanshah valley, western lran and the
sporozoite rate for tf i i i f f i-a' November 1943 was O'4L7' (2/486 dissected)' Both
sporozolre-poetrlve speclmene ,n".".i l i"a-ir,-.1".,n"tr !:1:il i, l: l:.1H::_:.,:":l:"1;"l3ilr'i i l";"";;;1;;-;;;im!i-*t"i-"."t"r""t can tranaolt some roalaria throughout the winter'
An. macui lpennls s .s . : This species ls abundant on the Plateau and i ts range just
exrends ro rhe """ f rpr ! r r i
; " ; i ; ; . - ' ;oss lb le factors l in t t ing l ts range of d ls t r ibut ion nere
considered, but it aee's that tenperature 1s probably the i iportant factor' The season of
greatest abundance ls frorn July tt October. its hibernatlon is conplete extending fron
0ctober to l larch. It was found resting ln houses and stables' It breeds in places sltollar
to those of sacharovl.. An. nPcullperrr,I" ".s.
w8s found naturally lnfected but lts exact
status as a vector could not be asseFd as lt was always associated nlth glf.@'
Howeverr it nas not consldered as serlous a vector 8s Eg!g!
In I raq, Pr lngle (1954a) produced an i l lust rated gulde for ident l ' f lcat lon of
anophelLne specles recorded ln the country ae well as those found 1n nelghbouring
couDtr les, wl th br tef notea on speclee dtst r lbut lon. .An. s?chaTovl -1: , "o^ot in val leys of
north Iraq, where lt ls partlcularly aesoclatgd Yllh fi lenslve irrlgatlon and rice
cultlvation. Perlodi.cally, lt tnvaded the alluvLal plaln, aPParently along the Dyala
r lver . under normaL condl t lons, Lt does not 6eem to be able to Dalnta in lcsel f aouth ' or
west of Jebel Hamrin. up to 1948, an lsolated focue of thls speclee exlsted ln the denser
date groves along shatt-Al-Arab near Basrah city' but dlsappeared later' slnce the
dtsappearance of thls focus the altitudtnal tt"g" of g!g! iT T:i l
ls frou 150 n to
1200 n. Regardlng nacullpennls e.s., lts larvae haveGiffi-a-g sfuoilar ecological
requlureneots ro those of !@!. 'no.= ia" l r r rpret r . t r6 s .B. tends to rePlace @! at
altltudes over 600 n, and 1t beeone's c6illf.:ffi?in-n?nt above 900 o' The upper
a l t l t u d 1 n a 1 1 1 n 1 t s o i @ " . " . i ' . t r a q h a s n o t b e e n d e t e r r o 1 n e d ' b u t 1 t 1 6 c o - n o nln surnoer at 1600 o. Thls typtcal foru of the An' nacullPenntg.conplex le the only forn
that 60 far haE been recoraea-tn lraq (tn addttlon to g@!)'
A1 Tlkrlty (1964) collected and oapped the records of anophellne specles found ln lraq
partly fron l lterature, and nostly frort surveys carrled out du;tng 1954' 1955 and 1959 ln
the Northern reglon; 1955-1958 ln the central and the southern reglons' supplenentary
aurveys were carri"i orrt ln dlfferent areas of Iraq durlng l96l-f963'- A total of 14
anopheline specles recorded and the locallt ies of dl 'tr ibittott of each specles rcere l lsted
vBc/90.3MAL/90.3Page 15
and presented ln a eerlee of maps. As far as members of the An. maeullPennls complex',sacharovl ls consldered the maln vector of malar la ln the nor th and nor theast of I raq. I t; "68""d in large nunbers ln the escarpment and footh l1 l reglons. The adul ts of th isspecl.es were found restlng lndoors in human dwellings and anlmal shelters both durlng theday and n ight . I t breeds ln sna1l s t reams, pools, r iver beds wl th or wi thout vegetat lon aswel l as ln r lce f le lds. An. rnacul lpennls a.s. was found 1n the eacarPment region at anal t l tude of more than 900 m where l t acts as a vector of nalar ia . I t was present ln wel lwatered areas wi th h lgh ra lnfa l l and 1ow summer tenperature. I t was a lso found rest lnglndoors in human dwelllngs and aninal ehelters. Lt was found breedlng ln swaropy placesar is lng f roro i r r lgat ion waters, s tagnant waters, r ice f le lds and ln srna11 st reans wi thvegetat lon in shaded s l tee or under d i rect sunJ- lght .
The seasonal dtstrlbutlon of saqbarcIl and ggpgtlgtus as an assoclated vector innor thern I raq wae studled by Abul-Hab (1958). As nent loned above, three lnpor tant vectorsof nalar la occur ln nor thern I raq: nacul lpennls s .s . , sacharovi and superplc tus. The f l rs tspecies ls conflned to hlgh arcriuaffi-ffianlya LlffiF;ovlncfiffig he rran/rraqborder and ln Penjwl .n Nahiya (= local l ty) . T--o-complernent the work of Macan ( f950) 'obeervat lons were conducted dur lng 1953-f954 by Abul- t tab ( loc.c l t . ) on the seasonaldlstrtbutlon of sag@l and euperplctus in some vil).ages 1n the Shahrazur p1aln' hithertoknorn to be a nr!frffiTi.lousEEffiear Suleiuanlya. The Shahrazur plain occuples theeouthernrnost part of TanJlero rlver valley, whlch runs southeastwardly along the foot ofthe escarpnent region of Uacan (1950),and dralne lnto the Slrwand, a trlbutary of the Dyalarl.ver. Three vll lages were selected for observations, of whlch tno were subJected to DDThouse spraylng ae lnlt lated in 1954 for malarla control. The vll lages were:
- Seraow: I t ls e l tuated at about 500 o a l t l tude. Sp1-een ratea among chiLdren [agesnot glvenl were l00Z ln l95l ard 947 tn 1954. The vll lage l les close to theSuleinanlya-llalebcha highway and has never been sprayed. The vll1age houees are clusteredon the banks of a broad, ehallow otrean flowlng froro sprlngs. The strean flows lnto abroad snanpy area close to the vll lage. Thls area whlch ls lntersected by slow flowlngchannele of clear water contalns patches of aquatlc vegetatLon and wll low trees along ltsuargin. Where the nater f lowed over gravel or sand, had sllght vegetatlon and wae sunlltat the margln, optlnun breedlng condltione fo" ggp3.glglg were found. Wtrere ltater ItaEdeeper, and flowed more elowly over a ouddy bottom, and where there was nuch eroergentvegetatlon, condltlons nere sultable for sacharovl breeding. I lowever, the larvae of thetwo speclea were not restrlcted to their Elff i irstic habltats and were often takentogether .
- Banuk: The vll lage ls sltuated on rislng ground, about three kl.Lonetres south ofHalebcha at about 640 n altltude. The spleen rate recorded anong chlldren ln 1954 was532. There were several epringe near the vll lage, from whlch lrater f lowed lnto shallow,often shaded and nuddy channels. Larvae of sacharovl were never found near thls vll lagetbut larvae of euperplttus were collected regffir-ty. lreedlng occurred 1n algae-coveredeide pools along theee channels, and also ln shallon plts ne4rby whtch had been excavatedfor naklng brlcks. The vtl lage na6 sgrayed with DDT at 2gla' ln April 1954, and surmerhute rrere eprayed.
- Rlngal: Thts vll lage ls sltuated at about l0 kn northwest of Halebchs on a flet areaat an altltude of about 460 n. 0n1y about 50 persons l lved ln thls vll lage and fourchlldren exaol.ned had very large spleens. I{ater frou several sprlnge flowed lnto two widedltches whlch eventually Jolned to forn a swlft f lowlng lrrlgatlon atream. Breedlng ofsuperpictue and g$!gl! was apparently conf lned to the two ditches, where the f 1ow waseloned down through the presence of aquatlc vegetatlon. The vlLlage ltas sprayed wlth DDTat the eame doeage as shown above. SlnLlarly tenporary aunrDer huts anil replastered houseswere sprayed.
vBc/90.3MAL/90.3Page 16
F ive p ren i ses ( l i v l ng rooms , s tab les , po rches e t c . ) we re ' se lec ted Ln each v i l l age as
f ixed capture sEat lons f ron which rest ing mosqui tos were col lected ( for tn ight ly in 1953 and
weekly i .n tSSq) by hand capture for t5 rn in in each. The capture stat ions were le f t
unsprayed. Densi ly ind lces were calculated to g ive the mean number of roosqui tos caught per
r r r r lho l . per nonth: For larvae, f ive potent ia l breeding p laces hrere searched in each
locar ion by naking 10 d ips wi th a 1adle. Larval lnd ices.were calculated on the basis of
the mean nonth ly nurnber of larvae col lected per l0 d ips.
Ihe resul ts were as fo l lows:
An. sacharovi : Larvae of th is species were encountered in sroal l numbers (4 lLO dips) by
tte eifi-i?Tfrffiruewhar earlier than those of .gg.rplctus.. They becarne nost abundant near
the v i l lages aur in j June (L62/ lO a i .ps) but the a"d i ty d"" l lned in July-August (17-75/LO
dips) . fhe densi t ! subsequent ly increased in Septenber (22-56/L0 d lps) , but no larvae were
found near rhe v i l iages f iorn ear ly October to the, la t ter hal f o f May. Indoor/ rest ing
adul ts were found in a l l nonlhs of the year ln the unsprayed v l l lage. The densi ty s tar ted
t o i n c r e a s e f r o m l ' l a y ( f r o n l l ; 0 / r o a n - h o u r l n A p r i l t o 3 2 i l l n M a y ) r e a c h i n g a p e a k i n J u n e(4L.2) . Thereaf ter , the densi ty per man-hour decl lned in July-August (14.9-7.5) , but
increased again in iepterober-OctoLer (21.8-27.0) . Wl th the onset of co ld weather , there
was a steady decl lne in densl ty , but adul ts cont inued to be col lected f roro the caPture
stat ions throughout the cold season. The spr lng lncrease ln aduLt densl ty appeared before
larvae were encountered near vil lages. Thls rnay have been due partly to the coDParatlve
abundance of seepages and other potentlal breeding places ln the sprlngr causing great
dispersal of larva! within the breedlng area. The lnpact of DDT house spraying on adult
sacirarovl populations ln Banuk and Rintal was well narked durlng the flrst three nonths
iiEE?G!?aylng rendering the early 6ulnmer peak negligible (0'0-6'7/nan-hour)'
Aaaitionatly, the normal auturnnal bu11d-up of adult populatlons ltas narkedly reduced
(1.0-1.7) . The response ln the two sprayed v l l lages showed a rnarked d l f ference. At
Rlngal , where sachaiov l was breedlng c lose to the v l l lage, the adul t curve af ter spraylng
was relativelyftff i followed the trend of larval density. In contrast' at Banuk, whlch
was distant fron any lnportant breeding place of @9g1, the adult denslty during the
breeding season r."-n"giigible, but ln the second wE&-iFNovember 32 -S!gg adults were
col lect id in I l /4 hours f rorn the capture stat ions of th ls v l l lage. Thereaf ter ' unt i l the
end of 1954, adults continued to be iaken occaslonally at Banuk. This roay conflrro the
well-docuroented observatlons that indicated the tendency of sachargli to dlsperse for long
distances dur lng the ear ly par t of the h lbernat lon season'
An. superplc tus: Al though th ls species ls deal t wl th under paragraph 2 below, l t ls
more convenlent to eummarize the avaliable lnfornation froo northern lraq on this specles
as being associated wlth sacharovl and the author gave the results of the two sPecies
slnulta;eously frorn the sEneEea. Larvae of ggpglctus nere flrst encountered ln
moderare numbers in lor , " (95-155/ I0 d ips) , a f f f i i lF ter the ear l lest appearance^of .
adul ts in the capture stat lons. t te greai"s t larval densl ty was.observed ln July (437/ f0
dlps) , a f ter wtr l t t r per lod the densi ty decl lned unt l l October (79/LO dips) . Subsequent ly '
no larvae were detected durlng wtnter nonths. In the nelghbourhood of the sprayed
vll lages, there was soDe delay 1n the build-up of larval populatlon" ?f :YP"t!1!t!::^T:
chere lras a rapld recovery ln- July. Subseguently, a rDore Pronounced decllne was observed
than ln the breedlng places of ttrl ,rr,"pt"y"d vll iage. I lowever, the author polnted out that
these flndinge should be lnterpr"t"d rlth- caution, sl.nce the nethod used .for estlaatlng the
denslty of larval populatlon6 was far fron being perfect' The flrst aPPearance of adults
of superplctus in the capture statloDs of the unsprayed vll lage occurred ln the first week
of l.(3y (0.5/nan-hour), and three weeks later in the sprayed vll lages (0.3/nan-hour)' In
the unsprayed vll1age, the adults became abundant ln the eecond half of June and a peak was
reached in July (ZS5.A/r."-hour). Desplte a decllne ln breedlng, a hlgh adult denslty was
Daintalned in Au;;;-i"pl"rU"t tfr.:.f- iAO.S/nan-hour), after whlch perlod the decllne was
rapld and rhe Iasr collectlon was nade Ln November (L.7lman-hour)' No +Pgry+-:lPt"
were collected in the wlnter rnonths untl l the ftrst week ln May. The author attenpte'l to
explain the presence of appreciable adult densltlee of superPlctus ln late suil ler desplte
vBc/90.3MAr/90.3Page l7
the apparent decl ine in larval densl ty . Apart f ron the posslb le def lc lencles in the ' iarvalsanpllng technlques, there nay have been sone other factors. The increaslng arldlty of theenvLronroent during that period nay have driven a greater proportlon of superpictus adultsindoors. Al ternat lve ly , l - t nay have been due to the proxin l ty of r ice f le lds to thevl l lages f ron May to Septenber shlch provlded a favourable breedlng habt tat forsuperpic tus. Rice f leLds were not lnc luded ln the larval 6urvey6, therefore, th lsassunpt ion could not be f i rn ly establ ished. Regarding the lnpact of DDT house spraylng onsuperplc tus, the ear l iest lndoor restLng densl ty was recorded seven to e ight weeks af terspraylng. Thereaf ter , the densi ty fo l lowed the normal t rend of the unsprayed v l l lage butat a much lower leve1. As ln the unsprayed v l l lage, the last adul ts erere col lected dur lngNovember (0.4/nan-hour) .
Abul-Hab (1956) work lng ln a malar la contro l proJect recorded the degree ofdevelopnent of the ovarles of sacharovl durlng routlne dlssectlons to deterolne theblologlcal actlvlt ies of thls ElE;i6T"rlng the coldest perlod of the year ln SuleLnaniya,northern Iraq. These observatLons covered the perlod October-May for three consecutl.veyears: 1952-1955. Records of cenperature and relatlve hunldlty were uglntalned throughoutth ls per lod. Classl f icat lon of the ovar ian stages fo l lowed that of Pur t (1951). Thepresence of b lood in the guts of the fenales naa recorded ae f resh ( red) or o ld (dark) .The presence or absence of fat body was alao recorded lrrespectlve of the quantlty. Dataof the three yeara were conaolidated and presented graphlcally to show the nean oonthlypercentage of the feoales dlssected over the three 6eaaon6 wlth ovarles beyond etage II,and those havlng blood ln thelr guts. These results showed that suppresel.on of ovarlanactlvlty was conflned to the perlod Novenber-January. Thereafter, ovarlan developnentproceeded elowly untl l conditlons becane favourable for oviposttlon. Suppresslon ofovarl.an activlty was hardly conplete even ln the coldest perlod of the wlnter and wasnlnlnal Ln the early part of the cold 8€aaoo. Illbernatlng feroales contlnueal to takebloodneals in every nonth, though on a reduced scale durlng the coldest perlod of thewlnter . Thls specles, therefore, exhlb l ted a degree of gonotrophlc d leeoclat lon and othercharacteristtcs ln wlnter ln northern Iraq ae shonn ln the followlng:
(a) A tendency to congregate Ln wlnter ln lnhablted roone.
(b) A tendency to contl.nue feedlng throughout the cold seaeon, to provlde nutrlttonalnaterlal apparently leadlng to replenlshnent of fat body.
(c) Incomplete euppreeslon of ovarlan developnent ln cold weather. The tlne of oneetof gonotrophlc dissoclatlon and lts steady tranefornatlon lnto gonotrophlc concordance ielnit lated by an endogenous factor [reactlng to changes ln the photoperlodl, and le notentlrely regulated by cllnatic changee.
The three wlnters durlng whlch the obeervatlons were carrled out were not of equalseverl.ty. The wl.nter of. 1953/L954 wae the coldest and that of 19541L955 wae the nlldest.The slze of the catchee nas too snall to allow Btatletlcal eetlnatlon of yearly varlation.However, sone observatlons Lndlcated that the number of fed feuales ttas reduced durlng coldepells a6 wao observed ln January 1954 when the mean tenperature waa 4.2" C. Thepercentage of fed feoales ln that uonth nas as low as 22. On the whoIe, the reeults oftheee obeervatlons confl.rn the conclusl.on of l lacan (1950) that the hlbernatlon of eacharovlln northern Iraq le lnconplete. On thls polnt Abul-Itab (loc.clt.) aleo suggested 6;?-further lnvestl.gatlons ehould be carried out to aacertal.n whether thle phenotrenon occurs Lnareas colder than Sulelnanlya. The epldenlologlcal elgnlflcance of theee flndlngs hae notbe aseessed, although the general lnpreselon lE that transmlsslon of nalarla ln wlnter LnSulelnanyle occurs on a anall Bca1e.
Sone observatlong were also conducted during June-October 1954 by Abul-Hab (1960) onthe nlght actlvlt lee of eacharovl and guDerplctus also ln the Sulelnanyla area, northeruIraq. Three vlllages weEffiEea foilEEJEFervatlons ln the northern end of theTanJlero valley near Sulelnanlya town. Inlet and outlet wl.ndow CraPs were lnstalled ln aroom, and nosqultos were counted accordlng to the specles hourly ln each trap. A l5-ntn
vBc/90.3MAL/90.3Page 18
col lect ion was Dade every hour of the n ight by hand capture ln the rooo of the t raPs.Moreover, a l5-n ln col lect ion was nade every hour of the n ight in a tent in which a Danslept , and the f ront door was lef t open. As d iscussed by the author , the resul ts showedthat g.gg-Itlglgg seems to leave the lndoor resting early in the night (1800 h), but a snal1propoiElon of l ts populat ion star ted to enter the t rap roon three hours la ler (2100 h) .Fron th is , i t was ln ferred that a good proport ion of the superpic tus populat ion renainsouts ide to cornplete the developnent of the ovar ies and subsequent ly ov iposi t . Observat ionsin outdoor resting shelters showed th.t gpgpl"tu" was conposed of half-gravid and gravidferoales. The act iv iEies of sacharovi as judged f ron the indoor rest ing catches in the t raproom shoned two c lear peaks: the f i rs t between 2300 h and 0400 h, and the second around0600 h. I t seens that sacharovl leaves the indoor rest ing s l tes dur ing the f i rs t hal f o fthe ntght as shown Uy tIfrff iE wlndow trap. Collectlons froro the tent showed thatsacharovl d id not b i te as soon as l t entered, but tends to res! for a whi le before seekingEffiEaf. Although the denslty per man-hour of superpictus taken resting lndoors wasalways h igher than Ehat of sacharovi , fewer superpic tus were taken ln Ehe tent thansacharovi. Thls was taken E-fi iff i te that sacharovi was nore atEracted to human blood-than superplc tus which aeens to f lnd other sources of b lood, but fur ther observat ions weresuggest .ed to ver l fy th ls assunpt lon.
[These observat lons lacked actual co l lect lons f roro hunan bal t . ] loreover , the resul ts ofwlndow traps observations could have been more meaningful if nosquitos were collectedhour ly , and then ldent l f led and c lass l f led aqcording to the b lood d igest lon stages insteadof vLsual count lng and specles ldent i f lcat lon ln s i tu l .
Fur ther , Abul-Hab (1961) repor ted the resul ts of h ls observat lons carr led out dur ing1952 and 1955 on the rest ing behavlour of sacharovi and superpic tge. Al though theobservatl.ons vrere roade oainly in Suleirantl l l l- iFttt or GllEfEcologlcal condltions ofth ls L iwa are s in i lar to those of the other three L lwas of the oounta inous reglon: Erb i1,Mosul and Klrkuk. As descr lbed by the author , l5- ro ln col lecEions of indoor rest ingroosquitos were made hourly throughout the nlght. Mosqultos were transferred to thelaboratory, the specles ldentLf led and c lass l f ied accordlng to the b lood d igest lon stagesdescr lbed by Mulrhead-Thonpson (1951). The fenale was considered gravid (G) when theabdonen was whlte, half-gravld (HG) when half of the abdonen was whlte, and non-gravid.[The last category should have been cal led b lood- fed (F) , s ince the unfed fenales wereexcluded f rorn th ls c lass l f lcat lonl . Col lect lono erere a lso nade f rom outs ide rest lngshel ters cornpr ls lng the unders ide of br ldges, cu lver ts , t ree holes, porches and verandas ofl lv ing quarters, suomer huts, th tck bundles of r ice p lants. In addi t ion, three caves wereselected at d i f ferent p laces in the 6tudy area as f lxed outs ide capture stat ions and werevlslted regularly over a perlod of l0 roonths. Females of sacharovl and g!gg!g!gg. werecollected iesting ln houses and stables in varlable nunberiTi'EJfy ceiff i ls, EaEs andeven at the corners near the ground. Plugged windows, cupboards, unders ide of beds, andhanglng obJeccs a lso provlded good-places for rest lng where large numbers of nosqul tos nerecollected. Llving rooma ylelded snaller nurobers of rnosqultos since 6oot accunulated oncell lngs and walle of l ivlng rooms through fires during winter nonths 6eem t.o determoequltos frorn restlng on these surfaces. The author assuned that the duratlon of thegouotrophic cycle ln both epecles under prevall ing condltlons was three days, hence theproportions of F, HG and G ehould be equal. lThis is not quite so, since the natural dall,yroortallty should be accounted for, reeultlng ln lower proportions of HG and G]. Fron theauthor-e tabulated data the rat los of F: I lG:G in saroples col lected rest lng indoors wasl :0.66;0.26 for sr1pglgtus and l :0 .85:0.52 fo. gg@!. This was taken to lndicate thatfenales of superplctue leave the lndoor restlng sl.tes before conpletlng the gonotrophiccycle to reffiff ide sheltere, probably near breeding places. Thls conditlon was lessrnanifested by g@! populations, suggesting that a larger proportion of this speclesconpletee the gonotrophlc cycJ.e indoors. The two species were found resting ln outsideshelters, ae they were taken fron porches of houees, Eunrner huts and caves. Onlysuperplc tus was found restLng Ln t ree holes, crevasses, unders lde of br idges, cu lver ts andthlck bundles of rlce plants. Data of collections fron the three cave6 coverlng the perlodJune 1954-March 1955 were tabulated. An. superpigtus was found ln abundance in the caves
vBc /90 .3MAL/90.3Page 1.9
durlng June-Septeober correspondlng exactly wlth the seasonal prevalence of thls specles
saropled f rorn indoor rest lng s l tes (see Abul-Hab, 1958 above). Thereaf ter , the nurnbers
decreased towards November. In contrast, no sacharovl rlas found restlng in the caves
durlng the favourable season, but 1t appearea fn snaff nunbers durlng October-March. Thls
ts the flrst t lne sacharovl and Sgpg!g.']!gg. were found restlng outdoors, thus conflrning
I' lacan (1950) who dEtrcel fron lndliect evidence that the two specles uae outdoor restlng
shelters. Abul-Ilab further polnted out that DDT house spraylng was much nore effectlve ln
reducing sacharovl populatlons unlike superplgtgs. Thls nay have been due to the fact that
superplctff iGEa uae the outslde reEllng shelters much more frequently tha. g!15gg!.
ISone reservat ions roust be expressed towards the author-s appl lcat lon of the
classl f lcat lon of b lood d lgest lon stages of Mulrhead-Thonson (1951) on sanples of oosqul tos
collected at nlght. Mutrhead-Thomson meant to apply thls classlflcatlon on the day-tlne
catch and he further stated |tCatches durlng the hours of darkness wll l also fall into tlto
categor les: b lood- fed, thoee whlch are f reshly engorged, and hal f -grav lds, those whlch fed
the prevlous nlght. In nl.ght collect1on6 there are normally no gravtd fenales, as they
have left the house at sundown.rr Accordlngly, lt ls clear how the exodus of gravld females
at dusk could have contrlbuted to the observed deficit of the gravld ProPortlon ln thepresent obeervatlons, However, tt 18 grattfylng that Abul-Hab could throw sone llght on
the behavlour of the two epecles at a tirne when lfunlted guldance was avallable ln the
llteracure and WIIO malarla entooology manuals were non-exlstant].
Abul-Itab (1969) reported the ieeulte of an entooologlcal eurvey carrled out lnNaynawah and Dhook provincee ln northern Iraq during August-Septerober 1955 before the areanas covered with DDT epraylng. A detalled descrlption of the area ltas glven and prevlous
records of Macan (1950), Pr lngle ( I95G,u c 1955a,b) and Al-T lkr t ty (1964) were rev lewed.As sumnarized by Abul-Itab (loc.cit.) nacullpennls a.so wa6 found at alt ltudes of 600 rn andabove, whlJ.e sacharovt was absent at sltttudes hlgher than 900 n. It overlapped wlthnacullpennls i lat aftltudee rangtng between 600-900 rn. An._ gacharovl was also found atff i i lEfuaes and further nest toirards the rlver Tigrls, and lt even occurred on theweatern bank of thle rLver tn locallt les of Shubalcha and Arlaha (ln Klrkuk)' Altalra(Erbt l ) , and Skl rkat (Moeul) . Thle extende the d let r ibut ton of sacharovi to the west ofthe l lne of Macan (1950) (eee below). An. superplctug was foundEffi the area and ltoverlapped wlth the other two specles ln all the area of thelr dletrlbutlon' but ltoccurred alone ln the steppe zone whlch occura ln the western part of the survey areaextendlng fron the north to the south, lncludlng the western border wlth Syrla. Datarecorded by locallty and vlllage ln the two provlnces ehowlng the density/uan-hour offenales of the three specles fron lndoor day-tlne resting shelters and larvae/dlp werepreeented.
In order to aaaeas the lnpact of resldual house spraylng on the geographicaldlstrlbutlon of anophellnes ln Iraq, particularly oalarla vectors, Abul-Hab & Al-Kassal(1986) exanlned the records collected by the malarla entonologlcal teams of the Northern,Central and Southern regl.ons of the country slnce 1952, wlth Partlcular attentlon on data
collected fron 1964 onwards. Labelled and Dounted specLnens collected durlng occaslonalsurveys were taken lnto account. The hlstory of nalarla control by resldual house spraylngwas aunnrrlzed. After the success of the malarla control denonstratlon proJect ln thenorthern regLon by DDT house spraying durlng 1954-1955, the country-wlde nalarlaeradlcatLon progranme nas started ln 1957 by applylng DDT house spraylng on a large scale.Wtren DDT reslstance appeared ln An. etephenel ln the southern reglon, a swltch was made todleldrln. In 1961, a hlgh levefif-Ellf i iEe to dieldrtn waa demonstrated, and DDT wabrelntroduced untl l l t was replaced by nalathlon due to double resistance. Slnce then' thecountry has been under nalathlon coverage. The elruatlon ln the northern reglon could notbe followed up systenatlcally due to war condltLons, but a change to nalathlon had alsotaken place ln that reglon. The results of examination of the records for the perlod1964-1985 were preaented for each of the naln vectors by provlnce ln each of the threereglone of lraq. The records nerely show the preaence of a species as adult or larvae anddo not lndlcate the level of denelty or degree of abundance. Slxteen anophellne specieswere recorded, of whtch four were consldered inportant vectors ln Iraq: !1|charov!t
vBc /90 .3MAL/90.3Page 20
superpic tus, pulqherr icus and g!* .ns i ; seven as less iEportant or suspected vectors; andt h r e e a s n o n - v e c t o r s . I n f o r m a t i o n i s s u m r o a r i z e d h e r e o n 1 y f o . g s ! g i a n d g @ ' ,the la t ter being considered anong the less i t rpor tant vectors. For the other species,i . n fo rma t i on i . s g i ven unde r 2 .5 f o r Fupe rp i c tus ,3 .5 f o r pu l che r r i uus and 4 .5 f o r s tephens i .
An. sacharovi : Reference was nade to the or ig inal d is t r ibut ion of th is species asUetngGiEE--l-Ehe escarpnent and foothl1l region to the east of a l ine extending fron
Qanichlye (Syr ia) and passing in to l raq through Mosul , Erb i l , K i rkuk, Ki f r i and Khanaqin,and ending at Kharranbad in l ran (c i t ing Macan, 1950). Af ter the d isappearance of l tsfocus f rorn Shat t -Al -Arab, the a l t i tud inal range of sacharovi renained f rorn 150 n to1200 n. The authors considered that the work of Al -T ikr i ty d id not add newer ln forroaEionon the d i s t r i bu t i on o f sacha rov l t han was ou tL lned by Macan (1950 ) and P r i ng le (1954a ) ,while rhe surveys of eUffiSLJT969) showed that the distribution of this species extendsto the west of the L ine of Macan (1.950) (see above). The tabulated records of sacharovishow that i t is s t i l1 present ln the nor thern region up to 1985, but in Sule ina;?t"
" .surveys could be carr ied out f ron 1980 onwards. In the centra l region a lso no surveyacould. be carr ied ou! in recent years; the avai lable records of prev lous aurveys show thatsacharovl rdas present ln Dyala ln 1973 and in Babylon in 1980. Dur ing the ear ly years ofnafa i fa contro l by DDT house spraying, sacharovl nas most af fected because of i tsendophl lyr . but as house spraying cont lnued, i t s !ar ted to exhib i t par t ia l exophi ly .
An. nacul lpennls s .e, : This specles was recorded f ron the h ighest mounta ins ln thenorth of I raq, nanely f roru Zakho, Amadia, Rowanduz and PenJwin (c i t ing Macan, 1950). Af ter1964, Lt was a lso encountered in these local i t les but la ter the surveys I rere in terruPted.Zakho, (where th is speclee nas recorded), ls s t l l l a focus of nalar la defy lng a l l e f for tsof contro l . Many v is lEs could be nade to Zakho ln recent year6, where malar ia s t l1 lex i .s ts , but cur iously enough no nosqui tos could be found.
On vector res is tance to lnsect ic ldes in I raq, Iyengar (1977a) in h ls accouont on th issubject , incorporated ln fonoat lon on sacharovl . As roent ioned above, at tack Deasures by DDThouse spraylng for nalarla eradlcatfoi-f iff iTarted ln 1957. These measures neredlscont lnued in the Centra l and Northern reglons ln 1963 for two d l f ferent reasons. In theCentrbl region there nas an apparent lnterruptlon of nalarla transuisslon, but two yearolater, this reglon had to be again put under DDT coverage. In the Northern reglontd is turbed pol le lca l condl t lons necessi tated the d lsrupt lon of the spraylng operat ions.Thl -s region renalned wt thout at tack measures unt l l 1970, and star t lng f ron 1973 the regionremalned wLthout spraying for tno year6 due' to problens of accessib i l l ty . When thespraylng operatlons were reLnstltuted ln 1975, the spraylng coverage was not more than60"1. The nain reasons were the rugged countryslde and scattered vll lagesr rnany of whichwere inaccessib le dur ing par t of the year , coupled wi th constant replaster ing of wal ls andrecondltloning of roofs of houses after spraylng. Susceptibil l ty testing of gg!!!1]f1 wasstar ted 1n 1970 in three provlnces in the Northern reglon. In Sule inaniya provlncer-adul tsof sacharovi collected fron unsprayed structures l-n two localit les showed 90.72-96.77"rorEii. iff ih-en tested wlth 42 DDT for four hours. In Erbtl provlnce, nearly siollarresults were obtained using the same concentratlon and exposure perlod with batchee of
sacharovl collected fron unsprayed houses ln two localit ies. Even when sacharovl was
|fr;cted fron outdoor resting shelters ln another locallty, the nortallty on the sane
concentratlon and exposure tlne did not exceed 77.72. Slnilar results were obtai.ned whenfurther tests were carrled out in Naynawah and Suleinanlya provlnces ln Septenber 1975.
Thus, the presence of DDT reslstance ln sacharovl ln the Northern region iras conclusivelyestabl lshed. However, Lt was d l f f lcu l t to determlne to what extent th ls reais tancecontributed to the persistence of nalarla transmission ln the Northern region, ln vlew of
Che exlstence of intervening factors affecting the spraylng coverage as noted above.
Observatlons carrled out in two localit ies sltuated ln Naynawah and Suleinaniya provinces
respectively showed that whlle falrly hlgh denaltl.es of sacharovi ltere recorded 1n huts
where recondltionLng of roofs or replastering of walls had taken place, subsequent DDT
vBc/90.3UAL/90.3Page 2I
spraylng reduced the densl t ies of th is vector to near zero. Sln l lar resul ts were obta lnedln huts used as apiar les ln cer ta ln d ls t r lc ts of Sule lnanlya provlnce. These aplar ies wereconstructed on the same pattern aa the lnhabtted rooms, having nud wa1ls and thatchedroofs. As the lnhabl tants refused to spray these apar les, they reualned a good source forcollectlon of J.arge numbers of g@1. A trlal was carried out ln these huts 1n onedist r lc t . whereby DDT spraylng was carefu l ly appl led whlch resul ted ln a dranat lc drop lnsacharovi densl ty . I t was, therefore, fe l t that ev idence of DDT res is tance aa der lved f ronthJWttO standard suscept ib i l i ty test a lone should not be suf f lc lent to warrant the changeof the lnsect ic ide unless supported by ev ldence of operat lonal fa i lure der lved f ron f ie ldobservat lons.
Fur ther , Manouchehr i e t aL. ( i980) repor ted that the use of DDT ln I raq has beenbanned by the Governnent whether for nalaria control or for agrlcultural pest control. Itwas p lanned to subst i tu te roalath ion as a res ldual insect lc ide for nalar ia eradicat loncoromencing ln August 1978. To detern lne the status of res ls tance of malar la vectora tolnsect ic ldes, as wel l as to establ lsh baee- l lne data for the suscept lb l l l ty of sacharovland Bfslg:Ilnus, a serles of tests was carried out durlng March-May 1978 ln the Southern,CentEGi?-ii6Ehern reglons of Iraq [written Iran due to typographlcal error]. Teste wlth4Z DDT for 4 hours carrled out ln May (1978) on sacharovi ln Sulelnanlya provlnce gave 727nortality, thus confiroing the flndinge of Iyengar (L977a). Froro tests tt lth Dalathion lnthe sane provlnce, the value of LTo. was determlned as 3l uln. Although dlfferentorganophosphorus lnsectlcldes (0P)'lncluding nalathlon were being used ln agrlcultural pest
control, sacharovl showed nornal susceptlbll l ty to nalathl.on. It wa8 declded to applynalathlon-touse spraylng ln the Northern reglon connenclng August 1978.
Results of tests'carrled out by the eaoe author on lgfg@!ry and 9,1!9!99! areshown belos under 3.12 and 4.12 respect lve ly .
In Iran, useful lnfornatlon has been provlded by Hotabar, Tablbzadeh & Manouchehrl(1975) ln thel r ar t lc le on the h ls tory of oalar la and l te contro l . I t ls re levant to g ive
a brief account of the geographical reglons of the country as thls would serve agorlentation to vector distrlbutlon and related etudles. Iran can be roughly dlvlded lntothree dlstlnct topographlcal zones: one third belng nountal.nous' one ls a plaln and therenalnlng Ls a desert. There are tno mountaln ranges: the Alborz whlch runs acroas the
country froro northwest to ea6t, and the Zagroe whlch extends fron the northwest toeoutheast. These mountaln ranges divlde the country lnto three aeParate reglons with thefollowtng featurea:
- The Caeplan Sea llttoral: Thls reglon conprleea the northern elopes of Alborzmountalne and the Casplan platn. It ls a narrow etrlp of foreeted land with aMedlterranean type of clinate. Water ls abun{ant whlgh nakea the area green throughout the
year. The rnean tenperature ranges between l0o and 35o C, and the average relatlveirunidlty (Rlt) rangea betneen 702 and 1002. Rlvers rlee fron the Alborz lrountalns and these
are flooded durlng sprlng and autumn. Thie together wlth hlgh ralnfall provlde auple
breedlng p laces for anophel lnes, 1n addi tLon to r lce f le lds.
- The Central Plateau: Thts plateau which ls sltuated between the Alborz and che
Zagros mountaln rangea, le very nountalnous ln the northeast where the ranges orl 'glnatet
and ls a de8ert ln the east, The cllnate ie dry: range of nean teEPerature 15
Oo-40o C, and average RH ls 352-657. There le a great dlfference between gun'ner and
wl.nter, the foruer belug very hot and dry and the latter cold and snow-bound. There are a
few rLvere whlch orlgl.nate fron the southern elopee of the Alborz Dountalns. These
t,ogether with sprlng- and other underground nater coursesr provlde nater for lrrlgation and
drinklng. The tenperature of the water varles greatly, and ln winter standlng water
f reeze s.
- The Perslan Gulf and the Khuzestan plaln: A11 of the reglon to the south of the
foothll ls of Zagtoe mountaln range has a troplcal cLlnate: range of mean tenPerature l '6
l2o-50o C, and ih" "rr"..ge
RII le 4OZ-802, the hlgher Rlt prevalls ln the coastal plaln.
vBc /90 .3MAL/90.3Page 22
The authors fur ther tabulated the aval lable ln fornat lon on the d is t r lbut ion and
aspects of the b iononics of roalar ia vectors ln l ran ' Wi th. regard tornenbers of the
An. nacul lpennls complex, ln fornat ion g lven is reproduced in Table l - '
Table I . Character is t lcs of nenbers of the An. macul ipennis complex in l r 'an '
Dlst r lbut ion( s e e a l s o F i g . 1 3 )
Seasonal d ls t r ibut lon- naxlmum densltY
- h lbernat lon
Range of f l lght (k^n)
Feeding hours
. Hunan blood index (Z)
Age ln daYs-No ofgonotroPhic cycles
Sporozol te rate (Z)
Insect lc ide res is tance :DDT
dle ldr in
Degree of oalarla6rabl l l ty
l. This and further data onM. Motabar and TroPleal Ge
@ s ' s '
Casp ian l i t t o ra l ;nor th & south s loPesof Alborz mounta ins lnor thrnor theast &northwest of .centra lp lateau; & s loPes ofwestern Zagtosmountains.
June-Oct .
Oc t . -Ap r .
r - 1 .5
After sunset
9 . 8 - 2 r . 0
18 days-6
0 . 3 3
Reslstant
Suscept ib le
Lese than 0 .5 ,unstable
shown below are
sacharovi
No r th rwes t and cen t reo f cen t ra l P la teau l& to sone extenta long the southernfooth l l ls of Zagtosmountains.
Aug . -Sep t .
Oct . -Apr .
r .5
After sunset
4 . 2 - 3 0 . 6
?
L-2
Resls tant
Suscept ib le
ltost areasunstable
Z u l u e t a e t a l . ( 1 9 5 7 ) r e P o r t e d o n s e a s o n a l v a r l a t l o n s l n t h e s u s c e p t i b i l l t y o fAn. rnacullpennis s.1. ln lran. They noted that Ansarl, Baghdlantz & Sanini (unpubllshed- +EFolEtff iff i larla Insrirure, Teheran, 1956) drew attentlon to the possibll i ty of an
lncrease of tolerance to DDT ln nacullPennls during october with the onset of hlbernatlon
1 n t h e I s f a h a n a r e a , b u t s 1 n c e ' ' 6 f f i c a r r 1 e d o u t 1 n t h i s a r e a 1 n t h e 6 u [ l D e r 'adequate cooparlsoo was dlff icult. Opportunlty wae,offered for rnaklng euch a comparlson in
Iefahan town, where an LC.., of 1.8 was-record.d ott 22 and 25 Septenber 1956 with feroales
o f g @ ' " . i . _ " o i r 3 8 t . a r . o ' t h e A r n e n i a n d 1 s t r i c t o f J u 1 f a , a n d o f 2 . 3 w 1 t h s a m p 1 e sobtained fron a capture statlon near the river where a certain nunber of females were
already developlng fat body. On 15 and 16 October, tests showed an tC.^ of 6'0 ln the
capture statlon of tt" Arnlnlan dlstrict, where "ot"
i"t.f"" "trrr
suo*8a fresh bIood, and
.i 'r.cro of 6.7 1n the capture statlon near the rlver, where all the females
reproduced by perro iss lon of Prof '
I & II ln the PaPer of l lotabar,other vectoraraphlcal l ledl
Tablbzadeh & llanoucne froo Tables
vBc /90 .3MAL/90.3Page 23
were developlng fat body. The d l f ferences between the beptenber and October resul ts whlchare stat ls t tca l ly s lgnl f lcant , shovr c lear ly to nhat extent the beglnning of h lbernat lon nayal ter the suscept ib l l l ty level of an anophel lne specles. Tests l rere repeated at Lot le i l , avll lage ln the unsprayed area in the Casplan region near Resht town, where an averageLC., . . ' o f 0.9 was recorded in nacul jpennls s .1. on 31 July and 5 August 1956. Later , testsweiE nade oa 22 October ln the saroe v i l lage, and an LC.r . , o f 16.4 was recorded. Here thedl f ference between the summer resul ts and those obta lndd ln October when h lbernatLon hadstar ted and. near ly a l l fenales had fat body, nas even wlder , and th ls was thought to beprobably due to the fact that nore tine had elapeed between the thto observations than lnthe caee of Isfahan. The authors further eaphasized that the variation ln temperatureunder which the tests were carr ied out naa comparat ive ly snal l , hence i t could hard lyexpla ln the great d i f ference observed ln the resul ts , which was probably caused byhlbernatlon. One such change ls fhe developnent of fat body - a process which may have adl rect bear lng on the lncrease of lnsect lc ide to lerance ln h lbernat lng nosqul tos. In v lewof the d l f ferences ln suscept lb l l l ty observed ln nacul ipennis s . l . ln I ran over a per lod ofonly three months, care should be exerc ised when lnterpret lng the resul ts of test6 nade atdlfferent t lnes of the year even when they are carrled out on the same speclee of mosqultosand in the sane locallty. On the ldentlty of nacullpennls conplex ln lran, the authorspolnted out that ln the Lotletl area of ttre Casplan ieglon both lqacullpennis s.s. (-t y p 1 g u e ) a n d @ w e r e P r e s e n t ' t h e f o r n e r b e 1 n g t h e p r e d o n l n a n t s p e c 1 e s . At h 1 r d f o r n o f t h " @ ' c o D P l e x w 1 t h n 1 x e d c h a r a c t e r s o f . ! I E g u 8 a n d g g ! g ! . g ! g g g w a saleo present ln the area. In Isfahan, typlcue appeared to be the predonlnant speclee butanother forn was a leo preeent , and accordlng to Prof . Raf faele (c l t lng personalconmunlcatlon, 1956), to whon the materlal was sent for examlnation, thls second formshould be consldered uesseae. However, lt 16 unllkely that there w111 be narkeddlfferences 1n suscepEl6ff-lty between the above naoed nenbers of the nalglflsg$ conplex.on the contrary, all the lnformatlon avallable lndlcates that in unsp@l-lGFthevarious specles of the nacullpennls complex have very slnllar LCsn-. when tested underthe eane condt t lons. [Accordlng to the maps of Stegniy (1982)r iEs5eae does not extend l tsdistributlon to the south of the Casplan Sea - eee Flgs. 3a & b ln SECTION II of thedocument VBC/90.1 - MAL/90. f1.
ManouchehrL, ZatnI & Motaghl (f976) gave the hletory of nalarla and lts control innorthern Iran, where nacullpennls s.e. and nalarlonetrlc surveye carrled out in l92I showeda spleen rate of 57.42 and a parasi te rate of 19.22. Af ter the appl lcat lon of DDT housespraylng ln a p l lo t pro ject , malar la contro l was extended ln 1950 and converted to nalar laeradlcatlon ln 1956. After 3 years of DDT houee spraylng, a malarlometrlc survey conductedln a nunber of vll lagee ln Gllan and Mazandaran provlnces showed a 9LZ reductlon ln thelnfect ion rates. By 1956, the area was f reed f rom nalar la and lnsect lc ide spraylng waswlthdrawn ln that year. In 1965, the area eras resprayed wlth DDT, but after 1968 no noretreatnents were made. The reeurgence of nalarla ln some of the consolldatlon phase areaapronpted the need for having effectlve renedlal Deaaur€s. Because antlnalaria Eeasuresdepended heavlly on resldual lnsecticLdes, 1t waa neceaaary to obtain knowledge on thesu8cept lb l l l ty level of anophel loe vectors ln the ear ly s tages of the Dalar la coi t ro lProgranDe. Dur lng the past fLve years, suscept ib l l l ty tests carr led out ln nor thern I ran:AzerbalJan, Gilan, Mazandaran and Khorasean provincee which were under the consolldatlonphaee, showed that, ln splte of the wlthdrawal of DDT spraylng, its use for agrlculturalpest control has reeulted ln the energence of DDT reslstance 1. gg$lpg@
".". However,
the DDT reslstance ln thle vector observed ln Iefahan ln 1954 had not affected the nalariaeradLcatlon prograrme ln that provlnce. The authors revlewed the results of susceptibll l tytesta carr led out on nacul lpennLs s.s . f rom l0 f lxed v l1 lages dur lng 1970'1974 ln Gi lan,Mazandar4n and Khorassan provlncee whlch had recelved 6-13 rounds of DDT spraying at a rateof 2 g/m" annually. The tests were carrled out during June-August, avolding the onset ofthe pre-hlbernatlon tol.erance ln the autunn. DDT reslstance nas indicated but the speclesremalned euscept ib le to malath ion and d ie ldr ln . In Gorgan, a cot ton p lantat lon area, DDTspraylng was w!.thdrawn eince 1968, but the appllcation of this i.nsectlclde on cottonplantatlons has led to the energence of DDT reslstance ln gggflgg$ s.s. Tests carrledout ln 1963 showed that an hour expoaure to 4% DDT kll led 942 of fenales of thls species,whereas the same exposure in 1974 k lL led only 35.57" of the nosqui tos tested.
Eehghy, ZaLnt & Yazdanpanah (1980) pursued the susceptlbll i ty testlng of nacullPennlsa.s. ln nor thern I ran. Tests were carr ied out wl th 42 DDT for an hour ln d i f ferent
vBc/90.3MAL/90.3Page 24
local i t les in Azerbal jan province and other areas of the Caspian l i t tora l dur lng July
L977. Review of the resul ts of suscept ib l l l ty tests carr ied out s ince 1970 conf i rned the
presence of DDT res is tance ln th is specles which reoalned suscept lb le to nalath lon and
d ie ld r i n .
I lanouchehr i e t a l . (L974) rev iewed the response of gacharovl to res idual house
spraylng and the resulEs of suscept ib i l t ty test6 carr ied out on th is vector s lnce 1957 up
to June 1973. ao.-"gS!" .o" i is par t ly scat tered throughout Azerbal jan, the centra l area,
the lrest and sofl i i ff i iTFars province. It ls found also in the northwest of Kermanshah
provlnce, but not ln Khorassan, Baluchestan and the Casplan Sea area. The resul ts ldere
shown for the fo l lowlng areaa:
(a) Izeh, nor thern Khuzestar i , southwest of I ran: DDT house sprayed at 2 g/az vae
star ted ln 1953 against s tephensi and sachargvl . Thls appl icat lon decreased the densl ty of
sacharovi to almoir zeroliFETFadultF-of Thls species were collected ln very sna1l
f f i n 1 } f r o n e a r t h e n w a r e P o t s u s e d f o r w h e a t ' s t o r a g e . B y l 9 5 7 , s t e p t r e n 9 1 , t h e m a l nvector became res is tant to DDT and th is lnsect ic ide l tas replaced wi th d le ldr ln in 1958. By
1960, s tephelqqi became res ls tant to d le ldr in , and DDT spraylng l tas re inst i tu ted. In 1967'
due to-Effi?llEarance of double resistance to DDT and dieldrin ln 9!9j!1].!!1'_the_area was
put under.DDi and malath ion epraylng ( twice a year wl th each lnsect lc lde) . In 1969'
iacharovl 6tar ted to reappear in houses and the suscept ib i l l ty te6ts carr led out l t l th DDT
showed that the LC.^ value steadl ly lncreased f ron l . IZ ln 1969 to 47 In L973. An hour
exposure to 47. ODTTYn 1973 gave about 532 nortallty and 2 hours exPosure produced 902
no r ta l i t y . ,
(b) Moshkln-Shahr, northwestern lran: The area was put under DDT spraylng (2 g/n-
once'a year) for 10- l l years. In 1970, g!gg1 was found to be h lghly res ls tant to DDT;
wirh I ,- 2 and 4 hours expoaure to 47. DDT;ffi-o;EA11ty was observed. The mean denslty of
sacharovi was 36/rooro. Sin l lar resul ts were obta ined In 1971 and 1973; the roean densl ty of
Effiii fron hunan and anlnal roons was l0-26/room.
J") Kazeroun area, south of l ran: Thls area l tas sprayed wl th DDT for f ive years. In
1959r 'one hour exposure to 47" DDT gave only 35.42 nor ta l l ty . The area l tas sPrayed wl th
dle ldr ln twice a year dur ing 1960-196f , and f ron 1967 to 1973 oalath lon spraying was
appl ied a lso because of double res ls tance to DDT and d le ldr ln ln s teP-hensi . Af ter d le ldr ln
appl lcat lon, @l d lsappeared and hae not reappeared s lnce then. In thel r
ctncluslons, f iff iors recoonended that.speedy measures should be undertaken to elininate
the other focl of DDT-reslstant g$g! so far dlscovered to l lnit the spread of this
reslstance, and to pursue systeniEffi-king of the Euscepttbll l ty level of g$g1 tn
other area6 of l ts d ls t r lbut lon in l ran.
2. An. superpic tus and An. f1uviat l l ls
2.1 Vector importance
An. superpictus ard Elf,t* ' i .!41" are widely distrlbuted [see Flge. 4 and ]r e s p e @ f I o N I 1 r e G a f f i E E / 9 o . | - M A L / 9 0 . r ] . A t t e n t i o n l s f o c u s e d h e r e o nareas where one or two specieg have been regarded as vectors or susPected vectore ' I t
should be noted that f luvtat l l is extende i ts d is t r ibut ign as far as nor thern Yjnen In
sourhwesr Arabia, wtteffi j i l lTeported by Maffl (1971)' and Kouznetsov (L976)- ' In
fact, the nap qf.Flg. 7 should be corrected to show the Presence of thls species ln
nor thern Y"retz 'J . - I t
hae been euggested that the possib le ro le of f luv l+! l : !g ln-
malarla transnlssion in southern and northern Yenen should be lnvestlgated- ' rn the
geographlcal area under review, suPerPictus is an actlve vector 1n northern Iraq
Tffi? ln6Fe-aE?ails, eee PART I, SECTION III (F) in document'VBC/85.3-UAP/85'3'pp. 214'220.2. The or lg lnal oap for f luv lat l l ts d ls t r lbut lon f rom whlch th ls f tgure l tas reproduced
should also be correctedEfi-oG6;t mtO/VBC/89.967, Map No. 4e' p' 19'
3. The error was polnted out by Dr Marlo l laff l, forroer I{IIO Malarlologlst (personal
cormunlcat lon, Ju ly-August , 1990).
vBc/ 90 . 3r'rAl,/go.3Page 25
assoclat ing rnacul lpennis s .s . and/or g le lov i ln cer ta ln areas (see under I above). ' I t
lswidely d is t r ibuted in l ran, except ln the area of the Caspian Sea ln the nor th and thecoasta l area of the Pers lan Gul f ln the south (see Fig. 3) . An. superpic tus Is animportant malar ia vector in the Centra l P lateau of l ran. An. f luv iat i l is ls a lso wl-delydtstrlbuted ln Iran extending fron the nestern and southeri-Jl6lEAffiEros mountains upto t he bo rde r o f Ba luches tan ( see F lg .4 ) . Bo th supe rp i c tus and f l uv la t l l l s have beenresponelb le for nainta in ing nalar ia t ransmiss lon due to thei r ref ractory behavlour lnsouthern s lopes of the Zagros chain. In the Northern province of Saudi Arabia, superpic tusdlsappeared under the inpact of contro l neaaures, but reappeared later dur lngepldenlo logical invest igat ions of nalar la cases tn 1982. An f luv lat l l is l ras recorded lnthe Eastern province of Saudi Arabia, but 1t6 role in rnalaE t--"tisslon renainsunknown. In Pakistan, superpic tus has been recorded in Baluchlstan and south WazLr is tan,whi le f1uviat1116 has been found In the footh l l l reglons of the Dounta inous t ractc in theno.thr-6lff i le in nalaria transmisslon ls not clear. rt has also been recorded 1nPunJab, Pakistan, but i t does not seeD to p lay any ro le ln Dalar la t ransmlss ion.
2.2 Breedlng habl tat
S e r v 1 c e ( r 9 8 6 ) d e s c r 1 b e d t h e b r e e d 1 n g h a b 1 t a t s o f 9 . s @ ' a . d I @ .An. superplctus breeds In flowlng waters euch as torrents of shallow water over rockystreana, pools ln r lvers, nuddy h111 st reans; vegetat lon nay be present ; prefers sunl lght .An. f luv lat l l ls a lso prefers f lowlng naters, such as h111 st reans, pools ln r lver beds,l r r lgatLon d l tches; prefers sunl lght .
Ln the present geographlcal area, Macan (1950) col lected larvae of superplc tus f rornthe edges of s tony st reaaa, belng the c lass lc habi tat ln I rag and l ran, but larvae werealso abundantly present ln any breedlng place where the water Ls clean, exposed tosunllght, and moderately shallolt.
In I raq, Al -T lkr l ty (1964) recorded superplc tue Ln the nor thern reglon (Mosul , Erb l l ,Klrkuk and Sulelnaniya Llwas) and ln sorneliwas of the central region (Dlala, Baghdad,Ranadi and Kut). It wae found breedlng ln rlveraln and lrrlgated areas lncludlng sprlngs,pools, s t reans and r lce f le lds.
In Afghanistan, Ramachandra Rao (1951) while reportlng on epidenlological studies andmalarla control demonstratlon project conducted durlng 1949 ln the Laghnan district of theEastern provLnce, presented data of larval co l lect lons (4th instar larvae) f ron d l f ferenttypes of breeding placee for the maln vectors: cullclfacles and EgP .. The oostf r e q u e n t o c c u r r e n c e o f 1 a r v a e o f t h e t w o s p e c 1 e 8 , f f i ' e r s a i d _ s t r e a o s , f r o n w h 1 c h t h elargest nuober of larvae was obtalned. Rivers and streans ln the study area carry waterfor most of the year and reach thelr lowest level ln October. A11 rivers and streans haverocky beds conslstlng of a nlxture of pebbles and boulders, thus provlde ldeal breedingcondltlons fo. gllgllgtg and superpictus and to aome extent stephensl..
A lso ln Afghanlstan, Iyengar (1954) lnvest igated the ro le of anophel lne epecles lnnalaria transmisslon ln Kabul durlng June-October 1952. Seven specles of $2p]99 wererecorded fron Kabul during the investigatlon nanely: An. superpictus, $!9P@!,.An. cu l lc l fac lee, An. f luv iat l l is , Anopheles turkhudl , Anopheleq gubPigtus and AnophelesannulariE.---An.
",tt.rpi"tn" wiE Ehe oost conmon.anopheline found ln Kabul and was
IidffiGE'teali-tre-prrncrpal vector of nalaria (see under 2.l l below). rt was foundbreeding ln pools ln the bed of the Kabut river and ln seepages. The roost prollf lcbreeding occurred ln the sandy and gravelly rlver bed. Rlver pools that were well expoeedto sunlight nere preferred compared wlth those shaded by overhanging trees. The hlghaltltude of Kabul lraa not unfavourable for a hlgh prevalence of superpictus. In fact thisspecles was found breedlng extenslvely ln pools and seepages alongslde a h111 streao abovePaguon, 40 kn fron Kabul at an altitude of about 2200 n. Occaslonally, sparse breedlng was
observed in lrrigatlon channels ln Kabul, when the flow was obstructed and the water wellexposed to sunl lght . I t was not found breeding in marshes, d l tches or rseLls. There sere
no rice ftelds tn Kabul, but ln Rishkhoor vll lage outside the clty, sooe of the terracedrice flelds were breedlng s_uperpLctus in snall numbers. The breeding areaa in these rlcefields were restricted to patcEes wtrEre the paddy nas aparse and the ltater was exposed tosunshine. When the paddy was dense enough to shade the water surfacer gerpfu, breedlngdid not occur. The seasonal prevalence of anophellne breedlng was studled ln Kabul rlver
vBc /90 .3MAL/90.3Page 26
as the lnpor tant source of breedlng. Dur lng March-Apr i l , the r lver swel ls as a resul t o f
local ra infa l l and the roel t lng of snow ln the h i1 ls . Dur ing June, the water in the r iver
recedes to a narrow channel , leaving a large nunber of pools in the r iver bed. As the
summer progresses wi th the associated drought condi t lons, the r iver becones a ser ies of
d lsconnected and stagnant pools. Anophel ine breeding star ts in June and increases rapid ly
reaching the h ighest leve1 dur ing the la t ter par t of Ju ly and the f i rsE hal f o f August '
Dur ing ieptenber, the r iver pools progresslvely dry up and the breeding area becomes
considerably reduced. Dur ing July , the larval catches f rorn the r iver and i ts pools y ie lded
almost ent i ie ly superplc tus. I t seems that the per iod July and the ear ly par t of August
represents t t re pEf f i i lo f superpic tus breeding in Kabul . Subsequent ly , there is a
progresslve d in inut ion unt i l Octobaf f ien only 102 of the larval catches f rom the r iver
poor" conta ined superpic tus. on- the other hand, the inc idence of g!s l@! showed a
progressive increase reaching 8 lZ in October.
Dhir & Rahirn (1957) repor ted on ln l t ia l oalar lonetr ic /entonological invest igat ions
carr ied out in fLve provinces of Afghanlstan dur ing f950-1953, and assessed the inpact of
DDT house spraylng ln a nalar ia contro l pro ject f953-1954. Based on entomological surveys
carr ied out by these authors and the above nent loned onesr records of anophel ine sPecies
encountered were l ts ted (see under 2.5 bel .ow), and notes nere made on the breeding habi tat
and the seasonal prevalence of d i f ferent species. The Preferent ia l breeding p laces of
superpic tus were shown to be pools in the stony beds of r ivers and natura l s t reams Open to
;ff i i i?Er. Next ln importance were rLce flelds durlng all stages of growth of rice plants'
The niin lrrigatlon canals and channels rarely harboured larvae of ggferpiclgg.. Dhir-&
Rahln ( loc.c l i . ) fur ther pointed out that there was l i t t le doubt that the densl t ies of
adul t superpic tus in the predomlnant ly r ice f ie ld areas such as the centra l par t of Kunduz,
rnanaUil-at:.eyrwere roainly arlsing fron the breedtng of thls specles in rice fields' as
hardly any r lver bed pools extsted in that area. (see more in forroat lon on breeding of
"rro".oi"tl" whlch was replaced by pulcherrirnus and };S ln the Kanduz area under 3'2
be low) .
In Paklstan, Mu11lgan & Bai ly (1938) repor ted on nalar ia and i ts vectors ln Quet ta,Baluchistan. A pre l i ro lnary survey was carr ied out by the f i rs t author in May 1935' and
innediate ly af ter l ts tern lnat lon Quet ta was devastated by a severe ear thquake. The
preLirolnary survey revealed that l i tt le was known about factors influencing the spread of
nalar ia in the area. I t was a lso realLzed that l f any considerat ion were to be g iven to
the nalar la problen dur lng the reconstruct lon of Quet ta, a rnore deta i led lnvest igat ion
would be essentlal. Thus, a comprehensive survey was conducted during 25 July-9 October
1935. From larval surveys, 13 anophel lne specLes l tere recorded, only three of whlch were
incr in lnated as vectora of nalar la : gperpic tus. , cu l ic i fac ies and st9Phensi .An. superplc tus was by far the no6t prevalent and lnpor tant of the three sPecles. wi tn
iEEa?d to it" Ureeding habitat, superpictus showed narked preference for breedlng in
flowing water; lts greatest abunEnce was seen along the edges of rlvers and streams.
Althouah the water veJ.oclty at the centre of these streams was sometlnes hlgh' the current
at the edges wae relatlvely slow through the presence of dense growth of Splrogyra. Large
nunbers of larvae of ggp3I3lctus were observed when the dense masses of SpirggyTa.were
b r o k e n u P b y h a n d o r ! ' i t G [ e c t 1 n g n e t . T h 1 s t y p e o f b r e e d i n g h a b i t a t y i e 1 d e d 5 0 Z o fal l the larvae of superplc tus col lected ln Quet ta. The species was a lso found breedlng in
abundance in seepalEE-iiff ishy areas where a gentle flow of ltater occurred. In such
places, green af la f growth wa" pres" . t t , and grasses, 1f presentr etere never suf f ic ient ly
dense to produce any apprectable degree of shade. This type of breeding pLace yte lded 192
of a l l larvae of super?lc tus col lected in Quet ta. Open i r r igat l -on channels connected wi th
rlvers, wells, taiff i iFsprings were also responsible for a certain amount of
superpictus breedlng. This was partlcularly seen ln winding channels conveying spring
Gter in which the current was relatlvely slow. Larvae were found nostly ln bays and
backwaters along the edges. Grasses and algae were usually falrly abundant. This type
yle lded L47 of a l l supeip ic tus larvae col lected in Quet ta. In addi t ion to the above tyPes'
s u P e r P 1 c t u s w . " . 1 " f f i e d i n g i n r e s e r v o 1 r s , p o o 1 s , s p r 1 n g s , s u b s o i 1 l ' a t e r 1 n c r a c k s;i l f issrlres Ln the ground, and other sinllar places in which there ltas no perceptlble
current of water . The amount of vegetat ion in these breeding p laces was var lable, but ln
no case were the larvae of supslEls.]lus found breeding where there ttas a dense shade' Froro
i -s . ;pFinee by the authors, a t tkarezet t may be descr lbed as a ser ies of
shaf ts , ih" bot toms of whlch are connected by a cont lnuous unl ined tunnel .
eubsoLl nater ls co l lected and eventual ly brought to the sur face where i t
l r r igat ion. In the Mlddle East , th is ls known as t tFala j t t
perpendlcularBy th ls method,
ie used for
vBc/90.3MAL/90.3Page 27
these types of breedlng places , L47 of the total larval catch of gggglglp wererecovered. A snal l proport ion (3X) of . superplc tus larvae were col lected f rorn breedingplaces other than those shown above. The prlncipal characteristlcs of the favourablebreeding p laces of superpic tus were:
- expoeure to d i rect sunl tght ;- f lowing water , par t lcu lar ly that wl th gent le percept lb le currenE;- abundance of aquat lc vegetat lon, par t icu lar ly that of the a lgal type.
An. superpletus was found breeding ln nost types of breedlng p laces Ln assoclat ionwl th other species of anophel lnes. The larvae of superpic tug are easl ly d ls turbed, and uayremaln subnerged for 15 mlnutes or more. I f th is character is t ic is not fu l ly recognized,the presence of the larvae of this species nay easily be overlooked. In narshy areas lnr iver beds, par t lcu lar ly Ln those ln which the water Ls very shal low, the presence ofsuperpic tus larvae nay be very d i f f icu l t to detect . This can be overcome by l i f t lng stonesand allowlng the nater, which becones nuddy, to collect ln snall pools. At the edges ofrlver beds the collection of larvae can be greatly facll l tated by breaking the dense Daasesof Splrogyra whlch ls usually abundant in such places. No reeent tnforrnation could betraced on the breedlng habltat of gggerplgtus ln Paklstan.
An. f luvlatl l ls was recorded fron the northern and central regions of Iraq where itwas r6lZfrid-iff ispected vector. It was found breeding ln etreaxos, sprlngs and pools off resh or sa l lne nater (Al -T lkr i ty , 1964).
In I ran, Eshghy et a l . ( f976) who wrote an account of the b lononlcs of f luvtat t l isdescr lbed l ts breedlng habl tat as belng f reeh, s low f lowlng or s tagnant r rater , vast
'marshes, rlver banke, plts ln rocky or sandy river beds as well as raln plts.
In Pakistan, Uul l lgan & Bai ly ( f935) ind icated that f luv lat l l is na6 exl remely rare lnQuetta; all l te larvae were collected fron lrrigatlon chaii lff i 'TifFing fron either artesianwel1s or karezes.
No other lnfornatlon could be traced on the breedlng habltat "f lfg-lati l l" in other
areaa of l ts d ls t r ibut lon in Pakistan. In a recent s tudy ln PunJab, Paklstan, Relsen &Ml lby (1986) descr lbed f luv iat l l ls and cul lc l fac les as ln to lerant to organlc pol lu t lon (seeunder 4.5 below).
2.3 Swarnlng and natlng
No lnfornatlon could be traced on swarnlng and natlng of .9ggg!gg, andunder fteld condltlons ln the present geographlcal area.
f l uv ia t i l l s
2 .4 D l spe rsa l
Llnlted observatlona are avallable from a few countrles in the present geographlcalarea. In Afghanlatan, Iyengar (f954) working ln Kabul area consldered ggperplctus a strongf l ler , sLnce l ts adul ts were col lected f rorn v l l lages about 2.5 ko f roo the nearest breedlngplace. In Paklstan, Mul l lgan & Bal ly (1938) found no ev idence that superpic tus d ispersesfor long dlstances in quetta, although no fl lght experlnents nere carried out. In groupsof vll lages, large numbers of superplctus adults were collected fron houees (19-422 werenales). ExtensLve breeding places fron whlch larvae of thls specles lrere repeatedlycollected, surrouonded theee vll lages wlthln 400-800 n. The fact that a hlgh percentage ofrqales was present provides some support to the bellef that ggpgps was dispersing forshort dlstances. On the other hand, Lt was observed that where no suitable breedlng placesfor quperplctus nere avallable wlthln a radlue of about 800 n, or where euch breedingplaces were under contro l measures, adul ts of th is specles nere very scarce. A goodexample was ehonn by the adult catches of superplctue made ln the Clvll Llnes area whichwas under careful control durlng the greater part of the ualaria season, and adultoosquLtoe were so scarce that regular catches were d lscont inued. Ar . ry"rp l " t * . as wel las other anopheline species were consplcuously absent. Sinllar oUffi i6ns G made lnother Parts of Quetta. Whlle these observatLons do not dlsprove that superpictus roay becapable of dlsperslng over long distances, they seen to lndlcate that under the conditlonsprevall lng ln Quetta durlng the nalaria season, thls specles showed no tendency to disperseto dlstances nuch exceedlng 800 o. The authors further lndlcated that thls question was of
vBc /90 .3MAL/90.3Page 28
part icu lar in terest wi th regard to the cholce of heal thy s l tes for the reconstruct lon and
expansion of Quet ta. The quest lon probably nuch depends, however, on lhe presence of
sui table sources o i tooa . r rd "h" l t " .
to t th is species between the breeding p laces and the
area to be protected. I t should a lso be borne ln n ind tbat in years which Prove
except ional ly favourable for breeding and longevi ty of suPqrpigtE, adul ts of th ls species
night in f i l t ra te fur ther in to inhabi ied areas and caueef f i ;E ions of malar ia ' The
authors thought that under such c i rcumstances the use of insect ic idal sPrays rn ight g ive
considerable benef i t , but caut ioned that th is measure would not have any ef fect on adul ts
of superpic tus rest ing in outdoor shel ters
In I ran, Eshghy et a l . (1976) indicated that no specia l exper lmenta l s tudies were made
to detern lne the i . rg" of f l ight of f luv lat : !1 : !q, but f ieJ 'd observat lons indicated that the
range was between 50d and 1000 n, ioh&ffiE: places occurred within a distance of i '5 kn
f rom she l t e r s .
2 .5 Loca l sPa t i a l and seasona l d i s t r l bu t i on
Br lef or ientat ion to the d ls t r ibut lon of superPictus and f luv iat i l is in countr ies of
t h e P r e s e n t g e o g r a P h i c a 1 a r e a h a s b e e n g i v e n a E f f i n a e r f f i ? d r t 1 o n a 1 1 n f o r n a t i o nis g iven here.
In lraq, Pringle (1954a) showed that superplctu-s ls wldely distrlbuted and comnon in
sumrner in riverain and lrrigated districtsfrff i-6fJebel Hanrln l l lanrln hi11s - see
f lg.2(a)1. Lt was found to Ue the predonir r . r r t ,anophel lne species throughout the nor th of
I raq, except at h ighest e levat ions. I t appeared sporadical ly ln the a l luv ia l p la ln of
Dyala, and in ffgris riveraln lands as far- as Baghdad' Its alt itudinal range is fron about
30 n to ar leasr 1500 ro. Wl th reg;rd to f luv lat i l iq , Pr lngle ( loc ' -c i t ' ) ind icated that i t
eras reported durlng cool weat.her from fnaiZ!'G a-na ftralis ln Dya1a Liwa, and more
conslstently fron Stri.ttrattra oasls ln the Syifan desert west of Kerbala' The known
al t i tud inal range is f ron about 30 u to 20b n. Al -T lkr i t i (1964) gave near ly the same
disrr ibur ion of superpic tus and f lgv iat i l ig ln I raq but wl th less deta l ls ' Abul-Hab (1969)
g a v e d e t a i 1 s o f t T e _ a i f f i b u t i o n - @ 9 . ' s _ : : : : " 1 . . " d w i t h n a c u 1 i o e n n i s s . s . a n ds a c h a r o v 1 1 n N a y n a w a h a n d D h o o k p r o v 6 E - i n E r t h e r n I r a q , a n d @6c-EGiEl-a1one ln the stePPe zone uP to the border with Syrla (see under I above)'
Abrrl"-Itab & Al-Kassal (1986) wtro trted !o assess the lnpact of resl-dual house spraylng on
Anopheles spp. recorded in f raq f .o i 1964 orr" ,ards (see under I above) ' ind lcated that i ts
a l t l tud inal range remains at 30 t - isoo t . I t s t l l l ex is ts ln the Northern reglon af ter
about 30 years of house spraying. This nay be due to the fact that thls species proved to
be endophl l ic /exopht l lc [see Abul-Hab, tSOb O 1961 under I above] ' Af ter 1964' superplc tus
was found spreading ln some other provlnces ln central Iraq as far south as Qadisylah' but
it ls nore abundant ln the northe.l-p".t of Iraq' It ls "iftf
found in Basrah area where
Macan (1950) found i t . I t iE a lso s i i l l found in Mlesan in Aoara L iwa in the southern
r e g l o n w h e r e t h e l r a g l s l o p e s o f t h e Z a g r o s t r r o u n t a l n s o C C U F o R e g a r d l n g l l g i g E l l i g ' t h "authors lndicated that pr lor to 1964, t I t rad been repor ted f ron Dany centra l prov incest
though not abundantly. After 1964, it was also ',""o',d"d fron i lajaf' wasslt ln the central
reglon and Naynawah in the Northern region' It renained rare as lt was prlor to 1964 due
to l ts wi ld babi te.
on the seasonal dlstrlbutlon, it has already been shown that Abul-Hab (1958) observed
superpictus aseocLated wrth- saqhalgv:L durlng 195-3-1954 tn Sulefunanyla Liwa' Northern
reglon, Iraq (see under t aU&6')IGter, AIul-Hab (1967) gave the results of an
lnvestlgatlon carrled out on hlbernaai"i 'of superPictus ln Suleinanlya and Klrkuk Llwas'
northern Iraq. The lnvestlgatlon covered ttri i ff i f lroro the beginning of October to April
for three consecutive years: lg53 r-tgsi ana 19-55 and followed the saoe Procedures adopted
in a study of hibernatlon of sacharovl in northern lraq (see Abul-Hab' 1956' under I
above). The adult populatlon denffof 'upgrplgtgs remalned hlgh throughout
August-Septenber, but started to-decilne au:T?lc-toUer and the last collectlon was
obta lned dur lng i t " t t t ra r "et or Novenber. v i ry few superPlg lug-adul ts were col lected at
each capture station durlng the perlod Novenber-i 'ebruafl, even when pyrethrun 6pray
coLlect lon (psc) was appl led to dr lve out mosqui tos f ron i t " t t h idtng p laces in houses '
Evidence obtained from larval coliectlons and adult dissections lndicated that superPlctus
vBc/90.3MAL/90.3Page 29
do not enter lnto hlbernatlon in October, and that hlbernatlon conmences ln Novernber. '
Energence f roro h lbernat lon seemed to take p lace 1n February, s lnce fernales d lssected dur lngthat roonth showed advanced ovarlan development and greater dependence on blood feedlng.However, during the perlod of study no larvae could be found untl l May. This could beexpla lned by the fact that a l though the specles star ts i te ov lposi t lon dur lng February orMarch, the eggs and larvae are washed away by the abundant rain causing fast f lowlng floodeln st reams and spr lngs. The h lgheet ra lnfa l l ln the study area occurs dur lngFebruary-May. The three wlnters durlng whlch the observatlons were made were not of equalsever l ty , wl th the wlnter of f953/1954 being the coldest and that of 1954/1955 theni ldest . However, the catches were too smal1 to permi t re l iab le ln ferences to be made onyear-to-year variatlon durlng Novenber-February ln each of 3 years of study. Although thetenPerature dur lng February d i f fered 1 l t t1e f rorn those recorded dur ing the precedlng threemonths, the females of superpLctus captured durlng February showed llore activlty ln bothovarlan developnent and blood feeding. Even durlng March shen the species resuued fu1lact iv i t ies, the tenperature na6 not s lgni f lcant ly h igher than those of the previous fourmonths. Thls suggests that superpic tus entera ln to h ibernat ion due to a physlo loglcalcycle triggered by cold weather, but thls cycle seem6 to end with the least luprovement.The sensltivtty to tenperature ls well denonstrated ln the Klrkuk €rr€a. The catches Lnthls area durlng 1955 presented a dlfferent plcture than that seen ln Sulelnanlya. TheKlrkuk area ls situated ln the foothll l reglon and the temperature tn thls reglon le nllderthan that of Sulelnanlya. Thls ntl.der cllDate greatly affects the wlnter activit les ofsuPerpictus. The catches fron January to Aprl1 1955 were htgher ln the Klrkuk area andblood feedlng actlvlt les nere alnost nornal. In thls area, superplctus nas aa actLvedurlng January-Aprll as durlng the eummer roonths.
In Saudi Arabla, superplctus was flrst recorded ln the oasea of Qorayat ln theNorthern provlnce near the border wlth Jordan (see flg. 9) as reported by Zahar & Dabbagh(f959) who carrled out a malaria survey ln the neatern and northern part of the countrydurlng October-Novenber 1957. 1". sup.rplc!"s wae consldered the naln vector of nalarla inthls area. It exlsted ln all tt;;;;E}E;Ls-as ar a denslty of 9.1/room, and wasassoclated wl th a snal l densl ty of eergent i l r 0 . l l / roon. Malar lonetr l .c eurveys showed thatnalaria was of 1ow endemicity ln thls area (spleen rate arong chlldren of 2-9 yearsage-grouP was 14.62 and the paraslte rate anong, the same group 2.62 and, there were twoposi t lve in fante; a l l ln fect lons were l . v lvax) . I t was assuned that appl lcat ion of o11larvicldlng 1n breedlng places 2-3 years prlor to the survey nay have led to reductlon 1nnalarla transmlssion. In Al-Jouf, ln the Northern provlnce of Saudl ArabLa, Afif l (f959)also recorded euperpictus and considered lt a maln vector. Frorn the Report of the UalarlaControl Servlce (1983), euperpl.ctue dleappeared fron the Northern provlnce under the lnpactof larvlctdal. neasures lnlt lally using DDT ln dlesel oll and Parls green and later tenephosdurlng the 1960-s. Halarla also dlsappeared fron the Br€a. Lt was not untlL August 1982that g.11gpl$ was found Ln Douroat Al-Jandal oasls of the Al-Jouf area durlng anepldenlologlcal lnvestlgatlon of a relapslng ca6e of 3. vlval, wLthout any slgn ofreeuuptLon of nalaria transmlsslon. Mults of ggp.glggg and g9lg9ggll were found in hlghdeneLtl.es restlng ln two abandoned and rulned uud houses. Accordlng to the Report of thellalarla Control Service (1984) larviclding nas lntenslfled and constructlon of a largedralnage BysteD ln the Doumat Al-Jandal area rra6 coopleted in 1983. A11 oalarla caaes rrerethoroughly lnvestlgated wl.thout f lndlng any slgn of reeurgence of oalarla lnto the area.
In the Eastern provlnce of Saudl Arabia, Daggy (f959) showed th.t: jg$ggl which lswldespread along the Persian Gulf le the nost lnportant vector. An. f luvi 'atl1ls was theeecond nost predoninant epecLes ln the Eastern provlnce and probaElfrFli l ff iportance a6a secondary vector, although no exact lnfornation on 1ts role 1n nalarla transroisslon wasaval lable. In h ls rev iew, Zahar (1974) lndlcated that f luv iat i l ls has not beenlncrininated as a vector of malaria in the Eastern pro.rlff i ff idi Arabla.
vBc/90.3MAL/90.3Page 30
In uAE and onan, f luv lat l l is was occasLonal ly found in some hi l1y areas ' but i t does
not seen to p lay any ro le in nalar ia t ransmiss ion ln the two countr les where cul ic lFacles
and g]!g$l are the recognized vectors'
A s s h o w n u n d e r 2 . l f l u v i a t i l i s d i s t r i b u t i o n e x l e n d s w e s t w a r d l y t o s o u t h e r n a r i dnorthern Yeoen, and so f; lff i ;G in malaria transoission remains unknown'
In l ran, the d is t r ibut ion of -ggts. .p1"ru" ln 1967 was roapped as shown in F ig ' 31 '
Eshghy, Janbakhsh i-ol". i.gtr (l9776p;1;;a that grperpictus ls widelv distributed in
Iran except ln the ".""
oi the Caspian Sea and the ff iGf t ' It is the rnal-n vector of
nalar ia ln the centra l P lateau, and an i roporEant vector in the mounta lnous areas south of
the zagros chain. Motabar, Tablbzadeh & llanouchehri (1975) showed that the season of
maximum density of sulell lctus i" j;;;-A"gust and- thai tts hibernati 'on occurs fron october
t oAp r11 .n "g " , a i , , f f i i l i " i ' ' n ' ; i a1 . (1976 )p resen ted "P "no f1 t sd i s t r i bu t i onin I ran as shown ln F lg. 4- . r t oc"r r l " "on the southern s lopes of the zagros chain ' f rorn
southnest of Kernanshah to Baluchestan in the southeastern Part of the country' It is
found ar a l t i rudes ranging f roro 50 i (sorazian and ldnab) t ;1100 ro (Sa1bi ' Kazeroun) ' r ts
seasonal actlvity and maxioun density covers two perlods on the plains: April-June and late
september-December. In footh l l l areas, the season-extends f rom the spr lng uP to the
beglnnlng of autumn. to.n ry"t01"!*'"lJ !!ry1?!:!*ls exhiblted refractory behaviour to
house spraylng ln cerrain aFaffiTran (see under 27612.7 below)'
In Afghanistan, Ramachandra Rao (1951) worklng in Laghroan, Eastern (= Mashriqi)
province recorded 13 specles .r Agqtt"4:'g"l1arl::-f*:5!E::il::*,PlE''llzgggg'naculatus, noshulegiis,.n:l!l:t"H""' S.lry' "t::":*;';"iffi1 ,"r" consldered-6uDerDictus. turkiffi;"a *'ggt"' 0f these' 9erBi99- - <:r:r-'-duil"r?ii-"r,a-+. lt, ;e;i-ffiD. eaililE or "lll"i-feFi= i:cProven vecto16 ( lstephensl nere the most abundantr constittttfttg 427 and 342 of the total nuDbers ot
anophel ines col lected , respect ive ly . Next to- these.nas ryerPicgus-const i tu t ing only l lz '
I lowever, the collections ol tosqutios ltere oade during tf,e nafi ia season' i 'e"
A u g u s t . O c t o b e r , h e n c e l ! w a s n o t P o s s i b l e t o l n d l c a t e w h e t h e r t h e s a m e r e l a t i v e p r e v a l e n c ewas the sane ln other months' nt'"i-tto"g indlvidual vil lages wide variations occurred in
the proport lon of d i f ferent "pectes.
Foi exarnple, Al lsh ing, a v i l lage s l tuated to the
north of the sprayed area' showed Eore g.gPgglg than all other species ln vll lages
occurring ro rhe souttr. In contrast, t i;fr;?[fi;;;-v1llages had more culicifacles than the
n o r t h e r n o n e s . F u r t h e r 1 n f o r n a t i o n I ' a 8 g i v e n o n t h e _ s e a I o n a t P r e v a 1 e @ a n dcul lc l fac les in re lat ton to nalar ia t ransro lss lon Ln Laghnan d is t r lc t as shown under 4 '5
below.
I n K a b u l , I y e n g a r ( 1 9 5 4 ) f o u n d t h a t 8 3 - 9 8 % o f h o u s e r e s t i n g c a l c h e s c o n s l s t e d o fs u p e r p l c t u s d u r l n g J u l y - A u g u e t . I n S e p t e o b e r , t h e p r e v a l e n c e o f g g 2 g r o i c t u s d r o p p e dsuddenly, reachlng 13.42 of the catche!. Io
"orrttai.,--*S:n"nt GffiCressively
increaeed, reachlng a hlgh level <i1.ay) in October' ff5ffi ' superPictus proved to be the
prlncipal vecror "I
rt wis the ooiy "p."res
found wlth infectedTarrff i lands ln the
i"U, t f area (see under 2 ' l l be low) '
Dhir & Rahio (1957) def lned the c l f inat lc zones of Afghanistan as fo lLows:
. D e s e r t c l l n a t e : G r l s h k a n d d e s e r t s o f B a k u a , M a r g o , K h a s h R u d a n d S e l s t a n .- stePPe cll 'Bate: Khandhar, }.[aqur, Chaman, Iterat and plains of north Afghanistan.
- Subtroplcal c l lnate: . la fafa i i i , ' f , "gt t . , , , fno" t (wl t i r cool winters and few f rosts) '
- Temperate clinate: Kabul, Kunar valley' uPPer Kunduz valley'
_ ExtreDe "rpio"
cllnate: in nountains with long severe winters.
-l. A copy of this map ltas provlded through the kind cooPeratiol 9f Yt
N' Eshghy - extracted
fron Geographlcal Pathology of l ran. Scient l f ic Publ icat ion ' School of Publ ic l tea l th &
Inst l tu te of Pubt lc I teal th Research, No' 1802' Teheran'
2. Reproduced by permlssion of Mr N. Eshghy and Tropical & Geograpltcal Medicine fron the
pape r o f Eshgy e t a1 . (1976 ) '
N . B . : N a n e s o f v a r l o u s l o c a l l t i e s w e r e a d d e d l n t h e t l t o r o a P s t h r o u g h t h e k l n d c o o p e r a t l - o nof Mr Eshghy (personal comrnunlcatlon, 1990)'
F lg . 3 . D l s t r l bu t i on o f An . supe rP l c tus l n I r an , 1967 '
vBc/90.3MAL/90.3Page 31
S . t . - ' \
@\
aZahedan a
@O
CASPIAJiSEA
o \lasht
o"3,Ro"q,
Ouax
aAhua?
vBc/90.3MAL/90.3Page 32
F i g . 4 . D i s t r t bu t i on o f An . f l uv ia t i l t s i n I r an , 1967 .
vBc/90.3MAL/90.3Page 33
0n the spat ia l and seasonal d ls t r ibut lon, the authors prov ided lnfornat lon onAnopheles specles encountered ln d i f ferent areas lnc ludlng superpic tus and f1uvlat1 l ls asfo l l ows :
(a) Laghnan (Eastern prov lnce) : Several specles were recorded c i t ing Ramachandra Rao(1951) (see above). These epecies were encountered dur lng l lay-October, but wl th the onsetof the cold season in November, thel r numbers becane negl ig lb le.
(b) Kunduz, Khanabad, Talqan and Kala lzal (Kataghan provlnce) , dur lng 1950-1951:four specles were recorded, vLz.: clavlger, hyrcanus, Pgfgherrlnus and SPg!g!g1i.. Thelrdensl ty s tar ted to bul1d up rapid ly f ron the f l rs t week of Ju1y, rnost ly due to lncreaeed
breedlng l-n rlce flelds. The peak denslty nas reached towards the end of August or thefirst week of Septenber. Thereafter, there lras a gradual decllne and by the end ofOctober, l t becaue extrenely d l f f lcu l t to obta ln any adul t anophel lne ln th ls area.
(c) Kabut (Kabul prov lnce) , dur lng 1952: e lght specles l rere recorded (see lyengar,1954 - under 2.2 above). The f l rs t appearance of adul t anophel lnes etas observed dur ingJune, and subeequent ly the densl ty progresstvel i lncreased, reachlng a peak dur lng thesecond hal f o f Ju ly-August . In October, l t became extrenely d i f f lcu l t to obta in adul tanophellnes ln thls 3r€4.
(d) Kandahar and Grlshk (Kandahar and Grlshk provlnces), durlng 1953: seven speclesnere recorded, viz.: cull.cifacies, hyrcanus, roultlcolor, lglcherrlnusr $98!Sltsuperpictue md gg!$!!. These specles were seen fron June to October. Ihe two prlnclpals p e . f f i ; e e u p ; F I E I G a n d ! @ w h 1 c h e x h 1 b l t e d t h e l r p e a k d e n s l t y d u r 1 n g t h elatter half of July and throughout August.
(c) Herat (Herat prov lnce) , dur lng 1954: Invest l .gat lone f ron July to Septenber wereconflned to a few places in the valley of ltarl Rud rlver (Obay and Herat). The only adultanophellne encountered was superp;lglge wlth lts peak recorded ln August. A few larvae ofclavlger were collected but no adults of th16 specles were encountered.
M o r e d e t a 1 1 s o n t h e s e a s o n a 1 d t s t r 1 b u t i o n o f s @ ' 1 n K a b u 1 a r e a t ' e r e g 1 v e n b yIyengar (1954). The nunerical prevalence of superpffi l i lEs was very high fron 16 JuJ'y
to f5 Augusr (forotng 85.2-90.02 of the totat-i i !ff ie collected). In September, theabsolute as wel l as the re lat ive prevalence of th ls species dropped suddenly (20.2-29.07 ot
the tota l co l lect lon) . In October, l t formed only L3,41 of the catches. Dur lng October,
when the breedlng lncldence of superplctus was greatly reduced, DeaaureDents of the body
and wlng lengthe of lts adults 6;t-G;;-5red out f ron larvae caught in nature, showed that
the adulte were larger than those whlch were bred out durlng July-August. It was also
observed that adult euperplctus fenales collected fron houses durtng October showed
conslderable accuruuliffiTEt body. The absence of full-gronn egge ln the ovarles of
these speciuene, whlle there was lndlcatlon of a recent bloodneal, showed that the
developnent of eggs had been suppressed, repreaentlng a caee of gonotrophlc dlssoclatlontprlor to hlbernatlon.
Cullen (draft asslgnment report to t{I lO, 1978) provlded nore recent lnformatlon on the
dlstrlburlon and behavLour of oalarla vectors ln Afghanlstan. At one tlDe' glglglE ltas
consldered the rnain vector |n Afghanlstan, wlth cullclfacles aa a secondary vector (ctting
D h t r & R a h i o , r 9 5 7 ) . B y | 9 7 2 , s i p e r p t c t u s w a s r @ o u t s 1 d e t h e h 1 g h m o u n t a 1 nvalleys, and then only when onsfrIf l i-. large scale DDT house spraylng durlng 1958-1973
obviously had a great lnpact on thls epecles whlch has renal.ned eo far susceptlble to DDT'
although DDT reslEtance na6 reported across the border ln TadJlkstan, USSR. IDDTreslstance ln gg.rplct,ts. roas i"ported later froro Afghanistan - see under 2.12 belowl.
C u l 1 e n f u r t h e r - I f f i t h a t e a r 1 y r e c o r d e o f t h e a c t u a l d 1 s t r 1 b u t 1 o n o f @ w e r erather ioprecise, and sone dobuts exlst as to rthether 1t had ever exlsted ln the lrrlgated
plains of northeast Afghanlstan lKunduz areal, slnce the terratn Ls not typical for thle
specles. During the past slx years only one adult superplctus lras collected Just outslde
Kunduz town and presuoed to be lnported. Since the wlthdrawal of large scale DDT coverage
vBc /90 .3MAL/90.3Page 34
af ter lgT3r gy jggglctus has re-establ lshed l tse l f ln the h i l ly zones, of ten in h igh
densi.t les, and trasal;aad to the plains except the lrrlgated area in the northeast' In the
p l a l n s r l t o c c u r r e d i n s r n a l l r r o t U " t " r b u t l n t h e B a l k h a r e a o f M a z a r - i - s h e r i f v e r y h i g hdensi t ies were observed in 1977. Wf i t r t t re conEinued restr lc t ions on the use of
insect lc ldes, the re-establ ishment of suPerPictus can be exPected to cont inue and th ls w111
pose a considerable threat to malar ia contro l oPerat lons '
ward (1972) who made a br ief entonological s tudy at Bel la Quchi v i l lage ' Kunduz area
dur lng July 1970, gave another .explana. lo" io t the d isappearance " t
gry ip1i ! " i - t i^ : l l : '
a f€a. I Ie lnd icated that the d isappearance of th is specles was aPParent ly due to ecological
c h a n g e s t h a t o c c u r r e d l n t h e K u n d u z v a l l e y w h l c h \ ' e r e a s s o c i a t e d w i t h t h e f l o o d i n g o ft remendous t racEa of land for cu l t lvat lng r ice ' In addi t lon ' wi th the increase ln human
and carr le populat lons, natura l . " ; ; ; ; ; ; ; o f warer whlch were prevlously the breeding
p l a c e s o f s u P e r p l c t u s r h a v e b e c o m e c o n t a m i n a t e d a n d c o u l d n o l o n g e r s u p P o r t t h e b r e e d i n g o frh is species. OnT6 other hand, o" l " i " t t i t " " : i1 ryg
lnvaded these habi tats which '
togerher wlth the rlce field envlroaiailfrzE becon;G of extensive breedlng' The
most abundant culicine species whlch were found ln thls area ltere also forms Ehat are
typlcal of polluted rural sltuatlone'
rn paklstan, infornatlon on the spatlal distrlbution of guperPjlgtus is roinirnal'
l iurl lgan & Balry (1938) polnted o,rt th.i tn the rndian suucontfrat@g1g-has not
been recorded east of r iver Indus i f i p t t f " t " t t l ' I ts aPPsrent rest rLct lon to the
northltestero "t"."
i in pakfstan] represents the eastern 1lult of this l lediterranean
specles. Hussaln (i951) lndicated itra-t- suPelJfggus was found uainly 1n Baluchlstan and
some parts of the irlbal area6 of the UoffiTffirn Frontier Provlnce (N'9I'F'P)' On the
seasonal dlstrlbutlon of "op".or"t.r",
ttre onty available lnforuation comes frorn the work of
Mull lgan & Baily (foc.cftl l iTi 'Iff i f i , f"t,r"t iatan' When the first author carried out a
p r e l i r o l n a r y s u r v e y t n M a y l g 3 5 ' a d u l t a n o p h e l l n e a l ' e r e e x t r e n e l y a c a r c e a n d e x h a u s t i v esearches lrere not pogslble ln the short t ine avallable. By 25 July- 1935 when the lntensive
survey waa starEed, superplctus rtas already Ehe oost Prevaient anophellne epecies in the
Quetta area, and witf iTffiptlon of two weeks ln August when-stePh.ensi was the nost
prevalent epecies, superplctus reralned oost predoroinait ttrrougtr6i-i l ff i trole period of the
sufvelo tts refaitG-E[Gffie over other specles nas Dost taik"d frorn the rniddle of
Septenber untl l the survey was terminated on 9 October 1935'
t l l t h r e g a r d t o f l u v l a t i l l s i n P a k l s t a n , o n l y l l r n l t e d l n f o r r n a t l o n l s a v a i l a b l e . A sm e n t 1 o n e d u n d e r i . i " . c f f i s i " c t " s w a s r e c o r d e d f r o n t h e f o o t h 1 1 1 r e g 1 o n s o f t h eEountalnou6 tracts. Its role ln malarla transmlsslon ls not clear although it ls knoltn to
be a vector ln the nelghbourlng countrles of Iran and Indta' i lalarla Las rePorted to be
hypoendenlc in the area doolnat.d';;-;; i" "p""r""
(lt ' tyana, unpubllshed rePort to WHo' 1968
- clted by Zahar, Lg74). It has also been iecorded 1n Punjab, Paklstan' and some
lnfornatlon on lts seasonal dlstrlbutlon Ln thls provlttc" ha" been obtained in the course
of s tudles on the oaln vectors (see under 4 '5 below) '
2.6 Rest ing behavlour and 2 '7 Bl t lng behaviour
In Irag, superplctue exhiblted partial exophlly ln the northern reglon (Abul-Hab'
1960 e 196r - set under I above) and itrrs behavlour enabled lt to perslst after 30 years of
h o u e e e p r a y l n g ( A b u l . H a b & A l . K a s s a l ' 1 9 8 6 - s e e u n d e r 2 . 5 a b o v e ) .
InIran,ffi*'-.:fi:lii"''*'ffffi"lT;"''i:'|",6iiji".;;'"::"T!ii:"'eprayLng, (MesglIran, partlcularly ln Kerrnanshah and Kaehai-rud, Khorassan, despite the campalgn agalnst
nalar ta, t ransmlsalon by " .o"rof" io"
p" t " f " t "a ( " " " r r " ,n ln fornat lon under 2 '9 below) ' The
s p e c l . e s w a s a I m o e t a u s e n t f f i " ; - ; ; ; i i i ; g " u , ' t P r e s e n t i n c a v e s a n d o t h e r n a t u r a 1shelters. Of fernales taken fron cales , 4.IZ shosed a posltlve reactlon for hunan blood'
Eshghy, Janbakhsh & ltottaghl (Lg77> noiea also that rnalarla transmlsslon ln the above
uentloned tero areas persisted deeplte the antlnalarla canpalgn, due to the behaviour of
vBc/90.3MAL/90.3Page 35
superplctus. Llkewlse, j! lg!g!!!g exhiblted exophll lc behaviour. Mesghall-found that ' in
lff i t, southern Iran, wffiff i i fEants nere sleeplng indoorsr 82.6Z of the feroales of
fluviatlLis caught in outslde shelters had fed on oan, lndlcating that they bite lndoors
; a , r e s t o u t d o o r s . I n B a n d a r A b b a s a r e a , o b s e r v a t i o n 6 i n d i c a t e d t h a t @ f e e d slndoors and outdoors, rest ing |n both houses and outs lde shel ters. Meehgal l Polnted out
that ln vlew of the absence of base-llne lnformatlon on the natural behavlour of
s u p e r p i c t u s a n d l @ ' i t 1 s d 1 f f 1 c u 1 t t o j u d g e w h e t h e r n a t u r a 1 e x o p h i 1 y p 1 a y e d aiole tn the pattern of behaviour encountered after epraying.
More detalled lnfornatlon on the behavlour of rygll is ln lran was provided by
E s h g h 1 e t a 1 . ( L 9 7 6 > . T h e s e a u t h o r s i n d i c a t e d t h a t @ r e 8 t 6 b o t h 1 n d o o r s a n doutdoors. I t has been col lected f rorn human dwel l ing-as wel l ae f rom cat t le sheds, where
lt was found restlng in corners and ln the lower parts of the walls. It has also been
found rest lng ln caves, cracks, holes, beneath rocks a long r lver beds, under the exposed
rools of t rees, in crev lces ln the t runks of t rees and ln ar t l f lc la l p l t shel ters. Females
of th is specles at var lous stages of b lood d lgest lon were found ln houses and stables as
wel l as 1n outs lde shel ters. I t ls recognLzed ln l ran ae endophl l lc /exophi l ic specles,
although ln sorue are86 it shows roarked exophll lc behavlour. Due to the outdoor sleeplng
hablt of the local lnhabltants ln these areas during nearly five nonths of the year'
f 1 u v 1 a t 1 l l s r e n a l n s e x o p h a g 1 c . R e g a r d 1 n g 1 t 8 b 1 t i n g c y c 1 e ' l @ 6 t a r t s f e e d 1 n gffi i€tefi after aunaet and contlnues feeding throughout the nlght, but lts roaln bit lirnoadfately after aunaet and contlnues feeding throughout the t lts roaln bit lng
actLvltles occur before nldnlght (967 ot. the epecluena were caPtured).
Manouchehrl, DJanbakhsh & Eshghy (1976) carried out special observatlone to study the
b 1 t 1 n g c y c 1 e o f . @ ' ! , @ a n d j l 3 l ! 1 n s o u t h e r n I r a n w h e r e t h e i n h a b 1 t a n t 6sleep outdoors dGingi the hot 6eason. As sFotn above, the last teto sPecles have a tendency
to rest outdoors. ltan-bait and corrbalt collectlons were made fortnlghtly for nlne months
at Ewo vLllages ln Khesht, Kazeroun at an altitude of about 900 n above sea level, and
every l0 days at trlo other vll lages Ln Manasanl, Kazeroun. These areas were under DDT and
nalathlon house spraying alternately.ln March, Uay, August and Septenber. The blting offluviatl lts on hunan balt started fron 1800 h and contlnued untl l 0400 h' wl.th nost bit lng
on nan and cow occurrlng ln the flrst half of the nlght. A11 bltlng actlvlt les ceasedafter 0400 h. The nean number of bltes/cow/nlght naa more than that of man, 7I.4 and' 29.4respectively, [stnce I cow has a much larger skln aurface area exposed for blt lng]. The
authora referred to a prevlous study at Chelow ln Bandar Abbas area (clt lng Manouchehrl eta l . , 1966) whereby the b l t tng of f luv lat l l le on nan extended f ron 1800 h to 0500 h ' butmosr of the bltes occurred durtngE-IEEEi half of the night. In Bandar Abbaa area whlchls situated along the PersLan Gulf, the dlfference ln ternperature betiteen sunset and
sunrlse ls about 2-3o C. In Shabankareh area, which ls about 60 k4 ln]'and, rhedl.fference between aunset and sunrlse temperaturee Ie rnore than l5o C, and there naa a
drop ln blt lng actlvlt les ln the second half of the nlght. Perhape the reductlon in
temperature ln that area accounts for the drop ln the bltlng. In the present studyvll lagee in Kazeroun, most of the btttng of the three specles: f luvlati l ls'.!$p!sl and
d-thal l occurred ln the f i rs t hal f o f the n ight . ( for nore deta l ls of the bt t ing cyc le of
iT6er and {@!! eee under 4.6/4.7 and 6.1 below reepect lve ly) .
In Afghanlstan, Ramachandra Rao (195f) lndicated that ln Laghnan dlstrlct superplctueand cuLlclfaclee were both taken ln very large nunbers restlng ln the daytine lnside human
awet@nEEables. As none of the people slept Lndoors during the n1ght, lt was
aseumed that these two ooequltos entered housee only for ehelter. No ntght observatlons on
the novements of nosqultos were carrled out, thue lt ls not posslble to descrlbe accurately
the degree of nlghtly turnover. However, lt has actually been observed that large nunbers
of anopheline adults entered houses ln the early nornlng. A11 dark Parts of the lnterlor
of the houses were found to be attractlve for the restlng of nosqultos. The roofr inparElcular , because of the nature of l ts constructLon, of fers the nost at t ract ive p lace for
restlng moequLtos and generally ytelds the largest number. Classification of the blood
dlgestLon stages of samplee of superplc tus ard Sgf ic i fac i "s col lected rest lng lndoors in
the early norning was oade tor 6Eaays, fron wtrlch lt was Lnferred that the degree of
outdoor restLng could not be great . Several at teDpts to col lect mosqul tos outs lde houses
ln sul table p laces fa i led. Moreover, three large ear thenl tare Pots were p laced in theproxinlty of vll lages, but they were not attractive to mosqultos as they only caught threefeoales of Ury and a few culiclnes. It was concluded that Dore work is needed to
vBc/90.3MAL/90.3Page 36
determine the proport ions of vector species rest ing outdoors, but a l l the ev idence
avai lable indicates that thei r p.opo. t io t t ls probably not h igh. In the Kabul area ' Iyengar
( f951) ind icated that - ry j l j ls rests ent i re ly indoors dur ing the dayt ine; the preferred
s i t e s w e r e w a 1 1 s a n a c f f i d a r k , i 1 1 - v e n t l 1 a t e d a n d u n f r e q u e n t e d r o o m s a n d 1 nstables. l lore recent ly , Cui len (1978) indicaEed that .9g3.erP1SS in Afghanistan remained
largely endophi l ic , despi te Dany years of DDI house spraying, though sone specinens I tere
col - lec ied . " l t i . rg outdoors in recent years, but th is is probably due to bet ter searches
wi th rnore entonological s taf f being avai lable.
In pakis tan, Mul l igan & Bai ly (1935) s tudied the d lurnal rest ing p laces of
supsrpictus in Quetta. in spite of the somewhat abnormal condltions under which the hunan
f f i " - o f Q u e t t a w a s 1 i v i n g a f t e r t h e e a r t h q u a k e ( s e e u n d e r 2 . 2 ) , a n o P h e 1 1 n e m o s q u i t o swere nuperous, wi th superpic tu i being the x lost prevalent . The lat ter f ind ing appl ied
equally to the areas-EGffi by the earthquake and to those which were l itt le. or not at
a lL af fected. Adul ts of lg lerp ic tu,s Idere col lected f ron a wlde var iety of rest lng p laces
associated wi th other speGs, pai iTcular ly cu l ic i fac ies and sFephgnsi ' In cer ta ln tyPes
of rest ing p laces, supeip ic tus was re lat ivef f f tEprevalent than ln others, a f ind lng
which could be exp1ZEiffi-sone lnstances by the proxlnity of breedlng places which were
nore favourable fo. .ggl" tp l " t * . than for other species ' In sone instances, however,
particularly in outd;ff iff iE Places such as karezes and caves' ryerPictus,."d"l:".t::"taptured in relatlvely greater nunbers than would have been expected considerlng that the
nearby breeding p laces l rere re lat iveLy nore sul table for other sPecies. 0n the wholer the
s u r v e y s h o w e d t h . t @ ' e x h i b 1 t e d a n u c h g r e a t e r t e n d e n c y t o s e 1 e c t f a v o u r a b l eo u t d o o r r e s t i n g p r a G - E f r f f i t h " ' @ o r s t e P h 9 n e t . w h 1 c h a p p e a r e d t o b e m o r edependent upon-human habltations orlff iEffing sG- tn ttre lnnedlate vlcinlty' Frora
the investlgatlon, it does not'appear that gPlgjls, would seek outdoor resting places
after "r"rg"rr""
fron pupae ln preference to-iearby hunan habitatlons for obtainlng a
bloodneal . In fact , a t fgn proport lon of the fenales of th ls species captured ln outdoor
resting places were fed, and a surprlsingly hlgh percentage of such females was found
infected wi th rnalar la parasi tes. This observat ion was consldered of pract lca l imPortance
because i t is posslb le that superplc tus resor ts to those outdoor rest lng p laces ln whlch
the tenperature and relatlveG-t' iEfrre partlcularly favourable for lts survlval' By
virtue of its abil lty to select suttaUte restlng places, S!3gp;!g!g nay be capable of
s u r v i v i n g t h e r e l a t 1 v e 1 y c o o 1 , d r y c 1 1 t o a t e o f Q u e t t a t h a n e 1 t t r e r c 9 } 1 c 1 f 3 c 1 e 9 o r r ywhich are apparent ly xoore donest ic in thei r habl ts . I t seems posslb le thst ln years ln
which the general clinatlc conditions are less favourable for roosqui.to longevLty than was
found dur ing the Per lod of the Present aurveyr superplc tus ntght reaor t to sui table
microcllnates to tn ".r"n
greater degree. This s#ffi iEtrt, therefore, be capable of
actlng as a vector ln yeais when neither Sg!!g!!gg nor 3,,1f!$! would be able to
survive long enough to be of epideniotogfiffiSlEGance. If thls turns out to be
correct, the danger of ualaria transnlsilon by glperDlcqus nlght be dependent Dore uPon the
state of its breeding places than on locaL condltlonE-of temPerature and hunldity durlng
the nalarla transmisslon seaaon.
W 1 t h r e g a r d t o I @ i n P a k 1 s t a n , t h e c 1 a s s 1 f 1 c a t 1 o n o f t h e b 1 o o d d i g e s t l o nstages ln sarnples cotlff idTiTPray caPture from houses ln the nountalnous areas'
lndicated that it ts hlghly enaopnfiic, (Akiyana, unpubllshed report to WtlO' 1968 - clted
by Zahar, Lg74>. In PunJab, l t nas found to be endophi l ic (see under 4 '5 below) '
2.8 Saropl lng of mosqui tos in f l lght
There have been llnited atterDpts to determlne the efficlency of l lght traPs in
sanpl ing nalar ia vectors ln the present geographical area. Daggy (1957) t r led the New
Jersey l ight t raps in the Eastern prov in le or 3auai Arabl 'a , and ZaIa et a1 ' (1986) tested
CDC llght traps ln the Chelow tt.. l Hormozgan provincel lran' Both trials ylelded a large
proport lon of s tePhensi and a snal ier propl r t t ln of f luv lat i l ls , as surnnar ized under 4 '8
below.
2.9 Host feeding Pat terns
In lran, Motabar, Tablbzadeh & Manouchehrl (f975) in thelr tabulated data on malaria
vectors In the country showed that the human blood lndex (HBI) of superPlgt r lg : " "9:1: :ot
4.g7 to 2L.47. but they did not show the sources of bloodoeal smears tested that gave Enese
resul ts . Sin l lar ly , Eshghy et a l .3 .42-28.67, . Addl t ional ly , the saneon b loodneal smears of f1uvlat l l lefo l l ows :
vBc/90.3UAL/90.3Page 37
(1976) gave the range of llBI of $!g!1!!g asauthors tabulated data of preclpl t ln tests carr led
col lected fron lndoor ehelters durlng 1950-1962 asout
Ilunan habltatlon---@-
26 .0 (397 tes ted )7 2 . 3 ( l l 2 t e s t e d )
Anfuoal shedsre-1 9 . 0 ( 9 5 4 t e s t e d )62 .3 (199 tes ted )
Based on these resul ts , the authors postu lated that t ransoles lon of nalar la ef fectedby thls vector could be lnterrupted by total spraylng coverage both ln space and tine. NewinfornatLon provlded by Mr N. Eshghy (personal cornnunLcatlon, 1990), showed that ln thearea where fluvlatl l ls is dlstrlbuted on the southern sLopee of the Zagtoa chaln, malariacontrol rs ! i,6,lEl-by applytng nalathlon 1n reeldual house spraying durlng L969-I977 andpropoxur dur lng f978- f990. Addl t lonal ly , larv lc ld lng operat lons us lng tenephos and/ord lesel o l l -detergent mlxture ls f requent ly appl led in th le a!€ao Moreover, larv ivorousf lsh, Gaobusla af f ln isr ls conoonly d is t r lbuted in the area for b lo loglcal contro l . MrEshghy also pointed out that along the western and Bouthnestern elopes of the Zagroa, wherefluvtatl l ls and suEIIlS are preaent, the denslty of these tlro vectors are low and;ffi;ffi- a-rastte-GffiiiFls also very low. The annual paraslte lncldence (API) recordedln the three ostans (prov l .nces) of Kernanehah, Khuzetan and Fare were 0.035,0.09 and 2.1per 1000 populatLon respect lve ly .
In Paklstan, Akiyana tn hts asslgilDent report (196q, unpublished report to wHo)showed that bloodmeal smears collected froo unsprayed mountalnoua areas gave an average HBIof 11.52, whlle sanples collected fron partlally eprayed hunan and anloal shelters ln theStnd platn gave an average IIBI of 5.42. He suggested that the populatlons of f luvlatl l lsln Pakistan Day be coropoied of two varlants: anihropophlltc ln the foothllls arr--iliffiIfcln the plains, but thls should be clarif led by further studles.
ReLsen & Borehau (1979) reported the results of an extenslve Lnvestlgatlon on hostfeedlng patterns of anophellne and cullcine ooequitoe collected frou eeveral locallt lee lnthe Lahore d ls t r lc t , PunJab provlnce, Pakistan dur lng 1976-L977. Of 95 posl t lve ly react ingbloodneal anears of f luvlatl l ls collected fron Sattokl-2 locallty, only one gave poeltlvereactlon for nan (l.Ff[;ugh nbre conrtnon 1n the hll1y reglon of the PunJab,f1uvlat.i l l6 nas rarely collected ln the Sattokl area, where lts distrlbutlon seesed llnitedEGffifconpounds lcattle shedsl near an lrrlgatlon well; 89 .57 of the posltive Enearawere bovld-posltlve.
No lnfornatlon on host feedlng patterns of g!g!g!gg ln Iraq and Afghanistan couldbe t raced.
2.10 Longevl ty
The only avallable lnforoatlon conea frorn age-gradlng studies carrled out ln Iran.As c l ted by Zahar (1974), the progress repor t of the Inst l tu te of Publ lc Heal th Reeearch,Teheran (1965) showed that by apply lng Polovodova's technlque (see Det lnova, 1962), l t wasfound that the proportlon of potentlally dangerous fenales in th" .rySglgtt" populatlon'i.e.; females havLng more than 3 dllatattons was 1.51. The saue rePort showed lhat theproportlon of potentially dangerous fenales, 1.e., those whlch conpleted nore than 3gonotrophlc cycles ln the fluvlatl l ls populatlon was 1-2.52. Further, l lotabar, Tablbzadehi lt"ton"t.hrl (1975) showeaT;ffi'"-rean age ln the superPlctus and $!g1!!!9populatl.ons was 24 atd 2t days, respectlvely, during wtrictr 8 and 7 gonotrophlc cycles wereconpleted, respect iye ly . Eshghy et a l . ( f976) work lng ln otd-November at a Deantemperature of 20.5 ' C calculated the durat lon of the sporogonic cyc le as 18 days forvlvax and 23 days for P. falcloaruu. The proportLon of potentlally dangerous femalesthe populat ion of th ls species nas calculated as 2.52.
2 . I l Na tu ra l l n fec t l on
KazerounJ l ro f t
Irag, the only lnforoatlon avallabLework of Chr ls tophers & Short t (1921.) .
on natural lnfectlon ln euPerplctue conegTwo sporozolte-pooltlve specinens ltere
P .Ln
Inthefrou
vBc /90 .3UAL/90.3Page 38
detected out of 27 superpic tus d lssected (L/16 at Zakho ln october, and 1/11 at Mosul in
D e c e u b e r 1 9 r 8 ) . n e @ , M a c a n ( 1 9 5 0 ) s h o w e d t h a t 2 8 0 s p e c i n e n s w e r edi .ssected f ron a v i l lage near Khana{ 'G-and a l l were negat ive for oocysts and sporozol tes '
Elsewhere in I raq, theie l tas no ev i ience to shon whether or not th is species p lays any Part
ln nalar ia t ransniss ion.
No newer in fornat ion could be t raced on natura l ln fect lon in e i ther superPictus or
f luv iat i l is ln l raq.
In I ran, Mesghal l (unPubl tshed observat ions, I968) recorded a sporozoi te rate of 0 '92
h gp"rp.i"tr" col-lecLed fron caves in nearby hil ls in Kermanshah area' In their review of
mal-ar la and i ts contro l ln l ran, Motabar, Tat ibzadeh-& Manouchehr i (1975) gave the range of
sporozoi te rates recorded fn ggperpi" t . r " ' " " 0 .65-4 '77" ' I t ex is ts as the nain vector ln the
Central plateau and as a s"co@lffir elsewhere. The sarne authors gave the range of
sporozoi te rates I t lE@ " l O.ZS-0.42 where l t occurs in southern I ran ' Eshghy et
a l . ( 1976 ) l i s t ed the spo rozo l t e ra tes reco rded ch rono log l ca l l y - i n -S luv ia t l l t s . co lLec ted
froro dlfferent areaa ln Iran. In Behbahanr a sPorozolte rate of IIZ was recorded in
Decernber 1957, but the number of fenales d issected was very snal1 (27) ' In Jahrom' the
sporozoi te rate was 1.47 ia October Lgsg (272 d lseected) ' In Kazeroun' a sporozol te rate
of 3.27 was recorded ln October f96O (95 d lssected) ' and ln Bandar Abbas' the sporozoi te
rate was I .7Z in Septenber-October l9d5 (404 d lssected) . No sporozol te-Posi t lve speclmens
w e r e f o u n d 1 n l f @ c o 1 1 e c t e d f r o n J 1 r o f t d u r i n g o c t o b e r , N o v e r n b e r a n d D e c e n b e r l 9 5 9and 1960 (326,-5ma-6?2 d issected, resPect ive ly) '
In Afghanistan, Ramachandra Rao (1951) work ing in the Laghnan d is t r lc t , Eastern
province found "rro"roi"trr"
and ggllclfacies naturally lnfected' The- sporozolte rate
r e c o r d e d t n s u p e f f i 8 0 . 4 @ a T ; s e c t e d ) d u i t n g A u g u s t - o c t o b e r l 9 5 9 . T h e r e f o r erhe two specles r f f ig ; ;a" i - " " -aer ln i te ly proven vectors (see resul ts of d issect ion of
cuLlc l fac ies under 4. .1I below). No sporozol te-poel t ive speci ruena l tere found in a sanple of
f f i r - i i " " i " . i r i " a l d 2 5 2 f e E a 1 e s o f s ! e p h e n s 1 d 1 s s e c t e d . F u r t h e r 1 n v e s t 1 g a t 1 o n srrere suggested toffifne the status of the..E-EG species vhlch are proven vectors in
eeveral areas of Indla. An. fLuvlatl l ls dld not occur in Laghnan ln sufflclently large
nunbers to be of rouch signlficance.
In rhe Kabul area, Iyengar (1954) d lssected 2059 fenal" : 9 f sYperplgtu i " t11: : : :1
from human dwellings and found ergtrt were posltlve for gland lnfecE6n, gtvlng a sporozolte
rate of 0.397,. The infectlon ln all the elght positlve specinens was heavy. None of the
other flve anophellne specles also colle"t"d f.ot human dwellings were posltive' Based on
the findlng of eporozolte-posltlve speciroens during July, August and septeuber, it was-
aeeumed that the aeason of actlve naiarla transmlssion in Kabul starts from the beglnnlng
of July to the end of septenber. The peak period of lntense transoission apPeared to be
fron the nlddle of July to the end of August, when the nunerlcal prevalence of auPeiPicFus
was alEo very high.
Dhlr & Rahirn (rg57) l- isted rhe resulrs of dlssegtlon: oade on supgrpic.tue rn3]1_aln8
thoee recorded by Ranachandra Rao (f951) and Iyengar (1954). As these have been shown
alove, only the results of dlesectlons made !n other provinces are given here ln Table
2 ' .
Table 2. Sporozol te rates of An. suPerplc tug recorded in
dlfferent provlnces of Afghanlstan
Province year No. d issected No. sporozol te & date sporozol te rate z
Kataghant l
Kandahar & GrishkIlerat
3 (Aug . -Oc t . )I (Sep t . )I (Ju ly)I (Sep t . )
1950l 9 5 r19531954
1787126428981238
0 . 1 70 . 0 80 . 0 3 40 . 0 8
l . Reproduced by PermlsslonMalarlology fron the paPer
of Dr V.P. Sharna, Edl tor ln Chlef ,
of Dhtr & Rahln ( f957) .Indian Journal of
vBc/90.3MAL/90.3Page 39
In Pakistan, Uul l lgan & Bai ly (1938) d iesected 1412 feuales of suPerplc tus in Quet ta,Baluchistan during the perlod 31 July-9 October 1935 and found a total infectlon rate of4.97, of whlch the proport ion found wl th gLand lnfect ion wae only I .567. . Towards the endof Septenber, the percentage of lnfected superplctus showed a very sudden and narkeddecl lne, and out of 300 speclmens d issected between 26 Septenber and 9 October, only onewas found to be ln fected (gut in fect lon only) . Dur lng th ls per iod, superpic tus began toshow certain changes whlch were lnterpreted as being preparatory to hibernatloa. Theauthors, therefore, thought iE very lnprobable that Bany Lnfections are carrled over thewlnter in h lbernat ing fenales of superplc tus.
In the rnountainoua area of Pakistan, Aklyaua (aesignnent report to WHO, 1968) foundno sporozol te-posl t lve speclnens ln 446 and 434 fenales of f luv lat l l is co l lected f ronunsprayed localit les ln the mountainoua area durlng August ir6'6=trfr-Eptenber 1967,respectlvely. Malarla endeniclty tn thls area nae low, the parasite rate ln the hunanpopulat lou was about I0Z.
2.L2 Vector reals tance to ineect lc ldee
In lraq, Iyengar (L977a) ehovred th.t gpg5glglg ln Erbll and Sulelnanlya provlncesof the Northern region proved to be htghly sueceptible to DDT accordlng to adult teets nadetn l97l and 1973. DDT house epraylng has been applled ln the Northern region slnce 1957wlth periods of lnterruptlon and lack of complete coverage.
In lran, Eahghy, Janbaksh & Mottaghl (L977) carried out adult tests durlng I97L'1974on puperpl.ctus collected fron nlne vll lages in Kermanehah, Ku5destan, Isfahan andKhorrassan which had been sprayed rlth DDT at a rate of 2 g/n- annually for 4'12 rounds,buE the appllcatlon of DDT wae dl.econtLnued elnce 1968. An. Buperplctus ltaa found to bes u s c e p t t b 1 e t o D D T , d i e l d r 1 n a n d n a 1 a t h 1 o n . E s h g h y , J a v a i f f i h r r ( 1 9 8 2 ) r e p o r t e dthe reeults of adult suecepttbll l ty tests carried out on fluviatl lte ln Chelow vll lage lnMinab area, Iran, durlng F-bruary tgZt. This area had r"Er-ff iounds of DDT houeespraylng, three rounde of dteLdrln, dnd elnce 1967 ualathLon was applled in two roundsannually (ln March and August). Conpared wlth baee-llne tests, f luviatl l ls was notsufficlently high to allow the perfornance of adult sueceptlbll l ty tests, and thls oaylndLcate lts contlnued suscepttbll l ty to nalathlon.
In Saudi Arabla, adult eueceptlbll l ty teste carrled out ln the Eastern provlncedurlng Novenber 1955-January 1958 by Peffly (f959a) ehoired that f l.uviatlf ls waa suacepttbleto DDT and dleldrln. Later, Peffly (1959b) detected dleldrln reGEiffi f luvlatl l lecollected fron dleldrln eprayed vti lages durlng December l958-February 1959,-.-EGe-speclee renalned Busceptlble to DDT.
The laet report of the I{IIO Expert Connlttee (mtO, 1986 - TRS No. 737) shons thateuperpictus ls reslstant to DDT ln Afghanlstan and the USSR, a.d !!gI!gl!!g ls reslstantto DDT ln Pakletan. No eueceptlbll l ty test reporte lnvolvlng ggpglglgg. and f1uviatl1lsnere connnunlcated to IfI lO durlng 1984-1988 fron the geographical. area under revlew, exceptaoue tests wtth fluvtatl l. ls Ln Jalalabad, Afghanlstan, carrled out during 1986-1987 whlchlndlcated ttrat tEFffiG le eusceptlble to nalathion and DDT.
3. An. pulcherrfunus and the An. hyrcanus groupl
3.1 Vector inpor tance
The dletrlbutlon of glg@Iggg has been given ln SECTION II, Ftg. 8 (docunentVBC/90.1 - 1.{AL/90.1). The d:tsEr:t5utton and taxonon{c statuE of hyrcanue has been revlewedln VOL. I (docunent VBC/88.5 - IIAP/88.2, pp. 39-40). Desplte the wide dlstributlon of thetwo species ln the geographlcal area, they have been found to act as vectora of nalarlaonly in two countrt."t gfglSglg5 ln the KerbaLa area, Central reglon of lraq, onepldenLologlcal grounds, and both specles in Kunduz area, northeast Afghanlstan as Provenvectora (eee under 3.l l below). Infornation on the blonouics of these specles ls derlvednalnly fron the tlro countrles concerned.
l. Sooe authora ldentlf led different varletles of An.-h1gg,. Untll genetic andc y t o g e n e t 1 c s t u d 1 e s a r e c a r r l - e d o u t o n m e m b e r s o t r f , @ c u r r 1 n g 1 n A s i a w e s t o fIndla, thls taxon ls treated here as An. hvrcanus Pallas (see VOL. I as noted above).
vBc/90.3MAL/90.3Page 40
3 .2 B reed lng hab l t a t
In l raq, Macan (1950) found pulcherr lmus breedlng in large nurnbers ln weedyl r r igat ion channels a long Shat t -A1rArab, in marshes, and in a l l types of c lean stagnantwaters overgrown wlth vegetation and not too heavlly shaded. The same author foundhyrcanus breedlng among reeds ln old flooded areas along Shatt-Al-Arab; it was alsorecorded ln i r r igat ion channels wi th no reeds, when such channels were heavi ly shaded bypaho t rees. Elsewhere the larvae were found in reed-beds.
Pr ingle (1954a) indlcaEed that the h ighest densi ty of pulcherr i rnus was recorded inthe great southern mnrshes and in the r lce growlng d is t r ic ts of southern I raq, v iz : Anara,Diwaniyah and Muntaflk I lwas. In contrast, J11gg. Itas rare at any distance fromestabl lshed reed-beds or emergent aquat lc vegetat lon.
Al -T ikr i r i (1964) descr lbed the breeding p laces of pulcher l lnus as s low novlngstreams, d i tches, r lce f ie lds, pools, marshes and'other types of waters wi th or wl thoutvegetation. The descriptlon of the breedlng places of hyrcanus was sinllar to that shownby P r i ng le (1950 ) .
Abul- I tab & Abdul-Lat t f (1985) l carr ied out longi tudlnal observat ions for 18 nonths( f ron August 1982 to Deceober 1983 ln two breedlng s i tes near Baghdad, I raq, to detern lnethe seasonal variation ln pulcherrious breedlng. The two slEes ltere: a circular poolpool 10-15 m in d ianeter , wLth no aquat lc vegetat lon, but wi th a few reeds and Tanar l .xplants at one side; the other site was a dltch about 1-2 n wlde and 15-20 o long, wlthweeds and the lrater surface covered wLth aquatic vegetatl.on and algae as veLl as densegrowth of reeds. The two sl.tee were lnspected at weekly Lntervals naklng 20 dips ln eachwl th a ladle. Larvae were c lasel f led accordlng to the lnstars and ldent l f led to thespeciis. Sometines, young larvae tfere reared ln the lnsectary to conflrn larvalidentif lcation. Water and air teDperature as well as nater levels were recorded at eachvls i t . Br lef ly , the resul ts showed:
- The breedlng actlvity of pulcherrinus was almost contlnuous throughout the sprlng,suomer and autuur. Durlng the wlntef nonthe, there was a low larval denelty ln the dltchtbut larvae were totally absenE ln the pool.
- There vrere trro peaks of pulcherrfuous larval denslty: a high one ln the sprlng and 4lower one tn the auturnn.
- The larval populat ion densl ty was great ly Lnf luenced by physlcal factors, 1. .e. ,temperature, wlnd, raln and sunshlne.
- There rras a clear preference for reeds and grasses covering the water surface ofthe dltch which harboured higher and a more contl.nuoua populatlon than the pool.
In Bahraln, Afrldt & MaJid (1938) during a malarla survey found that the favourableb r e e d 1 n g p 1 a c e s f o . g 1 @ w e r e s e m i . 6 t a g n e n t d r a 1 n s o v e r g r o 9 ' n w 1 t h g r a s s ' s e e P a g epits, lrrigatlon welle and iwanps. The general lnpression ltaa that thls species favouredwater collectlons whlch had a lower sallnlty than those harbouring stePhensl. (see. 4.2below)
In AfghaniaEan, Ranachandra Rao (f95f) tabulated the results of larval surveys madedurlng Septenber-October 1949 ln dlfferent typee of breeding places ln Laghnan distrlct 'the Eastern province. I{hl1e pulcherrinus was not encountered as larvae, EIg1g!19predomlnated ln rlce ftelds, Fi@Gi-Ihannels and dralns as lte1l as in swamPs. Thepresence of large numbers of }gganug larvae ln lrrlgatlon channels was Presunably due to
the close associatlon of the ahail;G wlth rlce fields. The channels often branch fron
rice flelds and larvae obvlously drlft fron the flelde to channele. The channels ltere
characterlzed by grassy Earglns, but sonetines the flow itas Eoo rapld for larval breedlng.Internlttent lrrlgatlon was establlshed ln Septenber whlch kept roany channels free fronlarvae.
r - E _ T E r 8 P a P e r a n d t h a t o f A b u I - H a b & A 1 . K a s s a 1 ( r 9 8 6 ) , ! @ w a s s P e I tlncorrectly pulcharrimus.
vDc/90.3UAL/90.3Page 4l
Dhir & Rahlo (1957) also lndlcated that larvae of lglgsg5lg were found prlnar{J.yln rlce flelde durlng all stages of growth of the plants ln Afghanlstan. In a few areas,larvae of pulcherrlmus nere collected frorn stagnatLng edges of rl.vers. The lrrlgatlonchannels and swanpy areae were the other sources of the larvae of this specles. Theauthors fur ther descr lbed the developnent of cu l t lvat lon of r lce f ie lds. The f ie lds areusually f looded and ploughed in the latter half of May every year. The transplantatlon ofpaddy f ron the nurser les ln to the f ie lds usual ly s tar ts ln the f l rs t week of June.Ilarvestlng commences the nlddle of Septeober and ls practlcally ternlnated by the niddle ofOctober. Observatlons on the lntenstty of breedlng ln rlce ftelds durlng the growth of theplants showed that unl lke cul ic l fac les which ceaaes to breed ln these f le lds af ter theplants reach a height of 30 cD, gfgherr$ and gg-*lgg5 breed contlnuously froo thetlne of transplantation to full naturity of plants. However, when the plants begln todroop wlth the weight of the ear-heads, the bulk of the larvae are to be eeen along theedges of the flelds. The ratlo of the larvae of superplctue and pulcherrlnus ln the rlcef le lds ln some par te of the country (Kataghan area) wae found to be 1:7.
Dukhanlna & Quadeer et al. (1974) descrlbed the breedlng placee of g\@19 andhyrcanus Ln northeastern Afghanistan. In the lrrigated zone, both epecles breed nalnly lnrlce fielde sl.tuated close to vil lages. In May-June, }2gggg, bregds predonlnantly ln ricenureerleg wlth the larval denslty reachlng as hlgh as 500 larvae/n-, while the denslty ofpulcherrl.nus at thls tlne of the year ls very low. Fron the nlddle or end of June onnarda,wlth the fornation of nunerous rlce ponds open to eunehlne, condltlone for breedlng ofhyrcanus becone unfavourable, but eultable fo" !gfg!g$ due to the Lncrease of naterteuperature. Also the surface area of breedlng places increages eeveral t l.mes. Whlle thedenslty of hyrcanue decreaees, the denelty of pulcherrl.mus lncreases to becone prevalent 1nAugust Ln rLce ponds (95-1002). At the end of August, rlce plants becorle hlgh and the
. nater gurface le rendered largely shaded. The larval denelty of }ryg. increases agaln,and durLng Septenber-October both specles occur approxlnately ln equal deneltles" Rlceharvestlng and conplete or partlal drytng of rlce ponde begln ln the otddle of September orln October, resulting ln an abrupt decllne of vector densl.t lee. Swamps wlth thlck watergra8s are another type of breeding place for pulcherrlnus. In theee BwaDps and ln1 n c o n p 1 e t e l y d r y r 1 c e p o n d s ' @ , o v e r w 1 n t e r s . I n t h e p l a 1 n r 1 v e r v a 1 1 e y z o n e 'Dulcherrlpus breede ln ponde wlth warn fregh water, whlle hvrcanus occura ln a very lowdenelty or Ls absent becauee of the hlgh tenperature. In the Eountain rl.ver valley zone,euperplctus breede rualnly ln pools auong rocks ln rlver beds. Breedlng of }aru ln thlszone occure ln ponds and ewarope wlth thlck gra8s. In areas wlth rlce cultlvatlon, at analtltude of 800-1000 r, Efglgglg ls abundantly present,.
S o n e 1 o f o r n a t 1 o n o n t h e b r e e d 1 n g h a b l t a t o f ! g @ r ' a s r e P o r t e d 1 u a r e c e n tetudy ln the PunJab, Pakl.etan (eee under 4.2 below).
3.3 Ssarnlng and nating
Ln Paklstan, Reisen, Aslan E Slddlqui (L977> observed swarul.ng and natlng of l0mosqul.to apeclee ln five vll lages ln PunJab provlnce (see also under 4.5 below). Swandngof pulcherrinus was observed in December 1976, four nlnutes before aunaet (lLlunlnatlon o
387 lx) when the tenperature naa 19" C and RIt 482. The ewarn waa aeen at 4-5 n above theground and occaslonally dropped to 2 n. The oarker (eee deflnlt lon under 4.3 below) wasbare ground. No palrlng was observed.
No Lnforoation could be traced on snarming and nating of }.gg, ia the geographicalarea under review.
3 .4 D i spe rsa l
The only lnfornatlon that could be traced concerne pulcherrlmus. I lorefall (f955)stated that thle speciee sometlnes mlgrates great dlstances whlle belng carrled by wlnd;fl lghts of. 25 km were clted. Referring to thls stateuent, Daggy (1959) found that thlscould explaln the occaslonal occurrence of lglcherrlnus ln Dhahran torn ln the Easternprovlnce of Saudl Arabla when the nearest breeding places sere at least 8-lI kD away fromathe town,
vBc/90.3MAL/90.3Page 42
Fron the ear ly observat lons in I raqt Chr is tophers & Short t (1921) pointed out that Ln
nany lnstancee the presence of .Ufche..l* numbers could be satisfactori ly explalned only
by a f l tght of 1.6 ko or even 37 kn. Very f requent ly the adul ts of th ls species nade
thei r f l rs t appearance fo l lowing a dust s torD. Specinens caught under these condi t ions
were fu l ly grav ld females and unl lke ly to have bred in wel ls , or any s i tuat lon other than
that of thei r norual breedlng p laces. The power of f l lght and res ls tance to desiccat lonpartlcularly seen to flt pulcherrirnus for ics role as the donlnant Anopheles in the
al luv ia l p la ln.
3.5 Local sDat la l and seasonal d is t r ibut ion
I n I r a q , l ' { a c a n ( l 9 5 0 ) r e p o r t e d t h " t ! @ w a s a b u n d a n t i n t h e a 1 1 u v i a 1 p l a 1 nregion, but nost nunerous ln the area of great rnarshes in the southern reglon. It was
found ln sDall nunbers at severaL places in the foothil ls, and there were two records from
the escarproent region. The hlghest seasonal prevalence of Pulcherrlnus was observed in
May-June and October-November. A narked drop Ln lts density was observed ln July-August at
three widely separated locallt les, but was probably a general phenomenon. It nay beadversely affecied by the hot dry summer condLtlons l ik" .g!gpg!. Feeding probably
contlnues throughout the year ae wlth stephensl. O" }yS, Macan found lt very abundant
ln the marsh reglon of south Iraq and Efong Ctre Shatt-A1-Arab, and was probably conflned to
these tno parts of the country. Its seasonal prevalence ltaa raEher short (May) after which
lts denslty narkedly decreaeed but ln the locallty of Runaltha at least, the drop in
numbers after l lay was not comparable in oagnltude for large catches of adults and larvaewere obtal.ned during June, August, Septenber and October.
Pr lugle (1954a) descr lbed pulcherr inus as an ubiqul tous specles, and of ten extremelya b u n d a n t 1 n e u D m e r t h r o u g h o u t t h ; @ E r o n o f I r a q . I t ' e x t e n d s 1 t s r a n g e 1 n t o t h efoothll ls, bu! was very rare at alt ltudes above 500 n.
Al-Ttkrlt l (1964) oade notee on the dlstributlon of pulcherrinus and Wgg ln Iraqsln l lar to those of l lacan (1950). Abul- l lab & Al -Kassal (1986), on the basls of screeninganophellne distrlbutlon Ln Iraq after 1964, deduced that the antlnalarla house spraylng(DDT, dteldrin and oalathlon) dld not nuch affect the populatlons of pulcherrinue' probably
because of lts partlal exophlly.
On the vectorlal loportance of pulcherrlnus, Macan (1950) indlcated that althoughthls epecles naa very abundant all ovE? thd southern part of Iraq, spleen rates were onlya s e o c 1 a t e d w 1 t h e t e p h e n s 1 . H e n c e ' ! @ c o u 1 d n o t b e c o n s l ' d e r e d a n 1 D P o r t a n tveetor, and probEbl]:lffied little or no partTn nalarla transolsslon. Abul-Itab &Al-Kassal (1986) Eended to agree wlth thle vlew, although Rlshikesh (L972) suggested thatpulcherrlmus was the probable vector of nalaria ln a focue ln Kerbala arear Central Iraqt
ea on epf-dentologlcal grounds (see under 3.613.7 below). Regardlng US' Macan(1950) considered lt also an unlmportant vector of rnalarLa ln lraq. Likewlse' Abul-Ilab &
Al-Kassal claseifled under the category of tt less lmportant vectorst'. The recorde of ltsdletrlbutlon ehoned that after 1964, lt was found ln Qurna (Basrah Provlnce) on several-occasions over eeveral years, but in rnuch reduced denslty
In Afghaaietan, the spatlal and broad seaeonal dletrlbutlon of anopheline specleslncluding pulcherrlous and @. ln different provinces have been shown above under 2.5
by nanactraii iEE-(f55t) and Otrfr & Rahln (1957). Cullen (1978) ln hls draft assignnentr e P o r t t o I | I l o , 1 n d 1 c a t e d t h 8 t P g f @ e h o u 1 d b e c o n s 1 d e r e d a n 1 m p o r t a n t m a 1 a r 1 a v e c t o rin the lrrigated zone of northffiaTEft;fstan baeed on epldeniological grounds (see also
under 3.l l below). In the irrlgated zone of the Eastern reglon (Jalalabad) wherepulcherrLmus occura tn high densittes slnilar to those occurrlng ln Kunduz, the lnpact of
ff iff i-traylng applled 1n thts area oay have been elther sufftcient to auPPress thevectorlal efficlency of thle epecl.es, or lt nay play a very minor role, lf any, ln malaria
tranenleslon ln this part of the country. A" lgl"h"t. l* ls a swamp breeder, lt ls found
tn hlgh densltlee only ln areaa where rlce ls ;-Ealor crop, up to an altltude of 900-1000 m
ln the htl l zone or 1200-1300 n ln the Khost plaln (Junobt or Southern provlnce). It ls
vBc/90.3MAL/90.3Page 43
also present in hlgh densltl.es ln some of the swanpy area6 ln the Helnand valley (Southernreglon) , but i t has l in i ted d is t r ibut lon in the south, south l rest and nest of Afghanlstan.Cu11en further explalned that egg batches of pulcherrirnus fron Kunduz and Jalalabad wereBent to the London School of Hyglene and Troplcal Medlc ine ' , f ron which colonles wereralsed. Croselng experlments showed that these colonies erere the same specl.es, andlnter fer t l l l ty was apparent when Ehese nere crossed wl th pulcherr lnus f rou I raq, hence a l lwere consldered to belong to one epecles. Regarding hyrcanus, Cul len suspected thepreeence of two specles of thls group ln Afghanistan: one is found in Nangahar and posslblyin other eaatern areas, and the other occurs in the rernalnLng areas of the dlstrlbutlon ofthis speciee ln the country. Altttough nany egg batches of these varlants nere sent to theLSHTM, they have never been successfully colonlzed. [It seens that sone batches recelvedearller fron Afghanl.stan were auccesefully ralsed ln a colony whlch was used Ln crosslngexperl.nents lnvolvlng hyrcanue stralns fron other geographlcal areas - see noEe by Prof. G.Davldson in VOL. I , p . 40. and aLso p. 39 for the resul ts of exanlnat lon of nater la l o fhyrcanus fron Afghanistan by Ward (1972) who found that over 982 of. the epeclnens resenbledal l PaLearct tc populat lons of An. hyrcanus] .
Cullen further referred to the reeults oilnvesttgations on the role of hyrcanus lnUSSR and northeast Afghanletan (eee under 3.fl) and surnleed that this epecles seems toplay a eecondary role In nalarla tranenisslon, perhaps ln the sprlng and autunn when lt lsoften found ln very hlgh denaltlee. It t6 poeelble that nherever effective controlDeasures can be applled agal.net the prlnary vector ln any area, lggg ls unllkely toDalntaln traneulselon by ltself.
Sone lnformatlon on the spatlal and seaeonal dtstrlbutlon of pulcherrlnus ln PunJab,Paklstan ls lncluded under 4.5 below.
3.6 Rest lng behavlour & 3.7 Bl t ing behavlour
In lrag, l{acan (1950) lndlcated that pulcherripus rest6 In houees and stables and wasa partlcularly eaey epecl.ee to catch, aa lt apparently nakee no effort to conpensate forlts striking ornamentatlon by seeklng out hldden resting sl.tes. It was also found restlnganong reeds. Regardlng hyrcanuE, Macan consl.dered lt a wlld epecles, and rarely enterahouees to rest. Aleo in Iraq Al-Tikrtty (1954) nentioned that adults of pglglgglg werefound ln large numbere In human dwelllnge and anfioal ahelters durlng ttre sprfng, -unrner andautunn' while Abul-Hab & Al-Kassal (1985) deecrlbed pulgherrlous a6 an lndoor and outdoorre8tlng specles, and probably i.ts exophl1lc tendency oade tt perslst under residual. housesprayLng ae mentloned above.
Rlshlkesh (1972) noted that pulcherrlnus was the roost widespread anophellne specl.esln lraq, yec lt has been considered as havlng no role ln oalarla transnlsslon unti l lE wasfelt that lt should be treated aa a auspected vector on account of lts high degree ofcontact wLth nan. To ascertaln thls, he organized a series of nan-balt captureobeervatlone durLng August 1969 in Erbll Liwa (Northern reglon) where .sacharovi andeuPerplctus are the rnain vectore, and ln Rauadl , Dlala and llt l la Li.was-(mf reglon)where etephensl le the princlpal vector. The nlght observatlons lrere carrled out outdoors,elnce Practically all lnhabltants elept outelde during aurmer. The nean nan-bitlng rateaof Pulcherr lpue ln the four L l .was nere respect lve ly 25.6,5.7, 18.3 and 33.8bltes/nan/nlght, far exceedlng those of sacharovi, glpgglss, and stephensl. At the sanet1ne, surveys of day-tlue lndoor resting mosqultos ylelded very J.ow densltlee ofpulcherr imus ln the four L iwas reepect lve ly 0.2, 1.6, 3 and 0.4 feoales per rooD.Preclpltln te6ts run on 64 bloodneal emeare of lgfSElS collected from hunan and aninalsheltere ln a Localtty in the Diala Llwa gave L7.22 posltl.ve for roan. The nan:anlnal ratloln the locallty vae 72:28. Outbreaks of nalarLa occurred ln the autunn of L969 and theaurnmer of 1970 ln the centre of Khan Al Hannad dlstrlct 1n Kerbala provlnce (Central
1. Referred to throughout the text as the LSttTM.
vBc /90 . 3MAL /90 .3Page 44
region) . The ent i re Kerbala prov ince was under DDT house spraying of the malar la
eradicat ion programme f ron 1957 to 1968. The spraying was t f t i ta t i t t t ln 1969 on the basis
of favourable t rends. Fol lowing the outbreak of malar ia ln the autunn (25 and 84 cases in
october and November 1969, respect ive ly in Khan A1 Hamal centre a lone) DDT spraying l tas
re lnstated on a focal basis . The whol l d is t r ic t , however, was put back under regul 'ar DDT
spraying in 1970, wi th tota l "o. r " . " t "
repor tedly achieved' in the f i rs t round ln Apr l1 ' The
second round appl ied in July 1g70 was uniat is factory and nopping uP oPerat lons were
repeated fo l lowing a r ise in nalar ia inc idence (167 cases ln 1970' a l l excePt one were
indigenous) . The inc idence nas low dur ing the ear ly par t of the year ' but showed an
increase in June-July fo l lowed by a sharpEr r ise in August-septenber-despi te reDedla l
measures inst i tu ted in ear ly August i .nct ld i .ng ef for ts to achleve fu1l coverage ln DDT
spraylng, act ivat ion of passive case detect lon (PCD) and t reatment of conf l rned cases
detected s ince Ua! tSZO. ' Entouological invest igat lons carr ied out ln August and November
1970 showed that pulcherr lnus r . " ih" only anophel lne species Present ln the area ' rndoor
resring co11""tioiiff i !?oductive and yielded only one freshly fed Pufctrerrl lu-9 fl:t ""open type of animal shelter Outtei window- traPs yielied only f lve ' ' ]"[*t^G f eroales of
which. two were unfed and three f reshly fed. . n i t t re same t lner man-bal t caPture outdoors
gave a Ban-biting rate of 16.5 and 3|'.4/nan/ntght on 25 August and I Novernber 1970'
respecrively. Dissection of a srnali sarople'of-pulch:IAlT:rs ItgT tt1;lait capture showed no
sporozoi te-posl r ives. From al l these oUservat i i f i lGi f r?sh ( loc 'c i t ' ) deduced that
pulcherr lnus can be consldered a probable vector of roalar la in l raq, and th ls cal ls for a
specia l v ig i lance ln areas where th ls specles ls prevalent ' A l though Ehe specles apPears
to be suscept ib le to DDT [Resistance to DDT in th ls species was recorded later - see under
3.12 below], iCs exophl l ic and exophaglc tendencies may lead to pers is tence of
extra-doruic i l iary t ransolss ion despi t ! sat ls factory DDi spraylng coveraget Par t lcu lar ly
;;; i;g-;;;-",-r*"r when almost all inhabltants sleep outdoors' Presurnablv' renedial
measures other than DDT house spraylng such as actlvated PCD and radical treat6ent of all
conf i rned cases nust have p layed a ' la ige ro le ln in terrupt ing nalar la t ransmlss lon ln Khan
A1 Harnnad centre la ter in 1970'
In Afghanistan, zahar (unpubl ished repor t to wt{o ' l97 l ) repor ted on an lnvest lgat ion
carried out ln eugusi 1970 tn Kunduz unit in the northeastern part of the country Eo
eluc ldate the reasons for pers is tence of malar ia t ransnlss lon despi te repeated DDT house
spraylng for a long tlne. In thts area'- ggpqrpictuq could not be found during the prevlous
15 years (see undei 2.5 above), a"a- i " i l t t@t ' "T i ! 'hvrgalug t : t " ,suspected to be the
responsible vecrors (see under 3.l l El;;revlousffi i6fogical observatlons lndicated
that both pulcherrlmus and llrye have perslsted ln the DDT sprayed area in hlgh
denslrles UiringTi' iGna anfiat!-oit;;;;" 'parttcu:-arly in the sunrner season when the people
and aninals s leep outdoors. The t to-"pecf"s l tere. f re luent ly encountered 1n outs ide rest lng
n a t u r a 1 s h e 1 t e r s b ' t ! g @ ' " " " 1 " o f o u n d 1 n u n s p r a y e d 1 n d o o r s h e 1 t e r s . I t w a sb e 1 1 e v e d t h a t s u c h b e h a v 1 o u r o f ! @ a r o s e f r o n 1 t s 1 r r l t a b t 1 1 t y t o D D T , w h 1 1 ehyrcanus rfas naturally exophlttcr 66ffienters lndoor shelters to feed durlng the#
period when hosts are not available ouiside. To overcome the exophil ic behavlour of both
species an at tempt was made to sPray a l l posslb le outs ide natura l rest ing s l tes dur ing the
DDT sprayirrg .orrnd of 1969. As couid be expected, the effect df this treatnent was hardly
norlceable. The avallable "',"""piiutl i ty
teste showed thtt lg@mus remalned
gusceptible to DDT, whereas lJgnus extriUttea narked reslstarrce to tf,G lnsectlclde' Both
specles showed nornal suscep a"- ai"i i i l" ' [Later DDT reslstance ltas recorded in
pulcherrinus, and hyrcanus ieslst"rr"" to dieldrln Itas also reported froro Afghanlstan - see
under r.rz ueroJi.Jtff f i""; ' i ; ;b, observarr.ons were carried our ln four vl l lages, of
which Zakhil and Khondan were selected on the basis that they were flxed entomological
lndicator v i l lages where regular . i i r i . i "g ica1/parasl to loglc ;L observat ions as wel l as
epidenlo logical ' lnvest igat l ins of nalar la cases were carr ied out ' These v i l lages were
sprayed ln the flrst week of . l,rn" i9ZO. The third vil lage, Nawabad' was sel'ected frorn
among those which had a large number of lndlgenoll" """t",
although lacklng regular
entomological or epldenlo loglcal observat ioni ; th ls v i l lage ta" t lso sprayed ln the f l rs t
week of June 1970. Whi le observat lons nere proceedlng, a four th-v l l lage, Issakhal t was
added because an lnfant aged four months was detected infected with .P' vivax ln August'
This vil1age was sprayed early 1n May 1970. No unsprayed vil lages wEtfif lable for
conpar lson, s lnce the area vtas st i l l under the at tack nt raserot Lhe nalar la eradlcat ion
progratrme. Spraying r ras appl led .a- . - i . " .ge of 1.S g bOt/nt . The entonologlcal
iecf ,ntques ut l l lzed in these eelected v i l lages l tere:
vBc/90.3UAL/90.3Page 45
- hand and/or pyrethrun 6pray capture (PSC) ln unsprayed or altered preolses and'aunmer huts;
- hand capture ln outs lde natura l rest lng shel ters l- tnan- and cotrbait capture outdoors since nearly all lnhabltants slept outdoors and
cat t le were kept nearby; observat lons were nade for 5-6 hours af ter sunset ;- co l lect ion of b loodneal smears for prec lp i t ln test lng (see under 3.9 below);- age-grading of sarnples collected by balt capture and froro natural restlng shelters
( see unde r l . l 0 be low) ;- l ln i ted observat ions by ex l t wlndow t raps.
In addl t lon to v l l lage houses, sunner huts are poor ly constructed to shel terlnhabi tants ln the f le lds guarding thel r crops (e.9. , melon, r lce, cot ton etc. ) s tar t lngfron July or ear l l -er . They seened more sul table for nosgul tos rest ing than natura lsheleers, being surrounded by vegetatlon and s{tuated ln close proxlnlty to watercollectl.ons. They were constructed during May-June, but t,hey were not eprayed unti l lateJuly-Auguet.
The data collected by the natlonal team and the tl l lO entonologlst 6lnce Aprtl (prlorto epraylng of the vll lages in May-June) were studled to follow up the trends ofPulcherrfuous and hyrcanus populatlon denslttee under the Lnpact of DDT spraying,Obvlously, this does not reflect the natural trends of the restlng and blttng behavlour ofthe two speciee, slnce the whole area had been under spraylng. The preeent reeulte showedthat :
- As lndlcated fron nan- and cow-balt capture and coll.ectLone from natural shelters,hyrcanus started to bulld up lts denslty early ln the aeaaon to reach a peak about the endof May' Lo€.; on€ nonth earller than that of pulcherrl loue. After DDT epraylng about thebeglnnlng of June, the densltles of hyr_c,anus decllned, but thls could have also been due toseasonal effects, for thle species rras aeen ln prevlous obeervatlone to occur ln very lowdensltlee in sunoer untl l the autumn when lts densltles butld up again. In contrast,Pulcherrlnus perslsted after spraylng bltlng nan and anlnale and resting indoors ln hlghnunbers throughout the sunmer when the nean temperature was about 30-32: C and therelatLve hunidlty na6 aa low as 20-372.
- Unsprayed prenlses were the main source of lndoor-restlng pulcherrlmus. At thetlne of spraylng of Zakhll Lndlcator vll lage (6 June 1970) four unsprayed roons ylelded 89pulcherrLous of whlch 50 were dlssected givlng one aporozol.te-posltLve epecloen. AtK h o n d a n 1 n d 1 c a t o r v 1 1 1 a g e ' ! @ f e n a 1 e s w e r e f o u n d a t a t r e a n d e n s l t y o f 1 l / r o o n 1 nfour rooms which renalned unsprayed for two weeks after the spraylng round (6 Juue f970).N e a r t h e s e r o o m 6 , n 1 g h t o b s e r v a t 1 o n s r e v e a l e d a 1 a r g e d e n s 1 t y o f ! @ b 1 t 1 n g r n a nand cattle outdoors, fron whlch one sporozolte-posltLve speclnen na6 detected anong 20fernales dleeected. In August, two conpounds at Zakhil whlch remalned uneprayed f.or 2 l l2Bonths af ter spraylng ln June due to the refusal of lnhabltanrs, harboureat 3g]g!!51.lg!1| .rdhyrcanue females ln d l f ferent b lood d lgest lon stages at a densi ty of 6.1 and 0.3 perman-hourr respectlvely. Suoner hute whlch can hardly be consldered Lndoor restlng shelterealso harboured a hlgh denslty of pulcherrlnus (10-21/hut) ln July before they were sprayed,and one sporozolte-posltLve speclnen was detected anong 37 dlssected. After they weresprayed, only a very few pulcherrinus could be recovered frorn these huts. Store rooDaf l l led wi th grasses or dung-cakes y le lded a few pulcherr lnus, but l t was d i f f lcu l t tosearch such rooms by hand or Bpray capture. The epldenlologlcal elgnlflcance of thepulcherrlnus populatlon shelterlng ln unsprayed prenlses naa reflected ln the flndlng of afew sporozolte-posltlve epecimens in eamplee collected fron these atructurea (see under3 . l l b e l o w ) .
- The uost productlve source of day-tlne resting nosquitos were the outslde naturalshelters such ae crevLces Ln outslde walls, nud-brick fences separatlng conpounde and drledsteu6 wlthln the yards of houses and outslde. In these eltes, p!{Slerfu fenales passlngthrough varlous blood dlgestlon stages nere encountered and occaslonally were assoclatedw 1 t h s n a ] . 1 n u m b e r s o f h y r c a n u s . T h e d e n s l t y o f E f @ c o n p r i s i n g f e d ( F ) h a 1 f - g r a v l d(HG) and gravid (G) fenales varied fron 6.1 to 34.3 peinan-hour catch durlng Auguet. Agedeternlnatlon showed that aone lndlvlduals could reach a potentLally dangerous age (seeunder 3.10 below). The rat lo of F: I IG * G was typ ical of the pat tern eeen ln outa lderesting populatlons, being about 1:l wtth a few exceptions. One of these exceptlons traa a
vBc/90.3UAL/90.3Page 46
rat lo of .3.25:1, but th is could have ar lsen by chance by col lect ing a snal l nunber of
nosqul tos (18 fenales) f ron a s i te where b loodfed specimens were concentrated, whl le a
lar te sanple (62 feroales) co l lected two weeks ear l ier f roro the same local i ty gave a rat io
o f l : 1 . The o the r excepE lons were ra t i os o f l : 3 .2 and l : 25 reco rded f ron two d i f f e ren t
local l t les respect ive ly , in which the col lect ions f ron the outs ide shel ters were extended
to the af ternoon, thus extendlng the chances of f ind ing females at advanced b lood d igest ion
stages. Col lect ion f rorn one of these local l t les roade l0 days ear l ier gave a F:H + G of
0 . 9 : I .
The outslde restlng population seened to endure a more arid mlcroclfuoate than the
lndoor rest ing populat lon. Measurenents of tenperature and re lat lve hunid i ty (RH) by a
s l lng hygrorneter at l4OO h and 1600 h ln shaded outs lde shel ters where-P$1$9!- i iP* ; :asfound ln h lgh densi ty ln two local i t les showed a temperature of about 35"^C^and _2O"1 -RH,while the records obtalned ln nearby dwell-lngs about the 6ame tlme were 29-32- C and
32-4OZ Wl. Nevertheless, a few lndlviduals of the outslde resting population of
pulcherr inus could reach a potent ia l ly dangerous age (see under 3.10 below).
- Bal t capture observat lons denonstrated a h lgh degree of man-vector contact in the
DDT sprayed area. As oentioned above hyrcanus appeared ln high denslty blt ing nan and
anlnals just before or shor t ly af ter s !@g. Subsequent ly , i t decl lned to a negl lg ib le
level aurtng the sumner and was expected to bulld up lts denslty again ln the autunn. In
contraet , gulcherr lnus pers ls ted b l t lng man-and anlmal outdoors ln h igh densi t ies in Zakhi l
and Khondai-IE6GliiTE the sumner. In vll lages with extenslve rlce cultivation and
permanenr slramp6, the bltlng rate ln August was 52-58.4/urar. per half nlght (6-hour caPture
. f t " . sunset) , 2-2 I /2 nonths af ter spraying. In Nawabad which ls s l tuated in the dr ier
part of the Kunduz valley on the fringe of the desert, cotton and nalze sere cultivated,
but rlce cultivatlon r{as patchy due to lnsufflclent nater. In thls vil lage the nan-blting
rate lraa the lowesE observed |n August, belng 2.2 and 4.2 bites of pulcherslngs- Per IDan Perhal f n lght ln two obaervat lona, respect lve ly wi th negl lg ib le nuobers of hyrcanps. Also '
the outslde restlng populatlon showed the snallest denslty, l0 fenales of glg!]!!]$ Pernan-hour. No entonological observatLona etere carried out prevlously in thls locality.
Sumer huts ln th ls local l ty were c lustered ln the f ie lds ln c lose proxln l ty to the v l l lage
appear lng as a haro let of scat tered houses. They were occupled by f05 Persons rePresent lng
about L07 of. the total nurnber of lnhabltants of the vll lage. Sone of these huts wereproper mud rooms lrlth thatched roofs, but others were conatructed of branches'and roats.
Although the construction of these huts had begun slnce May-June 1970, they ltere not
spray.d durlng the sprayl.ng round on 5 June. They were only sprayed about the beginnlng of
Augustr l .e . , shor t ly before the b i t lng observat lons l tere conducted. Most ind igenous cases
gave a hlstory lndlcatlng that thelr prluary attack occurred in June-Ju1y, and several of
then were l lvtng ln surnmer hut6 since June. It ls quite l lkelyr thereforer that
contractLon of lnfectlon occurred during June-beginning of August before the suromer huts
nere sprayed, when the man bitlng rates of pulcherrlnue and Ury Itere Probably nuchhigher than those obeerved ln August. In IlEaEEEf, aZ-loonth old lnfant ltas detected tt lth
P. vlvax lnfectlon on 15 August and the onaet of his fever occurred one week earlier. The
@was aprayed on 9 May 1970, and there were no entonological observations or
epideolo loglcal lnvest igat lons carr led out af ter spraying unt l1 the present invest lgaclon
was conducted on 18 August. The vll lage is conposed of scattered hanlets situated anldst
f le lds wi th large areas of r lce cul t lvat ion. Sum.er huts were few and sparselydls t r ibuted, and a l l were sprayed. Inspect ion of houses ln the hanlet of the posl t ive
infant showed that about 402 were replastered and a snaller proportlon lrregularly
sprayed. A snall uumber of pulcherrinus was'collected fron the thatch of unsprayed and
sprayed kltchen verandahs coiiffid--jil1ffioot, Ilowever, balt capture yielded the highest
d lns l ty observed dur ing the present lnvest lgat ion; the b i t ing rates per 6-hour catch were:
102 per nan lndoors 1n a replastered room, 126.6 and 1825 per nan and cow outdoors,
respecttvely. An. hyrcanus appeare'd in very sroall numbers in the bittng catches. I{hlle a
f e w - p u 1 c h e r i t r o u f f i 6 i n t e r e d r e s t 1 n g 1 n d o o r s , t h e r e I { a 6 a h 1 g h d e n s 1 t y o f t h 1 s s p e c i e sr e s t I - b r s h e l t e r s ( 1 n y a r d s o f h o u s e s a n d o u t s i d e ) ( 3 0 . 8 / n a n - h o u r c o n s 1 s t 1 n g o f F+ HG + G), assoclated wl th a very sroal l densl ty of Utca"u" . Nevertheless, the b i t ing and
outslde resting populations of pulcherriroug were coroparatlvely younger than the populatlons
of the other vll lales. Circunslan-ence indicated that the'day of sarnpllng
vBc/90.3l'rAl/go.3Page 47
c o 1 n c i d e d w l ' t h a n l n f ] ' u x o f n e w 1 y e n e r g e d f e n a 1 e s o f I @ 1 n t h 1 s 1 o c a 1 1 t y w h e r ethe farnere adopted the procedure of lnterruittent drylng of rice due to shortage of water( see unde r 3 .10 be low) .
Llnlted obeervatlons rrere carried out by exlt wlndow traps at Isakhel andKhondan/Zakhl1 locallt les for elght consecutlve days. The trap collectlonas fron Isakhelsuffered fron hlgh roortallty due to Long transportatlon of mosqultos on a rough road to thebase laboratory. Fron Khondan/Zakhtl the dlstance travelled was shorter and mosqultoscould be brought Eo the laboratory wlthout too nuch danage for a 24-hour holdlng perlod.Mosqultos were collected fron the traps ln the evening (three hours after aunse! and ln theroornlng ( f ron dawn to about one hour af ter sunr lse) . The fo l lowlng resul ts were obta lnedfrorn t rap col lect lons at Khondan/Zakhl l local l t ies:
Spray statuoof traD roons
Sprayed
Blood d lgest ion6tage8
UT. F + I T G
pulcherrluus feroalesTota l Dead* Z nor ta l l ty
colLected
6847
6628
9 7 , L59 ,6
* Dead ln the traps and after a 24-hour holdlng perlod.
The lndlcations derlved frou theee obeervatlona nere:
- There Le certaln entry of pulcherrlnue lnto sprayed houses
- The exodue of unfed fenales fron prenleee ls cornrnon even under uneprayed condltionsespeclally when no bat.t 18 avallable lndoors. As expected, these unfed females weregreatly affected by the ineectl.clde.
- The fed fenales represent the proportlon of the populatlon that eeek shelterlndoore after havlng fed outdoore, since nost hunans and aninals were outslde at nlght.The naJorlty of the fed femalee, posslbly lrrltated by DDT trled to escape fron the sprayedfOOloa.
- It cannot be explalned wlth certal.nty whether the exodus of half-gravld females nasdue to natural exophlly after ependlng part of the gonotrophtc cycle on unsprayablesurfacee ln eprayed roona or because of irrltabtl i.ty to DDT.
- Cogelderlng the nortallty of the F + IIG portion, the effectlvenees of the dosage ofl .5g DDT/n- as lndlcated f ron these observat lons d ld not exceed 602 t rap uor ta l l ty af terl0-f2 weeks fron eprayLng. This le desplte the results of wall bloaseays ln two trap rooosdurlng the preaent obeervatlone nhen l00Z nortallty was obtal.ned (56 pulcherrlnus exposedfor half an hour with no nortallty ln the control).
- The eurvlval rate of wlndow trap catchesactual happenlng 1n the proportlon of the vectorTherefore, attempts should be nade to lnplenentt raps.
gave a nore rellable representatlon of thepopulat lon c l rcu lat lng lndoors.
ex l t t rap obeervat lone and ut l l lze ln let
Fron all the above observatlons, lt can be concluded that ln the sprayed area ofKunduz unit, hyrcanue appeared tn htgh denalty early ln the season (l{ay-June), after whlchperiod lts deneity decltned ln sunner when pgf*IIS pereisted after spraylng Ln veryhigh deneltlee bltlng man and animala outdoors and restLng in outside natural shelters,Particul.arly ln locallt lee wl.th rice cultlvatlon. The naln source of endophll lcpulcherrLnus !ta6 unaprayed prenlses and aunmer hute as well as tents of nonad canp6
vBc /90 .3MAL/90.3Page 48
installed in lare August berneen vil lages fron whlch-bloodfed females of Plg*ry ltere
col l .ected rest ing. Thus, the sprayed l rea suf fered f ron naJor oPerat lonal defects
contr lbut lng to the natn ienance of- large vector densl t les ' The epidenlo logical
signiflcance of the lulcherrlngs pop,rfltron persistlng ln the Eummer in the sprayed area
was ref lected by theJindlng of sporozoi te-posl t ive -s f ,ec imens a l 'ong the sanples col lected
froo unsprayed prenises and sunmer hoa" . " wel l as f ron bai t CaPture ' Evidence of
pers ls tence of nalar ia t ransmiss ion was establ lshed by the f lnd ing of . the roaJor l ty of
indigenous casea af ter spraying in June. Apart f ron ihe roajor op-rat lonal ef fects ' the
exophil lc tendency of Pulcherrigus seerned to have contrlbuted to the oalntenance of a large
f r a c t i o n o f i t s p o p u l a t i o n i n t h e s p r a y e a a r e a . I n . t h e a b s e n c e o f b a s e . l l n e l n f o r r o a t i o n o nthe natura l behaviour of th is speci ls in nor theast Afghanistan, l t ls d i f f icu l t to s tate
whether the exophil ic behaviour has resulted frorn the excitorepellency of DDT' By analogy
o f o b s e r v a t i o n e o f M a c a n ( 1 9 5 0 ) o n , g @ 1 n . I r a q , i t m a y b e . a s s u m e d t h a t n a t u r a 1exophil ic tendency pre-existed tn tf,ff i i ff i1n Afghanistan and has-been exaggerated by
the i r r i tant ef fect of pro longed spraylng wi th DDT' However ' l t should be reroembered that
the endophil ic elernent of !gl*g.l 'u" "ifff exist's as evldenced by the findlng of
appreeiable densirles .t *ri?Ttff i6a digest.lon 6t-ages restlng in unsprayed structures'
Onor i e t aI . (1975) br le f ly rev iewed the h ls tory of nalar la contro l ln the l r r lgated
a r e a o f t h e n o r t h e a s t o f A f g h a n i s t a n . w t t h t h e " * p " o " l o o o f r l c e c u l t l v a t l o n ' r l c e f t e l d sprovlded favourable breedln! conditlons fot lry
and pulctrg:r:lnus' Under continuous
a p p 1 l c a t 1 o n o f D D T h o u s e s p r a y i n g , - t , * , i " " n " " @ a s i ? 6 i f r ! [ f r 6 1 o g 1 c a 1 r e s 1 s t a n c e t oDDT. Addirlonally, thls insecticldt;;P-ed to have a pronounced deterrent effect on
pulcherrlnus which also showea eariy "i irr"
of- reslstance' With the exophaglc/exophll lc
figffi"-p"r.ry-"xophagic/e*op"r.r.iil pglchelrlngs, and a huoan PoPulatlon sleeplng
outdoors durlng the tran'mission """"orr,
t,#GG;f continued appllcatlon of DDT house
spraylng was questioned, slnce Dalarla transnlsslon has been on the lncrease ln recent
years. Therefore, i t was declded io-" . t .y out a t r la l for an epldenio logical assessment of
the value of the effectiveness of DDT house spraylng under the tondltions prevall lng ln
Kunduz uni t whlch consists of f fve l is t r lc ts and 23 sub-dlet r lc ts ' Two sub-dis t r lc ts
having siroilar ecologlcal condltions and the same malarlogenlc Potentlal were sel'ected for
the rrlal: B-9 was sprayed with opi In L972 and 1973 at a coverage of 977' a1.d 987'
respectively, and S-7 was left wtthout sprayt"g for t lto consecutlve years 0972-L973) for
comgarlson. All other sub-distrl"t" re.L under regular DDT spraylng 8t a dosage of 1'5
g / n ] o n c e a y e a r s l n c e l g 5 0 . I n t h e t w o s u b - d l s t r i c t s l A C D a n d P C D a s w e l l a sepldenlologlcal lnvestlgatlons around posltive cases were carried out regularly and as far
as possib le wl th the saoe "o ' , r " r .g"- [ " " ! - i , ;U""" t lon
(1 i ) , I be low] ' For ento l lo loglcal '
observat lonE, t to ind lcator v l l lages-were selectea- in each of the sprayed and unsprayed
areas. prans rcere made to carry orrl ."g,rr.r fortnightly entomologlcal observatlons durlng
1g72 t ransmlss lon aeason, but due ao. I to . tage of s taf f and t rarsPorcr the reeul ts of
these observatlons nere fragmentary ana lnconiluslve' Wtren the dlfftcultles experlenced
rrere overcoDe Eo 6ome extent, it was posslble to-:3tty out the entonologlcal obser-vatlons
at regular inrervale in the " . r . " i " I
i ia t " raot vr l lages dur lng.Jul l -october 1973' the
results of whlch were a6 foll0ws and shown ln Tables 3(a) and (.b)"
Indoor restlng catches Table 3(a): l0 roons were checke-1-1"^:i::":: ::""::: '
r'ar..iolt::iil::Tl?tir'.i"-"ilil-r"".ioned perlod; 5 rooms 'ere 'earched bv hand capture- - - - - - r - - ^ . . - 6 ^ . r n l { . snn rec ' l - ab l e
:llt;':::,:'i;'fi;.*iil"ul'Jl :il;"fir;i pprci'.'ri'-g"-^:":-:*:f -::"?: *:":::T:t:*"i l i ' ] ' l '?l"nlIJl!""i"inl. i l";;f i" '"., ' i f f i*,"n"o,,,,t"redinhouses1nthe- r ^ r r - a - i l r a r r n q n r r v e d a f e a d U tll:fll ::"n":"'ii:"':'."';:':il;^;i=;'i;;";JF: ::li::'::..'-I:',:n:.:::H::"1i':',15:l:s p r a y e d a r € a . T n e m e a n o e q s r t y ' . H f f i . ; 7 ; ; ; ' c a u g h t 1 n S e p t e n b e r a n d a m i n l m u m o f. f l ty-OctoUer l ras 2.43l room, wi th a t "* lT" i - : :^ ' : i ' l l l ^^r
racr{ns oulcherr lous was;:i;H;T ffi";";:"il;',f;l-;.-s;;vra rarro of lndoor resrins pulcherrlous was
- r ^ ^ - - ^ { r l r a r { n t h e r r n s D f a v
l:il6l?!T 'L:';;::;""^;:"';:":;
ioit""'"u restins lndoors ei.rtrerrn-the unspraved or
sprayed ar€as.
- Outdoor restlng catches: 4 man-hours Per month
searchlng for outdoor rest ing mosqul tos ' The resul tswere 6pent {n each lndlcator vll lage
showed that rlore pulcherrimus were
1T"E , i f f i ' & (b )a re rep roducedbype r ro i ss1on .odDrE .ono r1and thea t - r #t: i : ; : i . :aPer or onor
vBc/90.3r{ALl90.3Page 49
found ln the unsprayed area (mean of 4 nonths !ra6 14.88/nan-hour whlch wae higher than^lnthe sprayed area (4.34/nan-hour) , whl le the reverse naa t rue for hyrcanus (6.78/nan-hour lnthe unsprayed area versus 26,/rnan-hour ln the sprayed area)
- Man- and anlnal-balt capture, Table 3(b): Prevloue experlence ln Afghanlstan showedthat mosqultos 6tart blttng at dusk and continue for 2-3 hours. Therefore, balt captureswere perforned on hunan and anlnal balts for three hours after dusk ln each lndicatorv l l lage at for tn lght ly ln tervals f ron July to Septenber, wi th catches carr led ouE lnOctober for only one hour.
The data showed that both pulcherrlnus and UgSg nere xoore actlvely blt lng nanoutdoors than lndoors in the two areaa, but pulcherrinus was bltlng nore 1n the unsprayedarea than ln the sprayed area, whlle the reverse was observed with hyrcanus. An.oulcherrlmus was conslderably more active blttng nan lndoors ln the unsprayed area than tnthe sprayed area, whl1e hyrcanus rras never found btting rnan lndoors ln the eprayed areaexcePt on one occaslon when one fenale blt lng man Lndoors ln the unsprayed area nasrecorded ln August. Conslderable devlatlon to blt lng of anlnal balt was observed outdoors1n both areaar but Lt was much more narked ln hyrcanue than ln 2g_lcherrlnusl thehunan/anlnal bitlng ratlos were l:8 for hyrcaniG-Aiii-f z2 for puGte-ils.- The uean manbltlng rate of pulcherripus/3-hour catch outdoore ln the eprayed -rea wai conparable tothat, recorded ln August 1970 by Zahar (1971) (52-58.416-hour catch ln vll lagee wlthextensive rlce cultlvatl.on - Bee above) desplte better spraylng coverage and poeslblytlnely epraying of the Euroer huts Ln the lnveetigatlon of Onorl et al. (1975). Thereforeboth lnvestlgatlons demonstrated that Dulcherrinus perelsted ln the sprayed area6 bttlnguan and reetlng outdoora
.l.n consl.derabLe numbere.
- Exit trap obeervatLonsj 4 exlt wlndow traps were lnetalled ln each indlcatorvil lage and operated at fortnlghtly lntervals. Although the observatLons nere very ltnltedln tine and nunber of trape, they 6t111 provlded ueeful lnfornatlon. {".-fSg""g, waa ootrecovered fron the exlt traps ln eLther the sprayed or uneprayed area.-;ff i6er hand,pulcherrlnus was collected fron the exlt traps ln the unsprayed area durlng July-Septeuber,but never frorn the trapo ln the sprayed aE€a. 0f 30 pulcherrLoue recovered fron the exittraPs ln the unsprayed area, f5 (502) dled during a 24-hour holdlng perlod, but 13 of thosewhlch dtd not eurvlve were unfed fenales, an lndtcatl.on that the nortallty nlght have beendue to nlshandllng and unfabourable holding condltl.ons.
Further, ArtenLev et al. (L977) aleo remarked that desplte DDT houee spraying ln therlce giowlng areas of northeastern Afghanlstan the lndlcence of malarla has not decreased,and by the end of the 1960-s the nalaria enderolclty na6 conetantly on the increase.Entouologlcal lnvestlgatlon by the Sovlet nalarla control team showed that DDT spraying dldnot k111 the nalarLa vectora.: pulcherrlnus and !11ry,. The former specles nas found tobe partly exophll lc and lrritable by DDT, and therefore had no contact wlth the eprayedeurfacee. The latter epecles was found to be exophll lc and reslstant to DDT. Therefore,it wae recoomended that DDT spraying should be discontinued 1n rlce growlng areas but notln nountalnoua areas where superDictua le the vector. Other neaaurea were suggested.
Malarla control meaaures suggested by varlous authors for Kunduz area are ehottn underSubsec t l on ( t l ) , I and 4 (a ) be low .
In Pakistan, Rel.sen (1978) reported the results of a noequlto survey carrled out lnaeven euburban and rural vl. l lages ln Lahore area, PunJab durlng L976-L977 and nade notea ont h e b 1 o n o n l . c s o f s p e c 1 e s e n c o u n t e r e d . A n . P u 1 c h e r r 1 o u s a n d & @ a s a n o p h e 1 1 n especles aesoclatlng the rnaln vectors, nere found restlng lndoors tn high deneltLee, butlarge nunbers of the two specles nere aleo coll.ected restlng in outslde restlng el.tes,uslng a nechanlcal sweeper. The outdoor restlng collectlone lncluded half-gravld andgravld fenales (see under 4.5 below).
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vBc /90 .3MAL/90.3
3.8 sappl lng of nosqul tos in f l lght
age 5 l
The only lnfornatlon that could be traced comes froro Saudi Arabia and Afghanistan.Daggy (1957) work ing ln the Eastern prov lnce of Saudl Arabla used the New Jersey l tght t rapfor sarnpllng nosqultos. A sroall proportlon of pulcherrirous was caught along with largenunbers of etephensl as shown under 4.8 below. Ward (1972) dur ing h ls observat ions inKunduz area dur lng July 1970, operated CDC l1ght t raps for three n ights at Anguor Baughvl l lage and for one n ight at Bul la Quchi v l11age. At the two v1l1agesr 29 pulcherr lnuswere caught (24 fenales and 5 roales) ; a lL the fenales were b loodfed. A very sna1l nunberof hyrcanus (l fenale ar.d 2 nales) was caught only at Bu11a Quchi vll lage ln a trapsuspended f roro a t ree near several te thered col ts .
3.9 Host feedlng pat terng
In Afghanlstan, Ward (L972) gave the resul ts of prec ipt t ln te6ts carr ied out onb 1 o o d n e a I s D e a r s o f ! @ c o 1 1 e c t e d f r o n d 1 f f e r e n t 8 o u r c e s a t A n g u o r B a u g h , 1 nKunduz area dur ing July 1970: 13 f ron CDC traps in house doorways or cour tyards, 3 f rom aCDC trap p laced ln a cot ton f le ld and 18 rest lng ln caves. 0f the 94 b loodneal smears,only 8.52 gave posltlve reactlon for nan whl1e 63.82 were posltLve for bovld and therenalnLng for other aninal hosts. Extenslve sanpling of bloodneal smears of pulcherrinugrag carrled out ln the Kunduz area coverlng elght vll lages durlng July-August 1970 asreported by Zahar (197f ). Ot. 243 sneara of lg}g$Ilrus collected restlng indoors (houses,suomer farn huts and tents 19.82 gave posltLve reactlon for man. Frour the outside restlngsl tes u l th ln the yards of conpounds, 7.27 of 321 snears gave posl t lve react lon for man, andfron outsLde the yards, 5.lZ gave a posl.t lve reactl.on for man. Based on the welghted roeanof sanplee of the three aourcea, the human blood lndex (IIBI) was calculated as 9.77. Thlsrather low value of HBI ls conpensated for by the large denslty of 3g!g!g5g!ry thatpersl.eted ln the sprayed area biting Ean and restlng outdoors (to compare the HBI recordedln d l f ferent v l l lagea aee under 1.10 below).
In the data l ls ted by Garret t -Jones, Boreham & Pant ( f980) , there ls a s lngle recordfron Pakistan showlng that tn 1974 no rnan-posltlve snear was found ln a sanple of 27 smearsof PuLcherrlnus collected froro a blotope where nan waa not available at night ln a eprayedar€8. Llkewlse, Relsen & Borehan (f979) found none of 90 bloodneal smears of pulcherrinus(84 f rou cat t le eheds and 6 f ron outs lde shel ters) co l lected f rorn Lahore d let r lc t , Punjab,Paklstan during 1976-1977 were poeltlve for man. These authors also clted previous recordsfron PunJab ln 1969-1970 lndlcatlng that all 282 snears
"f tgf:ttgglg nere negatLve forhunan blood.
N o n o r e r e c e n t 1 n f o r n a t 1 o n 1 s a v a 1 l a b 1 e o n t h e h o s t f e e d 1 n g P a t t e r n s o f P @ 'and no lnforrnatlon could be traced on the hoet feedtng patterns of Ug ln thegeographLcal area under revlew.
3. l0 Longevl ty
The only Lnfornation avallable concerna pulcherrfinus and @, in Kunduz area lnnortheastern Afghanlstan where extenelve age-gradlng of its populatlons naa carrled out byvar ious authors. Zahar (197f) presented the resul ts of age detern lnat lon carr led out onsanples of puleherrlnue col.lected by dlfferent nethods ln four viJ.lages l-n Kunduz areadurlng August 1970. No Ug were dlssected slnce the numbers collected durlng thatnonth were too snall to lead to valld concluslons. The tracheole nethod of Detlnova (1962)was nalnly utl l lzed for deternlnlng the parous rate in sanples of bait capture. Since theo u t d o o r r e 6 t l ' n g p o p u 1 a t 1 o n o f I @ c o n t a l . n e d a s 1 z e a b 1 e P r o P o r t 1 o n o f B , I | G a n d Gfenales, the rnethod of elnpllf led Polovodova-s technlque (see Detinova, 1962) described byLewls (1957) to sloply Beparate the null lparous froo parous feoales was applled. I lowever,attenpts were nnde to count the nunber of dilatations in speclmens whlch had degeneratedfo l l lc les, or fo l l lc lee wl th r r fa le.e d l la tat ionstr (1.e. , fo l l lc les that eeparated out lnovarloles ln whlch developuent had never taken place - see Detlnova, L962). Llkewlse, thedegenerated foll lcles when present were used for countlng the number of dllatatlons lnepeclnens of pulcherrfinus caught by rnan-balt capture, the najorlty of which appeared wlth
vBc /90 .3MAL/90.3Page 52
fo l l i cu la r sac ( i . e . , f eed ing occu r red on the n lgh t as ov ipos i t i on ) . S ince Po lovodova -stechnique could not be appl ied on a l l specinens col lected f ron nan-bi t ing or outs lderest ing shel ters, i t was not possib le to est i t rate the proport lon of potent ia l ly dangerousfemales ln the populat lon. I t was only possib le to establ ish the t tmaxlnrunt t nunber ofd i la tat lons (nore than two) seen in specimens having degenerated fo l l lc les. Thistentat lve ly ind icated that such physlo logical age could be reached by sone feroales at thet ine and p lace of the invest i .gat ion. As shown in Table 4, the data of the Parous ratetogether wi th other entoroological ind ices recorded in four local i t ies in the Kunduz area,were used for ca lculat ing theoret ica l parameters to establ lsh quant i ta t ive ly the potent la l
epidero lo logical s igni f icance of pulcherr i rnus populat ions dur ing August 1970 when intensl -ve
observat ions were carr ied out .
Table 4. Recorded and cAlculated entomological Paraneters^ in fourlocalit ies under DDT spraying in the Kunduz area duringAugust 1970 (Nurober examlned in parentheses)
Man bi t -ing rateoutdoors
( l )
Proport ionParous
( 3 )
Probabl l l tyof survivalthroughone day
( 4 )
Expecta t lon Vector ia l
Local-l t y
IIBI
( 2 )
of ln fect ive capaci tylife through8 days
(s) ( 6 )
Zakhil
Khondan
Nawabad
Isakhal
52.0
5 4 . 8
3 . 1
126.6
0 . 0 7 5 r( 2 1 3 )
0 . 0 7 r 4( 2 3 8 )
0.0926( 1 0 8 )
0 . 0 3 3 3( rzo l
0 . 5 6 6(so7)
0 . 5 8 0 4(42e>
o.6240( 2 s 0 )
0 . 3 5 8 8( 7 0 8 )
o.7 523
0 . 7 6 1 8
o.7 899
0 . 5 9 9 0
0 . 3 6 0 6
o . 4 1 7 2
0.63400
0 . 3 2 3 0
0 . 7 0 4 2
0 . 8 6 9 7
0 . 0 9 2 3
0 . 0 6 8 2
(l) Estfunated from man-balt capture for the first half of the night when naximun blting
occurredl the rate represents na of Macdonald (1957).
(2) Mean human blood lndex (HBI) of pooled resul ts of prec ip i t in tests run on samples
drawn froro lndoor resting shelters (where avallable) during June-August 1970 and sanples
col lected f roo outs lde rest lng shel ters dur lng August 1970.
(3) Mean parous rate of pooled sanples of man- and anloal balt capture and outside
rest ing.
(4) p of Macdonald (1957), belng the probabl l i ty of dal ly surv lva l ca lculated accordlng
to the nethod of Davidson (1955) '
proportlon paroua, assuming that the duratlon of the gonotroPhlc cycle was 2 days.
(5) pn of Macdonald ( f957) , n eat inated as 8 days fot Lglg dur lng August 1970,-1og.p
frorn the tEble of Oganov-Rayevsky ( in Det lnova, 1962, P ' 128) '
t -(6) naZpn der tved f ron Macdonald (1957) by Garret t -Jones (L964); a=HBT/2.
- logeP
fTEe A-Lcffitlons were checked through the ktnd cooperatlon of Dr L. Mollneaux, Chief
Operatlonal Research OPR/CTD.
vBc/90.3MAL/90.3Page 53
These data clearly showed that only two locallttes: Zakhll and Khondan gavehonogenous resul ts qul te d l f ferent f ron those of the other two local l t les. Zakhl l andKhondan occurred in an area of extenslve rlce cultlvatlon. At Zakhll, epldenlologica.linvestlgatlon of nalarla case6 provlded evldence thac some Lndigenous case6 may havecontracted the ln fect lon at the beglnnlng of June 1970, Juat before spraylng or ehor t lyafter. At the tlne of spraylng on 6 June, nany Elcherrlnus were found ln unsprayedpremlsee and a sporozol te-posi t lve speclnen na6 detected (see under 3.6/3.7 above).HistorLes of other lnd igenous cases detected ln July lnd lcated that the Lnfect ion nay havebeen contracted in late June or durlng July through the presence of lnfectlve epeclmeneof Pulcherrinus that Day have taken refuge 1n unsprayed prenises or ln suruler farm huts andln outslde resting shelters. Sunmer huts renained unsprayed unti l late July. At Khondan,there was also evl.dence that. rlost of the lndlgenous caaes detected ln June 1970 nay havecontracted the infection before spraying on 6 June or shortly after, and that the largenajor l ty of lnd lgenous cases detected ln July were ln fected ln la te June. I t was a lso lnthls localtty that an appreciable densLty of pulcherrlnus was found in unsprayed preolsestwo weeks after spraylng and a sporozoit.e-poeitlve epecloen nas detected in a eanple ofb l t ing catches at a nearby s l te (see under 1.11 below). Ln August , the populat lon eanpledfrom men- and anlnal balt capture and fron outslde restlng shelters at Zakhll and Khondangave conparable parous rate6, and the ttnaxlmuntt nunber of dllatatlons seen (lncludlngsauples of the outs lde rest lng populat lon) was 4-6,1. .e. , a proport lon of the populat loncan reach a potentl.ally dangerous age, baeed on a aporogonlc cycle of 8 daye for P. vivaxand a gonotrophlc cycle of 2 days. WJ.th regard to Nawabad, this loeallty belng sltuated lnthe drler part of Kunduz valley had patchy rl.ce cultlvatlon (see 3.6/3.7 above). It hadthe best survell lance actlvlty due to the presence of a coneclentlous voluntarycollaborator, but no entomologlcal observatlons had been carrled out prlor to August 1970.Thls local l ty was a lso selecteQ for observat lons on account of belng representat lve oflocallt les havlng the hlghest number of nalaria caa€s. The prlnary attack of eeverallndlgenous caaes occurred durlng June-July, whlle others durlng the flrst l0 days ofAugust, Just before the entonologlcal Lnvestlgation wae carrled out. Most of theee caee6lndlcated that they l lved in sunner huts. As shown under 3.6/3.7, these huts appeared ae ahaulet of scattered houeee cloee to the naln vll lage. They were constructed ln May-Juneand remalned unsprayed unti l the beglnntng of Auguetr l.e., about l0 daya before theentonologlcal obeervatlons were made. fhls seened to have nuch reduced the denelty ofpulcherrlnue in the area whlch already had a 1ow vector output due to l inlted rlcecultivatlon. Yet, aged lndlviduala were sttl l cLrculatlng ln the area aa ehown by a falrlyhlgh parous rate recorded durlng 10 and 20 August, belng on an average: 0.5714 fron'nan-bl t ing (28 d lseected)r 0.6931 f ron anloal bt t lng (88 d lseected) and 0.5896 f ron outs idereetlng shelters (134 dissected); the rrrnaxluum" nunber of dilatatlons eeen was 4-5 lnsanples of outside restlng shelters. Thue, lt would eeeu that desplte spraylng of aummerhuts, an appreclable denslty could 8t111 flnd refuge ln outslde restlng eheltere(f0.5 F + HC + G/roan-hour). In Isakhel, an infant was detected wlth P. vtvax lnfectlon on15 Auguet wtth the onaet of fever one week earller. As shown under 3.613.7, thle localltyconprlsed scattered hanlete sltuated anidst ftelds wlth large areas of rlce cultlvatlon.Surmer huts were few and all sprayed. Houees ln the hanlet of the posltive lnfant ehowedei.gns of lrregular spraylng and that a proportlon of eprayed preulses were replastered.Thls locallty gave the hlghest Dan and anlnal bttlng rates of pulcherrlnus Ln Auguet (eee3.5/3.7 above). Even the nan b i t tng rate ln a replastered roon naa aa h lgh as 102/nan/ha1fnlght. On the other hand, the parous proportl.on was the lowest recorded ln observatlonenade ln August , being 0.3741 f ron nan b i t tng outdoor (286 d lssected) , 0.4390 f ron uanbt t ing lndoor ( replastered roon) , 0.3456 f roo anlnal b l t lng outdoor (217 d leeected) and0.2927 froro outslde restlng shelters (123 diesected); the naxlnun nuober of dllatat.loneeeen in nan bltlng and outdoor restl.ng sanples was 4. The lon parous rate recorded tn thlslocallty posed an lnportant questlon as to the source of breedlng eepeclally that rnost ofthe rice flelds ln the surroundlng area were dry. Enqutry showed that ln thls local.ltyfarmers had to reaort to lnternlttent drylng of rlce ftelde due to a shortage of water lnthat season. They lrrigated rlce flelds every 9th day and the nater ln the flelde dld notstand for more than one or tno days. The stagnant nater ln lrrlgatlon canals wouldtherefore aeen to have been the naln source of anophellne breedlng. Detalled examlnatlono f t h e d a t a o f a g e - g r a d 1 n g d 1 e s e c t 1 o n s o f t h e s a n p 1 e o f ! @ c o l 1 e c t e d f r o o t h e
vBc/ 90. 3MALi 90 . 3Page 54
outs ide rest lng populat lon showed that of 123 fenales exanlned, 35 were unfed of which only
one nas parous, ani of the other 88 fenales, 35 were Parous; the overal l mean of the
proport ion parous was 0.3588. I t was, therefore, Possib le that the day of sarnpl ing at
i " "Lt" t co inc lded wi th an ln f lux of newly emerged pulcherr inus females causing a temPorary
inbalance ln the Parous rate. For this reason, it l | totl1d btneg:s:ary to determine the
par i ty of the vector populat ion f rom repeated sarnpl ing of the b i t lng and rest ing
populat lons dur ing the t ransmiss lon season. l toreover , the exper ience obta ined f rom Isakhel
caLls for carefu l assessment of the ef fect of in tern i l tent dry ing of r ice f ie lds and for
prevent lng stagnat ion of the water ln l r r lgat lon canals '
Wlth due reservations to sanpling probleros, the corobinatlon of the entonological
paraneters neasured under conditions pievail ing ln August as shown ln Table 4 ln terns of
the index of vector la l capaci ty would indicate that nalar ia t ransniss ion was l ike ly to
persist ln the DDT sprayed area of Kunduz having the sane ecology as thet of Khondan and
Zakhil, but at . r,r"ir lower rate ln localit les slnilar to Nowabad and Isakhel' The
calculated lndex of vectorial capaclty denoLes that at Khomdan, Zakhl1, Nowabad and
Isakhel, the potentlal nunber of secondary cases Per an untreated P. vlva:l !1ri11l_"?":"
wou ld Ue O .ZO+2 ,0 .86897 ,0 .0923 and 0 .0532 pe r day resPec t i ve l y ' o r one case eve ry I ' 42 '
1 .15 , 11 , and 15 daYs resPec t i ve lY .
In the t r ta l o f Onor i e t a l . (1975) sanples of pulcherr inus and hyrcanus col lected
restlng ln day-tlne and bltlng oan and animal lndoors and outdoors ln the unsprayed and
"pr.y"i areas ln Kunduz were dissected for deternlnlng the Parou6 rate and countlng the
fo l l lcu lar d l la tat ions. Deta i ls of nonth ly resul ts we;e tabulated, but only the tota ls of
the perlod July-october are reproduced trerl tn Table 5r'
Table 5. Proportion parous of day-tloe restlng and bltlng populatlons of
Pullherrlnui and hyrcanus- in Kunduz, July-October 1973-(Fo.
dGsected tn Parenthesls)
Source Dulcherrinus hyrcanus pulcherrimus hvrcanus+
DDT sPraYed area
Indoor outdoor lndoor outdoor lndoor indo'or outdoor
Day-tlnerest tng
Bi t lng Dan 0.29(48 ) (22s ) [ r l * $2 ) [ z ] * * ( r40 ) 0 (79 )
aninal
*[f] Onty one feoale was collected and found Parous'**[2] Only tno feDalea were collected, of whlch one ltas l-parous'
A s c a n b e s e e n f r o m t h e s e d a t a , t h e p r o p o r t l ' o n p a r o u s o f ! @ T d y + qwas generally low in both the sprayed and unsprayed areaa, and the authors also reDarKed
that the Percentage of females lf potentfally dangerous age was very low ln both areas'
p u l c h e r r l n u s w a s m u c h l o w e r t h a n t h a t r e c o r d e d b y Z a h a rln the Kunduz area (6ee Table 4 above) even lf couparlson ls
1970 and tho6e recorded by onor l e t a l . (1975). Di f ferent
i:-EA;."4""ed-by pernl.sslon of Dr E. Onori and the Transactlons of TroPlcal Medjlclne &
I lyg lene f ron the paPer of Onor i e t 41. (1975)
0 . 1 7( 6 3 3 )
- 0 . 2 6( s40)
0 . l 4(223)
0 . 2 6( 4 5 1 )
[The proportlon parous of( f97f) f ron sprayed local l t lesnade between the data of August
(2r7 )( 4 7 6 )
vBc/90. 3MAL/90.3Page 55
ecologlcal condltlone nay have accounted for the dlfference ln the parous proportlonreco rded by Onor l e t a l . ( 1975 ) and Zaha r (1971 )1 .
I t ls usefu l to note that Ar tenlev et a l . (1977) (see 3.6/3.7 above) nent loned thatdlesectlon of more than 20 000 fenales of !g@1!0us and lyIggg for deteroination oftheir physlologlcal age conflroed that the reconmendatlon to dlecontlnue DDT spraylng andreplace 1t by ant l larval measures rvaa correct , s lnce the percentage of potent ia l lydangeroue fenales and the degree of their contact with rnan dld not lncrease after DDTspraying wae wlthdrawn.
Dukhanlna & Quadeer et al. (1974) dellnlted the nalaria transnlsslon season 1n Kunduzarea from the data of potentlally dangeroue fenales of hyrcanus and glg@S as shownLn Subsect lon (11) under I below.
l . l l Na tu ra l l n fec t l on
As noted by Zahar (197f) , g land infect lons were detected by M.S. Badawy, f f iOEntonologlet ln Afghanletan (unpubllshed report to l lHo/EMRo, 1970), aEong sanples ofpulcherrinus and @, caught frou Kunduz area durlng July-August 1969, but the rnaJorltyof poeltlve epecloena cane fron delayed dlssectlone, as the sanples were kept under tdealcondltlone ln the laboraotry for varylng perlode up to 10 days. 0n1y the results ofdlssectlons carried out wlthln one day froo the date of capture (Table 6a) could beconel.dered rellably Lncrlnl.nating the two epeclea aa vectors of nalarla ln the Kunduz aE€a.
Table 6a. Results of gland dleeectlons, Kunduz areaJuly-Septeuber 1969.
Locall.ty& date
Pulawkanar8 July
Lalaualdan15 July
Zakhll3 Septenber
Source pulcherrlmus hyrcanus
Dlssected Sporozol te * Dlesected Sporozol te *Nlght bttlng
outdoore* 36 2
r f 6 2 L
Outs ldereet lngahel tere
Total 3698
Sporozoite * 3. rz 2 . 8 2
* Sanple fron nan and anlnal bit lng were pooled.
Further dl.eeectlone carrled out by Badawy ln 1970 lnvolved only pulcherrfuoue(pereonal coomunlcatl.on, 1970) as shonn ln Table 6b.
Table 6b. Reeults of gland dlseectlone carrled out on oulcherrlmusKunduz area. June-Julv 1970.
Local l ty Tota l co l lected Dlesected Sporozol te +& date & eource
Zakhll,6 June
Khondan,2l June
lladrasa,13 Jul
89 fron 4uneprayed roolrs
Nlghr btttrig(cattle)near ungprayed rooue
43 froo 3sumer huts
Sporozolte +
37
2 . 8 2
vBc/ 90 . 3MAL/ 90. 3Page 56
I t nay be of in terest to note some exper inenta l in fect . ion carr ied out in nor theasternAfghanistan. Muir (unpubl ished repor t to WHO/SEARO, 1966) succeeded in ra is ing ln fect ionexper inenta l ly in Dulcherr imus f ron pat ients of P. v ivax in the Kunduz area. Later ,Anufr ieva, Koshelev & Mark in (L977) ln fected hyrcanus and pulcherr iqus on L;1!g pat ientsin nor theastern Afghanistan. 0f 123 females of hyrcanus d issected, 2 were posi t lve foroocysts, and of 60 feroales of the same species d issected for g land infect ion, one was foundto be posi t ive for sporozoi tes. Wl th pulcherr inus, 2 specinens out of 10 d issected werefound wi th oocysts. These exper imenta l resul ts were taken to lndicate that the thro speclesIr tere suscept ib le to the local s t ra in of P. v ivax and conf i rn thel r ro le in nalar iatransmission in rice growing areas of noitlff irn Afghanistan.
3 . I 2 Vec to r res i s tance to i nsec t i c i des
In I raq, Iyengar (L977a) shoned that DDT res is tance in pulcherr inus was indicatedfron tests carr ied out in 1971 in a local i ty in Baghdad province where one-hour exposure to47" DDT gave 47.32 nor ta l i ty . In 1974, tests wi th the sane exposure in the same local l tygave 69.62 roortality, and prolonged exposure for two hours on the saDe concentratlon gaveonly 882 mortality. At the sane tlme, pl4glglgg showed normal susceptibll i ty tonalath ion.
Fur ther , Manouchehr l ( f980) conf i rned the presence of DDT res ls tance ln pulcherr inusfron tests carried out in Mlssan and Salahuddln provinces in Iraq during March and May1978. The species renalned suscept ib le to Dalath ion, and ln Ashegh v l l lage in the la t terprovlnce whlch was not sprayed with nalathlon, the LT* was about 15 nln.
In Afghanistan, Onor i e t a1. (1975) noted that tests n l th one- hour exposste to 47"DDT during 1968-f970 showed th.t !gfg@!g ln the Kunduz area wa6 qulte susceptlble toDDT as l00Z nor ta l l ty was recorded (758 tested) , but i t 1972 the nor ta l l ty was 96.82 (L29)tested and dropped fur ther to 89.77" (78 tested) ln 1974, ind lcat lng lnc ip lent DDTresi .s tance. In contrast , pronounced DDT res ls tance ln hyrcanus was indlcated f rorn te6ts in1969 wi th one-hour exposure to 47 DDT whlch gave 53.82 nor ta l l ty (ZZS tested) . Fur therdeter iorat ion in suscept ib l l l ty of hyrcanus to DDT was observed in 1972, when the sameexposuie gave only 24.27" rnor ta l l ty (66 tested) . Zahat (197f) showed that Badawy's tests lnthe Kunduz area durlng L970 lndicated that whlle pulcherrlmus waa susceptlble to DDT,hyrcanus was qul te res is tant to DDT, but both species nere auscept ib le to d ie ldr in .
Fur ther , Kulkova, Ern ishev & Polevoy (1975) repor ted the resul ts of suscept tb l l t tytests carrLed out ln the districts of Kunduz, Imam-Sahib and llodJagar ln northeaaternAfghanistan. These tests conflrned the presence of, DDT reslstance ln tJlrcanus as l-2 hourexposure to 47 DDt did not glve more than L5-242 nortallty. At the saiff inireducedsuscept ib l l l ty to d le ldr in was noted. In July 1973, one- and two-hours exposure ofpulcherrirous to 4"1 DDT gave 417 and 977" mortaLity respectlvely, but ln Septenber ruortalltytn this species lncreased to 827" nlth one hour exposure to 47" DDE.
Ln Saudl Arabia, Pef f ly ( f959a) noted that DDT house spra iy ing was appl led fornalar ia contro l ln the Eastern prov l .nce f ron 1954 to 1958. In v iew of DDT res is tance lnthe maln vector, ! '1!gp.@!, DDT was replaced by dleldrln lnit ially on an experfuoental baslsin 1954, and on a large scale frorn 1955. I{hile DDT was being used, pglg$lggg !ta6collected fron aprayed houses only occaslonally and ln sna1l nurobers, but under dieldrinspraylng, i t s tar ted co appear ln greater nunbers ln sprayed premlees. This t rendcont lnued f rorn 1955 through 1958. Tests carr led out in 1957 and 1958 showed thatpulcherrfuous ri las ausceptlble to DDT, but reslstant to dleldrln. The author reviewed theprevioue L i terature regardlng the possib le ro le of th is species, and concluded that i tshould be carefully watched ln the Eastern provlnce of Saudi Arabia.
The WIIO Expert Connl t tee repor ts (1980, TRS. No. 655 & 1986, TRS. No. 737) l ts tedhyrcanus as reststant to DDT ln I raq, Afghanlstan and Paklstan, wi th d ie ldr ln res is tancerecorded ln thls epecLes ln Saudl Arabla and Paklstan. The latter rePort showed thatpulcherr i rous ls res ls tant to DDT ln Afghanlstan, I raq, Paklstan and USSR.
vBc/90.3MAL/90.3Page 57
4. An. stephensl and the An. cullclfacles conplex4.1 Vector lmportance
An. stephensi and $!!g!.!g!g are wldely distrlbuted in the area ofIndla (see nape of ,F lg. 9 and Flg. 10 reepect lve ly under SECTION I I o f VOL. I IVBC/90.1-1.{AL/90.1)^. Thei r d is t r ibut lon over laps in several countr l .es of chegeographical area under review. Both act aa vectors of malarla in most of thelrd ls t r ibut lon ranges. Ear ly s tudies showed that two forns of An. etephensi ex ls t :A n . s t e p h e n s 1 t y p e f o r n a n d 4 9 : - @ . 1 v a r . @ ' , t h e e e p a r a t 1 o n b e t w e e n t h e t w ohras Easedon egg measurements. Recent studles have lndlcate{ that the two forms should beregarded as populat ion var lants a6 shown ln deta l l ln VOL. I - Recent ly , cytogenet lcstudies succeeded ln ldentlfying four sibling speqles: A, B, C and D tt lgF"llgg$popul.atlons ln Indla as also descrlbed ln VOL. I. ' Subeequently, exam{natlon of thepopulatlon of culicifacles in Paklstan showed the presence of apecies A and B, andldentlf lcatlon oFuateilal fron cullcifactes frorn UAE and Onan revealed the presence ofonly specles A. As shorrn ln VOL. I- an experluent was carrled out to deterrnlne theeueceptlbil l ty of specl-es A and B to P. vl.vax under laboratory condltlons ln Pakletan, andfteld studles were conducted to deterilff i vectorlal efflelency of Sgl$llgglg s.1. lncomparlson wlth.ggg3@.! and eubplctue ae ehown under 4.l l below. In Indla, progress haebeen made ln field studEe alned at detenoinlng the relatlve lnportance of epeclee A and Bof the An. cullcifacleg couplex ln nalarla transnlseion. As nentloued ln the IMRODUCTION'lt ls useEufto sutmarize the fleld experl.ence galned fron studles carrled out ln Indla onroenbere of the An. cullctfacLes conplex, deepite the fact that Indla Le not lncluded ln thegeographLcal arffi
4 .2 E:eedtng habl tat
S e r v 1 c e ( l 9 8 5 ) d e s c r 1 b e d t h e b r e e d 1 n g h a b 1 t a t s o f 9 . g @ 1 ' a n d @ 1 'general. An. stephensl breeds Ln man-nade habitats aesoclated wl.th towns, euch ascls terns, nel1t=ut ters, water s torage Jars aad conta lners, dra lns, f reeh or bracklehrratera, and even polluted naters, and ln rural situatlone ln grassy poole and alongslderl.vere. An. cullclfacles breeds ln great varlety of clean and polluted. habltate,t r r 1 g a t t o i @ f 1 e 1 d s ' 8 I ' a D P a l P o o 1 e , w e 1 1 e , b o r r o w - p l ' t s a n d o c c a e l o n a 1 1 y 1 nbracklsh rrat€Eo It prefers sunllt or ehaded habltats.
N e w l n f o r n a t l o n o n t h e b r e e d 1 n g h a b l t a t o f e t e p h e n s 1 a n d @ c o D e a f r o u afew countries ln the geographlcal area under revlew. Thus, old observatlons are eunnarlzedln order to provlde a background on the baelg of whtch new studlea caD be planned under theprevall lng ecologlcal conditlons
In lraq, past studies of l lacan (1950) showed that.g,'1!g$.! larvae ln the alluvlalplaln reglon was found Ln large nunbere ln snall breedlnf placee. Burrow-plte' both wlth
and without vegetatlon often ylelded a high denelty of g,'1!9j!gg.! larvae. In certalnlnstancee, lt wae found breeding ln burrorrplts anong hunan habltatlone contalnlng water
whlch appeared to be polluted, though there naa no aualysle to conflrn thle. Larvae of
etephenii were aleo found breedlng ln eeepage pools along the shore of the Tlgrle river
ffie-L;fr-water level was low. Moreover, larvae of thls epeciee were found ln hoof-prlnta
full of nater from an lrrlgatlon canal. In the Shatt-Al-Arab date paln reglon, larvae of
stephensl were found aesociated wlth the followlng condltlone ln the lrrigatlon channels:
abeence of t ldal moveuent; abgence of f ieh; presence of vegetatlou. l lhen a channel dried
up, breaklng Lnto poole, a large populatlon of etephenei larvae wae often encountered.
Cfifng a report from lran, larvae of etephensi rere Touna' aooetlnee abundantly at
T:-fre-a'i'Gii-lbutlon of cullcifacles and lts subspecles, @ehould be errendea fn tfiElilIii-,-ot ffg. l0 tn SECTION tr oilvOl. II, to cover the coaetalarea of northern Yemen as reported by Kouznetaov (1976). Likewiee, ltaP 4d, p. 19 ln theorlglnal docunent, lnO/VBC/8t.957 should be corrected. For detalle of the dletrlbutlon of
An. cullcifacles and An. cullclfacies adenensls ln southern and northero Yeuen, eee PART I,
Asla west ofin document
[email protected]. VOL. I: VECTOR LABORATORY STUDIES' Document VBC/88.5-UAP|88.2' pp. 48-52'3. The same docuuent of VOL. I, pp. 40-45.4. The sane docuuent of VOL. I , p . I51.
vBc/90.3MAL/90. 3Page 58
I , tasJ id- l -Sula lnan, in any stagnant pool not ln f requent ly n ixed wi th decaylng lnsects and
occaslonal ly in hrater s l ight ly s ta lned wi th nanure '
Hul l igan (1967) rev iewed the observat ions made on malar ia in I raq and I ran f roro 1941
to 1943 dur lng Wor ld war I I and conpared these wi th the or ig inal observat ions of
Chr ls tophers & Short t (1921). Dur ing that per iod_r- s tep\ensi was recorded f ron many
localit les ln the alluvial plains exlendlng fron rhiiEqTi to the Persian Gulf (see
Flg. f ) . I t was found breeding ln a wide var iety of p lacest most of whlch were man-made'
I ts larvae were f requent ly encountered ln burrow-pl ts and excavat ions f roo which ear th was
taken to repal r r iver banls. Such p laces were found to hold ldater for pro longed per iods
during sprfng and early sumper when river levels were high, but by far. the nost inPortant
breedlng p laces for s tephensi were associated wi th i r r igat ion, Par t icu lar ly tn the systexos
where water rr"s di"#iff ia-Ey gravlty. A high incidence of nalaria was alnost invariably
assocl .ated wl th perennla l l r r igat lon. The problems arose not f ron the l r r igat ion canals
pslE, but f ron 1eaks, seePages and over f lo l ts f roD then, as wel l as f rom inter ference wi th
natura l dra lnage and f ron the general wastage of water caused by care less nanipulat ion of
water by farners. Natura l depresslons and excavat lons l tere f requent ly f i l led by water
leaklng or seeping fron lrrigltton canals or aqueducts, and sometlmes by the exposure of
the greatty elevaled lrater taUte caused by pourlng water on to the land in the absence of
counter-dralnage. In sharp contrast to tire htgh lncidence of nalaria associated with flow
lrrlgation, l. l i t le or no lnfectlon occured in areas where the land was higher than the
leve1 of the r lver . I t was neceasaryr theref ,oret to ra ise water for i r r lgat lon e l ther
nanually or by nechanical PuEPs. This vlrtually l lnited the amount of water used to
rninfunal requireDents, and as 1t was dlstrlbuted lnternlttentlyr no Permanent breeding
places were formed. Any excess lrater readily found lts way back to Ehe rlver through
natura l dra{nage. In those par ts of the a l luv ia l p la ins which nere not d i rect ly ln f luenced
by 1arge r lvers or l r r igated f ron then, water was of ten found at a dePth of 5-6 n ' I ' Ie l ls
in such areas were free frorn anophellne breedlng, posslbly because of the hlgh water
sal ln l ty or because of thel r f requent use for l r r lgat lon PurPoses.
I t is in terest lng to note that Zulueta et a l . (1968) suspected that Dore than one
fom of stephensi exisled ln lraq. The fact that in Fao Marolaha area of southern lraq, the
breedlng p laces of s tePhensi of ten had a very h lgh sal in i ty , equal to or h igher than that
of sea water, sugges-EFEfriposslble exlstence of a salt-water-breeding-@.!
b lo loglcal ly d is t inct f ron the f resh water forn. Stra ins of !gP!s! f roo th is- local i ty
were cro6sed wl th others f ron I raq, I ran and India. A11 grosses produced a v iable Ft
generat lon and there nas no ev ldence of hybr ld s ter1 l l ty ' -
In Kuwait, I l lra, Behbehanl & Al-Kandart (1985) who reported a considerable increase
in the number of inported malarla ca6ea ln this nalaria-free country between 1980 and 1983'
d lscussed the possl l i l t ty of the establ lshnent of oalar la t ransrn lss ion. Since 1981 ' the
larvae of stephensl and pulcherrlnus have been found ln seepage pools periodically and ln
snall nuobers al,fiE ttre fiI!f,@lEiding lnro Kuwalt fron rraq (cltlng inforrnation provlded
by the Insect and Rodent Conbtrol Section, Kuwalt). Both specles are known vectors of
rnllarla ln nelghbourlng countries, but the authors considered that clinatic conditlons
rhroughour rhe year ln Kuwalt would work agalnst the survlval of adult_a".P|:11::t :: :n'
coopletton of the sporogonlc cycle. A report by the l ' talarla Advlsory Tean (1985)- showed
thai stephenel larvae contlnued to be recorded ln breedlng places ln the nll l tary zone and
ttre sffi l f igs from 1981 to 1985 lnclusive, lndlcating that thle specles has becone
eetabllshed in Kuwalt. Due to a ehortage of nanpower, larvlcidlng operatlons have not been
conducted weekly as planned. Rather than ftnding the aource of lnfi l tratlon of this
mosgulto, {t was deened more loportant Eo organlze its control regularly and to conduct
entonological lnspectlon fortnightly all year round'
Rathor (f988 - unpubllshed report to WHO) vislted Kuwatt ln Decerober 1988' He
surveyed 13 farns 1n Ahnadl, Itawally and Al-Jahara governorates and only one farrn was found
posltive fo. [email protected] larvae. He Lhought that thls night have been due to the low denslty
f$E-ror;Erails 1n VOL. I, document VBC/88.5-MAP/eA.Z, P. 49. -2. Report of the l la lar la Advleory Team, (Far ld et a l . ) 28 ot tober- l3 Decenber 1985' Heal th
Secretar lat of the Arab States of the Gul f . ( In Arablc) '
v B c / 9 0 . 3MAL /90 .3Page 59
prevall lng 1n the cold season. Exarninatlon of larval survey data showed that the posltlvebreedlng p lacee fot [email protected] lncreased f rom 57 ln 1987 to 6% ln 1988. Moreover, larvae ofstephensl were found breedlng 1n three areas ln the capl ta l c l ty . Two farms were foundposl t lve 1n Apr l1 1988, which represents the f l rs t peak densi ty per iod. Probably,t reatEent of breedlng p laces was d lscont inued and no act lon was laken to e l iu inate theadults, therefore the two farms were poeitlve agaln ln October. The data of the nurober oflarvae detected nonth ly dur lng f98f-1988 lndlcated that there are two peaks annual ly : theflrst ln April-July and the second in October-November. For oaintainlng effective veclorcontrol, an lncrease of rnanporrer was recommended.
In Bahraln, Afr id l & Maj id ( f938) dur lng a malar la survey ln d l f ferent par ts of thels land, found stephensl to be the predoninant specles. I ts larvae were col lected chlef lyf ron agr lcu l tura l dra lns, leakage pools, ehal low domestLc wel ls and garden p i ts conta ln ingseepage water . Thus, the breedlng habl tate of th ls species ln Bahraln resenbled thosedescr lbed f ron lower Mesopotamia (c l t lng Chr is tophers & Short t , 1921), but contrasted wl ththose of Muscat, Onan, where 1t was not found breeding ln wells. [Later Burveys ln Omanrecorded stephensl breedlng ln wel1s - Eee belowl . Unl lke the s l tuat lon in Bonbay, Indla,no gEp,Iggg! larvae were found ln overhead cisterns in Bahraln. It was lnterestlng toobserve that ln unused welle and garden plts ln Bahrain, the lntensity of breedlng ofstephensl varled considerably, and that whl1e large nunbers of larvae were found ln soneexcavatl.ona, others ln the lnnediate vlcl.nlty nere negatlve. This occurred when theexcavatlons remalned unused for sone tine. On the other hand, the presence of seepagenater in a waterlogged area had the opposlte effect of lowering the eall.nlty, and euchbreedl.ng places were therefore favourable for nosqulto productlon for a longer perlod. Thenater sal.inlty wae deternlned ln sanples taken fron various type6 of breedlng places. Theupper l lntt of water sallnlty ln which stephensi larvae were found was 2.752 chlorlnecontent. No larvae or f leh were found Ln unused welle whlch had a sallne content of 37.The breedlng of cullcifacles in Bahraln was very l lntted; lts larvae nere encountered ononJ.y two occaslons: ln an lrrlgatlon channel of an arteslan weII, and in a tank containlnglnpounded water frou an undergrouod aqueduct. The breedlng of pulcherrlnus ln Bahrain asdescrlbed by the authors was shonn under 3.2 above. The breedlng of f luvlatl l ls ln thelsland nas very l lnlted.
In Saudl Arabla, Daggy (1959) polnted out that nalarla ln the Qatlf and Al-l laea oaaesof the Eastero provlnce wae largely man-oade; the great naJorlty of anophelLne breedingplaces resulted frou the inefficlent lrrigatlon and draLnage Bystems whlch had beenprevl.ously constructed. Aluoet all the anopheline breeding placee could be attributed tothle source. Daggy descrlbed 12 types of breeding places and revlewed the lLterature onthe breedlng habltate of g-gg.p$g! Ln other countrles where Lt exlsts. Fron hlsconclueloas, stephensL can uti. l lze a wlde variety of ground water accunulatlons forbreedlng ln the oaaea of the EasterD province, Theee vary ln slze froo hoof-prlnts toProtected nargine of large lakes or swamps, fron puddles free of vegetation to overgrowndralne and eeepage areaa, fron stagnant water to protected oarglns of eddies ln swlft lyflowing dralnage dltche6, fron freeh nater to highly bracklsh wate.r, and froo clean tohlghly polluted watera, The larger snamps nay be lese frequently used by stephensl than byother anophellnes. The only breeding sites whlch were totally free f.or [email protected] were Ehelarge rtave-anept tenporary lakes and the snall artlf lcial contalners.
In Qatar, no local nalarla tranemlsslon has been recorded whlle lnported cases havebeen reported contl.nuously. Several aurveys of the avallable breeding placee have beencarried out by tl l lo advisers whLle tnvestlgating the malarla situation in the country.Inlt lally, van der Kaay (1967-unpubltshed report to $ItO) recorded Btephensl breedlng ln afew wells Ln gardens at Al l{ukalr and Al Raggan vil lages sltuated 8t 10-15 kn fron thecapltal clty, Doha, and eurrounded by desert. At Un al Silal vl11age, also eurrounded bydesert, stephensL larvae were found ln d cenent reeervolr used for storage of irrigatlonrrater drawn from a well which had been larvlclded wlth o11. At the saroe vlllage, gj.g!g!g!Larvae were collected frorn a depre.esl.oo created by renoval of clay for house conetructLon.In Doha ltself, no 9.9g!9g! larvae were found, although potentlal breedlng places exlstedin gardens ln the town. Further, Shldrawl (I978-unpubllshed report to WIIO) did note n c o u n t e r 8 t e D h e n g 1 b r e e d 1 n g 1 n D o h a , b u t c o 1 1 e c t e d @ a s 8 o c 1 a t e d w l t h c u 1 1 c 1 n eIarvae ln low densltles in a sallne nater slrarop at the eeaside. Later, Farid(I980-unpubHshed report to WHO) reported the resulte of larva1 surveys carrled out by the
vBc /90 .3MAL/90. 3Page 60
local entonological tean in several towns and vil lages, although the tlning of the survey(Septenber-October) was unsui table as breeding p laces were few af ter seven nonths of a drysurntner period which followed the raln that nornally occurred during the previousautumn-wint .er seasons. Nevertheless, .@91 larvae could be found in several p laces:f resh water swamp in Doha; water co l lect ions near cement water baslns at Rayan, Un Kihaband Shahaniyal etagnant r . ta ter wi th a lgae and vegetat lon in 'a cenent l r r igat lon canal and abasin in two roodel farms; and two unused wel1s (5 n deep) ln a farn near A1 Waklr v i l lage(where van der Kaay recorded larvae of s tephensl ) . In h is remarks on the f lnd ings, Far id( loc.c l t . ) pointed out that in most coasta l areas where local lnhabl tants l lve, only a fewbreeding p laces were found, whi le in the in land farns in the nor thern par t of the country,s tephensi could be found 1n any water co l lect ion. Several of these farms had groups offore ign labourers, amongst whom parasi te carr iers may exis t , poslng a threat towardsestablishi.ng nalaria transmLsslon. Future entonological surveys should be conductedi rnnedlate ly af ter the ra lny season, i .e . , February-March, so that depresslons f i l led wi thwater near or lns ide torms can be checked. Dur ing,a more recent v is i t , Far id( I984-unpubl ished repor t to WHO) carr ied ou! a br le f survey ln Doha and recorded stephensll -arvae' ln water co l lect ions near abandoned houses and on ' the coasta l road. A11 the aboveauthors reconnended several neasures for deallng with the problen of lnported nalaria lnQatar and for aroellorating control Deaaures and strengthening entonological vlgllance.
In UAE, Zahat (1969-unpublished report to WtO) carrled out a prelirnLnary roalarlasurvey durlng March-Apri1 1969 Ln certaln part6 of the country [hltherto known as theNorthern Trucia l States l as a basis for p lannlng nalar ia contro l measures. In the eaaterncoastal area, the natn anophellne breedlng places were we1ls and cenent baslns used forstorage of i r r lgat ion water drawn f roro wel1s. Water s tagnat lng ln the course of Lrr lgat lonwas hardly seen. This was considered an advantage, as lt would make control measurea Doreeconooical and falrly easy to organize and supervise. Both cullclfacies and g!39@! werefound breeding ln we1ls, th" lar*'ae of the forroer were recoviled-lls wiFh-lTluundepth of 8 ro, while larvae of the latter were collected fron wel1s wlth a naxinuo depth of3.5 n. Of 13 posl t lve cement baslns (exc luding those whlch harboured ls t and 2nd lnatarLarvae) , 12 were posl t ive for cu l lc l fac ies, one for cu l ic i fac ies 8nd g: !El ! , but none waspositive for gggg1.. Large ttr a ?ffitratt larvaenere seen ln cement bastns which were enptled but had a l ltt le \dater at the botton. Anumber of unused wells harboured culiclfacies and stephensl larvae, while others were foundwith putrif led organic natter ana-fi i ' ' ,Efrff i iry aeZT-currcrne larvae r{ere encountered. Assoue we1ls remain unused for a long tlne, the accunulation and decay of organic matter makethe water unsui table for aquat tc 1 l fe . The presence of unused wel ls resul ted f ron theintroductlon of power drlven water puDps to replace the old systen of l l fttng the waterfron wells by aninal drlven bucket systems. As part of the control Deaaures, these unusedwells should be fl l led in, but Local inhabitanta were reluctant to do so for fear thatunder drought conditlons such wells would be brought lnto operatlon particularly durlng thehot dry season. Used wells had a power drlven purnp which l lfced the water through anlunersed draw tube, hence lltt le dlsturbance occurred, and most of such wel1s were positlvefor anophellne larvae. An unusual type of breedlng place was small 15 cn high tlns duglnto the ground to dissolve organic Danure, two of which were found positive forcullcifacles larvae. In the nestern coastal area of Ras Al Khaina State, sone of the wellsanG;ffiasins were scarcely used but nere found to harbour both cullcifacles andsteJhensi larvae. In pools of brackish water forroed by a uixture ofG6-ii7Ga water,s tephensi larvae were found in associat lon wl th rnul t lco lor . In the eastern h i l ly areatcullcifacles larvae were recovered fron wells at l lasafi and Bithna. From side pools inf r f f i r v a e o f d - t h a 1 i w e r e a b u n d a n t l y P r e s e n t a s s o c i a t e d w i t h a f e w 1 a r v a e o f
was recorded as adul ts , i ts larvae could not be found.turkhudl. Although fluvlati l ls was recorded as adults, lta laryae coufd not be toundFron side pools in Wadi Han near Masafl and Bithna, larvae of an undetermined speclesFron side pools in werecol lect .ed of which gpecinens were senE to Dr M.T. Gi l l les ln the Br i t ish Museun(Nat . I t is t . ) , London' , as they could not be ident l f ied wl th che avai lable keys. In thew e s t e r n h 1 1 1 y a r e a ' 1 a r v a e o f @ . . d @ l ! w e r e c o 1 1 e c t e d f r o n 6 t a g n a t l n girrlgatton canals and dlstrlbutlng pools covered with algae and overgrown wlth vegetatlon.
a-r-.-.-g
I; D;Ell les at that t lme was unable to ldentlfy these larvae, but later he receivedeLrnllar speclmens frorn Ornan and UAE whlch were descrlbed as belonglng to a new species -
see under Onan.
vBc/90. 3MAL/90. 3Page 5 l
A. morethe
sln l larf o r
No stephensl larvae could be found, although sone aduLts nere present in houses.thorough search for l te breedlng p laceeeaEtern and western coasta l areaa, goDet o t h o s e o f @ 've r l f i ca t l on . -
ln th ls area waa suggested. In surveys oflarvae of culiclfacles showed head narklngeof whlch e!ff iff ie sent to Dr Gll l iei
The Annual Report of Malarla Actlvlt ies ln UAE (L979) showed that gLg2lSL erasrecorded by the nalar la entonologlcal teau for the f l rs t t lne 1n 1970 f ron Abu Dhabl . I twas found breeding ln barrels and shallow dltches, as well as public fountalns ln theclty. In 1976, the plcture nas changed ae Sgl!g!1!g!g larvae were collected ln largenumbers frorn cenent nater baslns whlch lncreased ln the ctty with the progress of bulldtngconstruction. The denslty of Sg!!g
vBc/90. 3MAL/90 .3Page 62
In Afghanlstan, Iyengar (1954) ln h is survey of the Kabul area, found stephensi to bethe second Eost prevalent species next to 6uperp-1ctus, but there were only a fewcul lc l fac les present . An. s tephensl was found breeding in r lver pools and d i tches. AsDent loned under 2.2 above, Iyengar found that whi le superplc tus breeding in pools of therLver Kabul rdas progressively decreasing towards the end of the sunmer, the inc idence ofstephensl breedlng lncreased reaching 8LZ of the tota l larvae of a l l species col lected inOctober.
In Laghrnan d i .s t r ic t o f the Eastern prov lnce of Afghanistan, Ramachandra Rao (1951)
found that rocky beds of r lvers and st reans forned of pebbles and boulders, prov lded idealbreeding s l tes for cu l lc l fac ies and superplc tus and to sone extent for s tephensi . As inthe nelghbouring paG-6ffiTGtan aiffiE,-frrigation channels and drains were goodbreeding p laces for cu l ic i fac ies and stephensl in AfghanLstan. In r ice f ie lds, whi leh y r c a n u s p r e d o m 1 n a t " @ ' 1 a r v a e w e r e e n c o u n t e r e d i n 8 o f 7 7 f i e 1 d s 1 n 8 P e c t e d .In a few fa l low f ie lds ex ls t ing at the t ine of the survey, larvae of cu l ic i fac ies were a lsoencountered. Swamps or ig lnal ly created by tak ing ear th for house construct lon nearvLllages and contalned rnuch vegetation harboured larvae of cullcifacles. There werep r a c t i c a 1 1 y n o o t h e r b r e e d 1 n g p 1 a c e s o f a n y s i g n 1 f 1 c a n c e ; r 6 ? f f i o w - p i t s a n d d r a 1 n sso character ls t lc of the Paklstan and Indlan p la ins, were pract ica l ly non-exls tent :
Dhlr & Rahin (1957) sumrnarlzed the lnfornatl.on obtalned frou larval catchlng statlonsln d i f ferent prov lnces ln Afghanletan. Breeding p laces of cu l lc i fac ies s in l lar to thoseshowrr above were descrlbed, whlle stephensl breedlng places ltere aholtn as river pools,dltches and burrow-plts.
In Pakistan, Uul l lgan & Bai ly (1938) in thel r malar ia survey ln the Quet ta area,rated cul lc l fac les as the second most prevalent specles of adul t Anopheles next tosuperplc tus. An. cu l ic i fac ies showed narked preference for breeding ln open i r r lgat lonchannele connected w{th spr lngs, wel ls , r lvers and karezes. Breedlng was chief ly observedln bays and backwaters along the edges of these channels, and in leaks and seepages fromthen. The nunber of cullclfacl.es larvae frou such sltuatlon exceeded that of any otherspecles encounterea aiGo-ifrFto 352 of all the larvae of thls species collected in the
Quetta area. The specles also showed oarked preference for other breedlng places such aspools, ponds, spr ings, and other col lect lons of s tandlng l rater ln whlch grassea were of tenabundant. An. cullclfacLes was also found breeding ln a varlety of other plaies but wasless prevaGffiFTG;as tncluded rlvers and streams (142), seepages and roarshy areas(82) , n lecel laneous breedlng p laces such as epr lngs under t reea, underground or par t ia l lyunderground karezes, welle1 €tc. (I0Z). An. stealg4sl was less prevalent in Quetta thansuperolctus or Sgllgllgggg. In the Quetta area, the great naJorlty of g9@.! larvaeand adulta was encouutered ln the low lylng tract between the rallway and the Lora stream.Thls area was knoso to be rlch In natural water resources such as springs, seepages,arteslan wells etc. More than 752 of all the sEephensl larvae collected in the Quetta areacame from breedtng placee ln thls locallty, and had lt not been for the control ueasuresadopted In thle part of Quetta, this proportlon would have been nuch higher. No otherprevalent epecles of .$g!9.}g, appeared to be so locallzed in Quetta. It was soroewhatdlff lcult to explatn the reasons for locallzatlon of stephensl ln thts locality slnce nanyof the breedlng places Ln other parts of Quetta did not appear to present any essentlaldlfferences from those ln whtch stephensl rras commonly encountered. Regardlng thecharacterlstice of the breedlng places, [email protected] was f ound breedlng in profuslon lnaeepages and narshy areas ln which a gentle flow of nater existed. As a rule green algaewere plentlful ln thls type of breeding place, and grassy vegetatlon when Present ltas notsufftclently dense to provlde any appreclable degree of shade. Froo such places 382 of allthe stephen8l larvae collected in the Quetta area were obtalned. Larvae of gj!g@! werealso conrnonly encountered in s tandlng r rater such as reservol rs , pools, wel ls , spr lngs,subsoll water ln cracks and flesures ln the ground. The amount of vegetatlon present lnthese varlous places tras very varl.able, but, ag a rule, algal growth was plentlful andgrassy vegetat lon, Lf present , was never dense. Fron euch breedlng p laces, 2LZ of a l l thestephensl larvae collected ln the Quetts area nere recorded. Larvae of cullclfacles wereZffiTfected ln large numbers fron breedlng places of these types. rrGlTifof-s tephensl was a leo seen ln connect lon wl th r lvers and st reans (L77.) ' where l t was f requent lyaesoc{etea wlth euperpictus, and ln lrrlgatlon channels (l3Z) where lt was more co.nonlyassoclated wrtn Eiiff i i . Desplte r-pe"ted searches, no larvae of g5g!g11 were everrecovered fror clEiEii i?ff ip wells, covered sprlngs, coollng tanks, concreteElphon pits,
v B c / 9 0 . 3MAL /90 .3Page 63
or other p laces of th is nature ln the Quet ta € l r€a. Thls was surpr is lng ln v lew of the 'reputatlon of gl@.! for breeding ln such places ln rnany cit les ln Indla. In thisconnect ion, the auEhor i pointed out that thel r observat lons ln Quet ta would suggest thatstephensi prefers open sunl l t breedlng p laces ln whlch nater ls e l ther s t i l l or f lowlnggent ty , and ln whlch vegetat ion, par t lcu lar ly Spl rogyra, ls p lent l fu l , A coroParat lve lysna1l nunber of s tg@! larvae was col lected f ron p8r t ia l ly shaded p laces, but larvae ofthls species werEAffiound ln dark places. It ts posslble that ln the absence of itsfavourable breeding p laces, s tephens:L nay adapt l tse l f to such p laces as deep wel ls ,c ls terns, covered spr lngs etc. 0n the other hand, l t ls possib le that ln the re lat lve lycool c l fuoate of the Quet ta area, p lacee of the la t ter type would be too cold for s tePhenslbreedlng. I t roay be that at an a l t l tude of more than 1500 n above sea level , and ln alocaLlty close to the l lnlt of lts dlstributlon, .1gg!9.E! wil l only breed ln warner sunlitbreedlng places. In the Hanna va1ley which ls abdut 2000 o, sna1l nunbers of stephensllarvae were collected, although apparently sultable breedlng places were a6 nuroerous as inthe vlclnlty of the Lora streao where stephensl larvae were seven tlnes as abundant. Theywere sere most abundant ln the Quetta area ln August, but wlth the onset of colder weatherboth tarvae and adults showed a sudden and rapld decllne. Probably stephensl ls moresusceptible to cold weather than elther ggllsljlglg or !.gPg!s..
Relsen et a l . (1981a) under l lned that the d ls t r lbut lon and abundance of rnosqui tolarvae reflects both the chol.ce of ovlposltlon sltes by the fenales as well aE the abll ltyof the lnrnature stages to tolerate the condlti.ons under whlch they were forced to exl.st.In large habltats such as rlvers or ponds, larvae may escape unsultable condltlons bynovlng to more sultable rnicrohabitate. In sroall habltats, however, the nlcrocosn remalnseseentlally honogeneous and the larvae Dust have the physlologlcal plastlclty to wlthstandthe ganut of condltlons to whlch they are exposed. Therefore, the authors carrled out anlntenelve study of larval breedlng habltats ln the Lahore area of Paklstan wlth a vie\t todeternlnlng the range of condltlons under which ground water nosqultos breed, thusprovldlng an lndicatlon of the ovlposltlon preference of the fernales and the physlologlcaltolerance of the larvae.
The oethods and procedures adopted are sumnarlzed as follows:
- Sl te select lon: Mosgul . tos were col lected arb l t rar l ly a long nost najor roads leadlngaway fron Lahore. Locallt les were all wlthln a 50 ku radius of Lahore. A11 potentlalsltes were flret lnspected for the preeence of oosqul.to larvae. Negatlve sltes were notexarolned furtherr slnce the absence of larvae could be attrlbuted to factors other than thecharacter let lcs of the breeding habl tat r Buch as lnsect lc ldal t reatment , the presence ofhlgh densltles of predators etc. Posl.t lve sltes were exanlned for deterntning larvalabundance and phyelco-chenlcal condltl.ons.
- Larval abundance: ThLs was estloated by countlng cullcine and anophellne larvaefound ln l0 to 20 dlpe using a standard enamel dlpper. The nunber of dtps varled with thesize of the habltat, the denslty and dieperslon of larvae. Fewer dips were nade ln snallhomogeneoue habltate euch ae ground pools, hoof-prints havlng unlfom nosquito denslty(approxloately equal nunber of larvae per dtp). l lore dlps were Dade ln heterogeneoushabltats euch as large ponds, dralns etc., where larval abundance varled fron dlp to dtP.In the laboratory, a maxlmun of f lve larval sltdes were prepared and ldentlf led. Therenalnlng larvae nere reared to adulte, ldentlf led and counted. The percentage of thetotal epecfunens ldentif led lncludlng both Larval elldee and energing adults wa6 used toestlmate the mean number of larvae per dlp for each epeclee.
- Physlco-chenlcal conditl.one: The procedures adopted were descrlbed ln detall forwhlch lntereeted readers ehould coneult the ortglnal paper. The physlco-chernicalparaneters meaeured were! temperature; turbldlty; suspended solids; conductlvlty; dlesolvedoxygen; pH; phenophthallne alkallnlty; phosphate; nl.trate; amonla; and eulfate.
- Statlstlcal nethode: For ionposltlons among selected habitat types one-way analysesof varlance nlth unequal sanple slzes was used, and for detectlng nean dLfferences, theleast s lgnl f lcant test (of Sokal E Rohl f , 1969) was appl led. I t has been observed EhatDosqulto Larvae exhlblt a clunped or contLguous dlstrlbutlon wl.th lndivlduale usually
v B c / 9 0 . 3l,rAL/ 90 . 3Page 64
aggregat ing in favourable n lcrohabiEats. In the Present survey, the coef f le ient of
a i ipe is fon (var iance/mean, of Sokal & Rohl f , 1969) was conelstent ly greater than l ,
lnd icat ing a c lunped d ispers ion. Therefore, the mean number of larvae/dLp (y) per sanple
was t ransformed to ln (y + l ) , where 1n is the base of natura l logar i thns, to nornal ize the
dist r ibut ton and contro l the var iance. Means presented were back- t ransforned values, the
geometr ic mean. Indices of ln terspect f lc associat ion (c i t ing Cole, 1949) were calculated
using presence and absence data arranged ln jo int occurrence BaEr lx . The authore expla lned
tha t Co le -s i ndex ranged f ron -1 .0 f o r pe r fec t J - y nega t i ve , t o *1 .0 f o r pe r fec t l y pos i t i ve
lnterspeci f lc associ . i io t " , wl th a value of 0.0 indlcat lng that both species were
dist r i tu ted randoroly wi th respect to one another . The stat ls t ica l cr l ter lon used to test
for a s ignl f icant departure f ron 0.0 was the s ingle-degree-of- f reedoo Chi :square tesE for
2 x 2 cont lngency t "Lt" (c i t ing Col-e, L949). Uslng these stat ls t lca l nethods, l t was
possib le for two lnf requent ly -o l lec ied specles that never occurred s imul taneouely ln the
sane col lect lon to have an lndex of -1.0 which d id not s tgnl f lcant ly d l f fer f ron 0.0. Lack
of significance Ln these lnstances was attrlbuted to the high estlmate of varlance whlch
was usual ly inversely re lated to the f requency of occurrence. other s tat ls t lca l procedures
were dpplled to ".r"Lr
the data for groups of physico-chbnlcal Paramefers and noequito
specie i -whlch s lgnl f lcant ly covar led over both t ine and space.
Eight tyPe6 of habl tats sarnpled were descr lbed as fo l lows:
(a) pond: This is a large body of sater (25 x l0 o) ' usual ly Perranent , adJacent to
vll lagee, from whlch nud had been annually renoved for house constructlon. Dependlng on
the size of the vll lage and pond, these habltats ranged fron moderately to heavlly polluted
wi th faecal mat ter f roro v i l lage dra ins.
, (b) pool : Thle ls a snal1 body of s tandlng water ( less than 25 x l0 n) , probably
tenporary (1.e. , dr les dur lng t t " hol months of May-June dry seaeon) ' f l l led by ra ln '
seepage or run-of f water .
(c) Rlce f le ld: This represents any f ie ld p lanted wi th r lce, f rou seed beds to pools
in recent ly harvested f le lds. Al though 22 f looded r ice f le lds were inspected, only two
were positlve for nosqulto larvae. This low Lncldence was presunably due to lnsectlclde
appl lcat lon.
(d) Burrow-pl t : This ls a snal l depresslon ( less than 10 x l0 n) excavated for
construct lon; l t t l a t t f tcu l t to d is t lnguish o ld burrow-pi ts f rom ground pools '
(e) Di tch: Thls ls a roadslde dra in to carry ra in water , or 1n agr lcu l tura l areas to
carry l r r igat lon water .
(f) Seepage canals: These are snall f lowing canals fi l led by seepage frorn the naln
irrlgation "..,1t",
partlcularly ln water-logged agrlcultural a.reas.
(g) Margln of s t ream: Thls conslsts of hoof-pr ln ts , back eddies, and qulet water ln
the niddle of vegetation nats.
(h) Catch basln: Thisstagnant ltater when the well
is a cement tank at tube-neIl effluent, usually f i l led with
ls not operated.
For each nosqui to epecles encountered notes were made as fo l lows:
- Frequency: Thts ls the number of t lnes a specles was col lected/ tota l sLtes posl t ive
for moequito breedlng, thus a frequency of 1.0 neans that the specles occurred 1n every
col lect lon posi t lve for nosqui to larvae.
- Habl tats : These are the nurober of habl tat categor les posi t lve for a g lven species
of the elght possible types, whlch glve sone lndlcatlons of the ovlposltlon preferences of
the adult females.
- Physlco-chenlca1 re lat lonships :coef f ic lento are l is ted.
vBc/90. 3l.rAL/90. 3Page 65
Var lables havlng s lgnl f lcant s iople corre lat lon
- Larval assoclat lons: These lnc lude only those species wl th s lgni f lcant posl - t ive or
negat ive Cole-s lndex values.
- Commente were nade to conpare the results of the present sutdy wlth those ofprev ious authors.
S 1 x s p e c 1 e 6 o f @ ' w e r e 1 d e n t 1 f i e d 1 n t h e P r e s e n t s t u d y , v i z : g ! g ! g ,cullclfacles, nlgerrfuous, Iglsbsrq:lnus-' -stephensl and ery.;
besldes which aeven
@ecles of _Figarb iC_and one specles of Mansgl la were col lected.
Infornatlon-lEEalntng to culiclfacles and stephensL as well as other anophellne specles ls
only glven here from the authors- notes and tabulated data.
An. annularis
Frequency: 0.446
tlabltats: absent Ln rlce flelds and catch baslne, but preeent ln all other 6 types(shown above) - no signlfLcant dlfference among habitate.
Physico-cheulcal relaElonshlpa: none slgnlflcant.
Larval aesoclatlons: poeltlve = !g\[g!g' ?tephensl;
An. cu l lc l fac ies
negatlve = Q}g sPP.
Frequency: 0.403 second nost Prevalent apecies.
Ilabltats: absent tn rice ftelds and catch baeine, but present ln all other 6 types -
slgniflcantly higher densltles ln uovLng natere and the margLne of ponda.
Physlco-chenlcal relatlonshlps: posltively correlated wlth dlssolved oxygen (r -
0 . 3 3 7 ) a n d p H ( r - 0 . 2 6 5 ) .
L a r v a l a s s o c l ' a t i o n e : p o s 1 t 1 v e = P @ ' @ ' 1 ; n e g a t l ' v e = g 1 € @ ,subpictus and cullclne ePecles.
- Conrents: In contrast to Senlor-Ifhlte (1926) who never found cullclfacies larvae at
ar,,rnonia concentratlons greater than 1.0 ng/l, larvae of thls sPecles were collected ln the
present study ln waters with up to 5.2 ng/l of eallne arnrnonla. Thle concentratloln was
well below the upper lethal ltolt of 12 rgl1 r""o.ded by pal (f945). Although cgl-l9lfqclgs
wa6 reported to breed ln almost any avallable type of water (clt lng the revlew of Bhatla &
Krlshnan, 196l), 1t was found ln the present sutdy to prefer clean nater tt lth sooe flow ln
areaa of the PunJab where lt was abundantly preaent ln rural envlronoents.
An. nlgerrlous
Frequency: 0.209
Habltats: absent in ditches and catch baslns, but preeent ln all other 6 types -
s lgnl f lcant ly h igher densl t les in burrot rp l ts .
Physlco-chenlcal relatlonshLps: none slgnlflcant'
L a r v a 1 a s s o c 1 a t 1 o n s : p o e l t 1 v e - 2 C u l e x s P P . . ; n e g a t 1 v e - @ ' 9 ! . s @ ! 'a n d 2 o t h e r $ ! g 5 " p p .
An. pulcherrlnus
Frequency: 0.144
vBc/90. 3MAL/ 90 . 3Page 66
I tabi tats : abeent ln d l tches, r lce f le lds and catch basins, but present in a l l o ther
types - no s ignl f tcant d l f ference anong habl tats .
Phyeico-cherolcal re lat lonships: none s lgni f icant .
Larval assocl-ations: posltlve = s99$!9, culiclfacies, g!32!9g9.i; negatlve =
nlgerr{mus.
Conments: In agreenent er i th Ansar i & Shah (1950) pulcherr inus r tas most prevalent in
open, sunl l t ground waters overgronn wi th dense subnergent vegetat ion. Larvae of th ls
species were able to to lerate s l l t ing and increased a1kal ln i ty .
An. s tephensi
F r e q u e n c y : 0 . 3 3 8
I labl tats : absent ln r lce f le lds, burrow pl ts and d l tches, but present ln a l l o ther
type6 - s igni f lcant ly loser densl t les 1n ponds, pools and sErean narglns than in catch
basins and seepage canals.
Physico-chernical re lat lonshlps: inversely corre lated wl th tenperature (3 = 0.28) ;posl t lve ly corre lated wt th pH (r = 0.439) , phenophthale ln and tota l a lka l in l ty( respec t l ve l y r = 0 .378 and 0 .369 ) .
L a r v a 1 a s s o c 1 a t i o n s : p o s 1 t i v e = @ , c u 1 1 c l ' f a c l e s , P - j 4 @ ' 1 n e g a t 1 v e =nlgerrlmus and 3 9g!g "pp.
Comrnents: Typlcally, *pEil breeds ln a wlde variety of both urban and ruralhablcats throughout 1ts atst r lbut ton (c i t ing Kr lshnan 1951). In the Present s tudy,stephensi larvae were found under harsh sallnlty regloes, but were rarely collected fronE1EfrFifted waters. The larvae were a16o found breeding ln sea water in the Karachl area(cit ing unpubllshed observatlons by Aslankhan & Relsen). Thls specles was lDore prevalent
during the cooler temperatures of the autumn and early winter. In the laboratory, Retsen &
Slddlqui (L977) found that stephensl prefers to ovl.posit ln larval rearlng htater with ahLgh aruoonla eontent.
An. subplctus
Frequency: present only 1n ponds, pools and burrow pl te.
Physlco-chemlcal re lat lonshlpe: Posl t lve ly corre lated wl th turb id l ty ( r = 0.383) andsuspended eol lds ( r = 0.461) , but not s lgnl f icant ly corre lated n l th tota l a lka l in l ty andnLtrates.
Larval aesoclatlons: posltlve = Culex trltaenlor-$$;2 .991"* "pp.
negatLve = cul lc l fac ies and
Conoents: In agreenent wlth Ansarl & Shah (1950), .g$!g!gg. was able to tolerate awide range of physlco-chenlcal conditlons and was frequently collected ln snall ' drylngpoole whlch were extrenely alkaline, hlghly sllted and devoid of other mosqulto larvae.The nean larval densl ty ln these s l tual lons nas aa h lgh as 31.8 larvae/d ip. This speciesdleappeared froo the Lahore area durlng winter and was not consldered able to tolerate cold
teDperatures (c l t ing Ansar i & Nasl r , 1 .955) .
In thel r concludlng remarks, Rel .sen et a l . ( loc.c l t . ) under l lned that typ lcalnosqulto habitats ln the Latrore area of the PunJab were modlfled by increases ln
teDperature, sa l ln l ty and organlc pol lu t lon. Seasonal changes of tenperature resul ted ln
tenporary shtft of the fauna with warro weather specles such as subPictus decreasing and
cold weather speclee such as stephensl increaslng ln abundance. TemPerature ltself Itaa not
vBc/90.3MAL/90.3Page 67
slgnlficantly correlated wlth changee ln the phyelco-chernlcal paranetera. Perhapstlne-eeries data fron the sane habltat nay reveal nore subtle relatlonehlps. Followlng thefornat ion or lnundat lon of the breedlng habl tats , deslccat ion and progressl -ve lncreases lnconductlvity and alkallnity caueed a qual.ltative decline ln mosguito fauna of tenporaryp o o J . e u n t 1 1 o n 1 y m o r e t o 1 e r a n t s p e c 1 e s s u c h a s 8 u b P 1 c t u 8 a n d @reoalned. Increases ln alkallnlty were usually accompanied by lncreaees in turbldlty,euspended sol ide, pH, phosphatee, n l t rates and sulphates which a lso exer ted a negat lveef fect on Dost nosqul to specles. L lkewlse, organic pol lu t lon, lndexed by anmonla-n l t rogenconcentrat lons, typ ical ly lncreased ae pools and ponds gren o1der. Sln l lar chenlcalrelatlonshlps were found longltudlnally along atream narglns below vll lage dralns. Mostnosqulto larvae seened able to tolerate sone eutrophlcatlon. I lowever, when arnmonLaconcentrat lons increased above 5 mg/L, specles d lvers l ty typ lcal ly decl lned. Pol lu tedhabltate were doolnated by Cx. trltaenlorhynchus and at t imes by subpictus durlng surrler,and Cx. qulnquefasciatus and to a leseer extent stephensl durlng wlnter. Breeding ofcertaln specLes seemed to be assoclated wlth other envlronmental features, as was seen withlarvae of annularlE and pulcherrlnus whlch were collected aoong thlck growh of subnergentnacrophyceE.--
Relsen, Azra & Uahnood, (1982) estlnated the l lfe stage survlval and duratlon of thelrnnature scagee of cullctfacies reared under tlree constant leve1s of teuperature in thelaboratory 1; Pakl8ffi;;ffirized ln vol.. Ir The same authorE nade a longltudlnaleanpllng of the Lumature etages of cullcifaclee wlth a vl.ew to conetructLng age- andstage-speclflc vertlcal l1fe tablee for the natural populatlon of thlE specLee lnPakletan. Two breedl.ng 8ltes were eelected ln an Lrrlgated agrlcultural system near therural vll lage of Kot Eaghlcha Stngh l{alla, Kaeur dletrlct, PunJab: slte I was a 0.5-krraectlon of watercourse, and elte 2 wae a pool wlth adjacent narshy area fed relatlvelyconstantly by lrrlgatl.on welle. I{ell operatlon depended on irrlgatlon schedules andperlodlc close-dorrne for repal.r and nalntenaDce. IDEature stages were eanpled wlth adlpper fron Aprll 1979 through May 1980, at no Dore than blweekly lntervals. Conparatlveobeervations were nade durlng the sprlng of 1980 along a sectlon of an agricultural dralnnear Sattokl vtl lage, PunJab provlnce. At Kot Baghlcha, dayEloe-restlng cullclfacles malesand fenalea were coLlected by hand capture fron four c8ttle shede near gLtes I and 2. Forproceeelng of Daterial, larvae and pupae collected tn each dLp were counted, wlth larvaepooled by elte and flxed ln the fleld wlth foroalln. Pupae nere reared to adults ln thelaboratory. Larvae were later grouped lnto lnetars baeed on general body size, and whenneceaaary on head capeule wl.dth. Subeauplee of 3rd and 4th lnstar larvae rrere Dounted andexanlned nicroscopically to conflrn speclea Ldentlf lcatlon and to deternine the prevalenceof lnfectlon wlth Coelooonycee fungue. Water sanples were taken eporadlcally tn allseaaons to Donitor the phyelco-chenlcal condltlone of the breedlng el.tes. For lIfe tablecalculat loua, the nethod of Serv lce, (1973 & L977> as nodi f led by Relsen & Slddlqul ( f979)was adopted. The nuubers of the Lmature stages ln each llfe stage were atandardlzed bythelr probabll lty of capture, and theu plotted ae a hlstograo at the nldpolnt of eachlnstar duratl.on, sluulatlng a reasonable plcture of the populatlon eurvlvorshlp curve (eeebelow). The duratlon of total lonature l lfe fron ecloeion to emergence waa calculaced frooDean water teEperature uelng a conblned heat eumatlon equatl.on, The duratlon of each llfestage and age at noultlng na8 then estlDated usl.ng the proportlon of l l fe epent ln eachllfe etage ln the Lncubator studlee [ln laboratory studles carrl.ed out by the eame authorgae mentioned abovel. The numbera enterlng each llfe stage nere eetlmated graphlcally andstage-speclfic eurvivorehip echedulee were calculated.
The results of larval and inago Eurveys together w*thBaghlcha were'l l lustrated graphically ae ehorn ln Flg. 5'.cullclfacles inmature stages (nudbere/dlp) at eltes I and 2
temperature records at KotThe relatlve abundance offluctuated narkedly due to:
(a) the effect of weather condltlone on adult relatlve abundance and survlval which,ln tura, altered the recrul.toent of new lndlvlduals to the populatlon through ovlposltlonl
(b) eeaeonal varlatlone ln lrrlgatl.on practl.cee.
o:il-Fffiinent vBc/88. 5-r4AL/ 88.2, pp. 84-85.2. Flge. 5, 6 and 7 were reproduced by pernleslon of Dr U.K. ReLeenlledlcal Entooologv fron the paper of Relsen, Azra & Mahnood (f982).
and the Journal of
vBc/ 90 . 3MAL/90. 3Page 68
As ehown in Flg. 5 ('curve B), adul-t relatlve abundance was lowest during the hot' dry
pre-monaoon and wlnter seasons. Transi t lons ln adul t fenale re lat ive abundance were rapld '
and thus the popuJ-at ion abundance wl th in seasons was re lat ive ly s table ' S lnce cul lc l fac les
females remaln gonotrophlcal ly act lve throughout the year , generat iona were essent la l ly
overlappi.ng, and the recrultrnlnt of the immature stagls was considered relatlvely constant
dur ing the seasons deslgnated for l l fe table construct lon ' ' rhe numbers of lnmatures scored
in each stage-c las" t " . I
corrected Uy t t re probabi l i ty of occurrence (see VoL' I ' PP' '
84-85) . Seasons wi th nean t . tp" t . t r r tes above 2ro C t t t " "ot t tc ted
by the laboratory data
of 28o C. whi le wloter season est inates at 20 '60 C were corrected by the laboratory
i l . l "o t " ia5t : " in" "or . " " red
nunbers were then p lot red ar Ehe rn idpoint of each instar
duration adjusted for water temPeratures as shown in Flgs' 6 and 7 ' The length of l i lDature
l l fe tn days was calculated f roro mean water teDPerature ( t ) by solv ing the pooled
tenperature surnmagion nodel r lV-= i l - - iZ. tS)14! 'S for the devel 'opnent rate f ron ec los ion
to "'"'g""* ""::.i;"iii;:"lrtltg.':|;:"'H"'::'r:l':::;';;":"i1fi';l**li l-i::':^:lf ernales ) . The duthe appropr late e ' t ioate of Lr , which 1s the Percentage of
- to ta l - l i fe t ine-Epent ln each
llfe stage. A l ine was then tftt"i through ti ie nldpoints of each 11fe 6tage to produce a
surv ivorshrp "u. . ,e-( ; ; ; " : ;
and-7) . -sa"g!-"peci f lc
1 l fe tables nere calculated f rom these
survlvorshlp curves (shown ln rhe iro-iri"."") uy graphlcally estlnatLng the nunbers
enter ing each l l fe s tage. The calculated etage-spect i tc nor ta l l t ies nere h ighest for o lder
stages, especia l ly the pupal ,s tage' Wl th the excePt lon of est lnates of the
spring of 1979 at Kot Baghlcha ana ttre spring of r-ggo at sattokl' rnortallty durlng the lst
and 2nd lnstars was nlnloal, conforntng wfttr-the laboratory observatlon-s at 28" t:,,-^
tlowever, the low number of pupae was difftcult to lnterPret (see Posslble explanations
dlscussed below), and est imates e.o i i t " surv lvorshlp curves ln F lgs ' 5 and 7 lndicated
that dur ing nost seaaona no adul ts woula eBerge, 1 'e ' , surv iva l f ron ec los lon to emergence
would equal zero. Extremely low survlval of lmnature stages seened- lnconpatlble wlth the
large numbers of adults routlnely """ittt
restlng in nearb! cattle sheds (see F1g' 5)'
pupal and total survivorshlp were recilculated using laboratory estinates and were lncluded
as dashed l lnes ln F igs ' 6 and 7 '
In their dlscussLon, the authors re-enphaslzed that conparlsone aEong stage-speclflc
survlval schedules ln 11fe tables "rrgg."a"a
irrat 3ra- and 4th-1n6tar and pupal survlval was
lower under fleld conditlons than ln ihe laboratory. seasonal observatlons suggested that
dtsproportionately more early lnstar larvae were Present when lrrlgatlon wells were
operated, whereas 'o lder inst l r larvae predomi 'nated^ln dry ing pools when the l r r lgat lon
we1ts r rere not operated. pupae r" i " - rare ly taken 1n a l l lco l lect lons ' Factors assumed to
explaln the disproportionate afstributtor, Lf lndlvlduala among llfe stages lncluded the
unequal ef fects of oor ta l l ty factors and/or d l f ferent la l d lspers lon Pat terns ' nhich a l tered
the probabiltty of capture. Factors that could reduce the nlnber of pupae collected when
trrlgatlon welts were not oPeratlve, lncluded lncreased pupal predatlon and losees due to
downstreao dr i f t . The downstr . . r ' i i "p taceDent of nosqul lo larvae-of .cu l ic l fac les ln
irrlgared rtce fietd' naa .onstaerei-i ievrously 1" i; i l ; iy Russelr e-nG--@OF Breedlng
concentrated ln effluents of the irrtgatton well would presuoably exert a slmilar
downstreao dlsplaeenent effect. The confirDatlon of this posstbil l ' ty comes froo the fact
that older larvae and pupae rtere mo6t often recovered from mlcrohabltats with reduced
dlscharge euch ae eddles at turns ln the watereourse' I lowever' few larvae and no' Pupae
nere ever taken fron newly rrrrgatel alrrcuttural ftelds' The dlsproPortlonate downstrean
displacenent of age groups from segmenls of ttt"t"out"ee w111 rtqulre further etudy before
the actual l 'pact of drlft on age !atrr"ao'" can be assessed' On the other hand' factorg
t h a t D a y l e a d t o a r e d u c t l o n o f p u p a t l o n - 1 n - d r y t n g p o o l s l n c l u d e c u m u l a t l v e e f f e c t s o fparaslt1sm and predatl.on.. Infe.tfo., Uy Coefon,olyi:s-fungus as well as encruatatlon of
1 n f e c t e d 1 a r v a e w i t h e P 1 b t o n t a , r e d u c e i ; @ i a " i . i g " " " " . T h e 1 n f e c t l o n r a t e w 1 t hCoelonomyces aDong 3rd and zrtfr instai-fatva" vae Z'itZ (659 exantned) and among adult
5al6;ff i37. (L7\4 exanlned). Lnfectlon ratea t"t" ' i f. i i" ' t arpng.larvae'concentrated wlth
Ercrocruaraceaoa tn drylng pools ;;-;;; i i ir:zl and seplenber (152) rn 1979' The lower
vBc/90. 3MAL/90.3Page 59
F l g . 5 . Tenporal changes ln (A) water tenperature atsltes I and 2 and aLr temperature Lnelde cattleshed rest lng s i tee, (B) the nunber of g and dAn. cul lc l fac les col lected rest lng lneide 4cat t le sheds per nan-hour of co l lect lon ef for t wl tha mouth asplrator, and (C) the Dean nuober of larvaecol lected per d ip at s l tes I and 2 at Kot BaghichaSingh Wal la dur ing 1979 and 1980.
l g ? 9 t g 8 0A M ) ' A S O X D J F I ' A H
ASONa 0
p3si roIu t 25F
c 2 oUJ
i r s] 6 .
= - 5
- a,n
Do 33s
2o 3
G6u f 2
c.j l
=0
F
SPRINGs
y WAYER
| | tsto€cAlrr€ sHEos
A } 1 t J A S O i l D Jr 9 7 g
F - ' - -
POST- IV INIER SPRI} IGH O N S O O X
F i l A I '| 9 6 0
A
1 0
3 5
30
2 S
2 0
t 5
r50
r 0 0 ii
5 0 ;
2 E 3o
r 0
6
Gt 0 6
5?c
I J
vBci 90 . 3MAL/90. 3Page 70
Fig. 6. Number of i nature stages of An. cu l ic i fac les- co l lectedat Kot Baghlcha, corrected by probabl l i ty of capture andplot ted at the est inated n idpolnt of each lnstar durat ion1n hours. Dashed l ines rePresent the possib le maxlmunnunbers of pupae Present based on laboratory surv ivorship 'A = sp r i ng L979 ( t e rnp . = 28 " C ) , B = pos tnonsoon 1979( 2 5 . 5 0 C ) . C = w i n t e r 1 9 7 9 - 1 9 8 0 ( 2 0 . 6 " c ) . P = s p r i n g
1 9 8 0 ( 2 6 . 6 0 c ) , a n d E = t o E a l f 9 7 9 - r 9 8 0 ( 2 5 . 6 . J c ) .
5 0 0
( 0 0
3 0 0
? 0 0
t 6 5 2 t 2 2 ? 0
t 0 0
6 0 0
a 0 0
2 0 0
t00
2 0 0
0 1 6 4 2 3 1 ? ? 0
r 0 05 E- r 0)o
6
Iocru,,oI:t2
0 0
9 2 r 5 2 2 t ( 2 6 9 0AGE AI I {OLTING (
5 t t 0 0H R S I
a
u n I l vP
0
0n i l l l v
c
!0 2 37 9
I
\
il
t 6
Dr:
i l l t v\
\
l l
E
\Il
Il l I
fi
vBc/90. 3MAL/90 .3Page 71
FLg. 7. Nunber of lmDature atages of An. cu l lc l fac les col lectedat Sattokl durlng sprlng 1980 (tenp. ;TffirOGr-cted byprobabll lty of capture and plotted 8t the e6tlmated nldpoint ofeach instar duratlon Ln hours. Dashed llnes Present the poesible
maxlouro nunber of pupae Present baeed on laboratory survlvorshlp.
r60
40
059 l0 l 166 231 272
AGE AT MOLTING {HRsI
?-!'.,'t
aJ r
- t<Lfo
o=
ctz
20
80
I
\
I I I I I P
IV
vBc /90 . 3MAL/90. 3Page 72
rate of ln fect ion found among adul t fenales perhaps lndlcated that nost ln fected larvae
succunbed to the d isease. In addi t lon, l t re posi i .u te that in fected PrePuPae roay have
reduced vagll ity and thus reduced c'hances of escaplng fron predators' The Iow nunbers of
Is t lnstar larvae encountered dur ing cer ta ln seaaons (see Fig ' 6 Ct D and E) could be
at t r lbuted to larval d ispers lon pat lerns and to cannlbal lsn ln-dry ing pools ' The
dispers lon of the ls t lnstar larvae of some ground water-breedlng nosqul tos exhib i ts
greater c lunplng s lnce the larvae tend to remaln aggregated near the s i te of ov lposi t ton '
Prevlous observat ions in India sho\ ted that cu l ic i fae- tes females were inhib i ted f ron
ovlposltion by clustered or overhanging .regffit- loi-(EfElng Russell & Rao, L942a)'
Posslb ly , ov lpoei t ion ln the study l t " i t . " thus l ln l ted lo oPen areaa a long l r r igat ion
channels. If the newly hatched larvae then progressively moved downstream as they agedt
the degree of aggregat lon would tend to decrease' Regarding cannlbal lsmt laboratory
experinents have lndicated that random contacta betwein lst instar and actlvely novlng 4th
instar larvae resul ted in the raptd e l ln lnat ion of the ls t lnstar larvae as observed ln
cul lc i fac les by Ehe authors (see voIJ. I , P. 85 and' ln s tephensi ' pp ' 73-74) ' As the
i f f i f f i g l , " i " "o ' " concenEra ted1n i ' y r "gpoo1s ' r? I f f iGd re fug1a , theyoungerlnstars would v l r tual ly have greaEer contact- t t tn o lder larvae, and thus be select lve ly
consumed, leavlng nost ly o lder lnstars aval1able for co l lect ion ' The avai labi l l ty of
alternatl.ve food dld not reduce cannlbalism under laboratory condlElons' [The Present
study demonstrated the varlous factors that can confront the consiruction of survlvorshlp
curves and verr lc . l - i i r " - i " i i " " ror the innarure srages of natura l vector populat lonsl '
The nalarra sltuatlon 1n Karachl clty, Pakistan was studled during September-october
1966 by Rahman et aI . (1967). In entonoto i ica l surveys, only two anophel lne specLes l tere
e n c o u n t e r e d a s ] . a r v a e a n d a d u 1 t s , " i " p t ' " " " i a n d @ . . n " : ' " " } 1 " ! f a c 1 e s w h 1 c h h a d b e e nrecorded in the past in Karachi was- never encounterefi-Ti-the-Ef-fTn-@ nade by these
authors excePE ln rura l areas outs lde the c l ty (see under 4 '5 below) ' The breedlng p laces
o f g ! s l s ' ! w e r e d e s c r i b e d a s : p o n d s , p o o l s ' d l t c h e s ' s e e P a g e s ' s l ' a m P s , b u r r o w - p l t s 'Leakages fron tanks and plpes, ltater i..rt", garden ctsterni, fountains and wells' Those of
suuictus. were: ponds, pooi" , d l . tches, s t raDps, seepages, hoof-pr ln tsr car t t racks,
fif iFFTts, watlr tanks, garden cisterns and wells'
Nal in et aI . ( f985) rePorted on a nalar la survey carr ied out ln-Karachl ' Pakis tan
during Septenber-october 1981. Of the entornologlcal toroponent, larva1 surveyE were carrled
out ' in nalarLa-af fected areas, and addl t lonal ly orr" "ut . t -y
was conducted across the c i ty
fron oranghi-I4 in the northeaat to Landl-6 ln the goutheast' Larvae were ldentlfted
nlcroscopical ly and c lass l f led ln to 2nd, 3rd and 4th lnstars ' Ot ' 42 s l tes in 17 local l t les
lncluded ln the cross-Karachi survey, only five were larvae-free' Sites positive for
stephensi larvae were confined to tire extiene Perineter where nalarla was prevalent and
nany buffaloes were Presentr while the central area had only supplclus larvae' Of the
1 a r v a 1 p o s 1 t i v e s i t e s , 2 0 h a r b o u r e d . W ^ a 1 o n e , t h r e e s t E i F f f i 1 o n e a n d f 1 v econrained both specles, while tfve wEffilTElve for tst tnffi;rli;ae only' Larvae of
both specieE occurred chief ly ln water- f i r r "a hoof-pr ln ts , tyre t racks, foot-pr ln ts ln nud
and sand, shallow seepage pools fron leaklng plpea, dralnage channels, and sallne pools'
S 1 t e s p o s 1 t 1 v e f o , @ t y p 1 c a 1 1 y h a d c 1 e a r , y e 1 1 o w - t i n g e d w a t e r . I n l l a s s a n C o 1 o n y o nLlyarl river tn then6ffiGa, at. i i tshy river U.ttt" had Lnnunerable hoof-prints of
buffaloes. of n1ne of these examlned, "L.r"o
contained a Dean of 35 larvae/hoof-printt with
each hoof-print contalnlng larvae of one specles olly. The streaE roargln harboured 9n1l a
f e w @ ' 1 a r v a e , b u t - t h r e e o f _ i o u r a r y t n g p o t h o i e p o o 1 s h a r b o u r e d b o t h 9 g @ ! a n dsubpictus larvae. l,tany seepage sltes near-houslholds contalned $riutnouefasciatus
larvae
t o o n u E e r o u s t o c o u n t ' . I n o r a n g h 1 1 n t h e n o r t h w e 8 t , - t n s p e . t t 9 1 @ c e r D e n terater tanks lbaslnsl f i l led by truckloads of water' and over 20 household seepage water
sitee, revealed the presence of steDhensi larvae at a trtean denslty ot 0'7ldLp ln only three
1l o-deep we1ls, and four publlc frt-Ants Partly covered wlth loose-fltt inS corrugated
metal sheets. private water tanks nere not larvrcrded becauee resldents consldered treated
water not potable. Surface water poofs near Alumlnlum Colony ln the west of the clty
vBc/90. 3I '{ALl90.3Page 73
harboured a few larvae of .g!g!gg desplte reported larvlcidlng operatlons. Pollutlon of'surface nater throughout uiban Karachl wae lntenEe leavlng very few water sltes wlth algae,energent vegetatLon and border shade where cullclfaclea larvaeadults of cullclfacies were found ln only one of three vll lageearea, Uut iElff i i ff i tered lnslde Karachl clty l lnlt.
can breed. Larvae andeurveyed ln Peryo Groth
In a recent s tudy in Delh l area ' India,on the breeding habltats of specLes A and B of4 .5 be low .
4.3 Swamlng and natl.ng
In Iran, Quratshl (1965) lntroduced hle obeervatl.ons on swarnl.ng and natlng ofAn.stephensl nyeorensl.e (for brevlty, lt ls referred to here sfinply ae stephegsl) byund-rltnfng thaB thls subJect though lt appeare to be of acadenlc lnterest only' lsbeconlng one of the aepecte of lncreaeingly practlcal Lmportance. The obeervatl.ons werecarrled out Ln a vll lage ln Kazeroun, Fars, Iran. To study the ewarmlng populatlon, a fewrepreaentatlve gwarma were chosen and collectlone oade fron thege by three collectore uelnglnsect nete 75 cm Ln dl.ameter. Another peraon watched fron a dlstance and eetinated theraclo of noequltoe caught to those dlepersed ae a reeult of the dlsturbance. l loeguitoscaught ln the neta nere counted, and a rough estlnate of the elze of the ewarnlngpopulatl.on wa8 uade. A eumary of f lndlnge followe:
- Swarm fornatlon: Durlng the flrst half of Auguet 1961, when the vtelbll. l ty was81111 very good 8t 1830-1840 h, enall anarna of gg@,1 started to forn over the hedge'tops of a few enall treea, and'on a few roof tops especlally thoee whlch had stacke ofdried hawthorn. At the beglnnlng, there nere approxinately l5-f00 rnalea ln each ewaru andmosqultos nere seen enterlng the errarm fron all dlrectlons. The awarDa reached thelrmaxluum etze ln about 10 mln. Those on the hedge and on the toPs of treee were spheri.caland the tot81 number of uales ln each never eurpaaeed 1000. The average-elzed ewarn8,nhlch forroed a rnaJorlty, contalned 500-600 nales e8ch. Two ewarms forned on trro roof topawhlch had blg etacke of hawthorn conelsted of an eetlnated 4000-5000 nosgultoe.Tenperature, humldlty and wind velocity were recorded dally et 1830 h (Juet before awarDfornatlon) and 1930 h (aoon after lte dlepersql). The oean uaxlnuo and uean ulnl.munEemperarures were, respectlvefy 34.1 and 32.40 C wlth l ltt le varlatlon. The average wlndvelocl.ty was 4-6 knots.
- Copulatlon ln the gwarms: Durlng the early stages of the fornatlon of the anarng(when they contalned 100-300 nalee) fenales entered at lntervale of f5-20 seconde. Later'a8 snarma grew to their full slze (500-600 nalee), nine fenalee entered then each mlnute.Swarnlng continued for about 40-50 uLn and there were aPProxlnately 400 copulatl'ons per
swarn of about 500-600 Dales. In the two large anarns on the roof tope' DetLng wescontlnuous. From a1l observatlone, the author estlnated thst about 50 000 nalee swarDevery evenlng and that about 30 000 pairlnge took place.each evenlng. It wae dlff lcult to
catch the nailng palre, elther ln the swera or after they left the snarm, but ln all ' l l
euch pairs (4 ln 1961, and 7 ln f962) were caught when they daehed out of the ewarus and
fell to the ground. The fenalee were dlseected to deternl.ne the degree of ovarian
developoent accordlng to the claeslflcation of Chrletophers (l9ll), and to eount the nunber
of dllatatl.on8. Of ihe Il fenalee, 7 were null lparous (6 wtth ovarlee ln stage I ' and I ln
stage II), three wlth one dllatag{on (etage II) and one with 2 dllatatlons (etage II).
Observatl.ona on the releaae of PJz-labelled gtephensl. ahowed that a few nales t@dlately
forned trro arrarua on tenta erected at the e1te-of-;elease, whll.e others fl'ew away. The
riunber ln each anarD sas between 200 and 300. Aeeuning that the uale/feoale ratio aEong
the label.led noequltos rraa l:1, lt wae eetiuated that approxl.mately 6Z of the total oales
forued awarDs near the polnt of releaee. Gopulati.one ln theee awaroa occurred ouch more
frequently than Ln natural awarns, obvloualy becauee an equal nunber of fenalee was Pre6entln the lmedlate vlclnlty. Releaee of radloactlve uoegul.toe and the eapture of copulstlngpatrs therefron showed that the unfed feoale Datee lnnedlately after releaee aud before
taklng a bloodueal. Capture durlng copulatlon of six unfed gephenel fenalee wlth ovarleE
sone obeervatlons havethe An. culiclfacles
provlded lnforruatlonconplex as shoirn under
vBc/90. 3MAL/ 90 . 3'Page
7 4
ln s tage I f ron natura l snarua, conf l rmed th ls observat ion. Af ter mat lng, the fenale
usual ty takee the f {5st b loodneal dur lng the f l rs t n ight of f l lght . Frou unpubl lshed
observat lons, a l l PJz- label led fenales captured hr i th ln 16 hours af ter re lease had fed on
blood. I t was a lso observed that th is b loodmeal helped the ovar les to develop to s tage I I '
and that a second bloodroeal was taken on the second nlght. Whether the fenale mates again
before th ls neal could not be ascer ta ined, a l though the caPture dur ing copulat ion Ln nature
of one nul l iparous fenale wi th ovar les ln s tage I I is suggest ive. The caPture dur lng
copulat lon of l -parous and 2-parous fenales, wi th no b lood in the a l lnentary t ract r and
wl th thei r ovar les ln s tage I I , showed that the fenale stephensl mates af ter the conplet lon
of eacl r gonotrop[{c cyc le, conf i rn ing the laboratory observat lons of Quraishi & Ar thur
(1963)r , us ing Prz- label led ^1gs2sg! nales.
- Fenale/nale ratlo ln the swarus and ln day-tl,ne catches: Observations on natural
s l rarms revealed a fenale/ rnale rat lo of 3:5. In lndoor catches the rat lo was 2 '3:1, and ln
pl t -shel . ters the rat lo was aPProxi rnate ly 1: I .
In paklstan, Reisen & Aslarnkhan (1976) explalned the inportance of knowledge of
swarmlng and rnat ing of rnosqui tos, as l t would assls t ln colonlzat ion of the specles, and
roay have dlrect rel"n.n"e tO genetlc control experlments to ensure adequate nating
competlt ivenes6 of the laboratory-reared, released males. Swarning and nating behavlour of
cul ic i fac lea was only descr tbed ln India f ron observat lons ln a large outdoor insectary
GftfrE-E"s"el & Rao, 1942a). Slnce genetlc control experlnents wlth 1j,1f!!1i!!!$!! were
belng l lanned ln Pakistan, the authors decided to study the swarnlng and oatlng behaviour
of th is specles l -n nature to ensure that Lnsectary observat lons were appl lcable to natura l
populattons. Observati.ons lrere rnade close to Ghulan Mohaned cattle shed near Sattoki
v l l lage, Lahore d ls t r lc t , PunJab dur lng Decerober 1975. Swarns were observed f rorn the star t
untl l f lnished against the l lghted western sky and they were Partly collected by several
net slreeps to deternine thelr conposi.t lon. Palring tlnes (the tloe the pair was first
observed untl1 the roale and fernale separated) etere recorded with a stoPwatch. Other natlngpairs were col lected lndlv idual ly wl th a net for exaninat ion in the laboratory to c lass l fy
the blood dlgestlon and ovarian stages. Parlty was determlned by applying the ovarlan
tracheole nethod (of Det inova, 1962), and lnseninat lon by d lssect lon of the spernatheca.
Temperature, relatlve hunidlty and llght lntenslty ltere recorded at 5-nln Lntervals between1600 and f800 h ou four evenlngs. Photometer readlngs were all taken at ground level wlth
the photoeensltlve cell lying parallel wlth the ground. A sumnary of the observations as
dlscuseed by the authors follows:
- Swarm deecrlptlon: Snarmlng actlvity comrnenced on an average 20.9 nin before sunaet
wlth one or trro males flylng slowly ln clrcles above a selected portion of the courtyard of
the cattle shed. Swarms were usually forroed above low obJects such as a mound of dlrt or aplle of stran, and nere con6l8tent1y seen at these locatlons, but a typical ttmarkertt was
not recognlzed. [In another paper trmarkertt was deflned as: ttabove or more or lesshorlzontal surface of contrastlng l lght and darkt'.] Swarms never formed above donestic
anlmals or humans, but they dld forn ln the imnediate vlclnity of Che cattle shed. Usually
the swarms were falrly low, l-4n. The swarms were eptrerlcal and aometlmes moved vertically
or horizontally, but alwaye returned to the area of fornatlon. Swarnlng at Sattoki began
at a much higher ltght lntenslty (f4I4 lx ) than that observed ln Indla by Russell & Rao( t 9 4 2 a ) , w h 1 c h w a s a b o u t 2 . 0 f o o t c a n d 1 e s ( - 2 l . 5 1 x ) . A t s a t t o k i ' @ w e r e f o u n dto bite cattle earller ln the evening durlng December chan Ln August. Perhaps swarnlng
acttvlty also shlfte to earller tn the crespuscular perlod becauee of the colder wlnter
tegperatures. In the evenLng, ltght lntenslty and tenperature dropped rapldly whlle
relatlve hunidlty lncreased oarkedly. Perhapa thts rapld change in tenperature and,/or
huntdlty altered the nornal reaponse to l lght lntenelty [see below]. Swarnlng contlnued
unt l l l i te twt l tght , endlng 21.0 n in af ter aunset wl th a mean durat l .on of 41.0 n in ( range =
36-47 nln) whlch-waa conelderabty longer than the 2 to 20 mln recorded by Russell & Rao(f942a). [The naln obeervatlons of Russell and Rao on swarming of cullclfacles were made
vBc/90. 3MAL/90 .3Page 75
durlng 29 August-26 October. These authors trled to flnd a relatlonehlp betweenneteorologlcal condltlone and swarning. 0n some days, for no apparent reason, althoughthere were abundant unDated lnagl.nes lnslde the large lneectasry cage, swarmlng dld nottake place. Ionedlately after or inmedLately before a raln, when the atmosphere waseurcharged wlth hunidlty, ewarmtng dld not take place. Durlng Noveuber, when lt ralnedalmost datly, no ewarning nas observed. It was concluded that no clear relatlonshlp ofswarmlng to any neteorologlcal factor could be found].
- Swarn conposltlon: Sanplee taken fron 25 cullclfaclea snarns ln six dlfferent1 o c a t 1 o n e a r o u n d t h e c a t t 1 e s h e d c o n e l ' s t e d o f s + s f f i i - T a f e n a 1 e s g 1 v t n g a r a t 1 o o f38.9:1, indlcatlng that these swarma nere conposed eseentlally of mal.es wlth feroalesenterlng the swarus to nate. Males or fenales of other specles rtere sonetlnes collectedw l t h l n c u 1 1 c 1 f a c 1 e 6 s I ' a r n 8 , v L z z m a 1 e 6 o f @ . l a n d @ , a s w e 1 1 a sfenateeE;;Gfs, g1gg1ggg ana putctr{tGl appa@tracted tobtrllar ntci6?liiilTfc 6n?'l.Erone or pffi?lffie rs" .
- l{atlng: Palrlng began on average 6.1 nln before aunaet and contlnued untLl 15.8 nlnafter sunaet, the average duratlon belng 2I.7 nlo (range - 15-31 ntn). After the swarn hadconpletely foroed, paire could be detected flylng, ln copulatl.on, away frou the naln bodyof the ewdrn. Occaelonally, when a fenale apparently approached the ewarn, a group ofmales would dart ln her directlon. Matlng wae I't lp-to-tl.prr, etlth the copulatlng palrleavlng the swarn and elowly drlfttug towards the ground. Copulatlon was nornallyconpleted before the palr reached the ground. The nean copulatlon tlne for 75 pal.rs was27.2 eecorde (standard error of the EeaD - 0.92 s). Copulatlon tl.ne wae conelderablyJ.onger than that reported by Rueaell & Rao (f5 s). Of 46 natlng palre collected wlth a netat Sattoki and dl.seected ln the laboratory, 28.32 were unfed, 19.62 recently fed, and 52.22had fed the prevl.ous evenlng. In 82.62 the ovarles developed to at least stage II(a) orear l ler of Chr letophers ( l9 l f ) . Most b loodneals were weak or par t la l feeds and ln nolnstance were the ovarles developed beyond etage II. A1l. fenales were null lparoue. Bloodfeeding by vlrgln cullclfacies fenalea naa reported by Rueeell & Rao (I942b) and waseuggesied- Uy n-faeffi iEffif, l i & Naqvl, (1976) who found unfertl l lzed, f reehly-fed fenalesof cullclfaqles restl.ng ln cattle sheds and also vlrglu fenales bttlng buffaloes. Thlslnit lal bloodneal was apparently ueed lnetead of a sugar dlet to develop the ovarles to therest lng etage I I .
Further, Rel.een, Aelan & Slddlqut (L977, observed the ewarnlng of l0'oosqulto specleeat f l.ve vll l .agee ln PunJab, Pakl.stan, froo December 1975 to Decenber 1976. Dawn swarnsItere not observed at Sattokl vll lage durlng 1975-L976. The obeervatLone were nade durlngduekr ln doneetic and perldoneetlc eituatlons, or ln adJacent agrlcultural f l.elde. Durlngduekl l-3 observers would begtn searchlng for oale arraroa ln the viclnlty of lndoor oroutdoor restlng sltee at an l l lunlnatlon of about 2000 lx. Uhen geveral oales wereencountered, the tlne, i l lunlnatlon lntenslty, and tenperature and relatlve hunldlty fron adry and wet bulb thermometer nere recorded. I{lnd veloclty was meaaured wlth a portablewlnd meter, and wlnd dlrectlon. recorded. The anarn nas then cont.inuouely observed agalnstthe ltghted weetern eky. Tlue, l l lunlnatton LnteneLty, and wet and dry bulb temperatureswere recorded when palring began and ended. Addltlonally, another obaerver contl.nued.togearch for other 8narm8, collectlng eubsanplee of each wlth a net. The tine of collectlon,helght of the snarn, the preeence of a Darker (lf any), approxlmate nunber of nales,dlrectlon of f l lght, and general swarn ehape were aleo noted. Occasl.onally, the nunber ofpalrs obeerved raa couDted to glve an estlDete of the relatlve frequency of natlng 1n nale8e8!D8o Patrigg time, fron let palring unti l separatloD, na6 estluated by a etopwatch.Soue palre were collected by a net to ascertaln by diseectlon the physlologlcal condltlonof the feuale at natiDg. The epecies obeerved were flve anophellnes: glgglgglg,cul lc l fac lea, atephenai , n lgerr luue, and pulcherr lnue (see under 3.3 above), as wel l asfour Culex and one Aedee epeclee. Infornatl.on le given here only for cullclfacles andatephenei aa follows:
vBc/ 90 . 3MAL /90 .3Page 76
An. cul lc i fac ies
- Locat ion: Sat tok l (a11 year) , Khano Harni (January-March) '- Shape : e l l i pso id , ho r l zon ta l ax l s .- Di rect lon fac lng: var iable.- S i ze : 15 - >3000 ma les- Type: f ree swarE (= over a f la t sur face independent of any d iscern ib le narker) .- l larkers: swarms consistent . ly forned at the same s l te, but def in i t lve markers were
not recognized.- Itelght: 1-3 rn above ground.- Pai r lng: f requent dur ing wl 'n ter and spr lng '- T lne of copuiat lon: shor ter durat ion as the anbient t :TP: :8t l .e increased, e.g. ,
December 197 i , r uean o f 76 pa l r s = 27 .2 a ' t e 'Pe ra tu re , l 5 -18u C ; Ap r l L L976 ,
7 pa l r s = 15 .6 s , t emPera tu re , 23 - C '- physlo logical s tate of patr lng fenales: inseminated, nu111parou6, unfed, wi th
ovar les at s tage I , or p" . t f " f fy fed wl th ovar ies at s tage I Ia ' Occasional ly , males
.would pair witi inseuinated fenales at. stage III or V or parous fenales'- T i rne of swarning: var ied seasonal ly , ear l le i ln re lat lon to aunset and at a h igher
ll lunlnatlon durlig winter. I l lunlnation at srtarD connencement lnversely correlated
w l th re t rpe ra tu re ( i = 0 .558 , P<0 .01 ) , bu t no t w l t h re la t l ve hun id t t y (1 = -0 ' 102 '
P>0 .0s ) .- T lne of pai r lng: var ied seasonal ly ; ear l ler dur ing wLnter , absent dur lng 6umm€! '- Renarks: observatLons durlng
",rtt lt agreed well with those of Russel & Rao (t942a),
but winter observatLons nere i l " " t "p. t t as polnted out by Relsen'& Aslankhan (1976)
(see above). Mat lng at male snarns sLtuated in f ront of entrances to lndoor rest lng
si tes was consldered suf f lc lent to account for nost lnsenLnat ions. However, pal r ing.was rarely seen durlng sprlng and sunner, and assumed that most Datlng oecurred
elsewhere.
An. j tephensl
- Locallt ies: Sattokl (January-August; October-December), Khano-Harni (March-July),
ir, i" i park (March-April), Khokhar (May-June) and Shah-dl-Khoi (October)- Shape: e l l lpsold, hor lzonta l ax is .
. - F l lghE pat tern: c l rcu lar root ion, para l le l to the ground'- Dl rectLon fac ing: south at Khano l larn l l var lable at other s i tes; occaslonal ly
shi f ted to oPPosl te d l rect lon.- Slze: 5-3000 males.- Type: narkerr toP.- l4arker : bovl i droppings, brush p11es, buf fa loes, feeding t roughs, corners of
butldings' wet ground.- Colour preference: dark under natural condltlons- Helght: (1 n above Darker.- Pai r lng: rare lY observed_ Tlme of copulailon: I palr seen = l0 s, completed on grbund._ physlologltal state of palrlng fenales: undeternlned.- Tine of swarrlng: Khano llarnll commenced (a nean of 15 observatlong = 7'7 nin
before Eunaet; l l lunlnatlon - nean of 437 fx ai 27o C'- Tlne of pali lng; Khano llarnl, mean ll lurolnatlon of three occasions = 48'4 lx'
- Remarks: Reference nas nade io Quratshl (1965) who descrlbed large swarms of
stephensl on rooftops of houees ln lran (see above), and noted that natlng rtas very
frequent (9 patrlng"/rftr). In the present study, the authors- rarely obeerved EaElngs
wlthln "ru".r"
and concluded that nost matlng must occur elsewhere'
B a k e r e t a 1 . ( r 9 8 0 ) n o t e d t h a t @ 1 s a s p e c 1 e s w h 1 c h h a s b e e n k n o w n t o b ed i f f 1 c u 1 t t o c o 1 o n 1 z e 1 n t h e 1 a p o r a t o @ c o 1 o n 1 e e h a v e b e e n e s t a b 1 t s h e d . i tPakls tan (c l t tng Alns ley, 1976)r and ln India (c i t lng Anear i , l tan i 6 ' Sharma, Lgl t ) - '
iGT-o'ffidocumenr vBc/8 8. 5-UAP / 88 -2, pp - 62'64 .
vBc/90.3l-{ALl90. 3Page 77
The colonles have been eelected for oatlng Ln cages to facll l tste genetlc etudiee. S{ncecoloniee of this species have undergone intensive selectlon, the authors carrled out tworelease/recapture experlments wlth cullclfaclee at a rural vlI lage ln Paklstan durlng 1979to test the rnatlng coupetlt lveneaa of oalee carrylng a double chrouosomal aberratlon. Asummary of the proceduree adopted follows:
(a) Stralns: Males and feuales ueed ln these experlnents lrere obtalned frou thefo l lowing aources:
- Release nales (destgnatef In- I /T- f ) carr led two aberrat ione: In (1)1 andT ( Y ; 2 L ; 3 ) 1 ( c l t l n g B a k e r e t a l . 1 9 7 8 ) ^
- Release females were of trro types: a laboratory wlld-type straln colonlzed ln1976 fron Kot Baghicha (KB), and the laboratory reared Fl progeny of wtld-caught (l lC)females fron the eame study area.
- Unnarked local uales and fenales collected at Kot Baghlcha (lM)
(b) Rearlng, countlng and narklng: Two roona were used for rearlng and holdtngnoequl . tos:
- a n
ll lunlnated atphotopertod ) ;
lnsectary nalntalned at 28-3Oo C and 50-802 RII, and artlf lclally16 L:8 D, wl.th f.5 h slnulated crepuecular perl.od (coneldered aberrant
roon maintalned at 26-300 C and 24-4OZ RH, wlth naturala l a rge wLudow (Ap r t l - 13 L : l l D , May - 14 L :10 D) .
- a rearl.ngphotoperlod provlded by
Larvae were reared undei uncrowded condl.tlone ln covered enauel pane and nere fed on llverpowder. Larvae/pupae aeparatlon was done once dally uslng an lce-water techntque (ofWeathersby, 1963). In the afternoon followlng the eraulng of euergence, adulta uereanesthetized wlth COo, sexed and counted nanually, and then narked wlth cohort-epeclflcfluoreecent dust (elttng Yaeuno et al. , L972>. After dusting, the noequLtoa eere placed ln0.95 l ltre paper carton cagea, offered 3Z sucrose eolutlon on cotton pads, and held ln thelneectary or the rearlng roon untl l transported to the fleld. Durlng the i lay experlnent,one cohort of WC fenalee and WC males nas transported to the study area aa pupae. Theadulta energed at a breeding elte and were narked wlth eelf-dustlng systeu (clt lng Singh 6Yasuno , f 97 f ) .
(c) Laboratory quallty controls: To test the effect of oarklng on adult longevlty,25 uarked and 25 unrnarked one day old In-1/T-1 oalee, t{C fenalee, and KB fenalee sereconflned in 3.8 1ltre carton cages Ln the lneectary wlth a 3Z eugar solutlon ualntalnedconstantly. MortalltLeg were recorded dally and age-epeclflc eurvlvorehlp was uaed toestlnate the nean expectatLon of l1fe at energence ln days for each cage uelng standardllfe tablea calculatlons. Fron thle, it was shown that dusted adults l lved algnlftcantly(P<0.05) longer than dld the undueted controle. To estlnate the natlng coupetlt lvenees (e)of the In-1/T-1 rnales undir ineectary condltlone, 50 nalee of thie straln:sO KB Dalee:50 KBfemales (a11 newly energed vlrgln feuales) were releaeed lnto 3.8 l ltre carton cagea, andprovlded wlth 3Z sugar solutlon, and at nlght with a restralned Dous€o Blood fed fenaleswere teolated for ovlposltLon. The reeulting fanll les rrere reared lndlvldually, andeubeanples of the energl.ng progeoy sere examlned cytologlcally to detect chrooosonalaberratlone. The 62 reeultlng fanll{ee nere aucceesfully ecored ln slx repllcate testa' lnwhlch 28 feualea were Lneemlnated by In-1/T-1 nalee. Thle ytelded a conpetltLvenessestloate (e) of 0.824 wlth a variance of 0.071. Thua, the In-l/T-l naleg nere cooslderedequally cgDpetlt lve, 1.e.r € - 0.824 was not el.galftcantly dlfferent frone ' l ' ( f ( l ) - 0 . 5 8 1 , P > 0 . 0 5 )
(d) Releaee: Marked Doequltos were released at a corpound conslstLng of f lvecattle-buffalo ahede and two others outelde the conpound, sltuated ln a rural aree about
i:, Gfi:Tdocuuent vBc/88.5-uAP/88.2r p. 191.
vBc/90. 3r.{AL/ 90. 3Page 78
3 kro northeast of Kot Baghlcha vll lage. Cohorts were released during nid-afternoon lnside
cattle sheds. Covers of transport cartons nere removed and nosqultos were allowed to
disperse for 15 nln. I losqultos renalnlng ln the cartons were subtracted fron the nurnber
dusted to calculate the actual nuobers released. Afternoon arnbient temPeratures and RH
inslde the cattLe sheds averaged 32.50 C and 582 during April (ExPerfuoent. l) and 29.7"
C and 602 durlng May (Experlnent 2), reepectlvely. Tenperatures durlng May were considered
unseasonal ly cool .
(e) Recaptures: Conmenclng the evening of re lease, oosqui tos were receptured dal ly
uslng three techniques:
- Adul t mosqul tos rest lng io the aeven cat t le sheds were col lected each af ternoon by
hand capture (2 col lectors for 15 n in/shed) and a roechanLcal sweePer (one col lecEor
for l0 n ln/shed). Sanples were held on ice unt l l re turned to the laboratory.
- 3 exit and 3 entry traps were fixed ln the windorvs of two sheds and oPeratednlghtly durlng ExperLnent 2. Durlng the evenlngs of 20-2L and 2L-22 May, traps were
changed at hourly lntervals throughout the night. Most nosquitos egressed within 30
nin after sunset and lngressed between 30 rnln before and 30 min after sunrlse.Thereafter, the trapa were set at least 2 h before sunaet and changed 40 n1n after
sunset and then rerooved about one hour after sunrlse.
- Startlng about 20 uln before aunaet, l-3 collectors began looklng for swarns in the
vlclnlty of the flve rnain cattle sheds. Swarms routinely forroed at eight sites(narked on a nilp near ca.tt le sheds), and were collected wlth a net to estinate thenumber of narked and unmarked local oales. Once swarns uere well-formed, lndoorresglng collectlona lrere nade by two collectors to enaure that the In-1/T-1 roales andtli l nales had egressed froro the sheds.
- Durlng the nlghte ot 20-2L and 2I-22 May, a tean of two collectors caught rnosqultosconing to feed on tethered bovlds for 30 nln/h frorn 1900 to 0430 h.
- All collectlona lrere provlded wl.th water-soaked cotton pads and then returned tothe laboratory where they were held at 50 C overnlght. The following roornlng,mosqul tos were etherLzed, examined for f luoresence under u l t rav lo let l lght lngtldentlf led and counted. Al1 blood fed or gravid marked and subsamples of unnarkedfenales were iso lated ln v ia ls wl th water for ovLposi t lon. Unfed females wereoffered humana and gulnea plgs as a source of blood and/or dlssected to deternlnelneemlnatlon. Fenales recaptured withln 48 hours of release and dylng beforeovlpoel t lon eere a lso d lseected for lnseminat ion.
(f) Assessoent of natl.ng conpetlt lveneas: Egg batches were held ln the lnsectary for24 houra, and then exaolned mlcroscopl.cally to deternlne the percentage of hatch. Eggbatches that dld not hatch were held for an addltlonal 24 hours before belng dlscarded.Egg batches nlth more than 402 sterl l l ty were reared lndlvldually and the chronosomes ofseveral energlng nales and/or females were exauLned cytogenetlcally to verlfy Ehe presence
of the holandr ic T(Y;2L,3) l t ranslocat lon and/or the In(1)1 lnvere lon. Egg batches whlchcould not be ver l f led cytogenet lca l ly and had greater than 402 ster l l l ty were deleted f ronfurther calculatlons.
(g) Stat ls t lca l ca lculat lons: Methods adopted to est lnate the absolute populat lon
slze from afternoon resting collectlone, the datly loss rate of each cohort (enlgratlon *
nortaLity * removal sanpllng), oale natlng conpetlt lveness, as well as procedures ofslgnlflcance teetlng, rrere descrlbed. Interested readers should consult the origlnal
PAPer.
Results were glven ln detail wlth data calculated to show the nating couPetLtlvenessof cullcifaclee In-1/T-1 males durlng ExperLnents I and 2 were tabulated. As suruoarlzed
anaEiffiiEiiTy the authors, the experlments showed that when In-1/T-1 males, WC and KB
vBc/90.3MAL/90 .3Page 79
feuales rrere entlalned on an aberrant photoperlod 1n the lnsectary, the In-1/T-1 nales ltere
super conpet l t lve (e)1.0) . However, when reared under a natura l photoper lod, In-1/T-1males were equal ly cornpet l t lve (e = 1.0) . Throughout , there waa no s lgnLf lcant d i f ferenceln (e) estlnated by elther l{C or KB fenales, indlcatl.ng that an aberrant natlng behavlourhad not been selected during malntenance of the colonlee ln the lnsectary. Most releasedfemales nated ln the lnnedlate vlclnlty of the daytlne restlng sites or Just after thecrepuscular egress. Few IJM feroales, or I{C fenales released as pupae at a breedlng site,nere Lneeminated by In-1/T-1 malesr indlcatlng that sone mating nust have occurredelsenhere or at dlfferent t lne6 of the nlght. The authors underllned that thelr releasesdld not show adverse aberrant nating behavl.our eelected durlng laboratory colonizatlonwhich rnay lnfluence future genetl.c control experl.nents. As roentioned abover there were nostatlstlcally sigoifl.cant dlfferences ln nale coupetlt lveness when assessed by KB or WCfenales ln Experlnents I and 2. When entralned on the proper Photoperlod, rnales carrylng a
conplex chrooosomal arrangement in a laboratory:adaPted geneEl.c backgroundr egressed and
snarmed wlth the local nales. Thts ls ln sharp contrast to slnllar studles wlth Cx.t r l taenlorhynchus, a fera l ooequl to epecles a lso d l f f lcu l t to colonlze. Stat ls t lETfyf f i 1 e o a t i n g c o n p e t l ' t 1 v e n e s a w e r e o b t a 1 n e d w h e n c o h o r t s o f W C . 2 c ( 2 d a y s o 1 d )and WC-2d(newly energed) nere used (e - 0.182 and 0.197, reepect lve ly) . This wasattrlbuted to the fallure of.the fenalee to contact the In-l/T-l nalee durlng the natlngperlod. The authors further'pointed out that obtalning an accurete estlnatl.on of nalenatlng conpetltiveoess Lo nature depends orr carefully planned experimental Protocole taklngLnto conslderatlon envlronnental condltlons such ae photoperlod and Dating behavl.our of theepeciee. Results of Experlnent I clearly lndlcated that lnaccurate fleld lnfornatlon maybe obtained 1f adults are reared and/or held under aberrant condltlons. Alao Experlnent 2demonstrated that blae nay arlee fron the eelectlon of release sltee for nales andfeuales. For future experirnents, lt would eeen Lnperstlve to dupllcate natural condltlonstand thle nay reguire that nosqultos be releaaed as pupae to a1low for the posslbll l ty ofexophlly by teneral feuales.
Followlng the above study, Relsen et al. (198fb) conducted an experlnent aleo lnPaklstan to deternlne the behavlour and nating conpetlt lveneas ln nature of ualeculiclfaclee arlelng fron pupae whlch had been Bexed by a genetlc eyeten and then treatedwith a chenoeterilant. A sumary of the nethods and proceduree adopted follows:
(a) Study area: the eaue cattle ehed conpound used by Baker et al. (f980) near KotBaghtcha.
(b) Stral.ns and productlon: The followlng etralns of cullclfacies were used:
- Dl3: A genetlc eexlng etraln produced by tranelocatlng the gene of dleldrlnreslstance on chromosone 3 to the Y-chronoeone and naintalned.by backcrosslng tohonozygoua dleldrln sueceptlble fenales (as deecrlbed by Baker, Sakal & Raana,r98 l ) '
- SAT: Sattokl, PunJab provlnce, a laboratory-adapted straln colonlzed by Alneley(1976 - aee footaote I under Baker et a l . 1980 above).
- KB and II l l : as ln Baker et al. (1980) above.
For production, 18t stage D-13 larvae were expoeed to dleldrln at 0.02 ppo for 24 hoursafter hatchlng. The survl.vl.ng oale larvae were then transferred to a serlea of coveredenamel pane ln.whlch they were fed dally on fl.nely slfted l lver powder. Larval/pupalseparatlon tere Beparated nanually or uelng an Lce-nater technlque as thown above. Pupaewere then treated wlth a lZ solutlon of the chenosterllant, bleaztt for one hour and rlneedsith well water. The nunbers produced iere estinated volumetrlcally (nean = 306.5 15.69pupae/n1). Progeny of SAT and KB fenalee irere reared ln pane ana fia on l1ver powdEr.
@ocuaenr vBc/8g.5-1,{Ap lgg.2, pp. 190-r9r.
v B c / 9 0 . 3MAL/ 90. 3Page 80
Soroe pupae were sexed and counted whl1e others were allowed to eurerge' Adults were
anesthet lzed wi th CO. sexed and counted nanual lyr narked wi th a cohort -sPeci f lc
f luorescent dust (aszshown above), and then held for 1-4 days ln cages wi th 3Z Eucrose
source. Al l nosqul tos were reared and held under the natura l photoper iod '
(c) Releases: Chemoster i l lzed D-13 nales and sorne SAT and K8 feroales re leased as
pupae ln a sel f - roark ing devlce (see above) Placed a long a nater course breeding s i te ' to
s imulate natura l condl t ions. Each fenale cohort was roqrked wl th a speci f ic co lour ' At Kot
Baghicha, .oor , r rg i t - i " ip"r"arr res ( rnean min inuro = 18.90 C) delayed developoent of the
pupae and two dayl were iequired for the emergence of each cohort' Pupae fail lng to
ernerge, d isperse or both f rorn the sel f -nark ing device nere subtracted f roo the nunber
rneasured volumetrically, to estimate the nunber of adults erDerglng lnto the study af€a'
Marked adul t fenales were re leased' ins ide cat t le sheds af ter lndoor rest lng col lect lons
were conpleEed, but at least one hour before sunset ' Speclnens fa i l lng to d isperse f rom
Ehe release cartons were subtracted fron the nunbers dusted to estiDate the numbers
re l eased .
(d) Recapture and assessoent : A11 recapture roethods ut l l ized by Baker et a l ' ( f980)
were adopted. Addl t lonal ly , p l t sheLters (of Mulrhead-Thomson' 1958) were dug between the
pupal release slte and the cattle shed copPound and rnosqultos restlng Ln these shelters
were collected each afternoon. Laboratory processlng of uaterlal followed the same
procedures ahown above. Fully hatched ani Lntratched or Partially hatchl'ng enbryonated egg
batches were scored as resultlng fron D-13 roale or IJM nale matings accordlng to a crlterlon
establ lshed by observat ions on qual l ty contro l '
(e) Dissect ions: Subsanples of lM fenales and both D-13 and UM nales were d lssected
to deterBlne reproductlve status. I,| l ' i th IrM fenales, samples were dissected to examlne the
spermathecae for the presence of sPennatozoa, lhe i.gt"L of ovarlan developrnent uslng the
classi f icat lon of Mer (1936) ' and i t re number of d i la iat lons ln a saople of ovar lo les ' Male
age was deterroined by the number.of spernatocysts and the relative ProPortlon of the testes
occupled by rhe ;;.; reservoir (crting Mahnold & Relsen unpubllshed observations)' Mating
tr i .s tory (1.e. , the nunber of prev lous !3aculat lons) was ascer taLned by the degree of
engorgenent of the accessory glands wlth secretory Daterlal, and the degree of sperrn
depletlon in the sPernt reservolr and postgonadal system' Thus, males were dlvlded lnto two
grouPs:
- vlrgin = those unmated and once mated but havlng reJuvenated;- mated = those once mated but not rejuvenat.ed, and those nated rnore than once'
( f ) s tac is t ica l ca lculat lons: In terested readers should coneul t the or lg lnal paper '
As sunnarized and dlscussed by the authors, energlng D-13 nales behaved sinilarly to
endemic unnarked males (Uu) in that the D-I3 uales rested outdoors untl1 sexually Dature
(lncludlng fuLl rotation of the terrolnalla, lnnigrated lnto the cattle ehed conpound where
they swarmed wlth the IIM r0ales, and rested indoors on the followlng day tn a proportlon
equal to snarn composltion. Moreover, equal proportlons of D-13 and uM males nated at each
col lect lon s i te . However, est lnates of nat lng conpet l t iveness based on the fer t l l l ty of
egg batches froo lndivldual SAT' KB and llt ' ! fernales were statistlcally less than I ' '0
( e = 0 . 3 8 5 r O . 5 8 0 a n d 0 . 3 0 9 r r e e p e c t i v e l y ) r s u g g e s t L n g t h a t D - l 3 r o a l e s w e r e l e s scgnpetlt ive In nature, although equally
"otp.ti!f"" u"d"r laboratory condltlons (s = 0'783;
Ff i r = 0.97; P)0.05) . Despi te
" r r .ouragt . tg e ln l lar l t ies ln rest ing, swarming' and
natlfg behaviour, coupled wlth posslble lnprovement ln release procedurest D-13 nales mated
with a disproportlonately lon nurober of SAi, KB and lJll females' The authors speculated
that thls maY have been due to:
' - loss of vlgour due to dieldrin and/or chenosterllant exPosures;- handl lng st ress assoclated wl th product iont t ransPort and re lease of roosqul toe;
alteratlons in behaviour and nating coropatibll l ty related to chrourosomal
rearrangeDent and laboratory-adapted backgound'
vBc/90.3MAL/90.3P4ge 8l
Laboratory experlments rrere conducted on D-13 males to aseess nating conPetlt lveness,with and wlthout dleldrin and chenosterllant treatnenta. The preseDt overallconpetlt lveneaa was 0.783 whlch was lower than desLred, although not slgnlflcantLydifferent fron 1.0. The authors lntended to inprove D-13 nale conpetl.t lveneas by changlngthe background genotype or loprovlng chemosterll lzatlon procedures before undertakalngfur ther f le ld exper lnents.
Further lnfornatlon on matlng behavlour of culiclfacles and .1!g$,9! has been1 n c o r p o r a t e d 1 n s t u d 1 e s o f d 1 s p e r s a 1 a " s h o w n u n d f f i ?
4 .4 DLspe rsaL
Lndlrect evldence lndicated th"t 91!g!9!g! and cullclfacles do not nornally dleperselong dlstaoc€a. In Bahraln, Afrldl & t{ajld (1.938) based on flnding roalari.a prevalent ln aJ.ocallty where no anophellne breedlng occurred, eurn{sed that BEephensl nust havelnf i l t ra ted f ron gardens Bl tuated at a d ls tance of 1.5 n l les ( - 2 .5 ko) . In Quet ta,Baluchistan, Paklstan, Mull lgan & Bally (1938) found that adulte of ste3$gg! andcullclfacleg became scarce at e dlstance of more than 0.5 nlles (- O]-Eil i-Fon theEreeainc slte.
Dlrect lnfonmtlon on the dlepersal of the two epecles nas provided froomark/releaee/recapture experlnents. In Iran, Quralshl, Faghlh E Eehghy (1966) carrled outan experl.ment ln an area of Kazeroun, about 100 kn southeaet of Shlraz durlng July-AuguetL962. Larvae were reared fron egge lald by eeveral thoueand An. eteohenel pysorenslsfenales collected fron the experlnental area. Fourth lnetar larvae of unlforn slze wereeeparated by a neclEnical devlge (of Fay & Merlan, 1959). The larvae were labelled byplaclng 15,uc of P" ln 1.5 l ltree of water ln each enamel vessel neaeurldg 36x24x3 cruwhich contalned approxlnately 750 larvae. The average couqt rates of nale aud fenale were4000 and 5000/rntn, respectlvely. Cagee contal.nlng unfed P"- labelled nosquitoe nhichemerged overnlght nere tranaported tn cagea to the elte of releaee (at about 2l kn frou thelnsectary) and kept 1n a tent. The cage doors lrere opened Juet before the natural awarningof uales was about to start ln the vlctnlty. Dates of releaees and nurnbere of ooequltoswere:
- near Shua-us-Saltane (24 July and 5 August, 1962) f00 000- Near Roodah, about 30 kn fron the above (25 July and 7 Auguet) f7 000.
The latter releaee was Deant to etudy the blood dlgeetlon atagesr ovarl.an developnent anddatly Eortallty. Comenclng the day after releaae, collectlons were taken dally byrotatlon ln 13 vll lages ln the following capture statlons:
- bedroone and stebles by PSC- l{agoon traps (of l{agoon, 1935), and plt eheltere (of }lulrhead-Thorneon, f958) byhand eapture.
All collectlons nere screened by a epeclal radloactlve nonitor. All eaptured nosqultoewere claselfted accordlng to the dletance flown fron the polnt of releaae. Ln the caee offenales, records nere nade of the ovarlan stage (of Chrtetophers, l9ll) and the nunber ofd l la tat lone, Lf anyr ln the ovar lo lee. The recapture rate was 0.1832 (51 Dales and 132feoalee) from the Shua-uE-Saltane relea8e, and 0.322 (7 nales and 48 feroales) fron Roodah
release. The hlghest ratl.o of radloactive-labelled noegultos to the total catch wasobtal.ned at Shua-us-saltane vll lage, which le nearest to the Polnt of releaael L.€.1
200-800 n. The loweet ratio na8 recorded at BorJsookhte-Olya vll lage, whlch ls farthest
frorn the polnt of releaee (4.5 ko) where only one nale and one feoale were captured. fhenunber of nosqultos recaptured wae dlstlnctly lower at 3.5-4.5 kn fron the Polnt of release
than at l-3 ktl. Both nales and feoales were able to fly 1.8 ku overnight. One fenale wae
caught ln a vlllage 2.8 ku frou the polnt of release slthln 16 houre of releaee. Labellednosqultoe were captured only durlng the flrst nlne daye after releaee. Slnce the nunber of
recaptures waa very snall and varl.atlons were nurDeroua, theee catches ehould be taken as
lndlcating a rough trend. (Infornatton on the gonotrophtc cycle and age detendnatlon leglven under 4.10 below).
vBc/90.3MAr/90.3Page 82
In Pakistan, Relsen & Aslankhan (1979) noted tha! research on genetlcs of .1|9!]!1|!has been carr led out in thei r laboratory for the pa6t e ight years, and re leases of se lectedgenotypes were being pJ.anned. Before undertak lng such exper iments, and ln order to Providedata of epldern io loglcal ln terest , narked stephensi males and feroales were re leased nearSat tok i v l l lage, Kasur d is t r ic t , Punjab p iov lnce. Mosqui tos were re leased about 45 ro east
of the Ghulan Mohaned cat t le shed (shed 5) which is in an agr icu l tura l area about 5 kn f ronSat tok i . The study area lnc luded a l l cat t le sheds wl th in a 2.L7 km extenslon to the east .The tota l nunber of sheds was 13 wi th shed L3 at 2.17 kn to the east . A11 cornpoundsconsisted of a roud-wal led enclosure wi th one to several nud-wal led but ld ings wi th nudplastered thatched roofs. Up to seven fani l ies l ived in these conpounds wi th a l l the l r
doroest ic anlnals . Sone of t le sheds had been sprayed dur ing the previous year wi th
nalath lon at a rate of 2 g/m' by the Malar ia Contro l Progranme. Tenperatures ln thecattle sheds durlng the norntng, nild-day and afternoott rolr" 22-251 29-33 and 28-420 C,
respect lve ly , then dropped to 20-29" C about one hour af ter sunset . Relat ive hunid i t iesln the cattle sheds were 95-972, 76-857. and 75-867, respectlvely and later 80-84%. The'procedures followed were shown as follows:
(a) Rearlng: During the sprlng of. L977, a colony of l lephens.l was establlshed in thelaboratory specl f lca l ly for the present re lease exPer lDent f ron fenales col lected whi lebi t lng buf fa loes and rest lng in cat t le shed No. 5 at Sat tok l . The females l tere taken tothe {nsectary which naa matntained at 27o C and RH 80 + 52, and were released into a cage( l n-) where Ehey were of fered 3Z sucrose solut lon andr at n ight , a tethered whl te mouseas a aource of b lood. The nethods of co l lect ing eggs and rear lng larvae unt i l pupat ionwere descrlbed. Then the contents of the rearlng pan were transferred to a bowl coveredwlth nosqutto nettlng for emergence. All the adults whlch energed wlthln a 24-hour periodwere col lected for eaeh day re lease.
(b) Mark ing: Af ter emergence, adul t nales and fenales were l lght ly ether ized,counted and roarked wlch f luorescent dust (d l f ferent co lour dai ly) , us ing a specla lapparatus (descr lbed by Yasuno et a l . , 1972). Af ter dust lng, the adul ts were p laced ln 0.5l l t re paper car ton cagea, of fered 3Z sucrose on cot ton pads, and held at room teDPeraturefor release the saoe evenLng. To test the effect of each dustlng, two sanples of 25 malesand 25 fenales each were etherlzed and one sanple was dusted. Both sanples were placed incages wlth 3Z Eucrooe, and daily nortallty recorded. The dead mosquitos were exanlnedunder ultra-vlolet ltght for slgns of f luorescence. To ensure that fenales weire lndeedvl rg ln at re lease, the spermathecae of 25 females, held in energence bowls unt l l 1600 h,were exanined for the presence of sperm. In addttlon, 25 males and 25 fenales weretransferred to a 0.5 l l t re car ton cage, held unt l l re lease t ine, about 1900 h, and thendlesected to deternlne whether lnsenlnaElon had occurred.
(c) Release: Three cohorts of gg$gl , consis tLng of 2585 fenales-2881 males,3254feruales-3675 nales, and 4080 feoales-4207 nales respectlvely were released on threeconsecutlve evenlngs at aunset, about 1850 h. The tops of the carton cages were removedfor 45 ntn. As ln the prevlous re lease exper lments (see 4.3 above), adul ts whlch d id notdlsperse frorn the cartona nere counted and their numbers subtracted fron the total numberdusted to calculate the nuober actually released.
(d) Recaptures: Connencing the day af ter the f t rs t re lease, narked roosqul tos wererecaptured by four methods:
- Indoor rest ing col lect lone: Two col lectors saupled nosqui tos rest lng lns lde 13fixed capture statl.ons (cattle sheds) by hand capture for 30 uln except ln three statlonswhlch were smaller and sarnpled for 15 nln only.
- Btttng collecttons: A tean of 2-5 collectors caught nosqultos whlch attenPted tobite buffaloeE ln the courtyard of shed 5 for a half-hour perlod cornmenclng 20 nln after6un8et .
vBc/90. 3MAL/90 .3Page 83
- Swann col lect lone: Wl th the onset of dusk, one or two col lectors atar ted to lookfor swarne ln the v lc ln l ty of cat t le shed 5. Pr l .or to col lect ton wt th a net , the locat lon,tlne of collection and the approxinate size of each snarn were recorded.
- Outdoor rest ing col lect lons: Dur ing the la te af ternoon, rnoequi tos were col lectedfron flelds eurrounding ehed 5, uelng a battery-operated alreeper. Thls technlque, thoughproductl.ve wlth cullclnes, was abandoned because only one narked and no unmarked stephenglwere col lected.
(e) Stat ls t lca l ca lculatLons: In terested readers should coneul t the or lg lnal paper.
A sumary of the reeults f ollows:
- Recapture rate6: of the l0 118 fenales and 10 863 nales of s tephensl re leaeed 721(7.132) fenaleg and 505 (4'652) males nere recaptured by all nethods-(resting, bit lng andswanoing). These recapture rates were uuch hlgher than those recorded by Quralshl, Faghih& Eshghy ( f966) wl th g lgh.re l 1n I ran (see above). Relsen & Aslankhan ( loc.c l t . )explalned that thelr recapture statl.ons were conflned to a smaller area and tended to beDore concentrated around thd, potnt of release. Uore feoalee than oales nere recaptured andthl.e was attrlbuted, ln part, to spending lrore effort on collectlon technl.ques whichrecovered only fenales, e.g. buffalo-bttlng catches. I lowever, slgnlflcantly fewer nale6than fenales ltere recovered fron restlng collectlons, and this proportl.on was slgnlflcantlyleee than the proporclon of males ln the released cohort. These dlsparlt lee ln the sexratlo wele attrlbuted, Ln part, to dlfferentlal nale and fenale uortallty and diepereal.
- Dlepersal: The total nunber of narked nale and fenalee collected resting decreased.as a functLon of dietance fron the releaee 81te a6 lndlcated fron the slopes of regreesionllnee of transforned data of the mean number of marked nalee and feoales collected perman-hour ltraneforned to Logrrr(Y + l)] plotted as a functl.on of the dlstance fron thereleaee polnt Itransforned t6-1og,,..,X1 . Ttrere lraa no slgnlflcant dlfference (P)0.05)betseen the slopes of the fltted iEgreeslon functione or the adJueted nean dLspersaldl.stancea for Dalee and fenalea applylng a covarlance analysls to the transformed data.The reeults lndl.cated that males and fenales dtd not evenly dleperse throughout the etudyarea' but reual.ned concentrated ln cattle eheds 5 and 6 (at 0.05 and 0.14 kro fron thereleaee Polntr reepectively). The overall nean dlspereal dletance, cal.culated frornuntransforned data for the f l re t e lght daye af ter re lease, wae 165.5 u for ' fenales and184.8 for nales. l lean fenales d lspersal Lncreaeed e lgnl f icant ly (P<0.05) ae a lLnear-functlon of t lne Ln days after release. 0n the other hand, roale recaptures were tooI'nfrequent and too varLable to detect a elgnlftcant change through tl.ne. The naxlnundletance dlepereed was 1.78 kn (ehed 12) frou the releaee point. Thie fl lght naa oade onthe nlght of releaee by a alngle fenale whlch had nated and taken a bloodneal (ovarles lnChrletophere- etage III), and by a elngle nale fl.ve daye after releaae. No narkednoegultos were collected fron ehed 13 (2.I7 kn to the eaet), or fron eeveral houses andcattle shede ln a vll lage el.tuated at about 3.5 kn to the south, end froro an additlonal.cattle ehed about 100 o to the north of ehed f (f.07 km fron the release potnt). Thenaxlmrn fltght dlstance recorded ln the preaent study was nuch lees than that flown by onestephenal feuale ln rran (recorded by Quraisht, Faghih & Eshghy, 1966).
- Swarnlng and oatlng: Ae sunnartzed by the authora, narked males fron all threereleaeee were coll.ected nhlle ewarnlng wlth wtld males. Inseminated narked and unmarkedfenalee erere captured at uale ewarDe. Fenales oated on the oight of releaee, 8or0e withln15 nln of relebee. In this lnetaace, uatlng preeunably occurred whlle the fenalea weretraverslng the 45 m fron the releaee polnt to the slte of the buffalo blt lng catches. Bothlnsenlnated and untneemlnated fenales nere collected btttng buffaloes. Snarn shape,locatl.on' narker etc. were essentl.ally ae deecribed by Releen, Aslau & Slddlqut (L977).lReau'lte of the etudy related to survlval of stephensl, duratlon of ltg gonotrophlc cycleand lte populatlon eize are shovrn.uuder 4.10 b-el.oiT.
Further releaee experlnents were reported by Reisen, Mahuood & Azra (l9Sl) ained ateetlnatlng ecologlcal paraneters ln culLclfacles, ggg3@g and subplctus Ln a rural area
v B c / 9 0 . 3MAL/90. 3Page 84
in Punjab provlnce, Pakistan. Mosqui to were col lected f rou a ser les of n lne cat t le shed
conpounds located a long Bal lok i canal near Kot Baghlcha v l11age, Kasur d ls t r lc t . The study
area tnc luded a ser les of n lne sheds wl th shed 6 centra l ly s l tuated and sheds I and la at a
dis tance of 950 ro. The longest d ls tance wl th ln the study area was between sheds I and 8,
about 1500 n. Mosqui to populat lons were studied afEer the r ice harvest in Novenbet 1979,
and the wheat harvest ln-May 1980 when adul t cu l je l lactes - reeLlng densl t les were re lat lve ly
high ar shed 6 (nuober of fernales and males pffi l i :fr-5lFwere resPectlvely 183 and 149.5 in
Novenber, and 90 and 46.5 in May). Temperatures and re lat lve hunid i ty were cool and hunid
dur ing Novenber (20.go c, RH = -atz)
and hor and dry dur lng l {ay (28"C, &l l =67%). At Kot
taghii.ha, cultcifacies was the rnost predominant endophil ic anophellner w!t113 suPlicFus
p r e d o m 1 n a t @ E e o o n s o o n a n d p o s t m o n s o o n s e a s o n s ( A u g u s t t o D e c e r o b e r ) . o n t h e o t h e r-hand, stephensl reached its maximal abundance during late Aprll and early May, but was
tntreqiff i l lected durlng the rest of the year. ltalaria was considered a noderate
public health problen at Kot Baghlcha and near Ballokl vil lage durlng a rnalarla outbreak in
punjab province ln the ear ly rsTo-s. In J .976, the Malar ia contro l Progranne repor ted 30
po" i r i . ' " cases ( f2 @ and 27 P. fa lc lparun ) of 208 b lood s l ldes colLected dur ing
acrlve case derecri;ff i ttre ro:.tff iEEFnly 6 of .243 slldes were positlve after a
country-rrlde spraylng progranme^was inlt lated. The Kot Baghlcha area was sprayed with
feni t roth lon ar " ' t " f " -
o f -L g/at 7n L977 and 1978 g lv ing a good thor t - terE lnpact ' but
the populat lon recovered rapid ly to pre-spraying densi ty levels '
The procedures adopted ln thls study were:
(a) Capture, mark and re lease: Adul t nosqul tos rest ing tn cat t le sheds were
col lected dai ly by hand capture (2 col lectors for 15 n ln/shed and a bat tery-operated
sweeper (aescr iUea by Davls & Gould, 1973)( l co l lector for l0 ro in/shed). Speclmens were
ether lzed, Bor ted by species and sex and then rnarked wi th a s l te-specl f ic f luorescent
dust . l losqul tos "o i t . t t "d
f ron sheds 1 and la as wel l as sheds 2 and 3, whlch were a loost
equidistant fron shed 6, were pooled and each marked with the saoe-distance-speclfic
colour. Specloens collected at shed 6 on day 0, and in May on day 4, were marked wlth a
s i te- and date-speci f lc co lour . Recaptured speclmens were readl ly recognlzed using an
ultra-vlolet lanp. Marked lonigrants were re-trarked wlth the colour of the resPectlve slte
and thbreafter considered a part of that nlcropopulatlon. l ' Iarked specinens were released
at the point of capture aftei recoverlng froro the ether. As ln the previous experlment,
specinens failtng to dlsperse fron the holdlng cages were subtracted frorn the total nunber
marked Co e6tl6ate the number actually released. Speci.oens were collected between 0900 and
1400 h, narked and released on the sane day at least one hour before dusk. Capture, mark
and release nere contlnued for f ive days followed by removal sanpllng for an additlooal
flve days. For deternining nortallty anong dusted nosguitos, batches of narked and
unmarked bloodfed and gravld fenales were held ln shed 6 tn 3.7 l ltre carton cages and
provided wLth nater constantly fron bottles wlth sPonge wicks and from wet cotEon pads on
the top of the cages.
(b) Dlssectlong: Subsanples of pooled Darked and unmarked nosqultos were diesected
durlng the perlod of renoval sanpllng. IneenlnatLon ltaa deternlned by the exanlnation of
the spennatheca. The blood dlgestlon stages were deternlned froro the external appearance
of the abdomen, and the ovarlan stages seie classifled according to the classlficatlon of
Mer (1936). The nunber of prev lous ov lposl t lons was detern ined by count lng Ehe nurober,of
dllatatlons ln a sanple of ovarloles. Parous rate ltas deternlned by the tracheole nethod
(Detinova, L962).
(c) Stat is t lca l ca lculatLone: Intereeted readers should consul t the or ig lnal paper '
A sumary of the results follows:
- Capture, release and recapture: The total number of cu11c1fa91es adults collected'
narked and releaeed durlng the experlmente of Novenber L979 afr'EEy t-galtas respectlvely,
4772 fenaLesl3369 nales, Ind 5f 23- fenales/2416 nales. The nunbers of ggg@! and
subpictus captured, rnarked and releaeed were much lower, reflecting lower Ebundance' A11
three specles were Dore abundant ln shed 6, a larger compound havlng nore buffaloee and
bullocks tethered at nlght. The overall recapture rate ienerally ranged between 10 and 202
vBc/90.3MAL/90.3
. Page 85
wlth varlatlon observed anong sheds. The recapture rate of cullcifacles fenales (192) wass l g n 1 f 1 c a n t 1 y g r e a t e r ( P ( 0 . 0 5 ) t h a n t h a t o f t h e n a l e e ( l 0 . 7 z ) - @ e n b e r , b u t 1 e s ethan the nales durlng May (L6.92 for the fenales ve 2O.47 for the nales).
- DlspersaL: The proport lon of recapturee of cu l lc l fsc l .ee recorded at the shed ofre lease was s ignl f lcant ly greater (>0.05) dur lng Novernber than 1n Uay, ref lect lng a greatereulgrat lon rate, but d ld not great ly vary between males and fenales (P(0.05) . Forstephenel and ggbplctus., however, slgnLflcancly (P<0.05) nore nales trere receptured atthelr point of release. The mean cunulatl.ve dlepereal rate per day (X + SE-) was hlgherfor cu lLc l fac ies dur lng l {ay (117.9 + 7.8 ro for fernales; 100.5 + 9.9 n f6r nAles) thanaurt i lGie Q4. I + 2.9 n for fEnales; 18.6 + 3.5 n for naTes) . Dlspersal rates dur lngeach experiment were c6nparable for fenales and iates. The total nurobers of recapturedfeoale and oale cullclfacles and etepheneL decreased aignlflcantly (P(0.01) as a negatlvecurvLlLnear funcffi?GEance T6i-E-point of releaee. The theoretlcal naxiroun fllghtrangi calculated statlstlcally lndlcated that durlng May the fltght range of gggg@! andcul lc l fac les was poselb ly greater than 3 and 8 kn, reepect lve ly . Theee stat lsCl ta lextrapolatlons nay have been realletLc, bearlng ln nind that Quraiehl, Faghl.h & Eshghy(1966) in l ran, and Releen & Aslankhan ( f979) ln Sat tok l , PunJab provlnce (see above)recaptured fenales as far as 4.5 and 1.78 kn, respect ive ly . Aleo Ruesel et a l . ( f944) lnsouthern Indla recaptured fenale culiclfacles dlsperslng 2.4 to 2.8 kn to vll lages on theperlphery of thelr experlnental area one day after relea8e. In the preoent study, fenaleand male cullclfaclee exhlblted el.nllar dlepersal patterns nlthln the preeent suall-elzedstudy arei-Slffiy, the study of Releen E Aelaukhan (1979) suggest;d that fenale andmale dlepersal of stephensi waa conparable. In the preseot etudy, the arlthnetlc neandlepersal rates for gplgg{ (103.5 + 17.8 u for fenalee; 53 + L6.7 o for ualee) were lesethan those recorded Ercen & AslanEhan (1979) during l lay (f85.5 m for femates;184.4 m fornales) although these dlffereuces Day have reflected the greater dl.stances between therelease poinE and recapture atatlona.
4.5 Local epat la l and seasonal d l .s t r lbut lon
In lraq' stephensl. nade a narked epread and retreat over the years. l lacan (1950)showed the area of dletrlbutlon of stephenel natnly ln Irag as recorded durlng 1942-1944 aefollows: [for the locallt les eee FtgE.-Z(a)-and (b)].
- all along Shatt-Al-Arab, nore than half the records caue fron thle aEea;- throughout the reglon lrrlgated by the various branchea of the Euphrates ae fer asMuealylb;- around Baghdad and thence up the Diyala rlver to Khanaqln, where tt Just extendedlnto the foothll l reglon;- ln the sprlng - fed.paln grovee of Shlfatha ln the deeert, 32 kn away fron the edgeof the regl.on lrrigated by the Euphratea;- along the Karun rtver, extendlng weLl lnto the foothlUe lln Iranl.
It wae not found along the Tlgris except at Baghdad and the laet 40 kn of the rlver. Alongthe Tlgrls, the dletrlbutlon of eteglg! wae uuch raore restrlcted. It occurred at QaletSaleh, 40 ku Ln a dlrect llne fr6iTFFface where the Tlgris and Euphratee Joln, butbetween that locallty and Baghdad lt wae not recorded, though a few hlgh spleen rates werefound, for exanple at Mahatta, near Kut, lndlcatlng that Lt uay have occurred at aoneplaces. There naa no evl.dence that glgplgsgl occurred between Baghdad and Moeul and theTlgrls rlver ln the etretch that f lows through deeert well below ground level, condltloneln general were unsultable, although the poaelbtl lty that.9g@,1 nlght have exieted at afew leolated places cananot be ruled out. l lacan.(loc.elt.) further polnted out that lt lsprobable, therefore, that the effec,tlve dletrlbutlon range of gp$.l aa a vector coveredthe whole of the alluvlal plain reglon, wherever condltlons were eul.table. It extendedJust lnto the foothll l reglon at Khsnaqln ln the north€ast and oore deeply to the aouth andsoutheaat. Thue, there was good evldence thst ggglgggl hae extended lts range ln the
vBc/90. 3MAL/90. 3Page 86
northeast s lnce l9 l8 when Chr is tophers & ShortE (192f) ehowed' that i ts l ln l t was Anara lnthe Southern reglon. From an epldenlologlcal standpoint, Macan polnted out that ln anyarea where stephensl l taa Present , sporadic htgh spleen rates were recorded. Froro theseendemic foc l nalar ia epidenlcs occurred in cer ta ln years. Wl th regard to i ts seasonalprevalence, the maln seasons were May-June and October-Novenber. The reduct ion in winterwas a lnost cer ta in ly due to the low teroperature, whl1e the reduct ion in summer was probablyre lated to h lgh tenperature and low hunid l ty , a l though the dry ing up of the breeding p lacesmay have been a factor . No evldence of h ibernat ion of g!Slh"* ! was found, but l t seemedllkely that lts population had been reduced to an unusually low 1evel by the abnornalJ.yco ld cond i t i ons o f t he w in te r o f l 94 I -1942 .
Pringle (1954a) showed that g!g.p991 was alnost entirely conflned to the alluvialp la ln of south and centra l l raq, where l t was assoclated wi th date and orchardcul t ivat ion. I ts a l t l tud inal l in l t was g lven as 183 n. The only local i ty outs lde theal1uvla l p la in f rom which stephensi was re l iab ly repor ted was Khanaqln Is i ro l lar to thef indlng of Macan (1950)1. Also Al -T ikr l ty (1964) who col lected and roapped the records ofanophe). ine speclee of I raq (see under I above), descr ibed stephensi as widespread in thecentral and southern reglons, where it was recorded frorn more than l0 Liwas.
Zuluet ,a et a l . (1968) whi le repor t lng on the lncrease ln the leve1 of DDT res is tanceln stephensi ln Basrah LLwa, Iraq under DDT house spraying, lndicated that the speclesspread beyond l te l ln i ts of d ls t r ibut lon ln the country (as far nor th as Ki rkuk L iwa),colncldlng with a great lncrease ln lts denslty in the southern part of the country.
In h is ass lgnuent repor t , Iyengar (1977b - unpubl lshed repor t to WHO) in fur thersutvey also record"d g!9I!S!g! fron Kirkuk and found lt to epread westwardly to Zannar onthe Syr lan border .
Manouchehri (1978 - unpubllshed report to l. l l lO) and }lanouchehrl eE al. (1980) whilerePort lng on the status of lnsect lc lde res ls tance ln anophel lnes ln I raq, napped the spreadand ret reac of s tephensl ln the country throughout L920-L977 as shown ln Ftg.8 ' . Theorlginal atstrt6ffi i5F stephensi was l inlted to the south of a 1lne extending fron Arnaraln the east to Kerbala ln the west (c l t lng Chr is tophers & Short t , l92 l ) . Fur ther surveyscarried out Ln L942-L943 lndlcated that the dlstributlon of stephensl had extendednorthwardly to a l lne Jotntng Kerbala, Baghdad and Khanaqin (c i t ing t lacan, 1950). By 1970,a further spread to the north was reported to extend fron Khanaqln through Tuz Khoruato andDibis [reaching Klrkuk as shown above] then westwardly to Quain at the Syrlan border.After the applicatlon of roalathlon house spraying ln the Southern region durlng I970-L972,as well as ln some parts of the Central- reglon, etephensl dlsappeared fron the northernl lne of l ts d ls t r lbut lon of 1920, and l t has been col lected only f ron Basrah provlnce. I tis worth not lng that ln Kerbala, NaJaf and Babi l prov incesr [email protected] has d lsappearedwl thout the aPPl lcat lon of nalath lon. There ls a posslb l l i t t thatTor unknown factor (s) ,stePhensl has been pushed back to lts orLglnal l i .rolt of 1920 and even farther to the8outh. The reappearance of favourable condltlone roay agaln deterrnlne the northward spreadof ggsthg!.
In a recent study of the lnpact of house spraying for nalarla control on thegeographlcal dlstributlon of anophellnes ln Iraq, Abul-Hab & Al-Kassal (1986) noted thatthe replacement of organochlorlne compounds wlth rnalathlon affected the populatlon ofstephensl. l lowever, there has been sooe evldence that the epecies 1s reappearlng in thesouthernnost parte of the Central regi.on, and as recently as December 1985, its larvae nerediscovered ln Youelflah, sone 40 kn southwest of Baghdad. In the Southern reglon,stephensi contlnued to exlst aB recent records were obtalned fron Theqar and Basrah.the work was lnterrupted ln 1982, only occaslonal vislts could be nade to Theqar inSouthern reglon, where etephensl rrag found to perslet.
Asthe
iffioauc6la-by pemtsslon ofControl. Aeeoclation, fron the
Dr A.V. ltanouchehrl and the Journal of Aoerican Mosquitopaper of Manouchehri et af. (i9d'd)T
vBc/90.3MAL/90.3Page 87
Flg. 8. Recorded d ls t r lbut ion of An. s tephensl I 'n l raq, 1920-1977.
ta! aatSal
t
a vInal
SAt ltt DDtll
.-t- -tJ
a---a \ .
,/ \./ '^ntll^
---ii -'''..-.<-r'-'-'''-.+, , , ,r, ttro
a.....r.. -.- '-
---- ||tt
f'Y "F.{:JIl'ri' d.ri-{'
rtns*r !,.j ii ,j*.ou^"
t)a,{-''-
*.. I t:i.t'
i \' -ti
- -.--.::r'-r.. ,,i !:::fid"-jsAuDr- ARABTA i_. i .rrr\"--r^u^,
i! r
i ,r''-'---- n,o t:..-..
-.?.r.-.-- l-fuu"^,,
vBc/ 90 . 3MAL/ 90. 3Page 88
Regardlng cul l .c i fac les, i t has scarcely been recorded ln l raq ' I t was found as
larvae in a few bGeGEl;Gces ar Shitha (Klrbala provlnce) ln Septenber 1957' Its adults
could not be found. (pr fngfe et a1. , 1960 and Al-T lkr l ty , 1964). Abul-Hab & Al-T lkr i ty '
1964). Abul-Hab & A1-Kassi l (1986) ienarked that subsequent to th is record, cu l lc i fac les
has never been found again.
In Kuwal t , i t has been shown above (see under 4.2) that both 9tgphgnsl and
pulcherr lnus have been recorded as larvae s lnce 1981, but no epidero io logical consequences
have so far been rePorted.
In Bahraln, it has been shown th"t g!33$! Itas the most predominant anophellne In
larva1 surveys carr ied out by Afr id i C UaJfr f f :a) (see under 4 '2 above) ' In lnago
surveys, "t"phqn"1
was also the nos't abundant anopheline and proved to be the principal
vector (see under=r , . f l be low). In a br ie f survey carr ied out dur lng Novenber 1978'
Shidrawi (1979 - unpublished rePort to WIIO) found that stePhegs:L was the only anophellne
encountered in breei lng p laces lnspected ln 14 loc i t t t i$ in Sahrain despi te ln tensive
control operatlons. ttowever, noticeable varlatlon ln larval densitles was observed ln
dl f ferent 1ocal l t les, probably due to var led ef f ic lency in appl icat lon of contro l
measures. These Deasures conslsted of residual house spraylng, larvlclding, fogging-and
ULV appl tcat lon. For larvLcid lng, a u ix ture of d lesef of f and crude o l1 to whlch 0 '2-0 '57"
Triton X-45 was added, was applled ln all stagnant ltater collectlons ln the country every
8-10 days throughout it" y".i. Several recornmendations were made to inProve the
applicatlon of larvlclding operatlons and to nonltor the susceptlbll l ty of 9.,!93$! and
cul lc ines to inagocides used.
In Saudi Arabia, s tephensl is conf ined tg the Eastern prov lnce where l t has been
regarded as the nain veEl ! ' i r f f ia lar la (F ig. 9r) . , .The province has two maln sectors:
Qatlf and AI-IIasa. In observatlons rnaae airi.ng L947-L949 tn Qatif oasis by Daggy (f959)'
s tephenst const l tu ted 90.62 of the tota l anoph- l lnes col lected rest lng lndoors; the other
species encountered r" r " f luv iat l l is (7.27">,- and Pglcherr inus (2.22) ae ! te1l af 9$ and
[ i " " "p" " ies (0 .6Z) .on f f i1s t r1but1on,5 f f i?Gted. tha t : : ! " l i l i+^ : l ^ :n "oases of the tno sectors can be found any Donth of the year, although che popuratlon
i"""iay-"i. i"" "ittt
the seasonal f luctualton of temPerature and relatlve hurnidity' The
population densi.ty reached lts lortest,level durlng mid-suomer (July-August) when
remperaEur"" r . . " 'h ighest (39.4- 41.1o C lndoors) and RI I lowes! (55-602) ' The densLty
increased suddenly ln october when the optlnun temperature (32o C was reached a few weeks
earller ln Septenber), and remained at f l l l peak durlng October and early November' --Jhfspeak resulted in a great increase ln malarla cases ln Novenber and early Decenber' wlth
the advent of cooler weather, the l ife cycle extended and the populatlon density decreased
to its lowest winter level in late January and early February, when the temPerature reached
its lowest level. t lowever, the winter nlnlnal vector populatlon densltles were stl l l
higher than the aupmer mlninal densltles. This was ln direct resPonse to the more crlt ical
su'trer condl.tions of tenperature extremes comblned wlth low RH. In addltlonr many of the
arteslan wells and eprlnis avallable 1n the area have rtar' nater, and thus provlde more
favourable teroperatui"" io, breeding stephensl ln colder months. As sprlng teoPeratures
lncreased and RH remalned favourabl!r-fr;-;; i 'he11ne populatlon-(nainly gtephen'sl)--, ^lncreased to a roaxirnun denslty fn nti-Aprfl ana early l ' !ay, fornlng-a,spring peak'
"19 "rnalar la norb ld l ty peak fo l lowed a nonth la ter in the epr ing ' Ratnfa l l had l l t t le 'e f fect on
the season.f ptop"!"i io., of stePhenei; the annual mean nas about $ mn' nostly fall ing
during January-May. As Daggy "*pffi6.a
(eee under 4'2 above), malarla ln the Qatlf and
Al-Ilassa oa6es was largely uan-made. l lost anophellne breedlng places were the dlrect
result of the inefficient lrrlgatlon and dralnage systems whlch had been constructed
previouslY.
Fron varloue rePorts, malarla control by resldual house spraylng in the Eastern.
provlnce of saudl Arabla ltas started ln 1948' Due to DDT/dieldrln reslstance 1" @!
whlch had operatlonal lnpltcatlons, thl 'e nethod of control was replaced by larvlcldlng
rcpr.euc"e-'by pernlsslon of the l{lnlstry of l lealth, Klngdon of Saudl Arabla' through
wrro/EMRo.
vBc/90.3r.{AL/90. 3Page 89
Flg. 9. Malarious areaa and oain vectora ln the adnLnletratlve provlncee ofSaudl Arabla.
Code No.
Central provcl.nceEastern provl.nceNorthern provlnceWestero provinceSouthern provlnce
h,lrrlou! en $L ZL.^affi
0 l02030405
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vBc/90.3MAL/90. 3Page 90
along wl th s t rengthening survel l lance act lv i t les and appl lcat ion of focal mass drug
adnln ls t rat lon. SLnce 1972, nalar la t ransmiss lon has been interruPted and only lnpor ted
cases have been recorded arnong labourers cornlng fron withln the country and from abroad.
The conetruct ion of an l r r igat ion and dra lnage scheme ln the southern par t of the Eastern
provlnce has contr lbuted to the e l in inat lon of nany stephensi breedlng foc i . The area ls
nov under v lg l lance wi th per lodic nonl tor ing of vector densi t ies, Isee rnore deta i ls in
Subsect ion (11) under paragraphs I and 3 belorc l .
In Qatar , several larval surveys indlcated the presence of s tePhensi (see under 4.2
above), but no inago checklng has been reported. The problen of ifrF6El-nalaria sti l1
pers is ts , but despi te the presence of th is known vector ' there has been no indicat ion that
nalar la t ransmiss ion has been esta l l lshed ln any par t of the country '
In UAE, the Annual Report of Malar la Contro l act iv i t ies (1979) showed that on the
east . coast , Ras A1 Khefuna (west coast) and the rura l area of 41 Aln, c9 l i ,g i faqi9s was most
predomlnant const | tu t lng 80-9OZ of the tota l anophel ines encountered, fo l lowed by
stephensi , 8 .6-L52, and other species, L.357. . The other-Anopheleq.species encountered
;@gg, @,. turkhudi , g ! ry { . . : : ]^ . "U se.rgenl i l ( rare) on the west
coast llia:Sfi DEblft;6;affrgE-surveys loade r-n rvl0, 9'1ggj$.1 wab most abundant
assoclated wl th a snal l populat ion of cu l l l l fac ies, but th ls-s i tuat lon changed ln 1976 when
culicifacles larvae becarne most predonffiUreeaing in cenent water baslns as explalned
u - i f f i o v e . L o n g i t u d 1 n a 1 o b s e r v a t l o n s c a r r 1 e d o u t a t a v i 1 1 a g e 1 n R a s A 1 K h a i r n a a r e afor one year showed that the peak density of E!@.! occurred in February-March, whlle
that of culicifacies appeared ln Septenber-October. In an unpubllshed report to IIIIO on
tnse.cts anaEfi€n-ln UAE, Wtrlre (198f) sunlnarized the neteorologlcal data recorded by the
UAE Departoent of Agr icu l ture at Al Aln, l97 l -1979. Su.rner tenPeratures preval l f ron Apr i - l
to october. wlth a mean maxi.nun of 45o C in June, but the nlght teEPeratures in summer
i .r i- ."- i i6 i-J. r."". rn wlnter, the coolest nonth is Janulry (ta*. zso c, nin.l lo C) . Annual oean,ra lnfa l l ls 181.7 on the wet test nonths belng Decernber-March.
October ls the only dry roonEh. Most of the seasonal easterly rnonooon frorn the Indian Ocean
faLls on the 0nan seaboard of the Hajar mounta lns, benef i t t ing A1 Ain to a lesser extent '
The UAE aqulfer ls largely replenLshed frorn precipltation on the nountalns in Onan(Flg. l0) r . Sunmer winds tend to be ar ld wester l les f rorn the deser t of Saudl Arabia.
Relatlve huroldiry as recorded in 1978-1979 fluctuates around 25-357" ln sumner and reaches
about 46-522 ln wlnter. ExtrapolatLng fron the tabulated records coropiled by tlhlte(Loc.c i t . ) qhe nean temperature (1971-1979). dur lng stephensl densi ty peak of February-March
wae 22.8-280 C and mean Rt l ( f978- f979) was 40-467. . - l *@"i f . . i . l
densi ty peak of
Septenber-October, the flgures show a utean temperature oE-7013:3412" C and RH of 3L-352.
In Ooan (Fig. l l )2 several lnvest lgat lons have been carr ied out . As nenEloned
under 4.2, the ln l t la l oalar la aurvey was carr ied out dur lng Apr i l 1973 by Far ld ' Nasl r &
Benthein (1973). The d ls t r ibut lon of anophel ines l tas as fo l loss: ( l lusandam region was not
surveyed )
(a) Eastern reglon: This reglon (shown as Sharqiya on the nap) conprises the area
extendlng fron the coastal vll lages of Qalhat and Sur to 100 kn lnto the deeertic
in ter ior . The eastern nounta ln range separates th is reglon f rom the Capl ta l and Bat lnah
reglons. El ther s tephensi or cu l lc l fac ies or both were found ln every v i l lage.A n l s t e P h e n s 1 p r e E G G ? - t e a o ' " ? @ 9 g P a r t 1 c u 1 a r 1 ' y i n B i 1 a d B a n i B u ( B . B . B . )E l 6 s i l t r 1 e c o n t r a s t e d w t t t r F G o b t a 1 n e d f r o n t h e o t h e r r e g 1 o n s , f u r t h e rstudles nay reveal the speclal ecologlcal condltions that favoured the relatlve abundance
of stephenll ln this r"glor, In Sur, however, which ls sltuated near the coast and had
n a n } f f i E a s 1 n s c o n n e c t e d w 1 t h 1 r r 1 g a t 1 o n w e l 1 s , @ s h o w e d a h i g h e r d e n s 1 t y .
fTep;oAGE-by pe rnls s lon2. Reproduced by permissLonRuebush (f982).
l lHO/EltRO fron the unpubllshed report of I{hite (1981).
MIO/EURO fron an unpubllshed report by Zahar' Delflnl &ofol
vBc/90.3l.rAr/90.3Page 91
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(b) Inter lor reglon: Thls region conpr lses a l l v l l lages s i tuated ln the footh l l ls ofthe western Dounta in range, whether fac ing the sea or s i tuated anidst theee mounta lns orscat tered ln the p la ins on the other s lde of the mounta lns. Both cul lc l fac les andstephensi were folnd ln nearly all focallt ies visited but the foroffi iFpredoulnant.
(c) Capi ta l reglon: This reglon compr lses a l l coasta l v t l lages extendlng betweenQurayat ln the south and A1 Seeb ln the nor th lnc luding the Capl ta l town, Muscat and. l tsextension, Matrah, and thei r adjacent suburbs. Both cul ic i fac les and stephensi werereco rded .
(d) Bat inah region: Thls region compr ises a l l v l l lages that are scat tered a long thenarron, curved coasta l sEr ip extending f rom A1 Seeb to the f ront ler of UAE tn the nor th.Although only eight sna11 towns exl-st in this strlp ot 22 kn, yet each ls surrounded by anunber of sroal l v l l lages and hanlets extending a long a cont inuous green st r lp of date palngroves that run paral le l to the coas! , and seldorn exceeds 3 kn in wldEh. Both cul l f icacLesI n d s t ' e p h e n s 1 o c c u r r e d i n a 1 1 v i 1 1 a g e s s u r v e y e d w i t h t h e ' f o r r n e r p r e d o r o 1 n a t i n g . -
(e) Southern reglon (Ohofar prov lnce) : This prov ince occupLes one-th i rd of the landof the Sul t .anate, and is s i tuated at more than 150 kro eouth of the Eastern region, andseparated fron lt by Wahiba sands. Most of the provlnce ls forned of roll lng l inestonehil ls which sEretch fron the coast to the edge of the Enpty Quarter where nomads llve theirpastora l 1 l fe . The h l l ly par t could not be surveyed, belng a o l l i tary area. The survey,therefore, was confined to Salalah town and suburbs, lncluding Taka vll lage sltuated atabout 45 kro to the nest. 0.1y gg!g,1 was found as adults and larvae, but nocullcifacles \{aa encountered. TEe otE- Anopheles species collected were d-thali and- ------coustanL in very snal l numbers.but no An. ganbiae s. l .was found. The very low lnc idence ofn a 1 a r i a s u P p o r t e t h e a b s e n c e o f @ s . 1 . f r o n S a 1 a 1 a h a n d 1 t s s u b u r b s .
In thei r conclus lons, Far ld, Nasl r & Bentheln ( loc.c l t . ) consldered oalar l .a ln theSultanate of Oman a naJor publlc health problen; lts level of endeniclty as revealed by thesurvey ln 1973 varled between hyper- and hypo-endenlclty. The results also sholted that itnaa a parElcularly serious problern ln the BaElnah reglon whlch has the highest Prlorlty insocioecononlc developnent.
- Recently, certaln areas of the Southern reglon nere surveyed entonologtcally andparaei to loglcal ly wi th the par t lc lpat ion of a nat lonal malar la tean dur ing 16 October- l4Novenber 1987 as repor ted by Del f ln l (1987a - unpubl ished repor t to Wt lO). Due to thel in l ted t lne and d l f f icu l t accesslb i l i ty , the survey was conf ined to cer ta ln areas asfo l l ows :
- coasra l p la ln (As-Sahi l ) : e ight local l t les.- Southern Dhofar s lope (Al -Jebel) : three Local i t ies.- Northern Dhofar slope, part of Al-Badyan: one locallty. (Mudhai).
Most of the deeert and senl-desert areas (Al-Badyan) could not be vlsited.
The entonologlcal survey showed that larvae of ggg$,1' re.g!! and d'thall werepresent ln the coastal plain. On the southern slopee-oF ttre DhoEEi range, only larvae of
*jrgentll were found ln water barrels at Medlna Al Haq. In Al-Badyan, the only place
Gftea on the northern slopes of Dhofar ranger gSll larvae elere encountered ln a water
collectlon orlglnatlng frorn a natural spring and used for gardenlng purposes. Thelnhabitants of thle locallty receive nater for doaestlc use through plpellnes fron the
surroundlng hll ls. Desplte the presence of anophellne larvae, only one g!g$i,I fenale
was collected durlng irnago surveys carrled out by PSC coverlng 60 rooms and by hand capture
in five roonrs. ltan-bait capture outdoors during the ftrst hour after sunset repeated for
slx ntghts produced only a few cullcines. In sone other locallt les of the Salalah coastal
plaln, larvlclding wtth temephos accounted for the abeence of anophellnes. 0n the southern
llop"" of the Dhoiar range, hand capture in 20 roons at Medlna Al-Itaq and another locallEy
yle lded no anophel lnes. In prev lous parasi to logical s tudles carr led out dur lng f983- f984
and the present survey, there was no ev idence of nalarLa t ransmlss lon in local l t ies v is l ted
vBc/90.3yAL/90. 3Page 93
GULF
DHOF
Fig. l l . l tap of Sultanate of Ouan.
I\rfER,OtIbri ,1.. --,
SULTANATE OF OMAN
$
afa-t
vBc/90.3MAL/90 .3Page 94
ln the Southern reglon. The anophel lne epecles encountered could be consldered as
potent la l vectora. For a descr lpt ion of the Southern reglon, the or lg lnal repor t should. be
consul ted. lMore deta l ls of the parasl to loglcal f ind ings are shorcn under SubsecEion ( l i ) ' l
b e l o w l .
Ou a v is i t to Ornan, Shldrawi (L977 - unpubl ished rePort to WHO) analyzed data
collected by the malaria control staff durlng L975-L976. There has been no change with
regard to rhe d lsrr ibut lon of rhe known vectors cul ic i fac l -es and.stePhensi , l l l l?"gh - . ,infornatlon fron the Southern reglon is sti1l fn6lopletE aue to ttre inaccessibil i ty of the
3 f € € I . A t G h o b r a ( C a p t t a 1 r e g i o n ) , s @ , @ ' i a n d 4 : g t ' e 1 1 w e r e c a u g h t b t t 1 n groan ln decreaslng ord"r of lntensltt-.Fil; i l (rnterlot region), lhe same three species
were recorded, and in addltlon !-1g1g411s was caught bit lng xoan as the second nost
p r e d o m i n a n t s p e c l . e s a f t e r g u t r c j f f i r n B 1 1 a d B a n t B u A 1 i ( J a a 1 a n r e g 1 o n ) s t e p h e n 8 ip r e d o n i n a t e d o v e r @ t h e p r e s e n c e o f a n e x t e n s i v e m a r s h y a r e a u r o r ee u i t a b 1 e f o r i t s u @ w a s c a u g h t r a r e 1 y a s a d u 1 t . F i v e m o r e . A n o p h e 1 e sspecies were encountered as , - turk\u i i t -W., - .r u p i c o 1 u s , a n d a n u n d e t e r n l n e d s p e c 1 f f i r 1 e c t e d b y S h i d r a w t 1 n l 9 7 5 f r o nfi i i l i i lG"ae of which rogerher wlth adglts ralsed florn larvae were sent to the Brit lsh
Museuro (Nat .Hist . ) for ldent l f icat ion.r Londl tudinal observat ions were conducted f ron
October 1975 to the end ot 1976 ln one v l l lage in each reglon but suf fered f ron the lack of
cont lnul ty ln some v l l lages and a shor tage of superv isory 6taf f in .others. Man-bai t
capture was conducted in only t ro v l l1ages: Ghobra . (Capl ta l regton) and Sanai l ( In ter ior
reiton), but in the reroalning reglons nosquitos were collected only by hand capture in l0
fl ied room6 in the obeervatlon vLllage of each reglon. Frorn the available datar soroe
lnfornatlon could be derived on the seasonal distrlbutlon of the two known vectors as
fo l lows:
- In the Capl ta l region, the b l t lng densl t les of cu l ic l fac les reached a peak ln March
and another ln Septenber wlth the Lolrest densltles occurrlng ln l ' tay-August and
Decenber-January. The denslty of stephensl dld not show clear peaks and was below 2
bites/nan/nlght throughout ttrl yeaiGlFin Aprll and Novenber when lt reached zero'
- In the Inter lor reglon where nuch snal ler densi t les of cu l lc i fac les ex ls ted, the
peak was observed ln Aprll-June, but the density decllned tn euFq-fr;;ths to Ehe end
Lt tft" year followlng the lntroductlon of a dralnage 8y8ter0 and the dlstributlon of 1ocally
avallable larvlvorous flsh. Sna1l nunbers of g!.gfhensl appeared biting man ouEdoors 1n
February, July and Septerober only.
- In Bllad Banl Bu A11 (Jaalan region) ' 9.1!9PlS!predoulnant anophellne constltutlng 98.22 of all adultedenelty attalned a very hlgh peak (80/nan-hour catch) ln(about 33/nan-hour) 1o Novenber.
- An atteBpt was rnade to deternlne the nalaria transmisslon seasons uslng the results
of lnfant paraslte survey6 conducted !n Ghobra (Capital reglon) fron October 1975 to
Septenber iglt. The lnfint parasite ratea plotted graphlcally lndlcated perennlal
transulesion w1th a peak durlng ltareh-May and a rlsing tendency in Septenber, after a
decllne 1n June-Juty, fottowfng ttre seasonal trend of cullclfacles. fhe density of
stephensl was too low to draw any conclusion on lts poEi$[fEFln nalaria transnlssion'
In a report of an lndependent aasessnent of the nalarla control ProgranDe of Onan,
Zahar, Delflnt & Ruebush (19b2 - unpubllshed report to l l l lO.) proJected graphlcally the
trend of parasitologlcal and entonological lndices recorded by the Central l lalarla Control
Segt lon a i Barka, " i
o . r "p" tyed vt l lage, Bat lnah reglon ' dur lng f977-198I , as shown in F lg '
L2- .
Iff iA;1-fr-fue specles has been recognlzed as a nert specles named AnoPhel-es paltrlnlerl i '
n .sp. as d lscr lbed by Shldrawl and Gl l l tes (1987). Speclnens of th ls species were
previously collected fron UAE ln 1969 as shown above. Thls specles'was found associated
wlth focal nalarla transnl.sslon ln wadis ln Oroan leee Muir (1989 - unpubllshed report to
f f i tO) , ln Subsect lon (11) , I be lowJ.2. Reproduced by p"trf""ior, of Wn6/eMnO fron the report of Zahar, Delfinl & Ruebush (f982)'
as shown abover ltas the mostcol lected rest ing ln houses. I ts
Aprll and a nuch snaller Peak
vBc/90. 3MAL/90 .3Page 95
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vBc/ 90 . 3MAL/90 .3Page 96
Only cul ic l fac ies indices were p lot ted as th is species outnunbered sEephensi in th is ar :a.Parasi to logical ly , only 6-roonth ly parasi te surveys were carr ied out , the indices of each ofwhich were presented on the assunpt ion that i t represents the cumulat ive ef fect of vecEordensi ty ind lces of the preceding per iod. In broad termsr there r tere t t to peaks ofcul ic i fac ies densi ty annual ly : the f i rs t in the spr ing and lhe second ln the autumn'usr*l l)r corrnencing July-August with intervening depressions in May-June and inDecember-January. There were thro except ions to th is seasonal t rend: one in 1978 when the
observat ions were d iscont inued, and the other in 1981 when the spr ing peak was retarded toMay-June. Storroy condi t ions abrupt ly broke out in ear ly May 1981, and raay have inf luenced
the deLay of the spr ing peak. Sudden cur ta i lnent of the autumn peak in Septenber 1978 and
in Qctober 1981 could not be expla ined in the absence of roeteorological data, a l though
saropl ing errors could not be excluded. Parasi to logical ly , the 6-roonth ly surveys couldi l lust rat .e the cunulat ive ef fect of vector peaks by the aPPearance of h igher parasl te rates
in Decenber and lower rates in June fo l lowing the decl ine of vector densi ty af ter thespr ing peak. The except ion was the low parasi te rate of the Decerober 1980 survey. This
may have been due to sanpl ing as i t xoost ly covered schoolchi ldren h l ther to under
chenoprophylax is .
As shown under 4.1 above, An. cu l ic l fac iee and i ts subspecies 4n: cu l lc i f l tg leqadenensis extended i ts d is t r ibut ton to the coasta l p la in of Yeoen and Socotra ls land in
;outhwes; Arabia (Mart ingly & Knight , 1956). I ts ex is tence ln Socotra is land has recent lybeen conf i rned (Thevasagayan, 1987 and Far id, 1988). As i t is the only anophel ine sPecies
encountered ln Socotra, i t has been considered the pr inc ipal vector of roalar ia ln theis land (Far id, 1988 and personal conmunLcat ion, 1990), (see nore deta i ls under 5 below).
In I ran, the d is t r ibut ion of s tephensi and cul lc i fac ies has been l - l lust rated on a naplncluded i.n a reporr by the ualariaffiEiotr o.geffiff i(1968) whlch is reproducedhere as Fig. 13. ' The map also shows the d is t r ibut lon of other vectors so that the
over lapping d ls t r ibut lon of two or more species can be recognized, e.9. , .@. l tcu l ic i fac ies and d- thal i . Motabar, Tabibzadeh & Manouchehr i (1975) out l lned theffiution of ste-i16?i as the low mountaln ridges ln the rdest and coastal plain of the
Pers ian Gul f , Onan Crul f and KhuzesEan p la ln, and that of cu l ig l fac ies,as being a long the
southern s lopes of Kernan (souEheast) , Baluchlstan mounta ins (east and southeast) and the
coasta l p la in of Onan Gul f . Regarding seasonal d is t r ibut ion, both specles ex is t a lnost a l l
year round, wl th no real h ibernat ion observed. In the l l t tora l and p la in regions,
stephensl has two peaks, and l ikewlse cul ic i fac ies has two peaks in the l i t tora l reglon.
More deta i ls on the spat ia l and aeasonal dts t r lbut ion of s tephensl and iEs specles
associat lon in I ran nere g iven by Manouchehr i e t af . (1976). In the coasta l area of the
Persian Gulf and the Gulf of Oroan froro Abadan to Bandar Abbas and Chahbaharr ggg@! is
an inpor tant vecEor of nalar ia , and in Dost areas l t i8 the sole vector . In h i l ly areas ofghe eouthern s lopes aod val leys of the Zagros chain, I t is associated wi th other vectorst
, ' i " : ! f @ , . : s g , l s a n d d - t h a 1 i , a n d i n B a l u c h e s t a n i t i s a s s o c l a t e d w 1 t hc u 1 i c f f i J n 6 E J i T f f i a r e a @ 1 s ! a r t s i t s s e a s o n a 1 a c t i v 1 t y a b o u t t h esf,gffiIng of May to reach a peak fn a@, followed by a gradual decline. Durlng the cold
winter nonths, l t [a lnost l d isaPp€8rS. In coasta l areasr g lsP$i is act ive throughout
the year wlth two peake, one ln April-May and the other, which le higher in
August-September. There are no repor ts of h ibernat ion or aest lvat lon occurr lng in
stephensi in southern I ran.
In thei r repor t on a f le ld t r ia l wl th fenl t roth lon house spraylng conpared wi th
nalathion spraylni, Eshghy, Motabar & Janbakhsh (f975) descrlbed the area of Mamasani where
the ef fect of the two insect ic ides was evaluated in 1974. The t r ia l area was located on
Fjproeuc;A by permisslon of the Government of the Islamic Republlc of Iran through
wHo/EMRo.
vBc/90. 3MAL/90.3Page 97
the eouthern slopee of the Zagros mountalns whlch have'a sgbtroplcal cllnate. The eunberls long and hot wlth naxlnun temperatures reachlng over 40o C. The wlnter ls ooderateand the temperature rarely drops below zero. The relatlve hunldlty ls ueually about30-502. Malar ia t ransmlss ion usual ly extends f rorn Apr l l to Novenber wl th a peak f ronroid-August to nld-October. The naLn vector ls stephensi while fluvlatl l lsr gllpgplg andd-tha1l are secondary vectors wl th exophl l lc tendencies. The main larval breedlng p laces;ff ie f ields, canals and river banks. As rlce ls cultlvated ln July, lt provldes vastbreeding p laces for anophel ines, hence great geasonal {ncrease 1n anophel lne adul t densl tyevery year ln th is area. Eshghy & Janbakhsh (1977) who reported on the b l t lng cyc le ofstephensi ln th ls t r ia l area (see under 4.6/4.7 below) lndlcated that the b l t lng populat ionof thls vector started to lncrease frorn late May and reached a peak ln July-August andearly Septenber, but steadily decllned towards the end of November.
In Afghanlstan, the nain adnlnlstratlve provlncee are shown tn Fig. 14 (a)1, andthe distributign of the nalarla unlts of the ltalarla Control Progranme by reglon Ie shownIn Fig. 14 (b) ' . Some ear ly s tudles prov lded lnfornat lon on the seasonal d ls t r lbut lon ofthe naln vectors. Raoachandra Rao (195f) reported on malaria control trlals by DDT housespraylng ln the Laghnan dletrlct, Easteru province and trled to explaln the eeaeonaldenslty trends of the ualn vectors: g.gg9gg!g!g. and ggllsllgglg ln relatlon to persLstenceof nalarl.a transnLeslon aa evidenced by the flnding of 87 lnfant paraslte rate ln eprayedvll lages. Ee put forsard the following aesunptlons baeed on hle experlence ln the area.Rlvers and streams became sultable for euperplctus breedlng ln the ntddle of ! lay, whencllnatlc conditlons sere also qulte favourable for nalarla transulselon. Appreclablenumbers of superplctus adults were collected ln that Donth. It ls reasonalbe to suggestthat Ln !lay, a low level of nalaria transnlsslon conoenced. In June, all the flelde wereflooded for rlce cultlvation and the productlon of cullclfacles began on an enorDousecale. By the nlddte of July very htgh densltles tff;IGZtTullt up. Cllnaticcondl.t ions belng favourable, transml.sslon by cullclfaclee waa expected to conDencetonedlately. Thls lrrigatl.on nalarla ls of a nuch hlgher order of rmgnltude than the lowgrade rrsuperpictue nalarlarr. At that t iue, the Etreans became lncreaelngly favourable forb o t h e u p e r p 1 c t u s a n d s g @ , a n d t o w a r d s t h e e n d o f S e p t e n b e r ' t h e o a x 1 n u u l e v e l o ftransnlselon by the two specles coobtned occurred. In October, cllnatlc condl.t lons werestl l l favourable for transnleeion, but with the advent of the cold weather ln Novenber,transnissl.on nas expected to become negllglble. On the baeis of the above pattern,Ranachandra Rao eu arlzed the eeaeon of nalarl.a transnl.selon ln Laghnan achenatically asfo l lows:
llonth
lfay \June tJuIyAugustSepteuberOctober
Speclee
guperDlctua
auDerDlctus-& cul lc l fac ies
Degree of transnleelon
low -
very hlgh wlthpeak ln Septenber
Breedlng placeg
rlverg E streaug
rtce f te ldsrchannelstrlvere & etreans
Rauachandra Rao further explatned that the flrst round of DDT epraylng was applled ln theflrst half of August at a time when the hlgh level of traneuleelon had comenced. It lsqulte pposslble that all the 8Z Lnfante were lnfected before the apraylng. Sooeeuggestlons were, therefore, made to adjust the tlnlng of epraylng: the flret round ehouldbe conpleted before the egd of Hay and the second ln the ulddle of Auguet; the target doseln theee trlale sae I glm' tt each round.
Z;-Eep;oauEEtby peroleslon of the Governrent of the Deoocratlc Republlc of Afghanlstan andtlHO/ElrRo from an uopubllshed aaslgnoent report by Kovchasov (1985).
vBc/90 .3D'AL/90.3Page 98
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In the Kabul area, Iyengar (1954) found that s tephensl was the second mostpredonlnant species next to superplc tus, and i ts densl ty great ly lncreased ln October
const l tu t l r rg 78.47 of houee restLng catches, whl1e cul ic l fac les naa scarcely present .
H o w e v e r , t h e r e w a s n o e v i d e n c e t h a t s t e p h e n s 1 o . @ p 1 a y e d a n y s 1 g n i f i c a n t r o 1 eln ualar la t ransulss lon, and the only speclee found wl th natura l ln fect ion was superplc tus(eee unde r 2 . l l above ) .
In h ls draf t aeslg i roent repor t to WI lOrCul len (1978) prov lded lnfornat lon on the
s p a t 1 a 1 d 1 s t r t b u t 1 o n a n d v e c t o r 1 a 1 r o l e o f s t e p h e n s t a n d @ a s f o 1 1 o w s :
stephensl: It is the predonlnant vector ln the Nangarhar and Khost plalns andvalley-ff is recorded ln the southern reglon (Zabu1 , Kandahar and llelnand) and the
neslern reglon as far as Farah unl t . In the Centra l reglon, l t wae encountered ln Kabul atan a l t i tude of 1820 n, and ln the Ghaznl uni t ix tending to a l t l tudes of over 2000 n. I ts
ro le ae a vector at h lgher a l t l tudes, where l t co-exls ts wl th superDlctus is not known, butl t nuet be considered as at 1ea6t a potent la l vector . I t was aPParent l .y responslb le fornalar la t ransnlss lon in recent years ln the Spln, Boldak area of southeastern Afghanistantand lt nas assur1ed to play an inportant role 1n ltelnand (Southern reglon) and ln Nfioroz andDllarain unlts (I{estern reglon).
cul lc l fac les: I t was lncr ln lnated as a vector of nalar la ln the Eaetern reglon lnl 9 4 9 t I m f f i a r a R a o , 1 9 5 l - g e e u n d e r 4 . l l b e 1 o w ] . D u r 1 n g L 9 7 2 - L 9 7 7 , g @ w a spresent ln elgnlflcant nuobers in Laghrnan, Kunar, Jalalabad and Ghazlabad areas (E86tern
reglon), colncidlng wlth the very aevere malarla epldenlce that struck these areas lnf975. Its luportance aa a vector of ualarla ln relatlon to glg$glg which was alsoabundantly present ln that year, could not be deternined. An. cullcifqcles was alsor e c o r d e d 1 n t h e K h o s t u n 1 t ( C e n t r a 1 r e g 1 o n ) a n d w a e b e 1 t e . , e i f f i l i ? E t . a 1 1 y r e s p o n s 1 b 1 efor lntenee tranenlsslon ln rhat area durlng L972-L973. It was aleo found ln very highdenslties ln the lower l leluand valJ.ey (Southern reglon), followlng the rlver to the south
-
and rrest reachlng Ninroz, and 1! ls probably an lnportan! vector ln that area of southltestAfghanlstan. It wae not found further north than Farah unlt ln the Western reglon. Unllkestephensl , cu- l lc l fac les naa not recorded at h lgh a l t l tudes, and l te uPPer l ln l t ts probably1300-1400 n.
In Paklstan, Mul l lgan & Bal ly (1938) found cul ic l fac les ln Quet ta the eecond moetprevalent epecLes next to superplctug. Out of a total adult catch of 7 023 speclnene ofa 1 1 a n o p h e 1 1 n e s p e c 1 e s , l 6 0 6 w e r e g @ . o n 1 t s e e a g o n a 1 p r e v a 1 e n c e , o n 1 y a f e wadults were caught durlng the prell l i lniry s-r-ey ln May, but adults were Prevalent when themaln survey began towarde the end of July. It was, therefore, not possible to 6teteexactly when thl.s spectee becaroe prevalent. Fron prevlous surveys by other authore,cullclfa.cles was the Dost prevalent epecles during May and June. In the Preoent study,cutlcifacle] waa the second tloat prevalent ln Quetta durlng August and Septenb€r, butff iEffi end of the latter month lts denslty rapldly decllned and by the f lrst week ofOctober, lte adulte ahooet dlsappeared. Although not so prevalent in Quetta fron July toOctober ae elther suoerpictus or gg]lgIgg!9g, stephensL was, nevertheless' sufficlentlyprevalent to be a Ftentlal danger ln nalarla transnlsslon in certaln Parts of the Quettaar€a. Of a tota l adul t catch ot 7O23 anophel lnes of a l l specles, l7Z were stephensl . ' Att h e e n d o f J u 1 y a n d e a r l y A u g u e t , s t e p h e n e 1 w a s s 1 1 g h t 1 y r n o r e p r e v a 1 e n t t h a n s @ ,but the latter epecles soon becanelhe more prevalent of the two, and remained so untl l thesurvey wae ternlnated early Ln October. A eudden fall in the prevalence of 9,!99!999! waeobserved towards the end of Septenber and by the early part of October adults of thlsspeciee were extreuely rare. Regardlng the mode of overwinterlng, the authors Pointed outthat 11ttle lnfornation was obtained since their survey was teruinated early Ln October.The wlnter ln Quetta extends froo December to l. larch and lt ls very aevere. Snowfalls arenot uocotuon and froste occor. The nean oaxlmum tenperature ln January 1e about l0o C,a u d t h e r o e a n m 1 n 1 m u m i s a b o u t 2 o c . I t s e e n s p r o b a b 1 e t h a t n e 1 t h e r @ n o retephensL overwlnter ln the adul t .s tage, whl le euDerplc tus passeo the wlnter ln t ruehlbernaEon, sLnce lts adults were stl l l abundant during the early part of October, andnany showed an lncrease ln fat body and arrest of ovarlan developoent. It was suggestedthat the whole questlon requlres detalled lnvestlgation ae lt nlght posslbly have anlmportant bearing on control of nalarLa ln the quetta area.
v B c / 9 0 . 3IIAL/90. 3Page 100
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Z a h a r ( l 9 7 4 ) r e v i e w e d t h e s p a t i a 1 a n d s e a s o n a 1 d l s t r i b u t i o n o f @ a n dstephensl in Paklstan. An. cu l ic i fac les is the main nalar ia vector in Pakistan, where i t
C r id" ly d ls t r ibutea ana f t t ras Ueen connected wi th an unstable type of nalar ia .
Throughout the rura l areas of centra l and southern Pakistan, i t is conmonly associated wi th
stephensl . Pre-spraylng observat ions showed that the two species were found throughout the
@ a p p e a r e d i n h i g h d e n s i t y i n A p r i 1 , f o 1 1 o w e d b y a d e c 1 i n e i nl t a y - . l u n f , 5 f f i E r t y i n c r e a s e d a g a i n i n S e p t e r o b e r - o c t o b e r . A n . s t e p h e n s i d e n s 1 t ydet l ined in JuIy but lndreased again ln August , reaching a peak in September. The lowest
densi t ies of both specles were usual ly encountered dur ing Decernber-February.
Reisen ( 197S) conducted a study of nosqul to populat i .ons in seven selected suburban
and rura l v i l lages ln the Lahore area, Punjab provlnce, Pakistan dur ing L976'L977. Ot
these, Kasur, Sat tok i , Khano-Harni and Kot Baghicha were chosen because of thei r abundant
anophel lne populat lons, whi le the other three v iJ . lages were selected to s tudy cul ic ine
populat ions. The survey covered cat t le sheds for indoor rest ing col lect ions, adjacent
agr icu l tura l f ie lds for ouEdoor rest lng col lect ions, buf fa lo bai ts for b i t lng col lect ions
and adJacent ground water breeding s l tes for larval co l lect ions which were Present at a l l
local l t les. The resul ts are g lven here for cu l lc l fac l "es and g!S!E! and other associated
anophel lne6 encountered in the study area, b[ t Tor cul lc ine mosqui tos the or ig lnal paper
s h o u 1 d b e c o n s u 1 t e d . T h e e n d o p h i 1 1 c r e s t l n g a n o p h e 1 1 . " " ' @ a n d g g g @ ! w e r ebinodal ly prevalent dur ing the spr lng (or the cooI , danp season' f ron 15 March to 15 May)
and the post-monsoor, " " . "on
(or dry season, Jroo 15 Septenber to 15 Noverober) . An.
eubplctus wa6 not collected froro the end of Decenber through the onset of the monsoon
;Gon Ghe monsoon or hot , net season which usual ly extends f ron 15 July to 15 Septerober) ,
despi te repeated searches for both larvae and adul ts . Presumably, populat ions of th is
species in Punjab becone reglonal ly ext inc! due to cold and/or drynese of wlnter , and are
repopulated annually at the onset of the nonsoon aeason. An. annularis rtas Eost abundant
dur ing the la te winter and spr ing, decreaslng throughout the rest of the year . An.
nigerrlmus was most abundant durlng the post-Eonsoon, increasing in numbers as the rice
E6!ffi"a. Regarding the daytirne restlng behavlour, the endophil ic species observed
durlng the present study included the two nalaria vectors, cullclfacies and g5g!99! as
w e 1 1 a s t h e n o n - v e c t o r . @ . D u r 1 n g L 9 7 6 - L 9 7 7 , a f e w s p e c 1 n e n s o f t h e s e s p e c 1 e s w e r ecollected outdoors Uy a nectranfcal sweeper. Most of the speclmens were laken near breeding
sl tes la te ln the af ternoon and had recent ly energed. In contrast , s lgnl f icant ly nore
a n n u 1 a r 1 s a n d ! @ w e r e c o 1 l e c t e d r e e t i n g 1 n d o o r s , b u t 1 a r g e n u m b e r s w . e r e a 1 s ooTt-"a Uy ouffi i?TGElitcal sweeper collections (lncluding half-gravld and gravld
fenales) suggest lng that a large proport ion of the populat ions of these two species rest
outdoors. Regarafng the ef fect of res idual house spraylng for malar ia contro l , malath ion
and fenitrothlon seemed effectlve ln reduclng the populatlons of cullclfacies and
stephensl. Mequate spraylng coverage at Sattokl, Khano-Harni and Kot Baghicha practlcally
ETGInated cul lc i fac les and, to a lesser extent , s tephensi populat ions. Al though
occaelonal spaEiiens o? cullcl_teg_Les were recovered ln the nalathion sprayed areas'populations ;t Sattotf aiff i-a-n-o-Rarni did not becoDe re-estabLlshed by mld-sumer of
fgig. The long-tern control of this specles was actually nuch longer than the residual
toxic effect of the insecticide. I lowever, the populatlon of culiclfacles at Kot Baghlcha
under fenltrothlon, recovered conparatlvely faster and pre-monsoon restlng denslties ln
1978 approached those recorded Ln 1977. On the other hand, stephensl populatlons at all
vflfagie except Khano-Harnl recovered to pre-spraylng levels within three nonths of _lnsecilclde appllcatlon. The populatlon of thls specles at Khano-llarnt did recover fasler
than cullclfacles, although pre-spray densities nere not attained through rnid-sunner 1978'
ttre aiG[6fTiff iEr lndlcated that rnalaria ln Punjab provlnce has been historlcally unstable
wl th epldero lce occurr lng at fa l r ly regular e lght year ln tervals , at t r lbutable, in Par t ' to
ehanges ln weather patt;rns, whlch nay lead to lnterruptlon of nalaria transnission for
pro longed per1ods (c f t fng Yacob and Swaroop, 1944). Dur lng 1976 and 1977, cul ic i fac iespopulatlons appeared to decrease even without appllcatlon of house spraying as aeen at
i . "n. (uosprayea), and pre-spraylng at Sat tok l . Unpubl lshed act lve case detect lon data
tabulated for the pa6t seven years lndlcated a general decl lne in the e l lde Posl t iv l ty rate
even before the lnlt latloo of the current Natlonal Malarla Control Progranme (clt lng J' de
Zulueta, personal comunlcat ion, 1977).
Further lnfornatlon on the seasonal trends of cullcifacies and $p$.1 as well^as
eubplctus lu Pakletan was glven by Relsen, Uahrnood & Parveen (1982) as shown under 4'lu
belotr.
vBc/ 90. 3UAL /90 .3Page 103
I n a s t u d y o f t h e s u r v 1 v a 1 a n d t h e d u r a t 1 o n o f t h e 1 n n a t u r e s t a g e s o f g ] . @ 'Relsen, l .3ra & Mahnood (1982) sanpled the adul t populat ion of th is species found rest lng in
cat t le sheds at Kot Baghlcha, Kasur d let r lc t , Punjab provLnce dur ing Aprt l 1979-May 1980.
The eeasonal abundance of thls epecles lras l l lustrated graphlcally as shohtn ln Fig. 5.
Fur ther , Relsen & Mt lby ( f986) s tudled the spat la l and seasonal d ls t r lbut ion, rest lng
behavlour and the inpact of resldual house spraying of endophil lc specles at nine vil lages
occurr ing Ln Kasur and Lahore d ls t r lc ts , PunJab provlnce. The study covered the 14 nost
abundant roosqul to epecleb: 7 anophel lnes and 7 cul lc ines col lected longl tudinal ly dur ing
1976-1980, us ing three col lect lon nethods at weekly or b iweekly in tervals as fo l lows:
- Indoor rest lng coLLect lsons: A tean of l -3 col lectors eanpled noequl t .os rest lng
lndoors ln I-6 flxed capture statlons at each vll lage by hand caPture. The nunber of
stations sanpled and the t1!0e spent ln collectLng nosqultos depended upon the size of the
statLon, con6truct lon, and nosqul to abundance. ' Changes ln occupantsr s t ructura l
nodlftcatlone, and collapee durlng floodlng prevented the uee of the sarne slte throughout
the entlre flve year etudy. I{hen changed, capture statlons were always replaced wlth
structurea of couparable appearance and noequlto abundance, located near the prevlous
s ta t l on .
- Outdoor restlng collectlone: Mosquitos resting outdoors at one to four sltes ln
agrlcultural ftelds or three understory were sanpled for 30 nlnutes per slte uslng a
bittery-operated 6neeper. Collectlona nere always made at the slte(e) which appeared nost
sultable and were eltuated closest to blt lng and/or lndoor caPture statlons.
- Buffalo balt collectl.ons: Femalee werebovld baits Blted ln courtyards as near to theabout 20 nlnutes after sunaet, and collectlonsstudtee ehoned that Bost mosqulto epecles fed
collected landing on and/or bit lng tetheredlndoor capture stations as posslble startl 'nglrere Dade durlng 30 nLnutes. Prevlous
frequently on bovlds at, thle tlne.
- All breedlng eltee were lnspected for noequl.to larvae at Eonthly lntervale' whlleflxed etatlons were aurveyed at weekly intervalg. Eabltat 1n6t8b111ty nade quantltatlve
analyele of data lnposslble. Howevef, the reeulte were useful ln eupportlng dlfferentoverwlnterlng strategles.
ResuLtsthose relatedfo l lows:
rJere preeented forto cullcifacles and
anophellne and cullclne epecles encounteredr but onlysteDhensi as well ae other anophellnes afe given as
(a) Spatlal. dlstrtbutlon: Urbanl.zation wae found to lnfluence the dlstrlbutlon ofeone specles which do not tolerate eutrophicatlon of the breedlng eltes. Specles weredlvlded lnto four groups based on abundance patterns anong varlous tyPes of vll lages:
- perl.-urban: gglglgg.- rural vll lage: @.!.- rural,-agrartatr: culiclfacles' !]otlg!$!g and nlgerrlnus- vegetatl.on dependent: annularle and pulcherrfunue
Perl-urban epecles flouriehed near polluted breedtng sltes where eutrophlcatlon reducedsyeteE dlverslty. Rural-vll lage speclea nere less tolerant of organlc pollutlon, andueually developed ln watere assoclated wlth agrlcultural Lrrlgation 8y6teDs.Rural-agrarian epeclea trere lntol.erant of pollutlon, and lnhablted only clean nater euch as
the efflueot of lrrlgatlon welle aod canal seepages. The segregatl.on of breedlng sltes
aDong these three subJectlve breedlng habltat categoriee wa6 never dlsttnct. Cattle shedsand vll lage run-off created eutrophlc envlronnents ln rural surroundings, whlle vegetableplot lrrlgatlon ln perl-urbau surroundlngs created clean ltater habltats. The fourth
category lncluded those specles whoee dlstrlbutlon na6 related to selected aquatlcvegetatlon and was independent of.the proxlnity of hunan populatlons. An. annularls and
pg-icherrlnus were found Eost frequentl.y near dral.ns choked wlth subn"rgEiffiGllfres(Uyrlophylluo and @!g$Illgg).
(b) Seasonal d iet r ibut lon: In the preeent s tudy, Releen & Ml lby ( loc.c l t . )
claeslfled the eeaeonal patterns of the aeven anopheline specles encountered as follows:
vBc/ 90 . 3I.,IAL/ 90 . 3Page 104
- uni roodal monsoon: n igerr lnus and subpictus- b inodal-spr ing aot , and,anngl9r is '- binodal-roons oon/pos t-totts ooiTiliattt' $!g1!!!g and !g!9@!g'
temperature had Ehe nost marked ef fect on mosqul to seasonal abundance' A11 species
(anlphel ines and cul ic ines except Cx. quinquefS,sc iatus exhib i ted reduced abundance dur ing
t h e h o t , d e s i c c a t i n g P r e - n o n s o o n P e r @ u g h e a r 1 y J u 1 y ) , a n d c o 1 d , d r y . w i n t e r(Decenber to March) season. The abundance of species prevalent dur ing the roonsoon' /Post
monsoon seasons (uninodal or b inodal-monsoon dominant groups) was corre lated posi t ive ly
wi th tenperature recorded concurrent ly at the t i t re of saopl ing, especia l ly dur ing b iL ing
col lect ions. Al though st ressed by premonsoon condi t ionsr 'aest ivat ion was not observed
dur ing the present s iuay. Four oveiwinter ing st rategles l tere Postu lated by the authors as
fo l l ows :
- cont lnued reproduct ive act iv i ty wl th delayed ovar lan maturat ion_: cu l ic i f?c iest
9!epM. i , f luv lat i l is , lu lcherr inus and annular is . In th ls grouP, cool temperatures
delayed ovarlan developnent anong t6p.oa,t;@ctive fenales' I lowever, ovlposltion
cont lnued, as lndicat" i Uy col tect ton of larvae throughout the wlnter , as wel l as rePeated
recovery of gonoact ive fenales in rest ing and bovid-bai t co l lect ions '
- cessat lon of reproduct lve act iv i ty , populat ion overht in ters as lnseninated, unfed
nul l iparous feroales: n lgerr lnus. Thls grouP exhib i ted ceesat ion of reproduct lon dur ing
late ia l l /ear ly winter , when nost of the fenales col lected were unfed nul l lparous at
ovar lan stage I . In addi t ion, larvae and pupae were rare ly found, lnd icat lng reduced
recru i tment .
- ovenrinters as imnature stages: no anopheline specles were observed l-n thls group,
which was represented only by Aedes caspius and Mansonia unLfornis'
- b e c o n e s r e g l o n a l l y e x t i n c t a n d r e - i n t r o d u c e d a n n u a l l y : @ s . S i n c e
anophellnes lack diapauslng e88sr the dlsappearance of the lnnature and'-adult stages of
subplCtus from January to June was explainei as being due to regional extlnction of thls
species. ReinEroduct ion apparent ly otcurred annual ly wl th the o! :9t of the monaoon ra ins '
which sweep across the Indian subcontinent from the southeast. This species ltas collected
by oCher workers throughout the year in southern India, and Ln sumrner lt appears
consistently earller in oetu in the Indlan Punjab than 1n the Lahore area ln Paklstan'
Specles were also classified by the nagnltude of numerical change based on the number
of s tandard devlat lons (s .D.) f ron the mean, t ransformed by ln( l + 1) . Three grouPs l tere
recognlzed:
- 6 t a t i o n a r y ( n a x 1 n a < l s . D . f r o r n t h e o v e r a 1 1 u e a n ) : g r l 1 1 c i f a 9 1 9 9 - . " 1 , H . :. D o d e r a t e 1 y t t u c t u a t i n g ( n a x 1 m a = l . 2 s . D . ) : s t e p h e n s 1 ' a n n u I a r 1 s ' r y a n q
pulcherr inus--fi-"rtedly fluctuaring (rnaxina >2S.D.), g!.1!{!!.
Restlng behavl.our: [As thls aspect forns an i.ntegral part of the Present study'
convenlent ly deal t wl th here rather than under t+ 'O-4 ' l l ' The authors 'c lass l f ied
encountered lnto three maJor grouPs, wlth the anophelines shown as follows:
( c )l t is morethe specles
- e n d o p h l l l c r r e s t l n g p r l n c l p a l l y l n s i d e h o u s e s o r c a t t l e e h e d s : c u l l c l f a c l q g : - - - ,
g l g P h e n s ! , L l u v l a F l l i s a n d - + 8 1 + s . T h e f l r s t t w o a r e t h e p r l n c i p a t n a t a i t a v e c t o r s a n dlrere expected to 6ffi6st af?,ff ia-Ui resldual house spraying (see below)'
- par t ia l ly exopht l lc , females rest indoors af ter feedlng on b lood' but outdoor
r e s t i n g w a s a 1 s o f r e q u e n t 1 y o b s e r v e d : a n n u 1 a r 1 s , n 1 g e r r 1 m u s a n d ! @ .
- exophi l lc , rare ly col lected indoors: three cul lc lne specles were l is ted.
(d) The ef fect of res idual house spraylng for roalarLa contro l ' : The authors pointed
out that thelr observatloLns on anophellnl "Lr.rrrd.r,""
were made durlng an inter-epidenlc
per iod, based on changes ln the po" iat . r iay rates-of s l ides col lected by ACD in Punjab
province (c i t tng Zulu l ta, Muj taba S-; ; "h, '1980) [see deta l ls under Subsect lon (1 i ) ' I
belowl. Seasonal f luctuations 1n malaria cases were roarked' wlth the naxlmum prevalence
occurring tn the post-monsoon season (septenber to November), and the nlnlnum durlng late
vBc/90. 3MAL/90.3Page 105
wlnter (January to l tarch) . Tranemlss lon (ae lndlcated by P. fa lc lParun cases) pers leted 1n
all nonths, but essentlally followed the saEe post-Eonsoon donlnated seaaonel' pattern. The
reportedly seasonal pat tern of nalar la prevalence d ld not Cal1y c losely wl th the spr lng
d o n i n a t e d b 1 n o d a 1 a b u n d a n c e p a t t ' e r n o f t h e r e c o g n 1 z e d v e c t o r a , s @ a n d 9 ! . @ . l .The authors offered four poeslble explanatlons for the dlscrepancy between the tlto seasonal
pat terns as fo l lows:
- res ldual house spraylng a l tered vector eeasonal abundancel- changes ln vector age structure and survlval were dlfferent from relative
abundance, and nore closely paralleled roaLarla seasonal prevalencel- the degree of man-vector contact and vectorial capaclty changed seasonally
lndependent of re lat ive abundance;- a n o p h e 1 l n e s o t h e r t h . n @ a n d s t e p h e n s 1 w e r e r e 8 p o n e l b 1 e f o r t h e n o n a o o n
donlnated t ransnLssion.
The authors trled to discuss the four poeslbll l t les ln the l lght of other etudles
carr1ed out ln PunJab. The Malarla Control Programe eprayed uost vll lages ln PunJab wtth
rnalathlon durlng l i76 ana $77. Study locallt ies (Khano llarnl, Sattokl and Kot Baghlcha)
wlth the nost abundant anophellne populatlons were sPrayed durtng the nonsoon seasons of
1976, Lg77 and 1979. Thus, the pat tern of vector seasonal d ls t r lbut lon deplcted f ron the
present etudy reflected the effect of these control ectivlt ies. Malarla prevalence
decreased durtng 1976 and half of 1977, but continued to exhlblt a Donaoon donlnated
aeaeonallty whlch naa comparable to pre-epraylng years (clt lng Zulueta, l luJtab & Shah'
1980). Seasonal changes ln parlty and survival of cullclfagles and 9!j iP!$l-ter!_ -inversely re lated to temperature (c l t lng Reieen et a l . ' 1986 - aee 4.10 below). o lder
rooaqultos nere proportlohately-nore prevalent durlng eprlng and late fall/earLy wlnter,
1.e., before and after the perlod of expected nalarla transnlsslon leadlng to an lncrease
ln prevalence durlng Septenber-November. Since both nunerlcal abundance and Perou8 rete8
were low durlng July-October, the seagonal patterD of paroue fenalee also wag not
assoclated cloeely with lncreaees ln malaria traneolselon. Regardlng the degree ofn a n . v e c t o r c o n t a c t , t h e p r o p o r t l o n o f b 1 o o d n e a 1 a E e a r a o f g g l @ a n d g ! @ ' 1 g l v 1 n gpoeltlve reactlon for oan was 1o!r throughout the year, but lncreased somerthat durlng the
nonsoon and poet nonaoon aeason (cit ing Relsen & Borehan, 1979 and 1982 - see under 4.9 and
4.10, respecti.vely). Increased nocturnal tenperatures and relatlve huroldity forced noat
vtl lagers to sleep outdoore durlng this perlod, and presunably thelr exPoeure to nosgulto
bltes increased especlally at sl.tes away fron concentratlons of cattle and buffaloee.
Increased tenperatures alio epeeded up the development of the extrlnslc cycle. The
estl.rqates of vectorial capaclty at Khano-tlarnl lndlcated the Potential caee dleeeDlnatlon
rate nould be greatest ln Augu;t (clt lng Releen & Borehan, 1982) whlch agreed well wlth the
nalarla preval-nce pattern. Regardlng the role of addltlonal anophellne specles' thls
aspect hae been pooity studled tn Punjab. The seaeonal abundance of g!g[g!g agreee well
wtttr ttre pattern of nalarla transmls8lon. l lorever, lunedlate and delayed-sporozolte ratea
ln thls siectes were much lower Ehan concurrently collected cullcl,facles (cttlng Mahmood'
Sakal & Akhtar, 1984 - see under 4.l l below). l in fact, ttreElaut--found all lmedlate
a n d d e 1 a y e d g l a n d d 1 s g e c t 1 o n 8 1 n @ ' n e g a t 1 v e ] . A n . a n n u 1 a r 1 s 1 e c o n e 1 d e r e d a ntoporranr vecror of ualarta rn orTsffidla icttlng n.6'iT6f)l-iiE'pglchgrrlP.ue hae beentnpttcatea lu nalaria transuleelon in northern Afghantetan (see 3.11 above). However, both
specles are not consl.dered of publlc health lnportance ln Pakistan. Recently, speclee A of
the An. culici.facles conplex wae ldentlf led cytogenetlcally 1n Paklstan and found naturally----.f i ' [-or"
.r"" (clt lng Mahnood, Sakal & Akhtar, 1984 - see Eore detallslnfected ln the Lbelow). rylhensl f ron the Lahore area appeared to be chronosonally uononorphlc and
extrtbttea..Gi-lo-Zlre rates than ggll@. Iu thelr conclusions, the authore
underllned thrt "olt"lfaclee
remalns tFf;-ryortanE vector of nalaria ln PunJab'
Ternperature and ;fa-ted changes ln vectorlal capacity aseoclated wlth eeaeonal
nodiflcatlone of huuan behavlour, eeemed to be responelble for the uarked eeasonallty of
oalarla cases ln Punjab. The seasonal pattern of nalarla ceaea dld not agree strongly-with
the seaeonal pattern of vector abundance and eurvival, an lnconsl'stency requlrlng further
epidenlologfcaf and entoroologlcal conslderatlon. [Uore detalle on the effect of house
spraytng a ie ehown by Relseu (1986) under 4.614.7 belowl 'I
Followlng the dlecovery of membere of the An. cullclfacles complex (see VOL' I)"
M a h m o o d , S a k a 1 & A k h t a r ( 1 9 8 4 ) c a r r 1 e d o u t a c o n ! f f i 1 a b o r a t o r y a u d f t e 1 d a t u d y o n
f:-T0t;-T-oCuaent vBC/88.s-l'lAP / 88.2, pp. 40-45.
vBc/90.3MAL/90.3Page 106
specles A and B in Pakistan. Laboratory s tudles have been summarized in VOL. f (pp. 42r 46& f51 ) . F ie ld s tud les conp r l sed the spa t i a l d i s t r i bu t l on o f spec les A and B , t helncrinlnatlon and age structure of culiclfacies in comparison rith S-t"ph"ns.l and glpiglggln four vlllages in Punjab where on$:l!ffiil of the An. culicit"ffii!'1e* wiFi d e n t 1 f 1 e d ( s e e u n d e r 4 . l 0 a n d 4 . i l b e 1 o w ) . R e g a r d i n g 6 ; f f i " t r i b u t i o n o f s p e c 1 e sA and B, surveys were carr ied out dur ing f979- i983 in seven d is t r ic ts in Punjab province:Lahore (Khano Harni and 6 other v i l lages) , Sheikhupura (one v i l lage) , Gujranwala (onevi l lage) , Dera Ghazi Khan (one v i l lage) , Kasur (Kot Baghicha Singh Wala and 7 otherv i l lages) , Sla lkot (5 v l l lages) and Muzaf fargarh (one v i l lage) . Indoor-rest ing roosqui toswere col lected by hand capture for t lned intervals (10 n in. ) f ron 0900 to 1400 h, andsanples of cu l ic l fac ies were chromosonal ly ident l f ied. In three d is t r ic t .s where areasonalbe nunber of cuLlc i fac ies was examined (Lahoret n = 2L4; Shelkhupurai n = 81;K a s u r : n = 5 2 6 ) o n r y @ - G s 1 d e n t i f i e d . I n G u j r a n w a 1 a a n d D e r a G h a z i K h a n , s P e c 1 e sA was ldent i f ied but the sanples r {ere too sna11 Eo be considered val id (n = 17 and l0respect lve ly) . I t was only in Sia lkot d is t r ic t that 19.62 of 1086 females examined werespecles B and the renaln lng were specles A. In a snal l sanple f ron Muzaf fargarh species Bwas ldentif led ln two speclnens out of slx examined. Sporozoite-positive epecfuoens weredetected ln specles A ln some v l l lages where i t was the only specLes ident l f ied, suggest ingthat epecles A ls the naln nalar ia vector ln those areas (see under 4.10 and 4. l l be low).
Mahnood & l{acdonald (1985) carried out ecological studles on Dalaria vectors withspecla l reference to the vector la l capacl ty of An. cu l lc i fac ies speclee A ln a rura l arealn PunJab, Pakletan. Four s tudy v i l lages rdere selected ln Kasur d ls t r ic t , 60 kn south ofLahore, where specLes A of the An.
"glSS1"" conplrx was ldentLfled. Mosqulto
collectlons for lndoor restLng ;G; were-;med out fron August 1983 to December 1984.Ten 11vlng rooma and ten cattle sheds were sampled by hand capture durlng 0730 and f200 hby two col lectors for 10 o lnutes ln each st ructure at for tn lght ly ln tervals . Weather lnthe study area ls wtthln the hot-dry steppe cllnatlc belt wlth most of the annual ralnfalloccurrlng ln two-monEh ooneoon seasorls. Uoequlto breeding sltes dry^up during the hot dryPre-nonsoon perlod of May-June when the daily temperature reaches 43" or 44"C. At thlstiner breedlng is largely conflned to permanent dralns and canals. The nonaoon ralns beginln June or July wlth the maximun nonthly rainfall ln August (314 rnm ln 1983, 373 in 1984).In 1983, the rains ended 1n Septernber except for very scattered showers lnOctober-December. Temperature recorded at the indoor rest.lng sltes in October., Noveuberand December 1984 were somewhat cooler than the prevlous year. Conseguently, the estlnatedduration of the flrst gonotrophlc cycle and sporogony nere longer than those calculated fort h e s a m e m o n t h 8 1 n l 9 8 3 . F r o m t h e i n d o o r r e s t l ' n g s i t e s , f l v e s p e c 1 e s o f @ , ' " r "recorded: cullcifacles, g!ghe\!, subpictus, annularls, and pglglgIlg wlth cullclfaciesbeing the nost abundant throughout the year. The naxl.nun numbers of cullclfacies werecaught in the November-December post-rnonsoon period, wlth two soalter@'iffi-Tfirll andJuly. Ae shown above (see Relsen & Mllby, 1986), subpictus becaue reglonally extinct froroJanuary to Auguet. The August ral.ns created a large nunber of breeding sltes favourablefo. gli$-and lts populatlon lncreased rapldly ln Septenber-Ocrober.cullcifaclee, stephensl dld not shon a peak densLty durlng the cool. winterpopulatlon peaks were after the eprlng and eummer Donsoon ralns.
Infornatlon glven by ltahnood & Macdonald (loc.clt.) on balt capture,patterna, longevity and sporozol.te rates recorded in the present study ls4 . 6 1 4 . 7 , 4 . 9 , 4 . 1 0 a n d 4 . 1 1 , r e s p e c t i v e l y .
Un1lkenonths. Its two
host feedingshown later under
Ae no further work has been done on the seasonal distrlbutlon of membere of theAn. cullctfaclea couplex ln Paklstan, it ls useful to euuDarlze the experience obtaLned lniiE'if,ffiEF-not ialllng withln the geographtcal area under review. Subbaro et al.(f987) carrl.ed out a longltudlnal study on the prevalence of the slbllng specles A and B inrlverlne and non-rlverlne vll lages around Delhi fron June l98l to Decenber 1983. Threevl l lages were gelected as fo l lows:
- Arthala: le situated at about 2 kn fron Hlndon rlver andResearch Centre (!tRC), Delhl.
- Basantpur: ls a typical rlverlne vil lage sltuated on theand located at about 30 kn southnest of the URC.
- Mandora: ls a typlcal rural vll lage sltuated at 3-4 kn fron a canal and ls about 40ku northwest of the URC.
35 kn south of the Malarla
banks of the Yanuna river
vBc/90. 3MAL/90. 3Page 107
In each v i lJ .age, a few hunan dwel l lngs, mlxed dwel l lngs.and cat t le sheds were selected.as
capture stat lons for noequl to col lect ions. Each v i l lage was v le l ted for tn lght ly and
re6t lng nosqul toe were col lected by hand capture. In each caPture stat ion, 15 n inutes were
spent Uy i , - j lnsect co l l .ectors. In a l l three v l11ages, nosqui to col lect ions were star ted
tn June- 1981, but man-hour densi t les were detern lned f ron October 1981. Hal f -grav ld
f e r o a 1 e s o f @ \ ' e r e P r o c e s s e d f o r c y t o g e n e t 1 c a 1 i d e n t 1 f 1 c a t 1 o n o f e p e c 1 e s A a n dB. The sanffi; i ff i-Bpeclnens were examlned for detectlon of sporozoltes ln the salivary
glands. Occaslonal ly , larvae col lected f ron breedlng p laces l rere reared to adul ts ln the
iaboratory for cytogenet ic ldent l f lcat ion of the s ib l lng species. Four anophel lne species
w " . " p . e . , a 1 e n t i n t h e s t u d y v 1 1 1 a g e s , v 1 z : @ , s ' 1 i c i f " c i * , @ 1 , a n deubpictus. The densl ty of cu l lc l fac les was re lat lve ly h igh f ron May to Novenber ln a l l
ffr iff iay vll lages. tn tEffiter ronths, culiclfacies nas virtually absent ln the two
rlver1ne vll lages, Arthala and Basantpur, whtff ift-e non-rlverlne vll lage, Mandora, the
denslty renalned above 5/uan-hour. Regardlng the tyPes of capture statlons' cu11clfa919g
denslty was relatlvely higher ln cattle sheds than ln hunan and roixed dwell lngs. In 1982,
housee were 6prayed with ttCtt tn May-June in Basantpur, and in August in Arthala, which
resulted ln a sudden decllne in the cullclfacles populatlon ln subsequent nonths, but later
the populatlon regalned Lts nornal densitles. -Tn
Mandora, three rounds of nalathlon nere
"pr .y" i ln 1982. ia tSA3, resul t lng ln tota l abaence of cu l lc l fac ies. In 1983, the natura l
densl t les of cu l lc l fac les |n 'both Ar thala and Basantpur were very low. In a l l three
vll lages, ttre-G-eTETGl specles A and B were found eyopatric. The proportions of the two
spect-e varled wlth the seasone, but rernalned roughly the sane throughout the observation
p e r 1 o d , e v e n t h o u g h t h e d e n s 1 t y o f @ v a r l e d . R e g a r d 1 n g t h e t y p e s o f c a p t u r estatlons, 1t appeared that the two ff i iGg specles do not have any speciflc preference for
cer ta ln iyp"s o i reet tng habi tat . Wl th regard to the seasonal d is t r lbut lon, specles A was
rnost predomlnant throughout most of the year. However, the proportlon of specles B
lncreased after the onset of the Donsoon conoenclng ln July and reachtng a maxluum 1n
Septenber-October. The lncreaae rsaa roore consplcuous ln the two rlverlne vll lages, Arthala
" td B"""otprr r . In the la t ter , the proport lon of specles B even exceeded that of A, whl le -
Ln Arthala it reached 352. In the noD-rlverlne vll lage, Mandora, the proportlon of specles
B never exceeded l0Z. Fron a l l types of breedlng p laces, v lzz ponds, ra in poole, r lver bed
poole and rlver banks, epecles A and B were ldenttf ied. However, the three study vll lages
had dlfferent type6 of breedlng places. In Mandora, cullclfaclee breedlng was rooetly
conflned to a blg pond ln the ce1tre of the vlI lage. -In
Arthala, a rlverlne vll lage'
breedlng was found only lu raln pools and snall ponds. Because of the embanknent, no rlver
bed poois nere forned, whlle Ln Basantpur, a typical rlverlne sltuatlon exlsted and
breeilng was found ln pools of the rlver banks and ln the river bed and raln pooJ-s. Wlth
the recieslon of f loods after the monsoon, the number of rlver bed pools Lncreasedtprovlding extenelve breedlng eltes for nosqul.tos. As nentloned above, Ln the post-tronsoon
perlod the proportlon of ep-cles B lncreased, and lt was elgnlflcantly htgher than that of
ipecles A Ln Basantpur. Thls euggests that there oay be a correlatlon betvteen breedlng ln
"i""r bed pools and the proportl;n of species B recorded in Basantpur. In fact, larval
aurveys, though not done regularJ.y gave the sane species composl.t lon as tn the adult
co l lect lons. The authors fur ther referred to Suguna et a l . (1983) who a leo obsetved an
lncrease ln the proportlon of specles B durlng the post-uonsoon per{od in vll lages situated
on the banks of the Thenpennlar rlver ln Tanil Nadu, where thls epecl.es Predoninated fron
Septenber to Decenber. Sporozoite-posltlve epecinens ldentlf ied as to epecles and the
ualaria eltuatlon ln the three study vll lages were Presentecl as shonn under 4.11 below.
4.6 Rest lng behavtour and 4.7 Bl t ing behavlour
T h r o u g h o r r t t h e l r d 1 s t r 1 b u t 1 o n r a n g e s , b o t h e t e p h e n s 1 a n d @ h a v e - b e e nregarded as largely endophll ic spectes except, for a few rePorts fron Iran involvlng
etephenel aad a elgnle report froro Afghanistan lnvolving culj lcifacles, where collectlons
nere DaaE frou artif lclal plt sheltera aa shown below.
' In Saudl Arabla, Daggy (1959) descr ibed stephensl ln Qat l f area as a donest lc specles
readlly attracted to man-made ehelters. Enorruols nurobars of adults were found restlng
durlng the day ln [ouses and stables. As nany as 500-600 steDhens.l females ltere taken
regt l ;g on t - i .5 roz of wal l eur face. I t const l tu ted 90.62 of house-rest ing anophel lnee.
vBc/ 90 . 3MAL /90 .3Page 108
In I ran, Manouchehr l e t a l . (1976) indicated that s tePhensi - ls considered an
endophi t ic and endophagic vector , but l t readi ly b i tes oGaoors aur ing the sumoer when
people and domest ic aninals rest and s leep outdoors ' I t has been found rest ing ln both
hunan and ani 'a l shel ters. I t has a lso b len col lected f rom tents and thatched shel ters
(known 1ocal1y as Kapar and Kurneh). This specles usuaLly rests on the lower par ts of wa1ls
and ,oay even resE on the ground in unoccupl ld shel ters. I ts preferent ia l rest lng s i tes are
furniture, hanglng clothel and splder webs. It is commonly found ln earthenware Itheat
conta iners. Dur ing the summer months ln sone areas such as Bandar Abbas' adul ts of
gleehenst were fouid Ln underground shelters such as welLs dug on sloplng land to bring
underground water to the sur face. In the study of the b i t ing cyc le of cer ta in x6alar ia
vectors in southern r ran (see under 2.6/2.7 ablve) , Manouchehr i , Djanbakhsh & Eshghy (L976)
showed that at three vi. l lages at shabankarehr Kazeroun, oan-balt capture ltas conducted froro
l80O h ro 0600 h for tn ight iy dur ing; lpr t l -Novenber 1967' The b l t lng of sgeph:nsl cont lnued
throughout the period oi nfint oUservattons, with 89il ot' the bltes occurrlng during the
f l rs t hal f o f the n lght (1860 h - 2400 h) ; only 4 '5% of the b i tes l tere recorded tn the
t h r e e h o u r s b e f o r e s u n r i s e . T h e s e a s o n a 1 ' b i t 1 n g a i t 1 v i t y o r @ i n t h i s a r e a s t a r t e din late April and continued to forD tlto peaks: ihe fltst ln early June and the second ln
early Septerober; the number of bltes/nan/nlght lndoors and outdoors during
Septenber-October i967 was t6 and 20, respeitively' In two other vll lages in the Manasani
area, Kazeroun, where houses t " . " "p i "yed
r r l th OP lnsect ic ides 1n July 1974' roan-bal t
capture nas conducted froE 1800 h to o6oo h every l0 days fron May to the end of November'
The b l r ing of s tephensl s tar ted at 1800 h, and about 74id of the b l tes occurred dur ing the
first half of ttre-i l i !fr?, only about 77 of the bltes belng recorded during the last three
hours before sunr lse (see nore deta l ls below). As the p iesent s tudy has shown that nost of
t h e b 1 t i n g a c t i v 1 t i e s o f c h e t h r e e r o a 1 a r l a v e c t o r a 1 n s o u t h e r n I r a n : " . ! l l ? l i l : , #and d- thal l take p lace dur lng the f l rs t hal f o f the n ight , the authors suggested tnat lor
adnin is t rat lve reasons bai t caPture observat lons Eay ue t tn t ted to the f l rs t hal f o f the
ntght .
l lore informatlon on the btting cycle of f luviati l ls as gLven by the sane authors has
been shown under 2.6/2.7 above and on d- thal i under 5 ' l be low'
'useful inforrnation has been glven on the resting and biting densltles of stePhens,!
and l ts response to insect lc ldal t iaoor res idual spt ty t t tg ln f te ld t r la ls ln southern
Iran. Eshghy et a l . (1973) expla ined that due to DDT and d le ldr ln res ls tance ln gtephensi
rnalathion was sprayed ln piace of DDT or alternatlng wlth lt ' As the frequency of
nalathlon applicatlon may lncrease the po'sslbll l ty of development of reslstance in
@.!r .a potent ia l reserve insect lc ide to replace roalath lon l raa sought ' Fenl t roth lon
(sunithion) was chosen for a fleld trlal ln the Mamasanl area, Kazerount southern Iran'
The naln obJecttve ltas to asaes6 lts lDPact on the maln vectol , g!!:nsl and the other
vecrora, d-thali, auperplgtus and fluviagflfs., ZOI? round of tenIE66Ii house spraylng
was applied ln August lg72 at a ao$!-F!/nz,(technical grade)' The spraylng covered
57 vil lages with l l 445 lnhabltants. The enlonological evaluatlon nas carrled out in flve
vll lages selected ln the fenltrothlon eprayed area, and two vl ' l . lages ln a comparlson area
treat;d with nalathlon. The entonologlcal technlquee used were:
- pSC: This was carrled out at l0-day lntervals ln elght f lxed caPture stations ln
each vll lage.
- Floor theet collectlon: The number Of dead uosqultos found on sheet8 EPread on the
floore of slx sprayed prenlses overnlght rtaa counted every l0 days'
- Larval collectione: The thlrd and fourth inetar larvae were ldentlf led a6 to
speclee and the denstty lndex was calculated on the basls of the number of these lnstars
pe r I 0 d iPs .
- Exlt window trap collectlons: 20 wlndow traps were installed in a number of sprayed
houses ( four t raps per v i l lage) . l lor ta l l ty wae cal lu lated on the baels of those found dead
in the trap at t-tre tfne of collectlon * those found dead aroong those collected allve and
h e l d f o r 2 4 h o u r s . T r a p c o l l e c t i o n s w e r e m a d e a t l O - d a y i n t e r v a l s .
vBc /90 .3MAL/90. 3Page 109
- Ar t l f lc la l p i t shel ter co l lect lons^: 20 p i t shel tera were establ lshed ln the
fenl t roth lon sprayed area (4 per v l l lage) and examlned every l0 days.
- All-night balt capture: Four local Den I'ere enployed as balts, and a cow and a
donkey r"t" u""d as anlnal balts ln three fenitrotblon sprayed vllJ'ages. Catches ttere
organized at lQ-day intervals. As the inhabitants and anlnale were outside durlng the
sur16er months, a l l ba l t caPture observat lons were oade outdoors.
- Age detern luat lon: The parous rate was detern lned by the nethod of Det lnova (1962)
on feroalee col lected ln the feni t roth lon sprayed v l l lage [The source of mosqul tos for
dLssect lon was not shown].
- B ioassay tests: These were carr ied out on var lous tyPes of sur faces, us lng
laboratory br"d :-g9$g9,1 fed fenales at weekly lntervals'
Data were pre6ented ln a eer ies of t8ble6. Froro these and as d lecuseed by the
authors, fenltrothlon spraying conslderably reduced the denslty of !-g@.!. The nean
indoor resr lng densl ty a.c ieai"a f ron 352.9/room before spraylng ln August to 4.2 ' 0 .07 and
zero/room in Eeptenber and October, 1.e. , 30, 50 and 90 days af ter spraylng, respect ive ly .
The totaL nuober of ltephensl collected by PSC before spraying and the claseificatlon of
the blood digestlon ff i-!f,otoed that 8.32 were UF' 4l .27. E, 37,82 HG, and 12.77. G'
lndlcatlng endophlly of thi6 vector. The decrease in indoor restlng denslty of d-thalt
after the appllcatlon of feultrothlon was algo conglderable, frou 20.9lroom before spraylng
to 5.4, 0.6-and 0.05/roon 30, 60 and 90 days af ter spraylng, respect lve ly . Very sual l
d e n s 1 t i e s o f g @ a n d f 1 u v l a t 1 1 1 e w e r e r e c o r d e d b e f o r e s p r a y 1 n g . T h e d e n s 1 t 1 e e o ft h e t w o e p e c t f f i a r t " i l i l E @ w e r e n e g 1 1 g l b 1 e . I n t h e t w o c o m P a r 1 e o n v i 1 1 a g e swhlch were treated wlth roalathlon, the reduction ln denslty of !!9l!9g9.! was less -pronounced: f rom 997.6/rooo before epraylng to 6.1 and 19.8/ roonr :S and 65 days af ter
spraylng, regpectlvely. A elnllar trend was observed wlth g'thalt; - lte denslty was reduced
f ton- tg. i t roor b" fote epraylng to 2.3 and 0.4/ rooo 35 and 65 days af ter epraying '
respectlvely. The ktl ltng effect of fenltrothlon on indoor restl.ng noequltos wae
denlnsrrated by rhe f lnd l ;g of 65 gtephensl and 213 d- thal+ dead-on- f1oor theets dur lng
August-Seprenber after epraylng. dEfrou-gn gghens:L=-qu1te endophll lc, it was found
reitlng in plt shelters due to the very tarfrlff i-outPut frou numerous breedlng places
associated wlth rlce cultivaClon ln the Mamaeanl area. The hlgheet denslty of 9@.!was recorded three days after fenltrothlon spraylnEt 2L.8/Plt, but the denelty decreaeed to
3.6 and 0.15/p i t , 30 and 60 daye af te i r 'spraying, reepect lve ly . . I { l th g j l$ f l ' whlch le
known Eo be an exophll lc speclis, the maxloun denslty was 49.3/PLt whlch was aleo recorded
three days after fenltrothlon epraylng, but the denslty of thle specles decllned to 9 and
8.9/plt, 30 and 50 days after spraytn!, reepectlvely. A very enall nunberg- of ggPry
p e r s t s t e d a f t e r " p , . y i , , g b . ' ! ' ' o @ w a e r e c o r d e d 1 n p l t e h e 1 t e r s [ T h e a u t h o r 8 d 1 dnor show the classlf lcatlon of the Tiff irgestlon stages of stephensl .11-9,!tt9l1,-
specimens col lected ln pt l shel ters l . Wl th ex l t t raps 24_9_g98heni1-and-507-9: t l tq ]+ were
c-o l lected. Of s tephensi , l4Z were UF, t6Z ?, I2Z I tG and 582 G' whl le the-d- thel+ saDPre
showed tttat to.37-iff iEi, 5o.tZ F, 2.42 HG and 7Z G. The overall nortallEy of trap
col lect lons of s tephensl and a- thal l before spraylng wae 562-and 63.92, resPect lve ly t but
none of the two "!ffi-s,rrvlvffiGr
fenl.trothton ipraylng [The-Possible leasona for the
very hlgh nortallt les observed before spraylng 1l;ere not explainedl. -Before fenltrothlon
spraylng, the nan b l t lng rare na6 35.4/aan' /nf !nt Uut decl lned to 16.6, 2.1 ' ' 0 '1 /nan/n lght
.i tb, 50 ana 50 days "it.,
spraylng, respectively, and reroained at zero durlng 60-90 daye
after spraylng. Xlih d-tha1i, the nan-bltlng rate wae very low before spraylng'
l. l /uanTnilntl ana ras-6--durlng 50 days after eprayl.ng, and renalned at zero
thereafter. The antnal bit ing rat! of etephenei atta a:t1"ff were 213 and 133'7/cow/nlght
before fenitrothlon, reaPectlvely. SotI-mecttnffir spraylng, reachlng 0'17 and
2.5, respect lve ly-dur lng 'October (70 days af ter spraytng) . The Parous rate,of gephqnEl
dro iped i rorn 54. i -52.47 before epraylng to 3.57, 15-40 days af ter fenl t roth lon epraylng '
Wft i r 'a ' tha l f , the parous rate aroppea i rcs767-before spraying to 39 '52, 15-40 daye af ter
sprayGffia reached 22.82 during |S-ZO daye af ter spraylng. Bloaesays on fenltrothlon
siray"a-rud surfacee using f/2-hour expoaure tlne gave 72.62 nortallty at 39 days after
re;Tesc;fprion of arrlflclal plt shelters in the Uanual of Practlcal Entonology ln
Malar la Eradicat l .on PART II ' 1975, P. 52.
vBc /90 .3MAL /90 .3Page ' 110
spraylng and dropped to 8Z at 102 days. On wood, the tests showed nore than 70% roor ta l t tyup to 95 days af ter spraying. Wl th nalath lon, l /2-hour exposure t ine on nud sur faces gave
a maximun nor ta l l ty of 68.6% at 11 days af ter spraying, whi le on wood sur faces thernor ta l l ty was 1002 at the same tLme. Sixty days af ter nalath lon spraying ' the nor ta l i ty on
mud and wood was 30.22 and 88.77, reepect ive ly . Adul t suscept ib i l i ty tests showed thats. tephensi nas suscept lb le to feni t roth ion and nalath ion but res is tant to DDT and d ie ldr in .
Frorn a l l the above observat ions, the authors concluded that feni t roth ion was
ef fect lve for the contro l o f ! - !ephe"s. l to the end of the t ransmiss ion season (more than two
months. The observat lons wer-per formed at the peak act iv l ty of s tephensl . Fur ther
studles are needed to conf i rm the ef fect iveness of th is lnsect ic ide.
A fur ther t r ia l was conducted to conpare fenl t roth ion (Suni th ion) wt th rnalath ion in
the same Maroasanl area, southern l ran, as repor ted by Eshghy, Motab4r & Janbakhsh ( f975) .
One round of fenl t roth ion spraylng hras appl led at a dosage of . 2 g/n ' ( technical grade)
f roro 4 July-7 August L974, ta 57 v i l lages wi th a gopulat ion of 12 2L0 inhabi tants.Malathion was applled in two rounds each at 2 g/n- during 1-31 JuLy and25 August- Septenber L974 in an adJacent area cover tng 26 v i l lages L, i th 7289 lnhabi tantsin the f i rs t round, and 23 v l l lages wl th 6 774 lnhabi tants ln the second round. In each ofthe fenl t roth ion and nalath lon sprayed areas, three indlcator v i l lages were selected for
entonologl .ca l evaluat lon, Near ly the same entoroologlcal technlques nere ut l l lzed as in theprevlous trial shown above. The results were l l lustrated In a serles of graphs showlng thedensl ty t rends before and af ter the appl lcat ion of the lnsect lc ides. As d lscussed by theauthors, the maxlmun lndoor rest lng densl ty of s tephensl recorded dur ing a 50-day per lod
before the appl lcat lon of feni t roth lon, was 48.5/ roon and the ProPort lon of HG and Gfenales wae 52.62. Af ter fenl t roth lon spraylng the indoor rest lng densl ty ranged bet l teen0.1 and l l . / roon dur lng July-October, and the proport lon of HG and G was only 5.12. Inthe conparison area, the naxinun density of gElhensl before nalathlon spraying, was122.8/roon dur lng June. Af ter the f l rs t round of nalath lon spraytng, the densi ty rangedbetween 4.7 and 5L2.2/roon dur ing July-August . The authors explatned that due to seasonalr lce cul t lvat lon ln June-July the densi ty of s tephensl adul ts greet ly lncreased in bothfenltrothlon and roalathlon sprayed areas. After the second ualathlon spraying round inear ly Septenber, the densi ty of s tephensl dropped to 43.9/ roon ln ear ly October ' andsteadl ly decreased to 0.8/ roon [wi th t t re seasonal decl lne in Novenber] . Dur lng tno monthsaf ter fenl t roth lon spraying a tota l o f 73 stephensl and 112 d ' thal l dead fenales werecollected fron floor sheets spread overnight ln sprayed rooms. This indicated thatfenl t roth lon had a le thal ef fect on lndoor rest ing mosqul tos. A s ln l lar nor ta l l ty wasobserved ln the nalathion sprayed rooos. Results of bait caPture ltere Presented in moredeta l l ln a separate repor t as shonn below. Exl t t rap col lect lons before feni t roth ionspraylng yielded 46 stephensl females, of whlch 52.22 were HG * G. After spraying' 64s t e p h e n s l w e r e c o 1 l e f f i t h e t r a P s d u r 1 n g 3 0 d a y s . T h e s e f e r o a 1 e s w e r e U F a n d F , n o n eoE wtrtch survlved after a 24-hour holdlng perlod. Before noalathlon spraylng, exit trapsylelded 80 stephensl durlng one oonth, of which 2L.32 were IIG and G. The survlval rate inthls sanpleGiE5Z. After the flrst malathl.on spraylng, the exlt traPs ylelded 754stephensl fernales of whlch 0.32 were HG and G. After the second round, 237 g!gg!1g11Eernalee were collected froro the traps, of whLch 2.9X ttere HG and G. The nortallty arnongtrap-collected fenalea nas 46.2-1002 after the flrst round and 26.6-1002 after the second.Collectlons frorl artlf lclal plt ehelters ytelded a mean denstty of 67.2 g3ghens:L/l ltshor t ly af ter feni t roth ion spraylng ln July , but the densl ty s teadl ly decl lned thereaf terreachlng O.2/ptt ln Novenber. In the roalathlon sprayed area, the denslty of .g!9g!1]-!'1!.!locreaeed f ron 0.6/p l t ln Ju ly to 156 ln August af ter the f i rs t round' but s teadl lydecllned after the second round from 23.6lplt ln Septenber to 0.l./plt ln November. Ovaries
dlssections nere perforned on samples of stephensi females collected restlng Lndoors. Theparoua rate deteroined on 220 stephensl fenalel was 55-58.52 before fenltrothion spraying.burlng a perlod of 75 days aftff iEiothlon spraying, the parous rate nas 8.5-162 (416
afssectea) . Pr lor to nalath lon epraylng, the parous rate of s tephensl . was 43.7-507. (220
dlssected) . Afrer the f l rs t round the parous rate dropped to 8.5:16Z (610 dtssected) .Bloassays were carrl.ed out on mud and wood eurfaces sprayed wlth fenitrothion, uslng a
3O-nlnute expoeure perlod. Theee showed 65.32 nortallty on mud wal1s 45 days afterspraylng. On wood, more than 702 rnortallty was recorded uP to 95 days after spraying.ffoassay l lortalLtles on nud surfaces sprayed wlth roalathlon were 63.52 after 35 days fron
the flrst spraylng. On wood, the nortallty vae 96.52 at 55 days after spraylng. The
alr -borne k l l l lng ef fect of fenl t roth l .on was observed lnelde sprayed houees. the cage ueed
ln these tests was cy l lndr lca l measur ing l0 x 16 cn. A tota l o f 6 cages conta ln lng
vBc/90.3MAL/90 .3P a g e 1 1 1
25 blood fed etephensl nas used tn each test, of whlch four sere lnstalled in four eprayed
roops and twoTpt-as-controls. Each cage was hung at 50 cn dtstance fron the wa1l and
ce1l lng ln sprayed houses. The expoaure t lne was 6 hours, f ron 0700 h to 1300 h, and
subeequently followed by a 24-hour holdlng perlod. The nortallty was 1002 and 807" at 45
and 85 days af ter spraylng, respect lve ly . As ln the prevlous t r la l , adul t suscept ib i l i ty
teste showed that .ElSt!@ wae quite susceptlble to fenitrothlon and nalathlon, but
renalned res ls tant to DDT and d ie ldr in .
Based on the above observat lons, the authors concluded that fenl t roth ion was more
effectlve agalnst sooe anophellnes than malathlon, and it gave satlsfactory contlol of
steohensl uttder the condltlons of thls trlal for more than two nonths. I{owever, safety
!' i f i i t tfons for operators should be closely observed when using thLs lnsecticide.
[The authors d ld not show the c lass l f lcat lon of the b lood d igest lon stages of
stephensl co l lectbd f ron pLt shel ters. However, the explanat lon g lven Ln the f i rs t t r la l
SGEEh-t er a l . (1973) should a leo be appl lcable here. I t was indicated that .s tePhensi is
known io be endophll lc, but due to extensive breedlng condltlons aesoclated wlth rice
cultlvatlon ln the study area, the adult output was so large that an appreciable proportlon
of the populat lon reeted ln .p l t ehel ters l .
Eshghy & Janbakhsh (1977) preeented a eeparate rePort on the bt t lng act lv l ty of
stephensl ln Uaroasanl area where fenitrothlon waa compared with rnalathlon ln the second
ffiffifewed above. All-nlght nan- and cow-balt capturea ltere carrled out outdoors ln
two 1nd1cator vll lages, one ln the fenltrothlon sprayed area and the other ln the nalathion
sprayed area. Befo ie fenl t roth lon spraying, the b l t lng rates of s tephensl ranged f rom 1.0
to L4.7/san/nlght, and 30 to 137.5/cow/ntght, and before oalathlon spraylng the ratea nere
0-5.7/nan/nlghr and 0-21/cow/nlght. Flve nonths afcer fenltrothlon spraylng' the bltlng
ratea of stephensl were 0-19.2/ran/night and 0-46.5/cow/nlght. The data preeented
graptrtcati!-?ffifly showed that the rnaxlnum 1evels of. L9.2/nan/night and 46.5/cow/nlght
were recorded ln August af ter fenl t roth lon spraying, af ter whlch the rates steadl ly
decllned reachlng ztro ln Novenber. In the ualathlon sprayed ares' the bltlng rates of
etephensl were 2.5-44.5/oa;n/nLght , aud 13.5-120/cow/nlght af ter the f l re t round. Fron the
grapfrtu [he maxinuo levels of 44.5lnan/nlght and 120/cow/n1ght ttere recorded about the
beglonlng of August after the firet appllcatlon. After the eecond round the bltlng rateg
on man and cor.r eteadlly decllned reaching zero ln November wlth the excePtlon of a srnall
rlse ln October. Regardlng the bltlng cycle, the highest blElng activity occurred durlng
the eecond quarter of the nlght, and the lowest durlng the flrst and Chlrd'quarters. After
0500 h bttlng becaroe very rare.
In Afghanlgtan, from the observatlons of Ranachandra Rao (1951) ln the LaghDan
d 1 e t r i c t o f t h e E a 8 t e r n p r o v 1 n c e b o t h g f @ a n d 9 s 9 r p 1 9 t Y 1 ^ ' : . " c o 1 1 e c t e d 1 n 1 a r g enuubers lnElde hunan habltatlons and staUtee. A,s shown under 2.6/2.7 above, classlflcatlonof the blood dlgestlon Btagee of sanples of the two speciea collected restlng lndoors ln
the early morning lndlcated that the degree of outdoor restlng could not be very'great.
Repeated attelopto to collect cullclfacles and gerplctus, restlng ln sultable outsl 'deshel ters fa l led.
Later , Cul len ( f978) ln hte draf t aselgnrnent repor t descr ibed stephensl andcullclfacles ln Afghanistan ae highly endophll lc, though sorne lndlvlduals were found
rg;tf i 'g-C=rtlf lclal pit sheltere tn Helnand unlt (see below). However, he questl 'oned the
valldlty of pit ehelters for meaeurLng natural exophlly.
In l lelnand province ln southwest Afghanistan, Eshghy (f977) and Eehghy & Nushin(1978a) euomarlzed the nalaria sltuatLon slnce the commencernent of DDT house spraylng ln
1953. The epidenlologlcal sltuatlon evolved very favourably fron that tn 1962 when some
areas were shlfted to the consolldatlon phase. However, ln 1968 and subsequently, the
nunbei of nalarl.a casea tncreaeed conslderably and epldenlcs flnally occurred ln the south
and southwest . The annual parasl te lnc ldence (API) rose t ron 0.22/ 1000 ln 1966 to 14.9 tn
l 9 7 l a n d 3 0 . 3 1 n l 9 7 6 . V a r i o u s e n t o r n o 1 o g 1 c a ] . o b s e r v a t 1 o n s s h o w e d t h a t @perelete ln thls area at hlgh densltlee durlng June-Septenber' blt lng nan and anlmals
outdoors, partlcularly when people and aninals sleep outdoor.s. Malaria transmlsslon
usually lasts for slx nonths every year, fron nid-May to uld-November. An. stephensl
starts ls actlvlty fron late August. {g. pulcherrlnus ln thls area ls regarded as a
v B c / 9 0 . 3MAL/ 90. 3Page 112
suspected vector , and rests nost ly in outs ide shel ters. Stror tg DDT res ls tance was recorded
in. cu l ic i fac ies in L972. ORe round of nalath ion spraying was appl ied in 1975 and a fur ther
i " " ;a=@i976 at 2 g lnz in 168 v i l lages rs i th a populat ion of 166 698. The spraying
was evaluated by ut i l iz lng several entomoiogical techniques s imul taneously ' Before
sp ray ing , du r i ng t he f i r s i ha l f o f JuJ . y , t he mean i ndoo r res t i ng dens i t y o f - cu l i c i f ?c ies i n
four ind lcator v i l lages by pSC was 57.5/ room. Only sroa11 numbers of the other species were
c o 1 1 e c t e d r e s t i n g i , , i o o r " i l s t e J h e n s i , 9 . @ a n d 5 - P + 9 h e I I j ? u ! . D u r 1 n g t h eper iod of 5-95 d iys af ter spr i lGgGfy t I " " f l " iTgig, a l l b loodfed fenales ' were
collecred. During August-Slptember, thl rneaffi iEfETE-per roon I{ere: 0'3-f '6
cul ic i fac ies , o .z \ -n l l s tepi ' rgnsi -and 0.03-2.1 pr l lc lerr i rous. rn an unsprayed v i l lage ' the
;;" i"d.o. resring aens@ r,ras-f7:i--n-d 29.6/roon during August and
Seprenber, respecr ive ly , and thb rnei rn-@ggg1 densl ty ' tas 20.2, 77 'L and 52 '8 l roon dur ing
A u g u s t , S e p t e r n b e r a n d 0 c t o b e r r e s p e e t i f f i 1 t t r a p s o p e r a t e d t w i c e d u r i n g t h e P r e - s P r a ype r i od y ie lded 94 cu l l c i f ac ies , g i v l ng 11 .52 and LL .77 " no r ta l i t y , r espec t i ve l y ' a f t e r a
24-hour holding peififf i i l lasslftcation of the blood digestion stages showed that of
rhe t rappea terar"s, i t .OZ, 26.5"1 , L3.2"1 and. 42.7%'vere UF' F, HG and G, respect lve ly '
F i f ty .days af ter nal .ath ion spraying, cu l ic l fac les col lected by ex i t t raPs Cere a l l fed and
showed 66.7-LooT. norraliry .1r", a'za:fr6ffi iTlGg period. Durlng a perlod of f lf ty days
af ter spraylng, a tota l o i toz cul ic l fac les fenales and 55 males, as wel l as a few
suDerDlctus and pulcherrlnus were r6Gffia on floor sheets spread overnight ln sprayed
roons. Thls lndicated that nalath lon had a le thal contact wl th the indoor rest ing
mosqui tos. Col fec i ions f ron p l t shel ters were carr led out before and af ter rnalath ion
spraying. Al though cul ic i fac ig ls qul te endophl l ic , h igh adul t outPut led a s lgni f icant
proport ion of i ts populat ion to re6t ln ar t i f lc la l p l t shel ters ' This nay have a lso been
assoclated with the outdoor sleeplng hablt of the hlrnan populatlon' The rnaxlmun denslty of
cul lc l fac les recorded before nalath ion spraying was 26.S/p l t . The nunbers of UF' F, HG
aand G fema les co l l ec red were : L24 (58 .5 ;0 , 33 (15 -67 " ) , 20 (9 .4%) and 35 (16 '5 ' / ' > '
respect ive ly . Afrer spraying, the densi ty of gf ic l lsg les dropped to l1 ' t /p i t (5 days
after spraying), then dropped to a very flt feffiE6'/plt during August-october'
Regarding srephensl , superplgtus and Ps+shgrr iBY:^negl ig ib le densl t ies I tere recorded before
spraylng: 0.1, 0. t and 0.9/p i t , respelEl f f iFter spraylng, the densLt les of the three
species renalned very low: O-Z' .2/pLt fo t s teg$, ! , 0-0.6/p l t for -superpigtus, ,and
o:r,. i7pit F;; rgt"n";*. Balr c.pt,rreffiZde entirely outdoors' since the
lnhabi tants s lept outs lde dur ing July-October. .Before epraying, the mean bt t ing rates of
cultcifacles were 5.5/rnan/nlght and 42.3/attnal/nlght, and nelther 9,1!g!g! nor -
pulcherrinua lrere recorded blting oan. on aninals' the rate fgt g4P! y?:.o"ly .0.25/batt/ntght, while for pulcFlr-rirous the rate ltas L4.7/baLt/nllhT'
-TfiE bittng rate of
culicifacies 95 days af ter ;;_;ting d-Allned frorn 4/nan/nlght ln July to 0 ln october'
f f i " - . , , i ' " r b 1 t i n g r a t e d E c 1 i n e d f r o n 9 l n J u 1 y t o 0 1 n - O c t o b e r . N e g 1 i g 1 b 1 enumbers of stephensi and pulcherrinuF rtere recorded biting nan after spraylngt while
r.l" "-i=;ameached
23'5/batt/nlght 35 days after spraylng butpulcherrlnus bit, i-decl ined to g lbal tTnlght af ter 95 days. Age detern lnatLon nade on 230 cul ig l fac leg
col lected f rom lndoor rest lng s l tes and 100 f ron the outdoor- : : : : i "g populat lon gave an
average parous rate of 57.37. atd,527, respectively. Susceptibll l ty tests showed that
cullcifacleE waa eueceptlble to nalaihlon but remained hlghly reslstant to DDT'
A;iiff i t i l ,,.t,rr" of the area, rhe l ivlng hablts of the local people, the type of
houses constructed of sun-dried nui brlcks, "ttd
th" results of the entonologlcal
observations [lade ln thls trial, the authors concluded that mal'athion house spray'ing-gave
satlsfactory .oriroi of guliclfacles for about tno months, belng the largely endophtllc and
naln vector specLes ln the ar€8.
[In thls report and the previous report fron Mamasanl area, Irant f lndlng
cul ic l fac ies or s iephensi rest ing tn ar t l l lc la l p l t shel ters cannot be taken as def ln l te
#?ffi"i"r;r exophil lc tendency Ln the t!to- species unless supported by evidence drawn
fron col lect lons f roo natura l shel ters. Under the condl t ions of h lgh vector outpuf
descr lbed ln th ls t r la l , a ProPort lon of the populat ion ut i l lzed these ar t i f ic ia l ehel ters
for rest lng. Probably a lso, the p iac ing of s lc i r shel ters near breeding p lacee and/or the
sltes of balt capture influenced the reiults. rt has been prevlously recoronended that
ar t l f ic la l rest lng devlce should be proper ly s l ted, and as ienarked by Cul len above' the
use of p i t shel te is should be carefu l ly assessedl '
In Paklstan, l lu l l igan & Bai ly (1938) ln thel r s tudlee ln the Quet ta area '
BaLuchlsta. r , .o t iected c i t tc i . tacte i i ro t . wide var lety of d lurnal rest ing p laces ' As
vBc/90.3MAL/90.3P a g e 1 1 3
ment loned under 2.612.7 above, cu l lc l fac les was of ten found c loeely aesoclated wl thsuperpictus and gjgp@.!, but lt was relatlvely leee abundant ln outdoor restlng sheltersthan euperplc tue. The fact that the breedlng p l .aces ln the v lc ln l ty of outdoor rest lngsl tes-were qul te sul table for cu l ic i fac ies, combined wl th the fact that fenales of th lsspecies nere young as indicated by the absence of blood ln the gut, the early stage ofdevelopment of the ovarles, and the lower lnfectlon rater led the authors to conclude thatcul lc i fac les nas more domest ic ln l ts habl ts than supqrElcqqs. Adul ts of cu l lc i fac lee were6fi4- GC;ge numbers ln human habitatlons and anlial shelters ln vlllages unaTEected bythe earthquake, ln occupied tents and rulned houses ln the lnoedlate vlclnity, and ln crudeshelters erected and occupled by earthquake vlctlns. Regardlng !-!g2!gg9!' Lt was nuch nore1ocal lzed ln Quet ta than ln e i ther of the other two Loportant vectors. Of a tota l o f 1200g!9$gnsl , 1 l19 were col lected in hunan habl tat lons or f roo crudely constructed shel ters.TEe-Tact chat such a large proportLon was collected froo these crude shelters dld notlndlcate any epeclal preference on the part of ggSI@! for such places, but was probablydue to the c lose proxln l ty of su l table breedlng p laces for th ls species. In Indla,stephensi has been regarded ae a domeetlc specles, belng comonly found ln houses and cowsneas. fn Quetta, fenales of this specl.es were observed restlng by day close to where theyhad fed at nlght. Thls epecles naa rarely found ln outdoor restlng places. Out of the1200." t "ph*. l co l lected ln Quet ta, only 81 were found in outdoor rest lng p laces ' a l thoughother epecles were absolutely and relatlvely uore abundant, and eultable breedlng placeefor etephensl were aval.lable nearby. Exanlnatlon of the conparatlvely erna1l nunbera ofsteptrensl feloalee collected frou outdoqr restlng sltee showed that all were probably newlyeoe-rged, slnce there na6 no evldence of ovarlan devel.opnent, Lngested blood, or nalerlalln fect lon.
Wlth the connencenent of -DDT houee spraylng progranoe for rnalaria control lnPakletan, eone diff lcultlee uere encountereil ae noted by Raft (1955). l loet of thefurnlture and other household obJecte were kept along the lower portlon of the walle. A1ot of tfule waa, therefore, apent lu renovlng furnlture and other articlee Ln order tocover the lower parEs of the wa1ls thoroughly. Horeover, women often raleed obJectlone tosuch removals. Therefore, Raf l ( loc.c l t . ) organlzed a eer lee of obeervat lone on thehelghts of the restLng eitee of the nain vectors, 911g!!g!g and g!g@! ln flxedcapture Btatlons ln eelected vll lagee ln the PunJab. In theee caPture statlons, anophellnerooequltos were collected at three dlfferent helghte under 3 feet (0.91 u)' bettteen 3 and 6feet (0.91-f.82 n), and above 6 feet (above I.82 u), aud observatlone cont,lnued throughout1952-1955. The data lndicated that the two above nentloned vectors ln PunJab exhlblted aunlforn preference for the hetght of the roon. Therefore, lt wae recouended that apraytngshould cover the entlre eurface of the lnslde walls of houeee.
I n o r d e r t o 8 t u d y t h e b e h a v l o u r o f t h e t w o m a l ' n v e c t o r s , g g l @ a n d g ! @ ' !ln Paklstan, Aklyama (L974> carrl.ed out a serles of experluents wlth outlet and lnlettraps. Inlttally, eingle outl.et wlndow traps were 8et up in housee, but theee were notproductlve. Therefore, further obeervatlone were Dade using four traps flxed lnto thedoorways ln vll lage houees. By thls uethod, a Large nuuber of nosquitoa irere caught as
they left housee. Several types of lnlet traps nere tried, but only one tyPe wes
eucceesful: ooequl.to nettlng flxed in a doorway fornl.ng a funnel-l lke shape wlth a rolled
up curtaln at the entrance. l loequltos paeslng through the doonray were collected every
hour after the entrance curtaln wae lorrered. Eourly outlet trap collectlons were nade
durlng Septeober-October 1952 at the unsprayed vll lage of Rakh Dala, Lahore dletrlct, by
ctrangtng lr.ps alternately fron Bunaet to sunrlee. A total of. L329 feoalee and 2090 nales
of cull.clfaclee, as well ae 3962 fenales and 2890_gg!ggg! uales were captured. Moet
noeliffiffilmediarely after sunset and by 2fOO-n]TdZ-of oales and fenalee of both
specles had left the houses. Half-gravld fenales of both epecles exlted throughout the
nlght, and 1t iras aaaumed that they nay have requl.red more bLood or they nay have been
se.ttng tenporary outdoor re6tlng ehelters durlng the nlght, ae they were aeen re-enterlng
housee at dasn. Femaleg found ln outlet traps were classlfied ae followe:
cu l l c l f ac tes : UF , 25 .87 ; F , 0 .62 ; I tG , 40 .82 ; and G , 32 .82 .f f iofrff ir , 24.87; F, o.77; ItG, 38.42; and G, 35.62.
l lornlng lndoor restlng catchee revealed large number of freehly fed fenales of bothspecles. However, very few of theee feoales were caught ln the traPs ao the fenales were
remalnlng restLng lndoors untl l they becane half-gravld or gravld. Thls seened to lodlcate
vBc /90 .3r,rAL/90. 3Page 114
that they rested indoors for at least 12 hours ( i f they had entered ac dawn). Thesenosqul tos were c lear ly endophi l ic a l though chey fed outdoors, as the lnhabi tants and thel rdomesl ic aninals s lept outdoors at the t lne of observat ions. In spi te of these nosqui tosbeing exophagic, theLr endophi ly nakes them amenable to contro l by res idual housespraying. However, spraying coverage of a l l rest ing s i tes lns ide houses was d i f f icu lE toachLeve, due to the conplex i ty of the roof and che large number of household objectsconnonly s tored in houses 1n rura l areas in Pakistan. Despi te Ehis d i f f icu l ty , thespraying squads achieved good coverage and consequent ly considerabLe reduct ion ln thedensl ty of the t rdo vectors occurred under DDT house spraying, and nalar ia t ranstr iss iondecreased. Fur ther observat lons were carr ied out at the unsprayed v l l lage of Lalu Kichi ,Lahore d is t r lc t , in May 1962, us ing in let t raps. 0n1y sna11 nurnbers rdere captured: 33feroales and one rnale cul ic l fac ies. 0f the feroaLes, 667" were F, 277" HG and 7Z G. Over 802of the freshly fed enffiff iGn 2300 and 0300 h.
To f ind a sul table technlque to establ ish man-vector contact , Akiyana (1973) t r iedbai ted net t raps 1n conpar ison wl th d l rect bal t capture dur lng August-Septenber 1967. Thetr la l was carr led out ln the hanlet of Dera Rohiwala, Sheikhupura d is t r lc t , which was underthe consolidatlon phase of the natlonal rnalaria eradlcatlon programme. The area wassprayed wl th DDT dur lng 196l-1965, and no spraylng was carr led out subsequent ly . DeraRohlwala ls an lso lated hanlet consis t lng of three stables constructed of nud br lcks wl ththatched roofs. The harnlet ls sLcuated at about 1.5 ko f ron the neareat v i l lage. Thedensl ty of cu l lc l fa_cles 1n th ls area 16 unusual ly h igh (1176/roon In August and 343/roon lnSeptenber). About 40 buffaloes and cattle were kept ln the conpound encloslng thebuilding, which was guarded by two or three nen who slept outdoors ln the conpound. Soneof the anlnals were kept indoors but the ruajorlty spent the night ln the open wlthin theconpound. The nets were of two s lzes: one neaaur lng 1.9 n long x I rn wlde x 1.7 n h igh,and the other 2.4 o long x 3 rn wlde x 2.2 n h igh. They were set up wi th a gap between theground and the botton edge of the net. One or tno nen were used as bait ln each net, andnosqui tos were col lected every two hours f ron 2000 h to 0500 h. For compar lson, d l rectnan-bai t capture was carr led out for hal f an hour ln each hour f ron 2f00 h to 0500 h. Aspeople ln the area s lept outdoors at th ls t loe of year , a l1 b l t lng catches were madeoutdoors ln the compound. Very few noequitos and no culicifacles_ nere collecced bynan-bait capture, but ruan/balted nets collected nany hyrcanus a.l., puLcherrirous and a fewannularls and .#tus. DaEa for sg!!g!!g!g were aa follows:
Man-balted netAueuF--pteuber
(5 t rap n ights) (4 t rap n lghts)
Dlrect roan-balt calguepEeppeg
(5 bal t n lghts)
UF 20r50HG 23c2Male 23
00000
7l 4I05
The data of the balted nets ahowed that males, HG and G fenales as well as freshly fedfenales were trapped. Analyeie of 78 bloodneal aneara prepared frorn freshly fedgullclfacles aa well as 14 ItG contalnlng a snall aoount of blood frorn the net traps, showedffi- i lh-ey were all posltlve for bovld. It 16 obvlous, therefore, that the nan-balced netswere not eanpllng the man bitlng fractlon of the nosqulto populatlon. The presence ofthree stables ae dlurnal lndoor restlng ehelters at the hanlet, and the presence of largenuobers of anlnal hosts 1n the surrounding conpound created a nocturnal concentratlon sitefor mosqultos. It would appear that the nets formed obetructlon sltes of differentcategorles of the nosquito population: tho6e leavlng the indoor shelters for ovi.position,swarnlng and natlng, those approachlng the bulldlngs ln search of a restlng site, and thoseattracted to anlnals ln the compound. Entry lnto the nets !ras, therefore, accldental andnot connected with the attractlon of the ba1t. Hence, the trapped noegultos nere not asarople of those attracted to Dan, but a sanple of the general night-tine oosquitopopulatlon circulatLng ln the compound. Thls was supported by the fact that in August atota l o f four cul lc i fac les ( two f reshly fed, one hal f -grav id and one nale) , f lvep u 1 c h e r r 1 m u s ' @ s . 1 . w e r ! c o 1 1 e c t e d b y n o n - b a 1 t e d n e t t r a P s . I n S e p t e n b e r ,collectlons by non-balted nets gave further eupporting evldence as four cullclfacles (oneUF, two freshly fed and one I tG), 38 lgl*glgrs, l fO @. s.1., one.g!g!g!gg'and two
vBc /90 .3MAr/90.3Page 1 15
annular ls were col lected. On the other hand, man-bal t capture fa l led to colLectgul,lclfactes, but ylelded 16 hyrcanus s.1. and 10 pulcherrl.nus 1n 5 balt nighce lnSeptenber. To conclude, the iuthor polnted out th;I-balted nets have provlded nuch usefullnfornatlon on hoat preference of nany nosqulto species ln nany areaa of the world, but thepresent exper lence l l lust rates the caut lon that roust be.exerc lsed in in terpret ing thereeul ts and the lnpor tance of conduct ing t r la ls pr lor to thel r adopt lon as sanpl lng tools .
[The author provlded convlnclng evidence that the baited nets were not sanpllng theoan b l t lng f ract lon of the cul ic l fac les populat lon, but d ld not at tempt, to expla ln whydlrect nan-balt capture ate6-ffi8-Io-attract any nan-bltlng indlviduals of ttrts
"p""1"".I t 1e poeelb le that the persons used ln th is t ra l l whether ln bal ted nets or d l rect capturecould not compete wlth concentratlon sltes created by the large nunber of anlnals and,/orthe loca1 guards ln the sane conpound. Ilowever, thls anorualous sltuation would deservefur ther observat lons] .
Relsen, Aslankhan & Naqvt (1976) observed the restlng hablts and ovarlan developnentof soroe cornnon PunJab nosqultos, especlally cullclfacles, stephensl and StrLtaenlorhynchue whlch were under extenslve lnvesttgation-for planni.ng genetfc control.Indoor and outdoor restlng collectlons nere oade durlng August 1975 at Ghulau Mohanmadcat t le shed and i ts envl rons 'at Sat tok l . , Lahore d let r ic t , PunJab, Paklstan and a lso atanother cattle shed on the eastern edge of Kasur, Lahore dletrlct. Indoor restlngcollectlons were nade by two collectors ueing mouth aepirators for a epeclfied peilod, andoutdoor collectlona were aleo nade by two collectors, but uel.ng CDC nlnl-sweepers durlngrhe saDe perlod. Theee outdoor collectlona were less quantltatlve than the indoorscollectlona a6 more tlme was spent in searchlng for eultabLe restlng eltes. The resultsfor anophellnes showed that cullclfglgg, stephensi and eubplctus were almoot conpletelyendophlllc and were rarely tffi;-ilffiE oiEI?iF-, agreeffiEI-prevlous observartonsrePorted by other authors ln Paklstan and.India. Apparently, eullclfacles and eubpictusrest indoors before natlng ae 16/23 and 4/9 unfed fenales, reslEffiy rdere norlneenl'nated. An. annularls appeared to rest both lndoors and outdoors, although the degreeof -exophIly nafrEffioia[y (crtrng unpubllshed observations by Aeiankhan d netsen)lMales of thls specl.ee were rarely taken lndoors during the perlod Lf
"t.rdy, indlcating ihat
they reoalned exophll lc. An. pulchgrrinus seened to be exophlltc. (.Infornatlon on theovarlan developnent is ehorm under {.T0 Uelow).
Releen et a l . (1976) pursued observat lons at Sat tok i dur lng la te suurner 1975 toprovide the background lnfornatlon neceasary for the etudy of nosquito populatlon dynanlcsand to plan genetlc control experlmente ln Paklstan. The nethode used were:
- Buffalo blttng catches: These were carrled out by two collectors for 15 ninutesevery hour frou 1800 to 0600 h. Collectlona were contlnuous durlng the evenlng and nornlngcrepuscular perlode 1800-1930 h and 0500-0600 h, reepectlvely. The tlne of the flrst andlaet nosqul to b l thg was a leo recorded.
- I luman bitlng catchee: Concurrently wlth the buffalo bit lng catchee, one collectoratteEPted to capture ooequitos coolng to blte hls bare legs while seated outdoors.
- Indoor restlng collectlons: These were all nade ln Ghulan Mohannad cattle shed,whlch wae 16 x 5.5 n wlth a roof about 1.5 o htgh at the eaves and 2.3 n at the apex. Theshed had 9 wlndows, 2 doors and a straw roof covered wlth clay nud. Straw proJectlngdownwards fron the roof provlded the prlnclpal restlng eltee for endophll lc specLes.DoDeet lc anloale, nauely, 1.2 cat t le , 1 l buf fa loes, l0 goatsr 2 donkeys, I horee and anuober of cats and doge occupl.ed the ehed. Four nen were also avallable ln addltion topereonnel who took part ln the observatlone. Durlng the hot aunmer months, all hoetsremaLned outelde both day and nlght. Two collectore asplrated adult rooequltos restlnglnside the cattle shed for 15 nlnutes each hour fron 1800 h through O7O0 h. Durlng thepreceilng week on aeparate daye, endophll lc noequltos were aeplraied for l/2 hour it 0900,1200' 1500 and 1800 h. Counts were standardized to glve a mean nunber of nosqultoe/I5ml.nutea.
- Outdoor resting roosquitos: Conconltant wlth the lndoor restlng collections, tnocollectore qualltatlvely searched for exophll lc epecl.es uslng two CDC mlnl-sweepere. Thehabltats whlch appeared nost suttable were thoroughly searched.
vBc/ 90 . 3MAL /90 .3Page 1 16
Seventeen species of rnosqul tos were col lected: 4 Aedes sPP., 7 !g!g spp. tMansonia uni forn is , and f ive anophel ine spp. 0n1y the resul ts of anophel ine species are
, stephensi and .g!g!ggg9 were considered truly endophll icspecies col le-Cted rest ing in the cat t le shed. An. annular is and Pulcherr inus were taken in1ow numbers rest ing lndoors, whiJ.e nales of the two species were a lmost never found rest lngindoors. Both these species apparent ly become endophi l ic dur ing autunnr as greater numbershave been found rest ing ins ide the shed dur ing November-Decernber (c l t ing unpubl ished.observations by Aslankhan and Reisen). An. culicifacles and gglPllgg were the mostabundant endophl l ic specles and were rare ly found rest ing on vegetat ion. The h lghestnumbers of the three t ru ly endophi l ic specles were col lected rest ing lndoors dur ingdayl lght hours. Most of the populat lons of these species moved outdoors dur lng dusk tofeed or ov iposi t , and lhose remaln ing lnelde the shed were most ly those lndlv iduals whoseovar les were in the in terroedlate stage of developnent . Throughout the n lght , f reshly fed,and to a lesser extent unfed feroales were readl ly co l lected rest lng on the outs lde wal lsand eaves of the cat t le shed. These lndiv iduals remalned outs ide unt l1 darn, when theywere observed enter ing through both windows and doors. No nosqul tos l tere col lected b i t lng!0an thfoughouE this study even though several inportant Vectors of hunan dlsease werep reva len t (e . s . . cu l i c l f ac les . Cx . t r l t aen io rhynchus and M. un i f o rn i s ) . Theee spec les we reregarded by otherTE6G-aE-typEalfy z-o-Fhll ic and thus cattle blt lng collectlonsprovided the sole index for b i t ing act lv i t les. [ I t rnay be that the so] . i tary col lector usedln the predent s tudy d ld not create a suf f ic ient concentrat lon s l te to at t ract the nanbl t lng f ract lon of the cul lc i fac les populat lon, othent ise i t ls quer led how th ls specleshas been regarded as the Daln \rector transnltt ing malarla in Punjab. A oore thoroughlnvest igat lon should be conducted to c lar l fy thLs anonalous s l tuat lon. In fact in a la terstudy, d l rect nan-bai t capture succeeded ln establ lsh lng the degree of man-vector contactln Kasur d ls t r lc t - 6ee Mahnood & Macdonald, 1985 belowl . .
Reisen & Aslankhan ( f97S) noted that the above ment loned observat lons on the d ie lact lv l ty pat terns of rnosqul tos at Sat tok l were carr led out dur ing August 1975, a t ine whenmost rDosquito specles lrere abundant. Subsequent routine evenlng bltlng collectlonslndicated that there nas a seasonal variatlon in both the abundance of the crepuscularspecles and the t lne of b l t lng of the la te-n lght specles. Thus, they carr ied out a ser lesof observatLons by all-night blt lng collectlons at the same cattle shed durlngJanuary-Decenber 1976. Enphasls was placed on the tiroe of nocturnal activity rather thanpopulation dynanlcs which w111 be dealt with roore extenslvely ln a further PaPer.All jnight anlnal bit lng catches were carrled out nonthly on evenlngs havlng falr weathercondltlons. The catches were started when il luninatlon had decreased to about 2000 lxr by2-5 experlenced collectors searching for nosqultos corolng to feed on cattle and buffaloes
tethered at their feedlng troughs. More collectora were employed durlng the wlnter andpre-monsoon seasons as the density becaue low. The first nosqulto collected was asplratedinto a separate carton, and the tine of its capture recorded. Subsequently, mosqultos were
asplrated in to car tons for 15 o lnutes each hour and kept seParate by t lne and col lector .Collectlons at dusk and dawn were nade contlnuously for 1.5-2 hours wl.th cartons being
changed every 15 uinutes. Usually, the last nosquito was also.kePt seParate and the tlne
recorded. However, on several occaslons thle nosqulto was mlxed ln wlth the rest of the
collectlon and thus not ldentlf led. A total of l8 873 ooequltos cornprlslng 18 specles ln
f o u r g e n e r a l ' a s c o ] - 1 e c t e d . C " . t ' t l @ ' r ' a a m o s t a b u n d a n t ( 4 7 . 3 z o f t h e t o t a 1c o 1 1 e c t e d ) , f o 1 1 o w e d b y p u t c @ t a r t s ( 1 3 . 6 z ) ' . s g l : g 1 g a c 1 e 6 ( 9 . 2 Z ) ' a n dt h e r e n a 1 n i n g l 4 s p e c r ' e s - ? f f m - g r s . L Z o f t h e s p e c i o e a ? c o 1 1 e c t e a f f i b e t h e b 1 t 1 n grhythns, the authors dlvlded the nlght lnto flve segEents: I = dusk to 2030 h; 2 - 2100 to
2200 h; 3 = 2300 to 0100 h; ( = 0200 to 0330 h; 5 = 0330 to dawn. The resul ts of
anophellnes rrere as followe:
- cullclfacies: Thls inportant malaria vector nas extrerely abundant throughout most of
lg7f,;-G;Tfiafig winrer Eonrhs, and exhlblted narked varlatlons ln lts bitlng tlnes
throughout the year. Durlng January-March and Novenber-Deeeuber, Eost bit ing occurred
o u t d o o r s d u r i n g t h e f 1 r s t 8 e g D e n t o f t h e n l g h t , a n d s @ w a s a E o n g s t t h e f 1 r s trnosqul tos col lected. Dur lng Apr l l -May and Septenberdctoberr-Dost b l t lng shl f ted to
segments 2 and 3, while during mld-sunmer (June-August) bittng ltas esaentlally arhythnLc'
wi th s tat ls t lca l ly equal numbers col lected throughout the n lght . The authors consldered
that thls """"or,. i
varlabil lty in bit lng tines was undoubtedly responslble for the
confllctlng reports in the l iterature, clt lng varlous authors ln Paklstan and India. In
the present study, all components of the bltlng curve were retalned throughout the yeart
although varylng in nagnttude. Thus, durlng January-}tarch and Noverober-Decenber, Lthen loost
vBcl90.3MAL/90.3Page I 17
bltlng occurred outdoors durlng or Just after dusk when 'cattle were outslde, a few
lndiv iduals were st l1 l co l lected feedlng on buf fa loes lns lde the cat t le shed late at
nlght. Conversely, during the remainder of the year when nost feDales fed frou 2100 to0400 h a few specinens were conslstently taken at dusk and dawn. The seasonal shift inbehaviour wa6 not entlrely nediated by the rooving of potentlal hosts lndoors, becauee inMarch the crepuscular peak predololnated, although all the hosts remalned outdoorsthroughout the night. A sinllar behavloural shift ln the tlne of swarming and nating ofcul lc i fac ies r ras a lso negat ive ly corre lated wl th tenperature (c l t ing Relsenr Aslan &ffieiqffi77 - see under 4.3 above)
stephensl : Thls species fed nost ly before ntdnlght , belng narkedly crepuscular dur lngperiodd-oE-T67aobient tenperatures. The authors found that thelr results durlng thenarner months agreed wlth those of Eshghy & Janbakhsh (f977 - see above) ln southern lran.
They a lso lndlcated that thel r data of Sat tok l agreed wel l wl th thel r unpubl lehedobservat lons on the b l t lng t lnes of s tephensi ln Karachi , S lnd provlnce, l .n wlnter . As lnthe case of cullclfacies, the crepuecular and late-nlght conponents of the blting curves ofstephensl. weffiffithroughout the year exqept ln January and February.
In thei r d lscuseion, the authors c lass i f led noegui to specles ln to grouPs accordlng tothe shape of the blting curves. The anophellne specles fell wlthln the followlng grouPs:
(a) unlnodal : pulcherr lnus, and usual ly cu l lc l fac les 8nd.@.! .(b) nostly blnodal. wlth- peak uaually early ln the evenlng but occaelonally wlth a
sIlght lncreaee durlng the fourth or f lfth segDent of the nlght: annularls and glgp!1i$.(c) blnodal wlth a predonlnant peak ln the evening and a well deflned pre-dawn or
dawn peak: certaln Aedes and Culex specLes and perhaps g!P!g!g.(d) occasLoni-ly nultf i6Ail or arythnlc cullctfacies, stephensl and subpictus.
T h e d e g r e e o f s e a s o n a 1 c h a n g e 1 n b 1 t 1 n g v a r 1 e d w 1 t h d 1 f f e r e n t 8 P e c i e 6 ; g f @ ,stephensi and to a lesser extent gubplctus exhlb l ted the greateat aeaaonal sht f ts ln b l t lngEfiff i ir lng waro weather, ttresealec-terwere typlcally late-nlght feedere' but theybecame crepuscular feeders durlng the colder nonths. The flrst two specles and to a lesserextent subplctus oalntalned the early- and late-nlght blt lng components of the bltlng curveln vary6lGliftude throughout the year. Durlng the cold perlod, when Eost fenales fed at
dusk, a few were collected late at nlght blt lng cattle indoore, and durlng the ltaro Perlod'when oost fenales fed late at nlght, a few were collected Just before or during dawn.AssurnLng a strlngent genetlc basis for' lneect behavlour, the authors oade epeculatlveexplanatlons for the aeasonal shlft ln feedlng tftnes observed wlth endophll lc anophellnes.Thls nay lnclude teroporal changes ln the relatlve frequencles of two tenPerature-relatedgenones. Lltt le lnfornation ls avallable on the genetlcs of nosqulto blt lng behavlour or
actlvlty rhythns. It has been shown that endophll lc anophellnes exhlblted seasonal'
varlatlon ln tfune of oaximum blting actlvlty and other phenomena such as swarnlng and
nat lng. Thls var labl l l ty .nere moat l lke ly assoclated wt th genet lc d i f ferences ln the
surlDer and cold-tolerant winter populatlone. Further research ls needed to deterrolne lf
other behavl.oural, physlologlcal or oorphologlcal varlants can be aesoclated wlth
cold-tolerant genoDes.
Relsen & Mahnood (1981) underllned the loportance of naklng accurate and preclse
estiDates of the frequency of nan-vector contact aE an essential comPonent ln
epldeulologlcal studles. Man-balt capture provldes a dlrect estluate whlch seems
satlsfactoiy when balts are representatlve of the entlre sleeplng populatlon and the vector
ls largely anthropophll lc. Itowever, these dlrect nethods are dlff icult to 8PP1y in rural
a r e a a o f P a k 1 s t a n w h e r e t h e o a 1 n v e c t o r o f o a l a r 1 a , @ a n d . @ l a r e 1 a r g e 1 yzoophll lc (clt lng Relsen & Borehau, 1979), feed throughout the night durlng the
transnlsslon season (clt lng Relsen & Aslankhan, 1978) and soclal custons prevent the
util lzatlon of certaln sex and/ot age-gtoup as balt. Attenpts to use lndlrect nethods such
as baited nets falled ln rural areaa of Pakistan, where vtl lagers sLeep near thelr
l lveetock, becauee nany bovld-fed fenales entered the net (clt lng Aklyaoa' 1973).
Recently, an indlrect estloatlon procedure conbinlng caPture-nark-releaee-recaPture uethods
and preciplt ln analysls of bloodueals was applled leadlng to che calculatlon of the
vectorial capaclty. l lowever, thls procedure was laborloue and would be dlff lcult to aPply
ln rural or perl-urban conounltiee large enough to study oalaria transmLeslon.
vBc/90.3l.{AL/ 90 . 3Page l l 8
Al ternat ive ly , the nethod of renoval sarnpl ing was found usefu l in est imat ing the numbers ofCx. quinquefasclatus rest ing in houses in a large town in India (c i t ing Yasuno, Rajagopalan& Russe11 ,1977 ) . I t was p roposed to es t i na te t o ta l popu la t i on s i ze i n t he cown by samp l i nga representat ive number of houses, est imat ing the s ize of the rest ing populat ion in eachhouse by renoval sanpl ing, and then extrapolat ing the f ind ings to the tota l number ofhouses in the town. ConsiderLng the d i f f icu l ty of conduct ing roark-re lease-recapture lnurban or per l -urban s l tuat ions, the removal sanapl lng approach seemed reasonable. Theproport lon of the fenales b l t ing on any g iven n ight could be est inated f rom the durat ion ofthe gonotrophlc cycle and the proportion feeding on rnan could be estinated fron arepresentat lve subsarople of the f reshly fed fenales, whi le the s ize of the huoan populat ionand the nunber of houses would be avai lable f ron census data. Thus, Reisen & Mahnood (1oc.c i t . ) carr led out a s tudy wi th the fo l lowing object ives:
(a) to ver i fy the appl icabi l l ty of renoval sanpl ing roethod to the rura l condi t ionsin Punjab provlnce, where culicifacles and .gplgl are the vectors;(b) to re late the resul ts of concurrent mark-re lease-recapture est inates; and(c) to develop a nodel for re lat ing the re lat ive abundance est lnates to populat ions i z e .
A11 collectlons were made at cattle sheds in or near the vll lages of Khano-Harni, KotBaghlcha, Punjab provlnce dur ing the spr lng and pre-nonsoon seasons of 1980. These studysi tes have been rout inely sanpled for the past 4-5 years to Dont tor tenporal changes lnanophellne relatlve abundance as Deasured by hand capture. For renoval sanpllng, tnocol lectors sanpled adul t anophel ines rest lng lns lde cat t le sheds for 5-o lnute ln tervals .Col lect lons r rere cont inued unt l l the nunbers col lected ln each sarople narkedly decreasedrelative to the nunber lnlt lally sanpled. The nunber of sanpling intervals was thusre lated to:
- the size of the shed;- the d lspers lon pat tern of the reot ing nosqul tos; and- the abi l l ty of the col lectors to locate the rest ing nosqul tos.
For mark-release-recapture, a total ofreared cul lc i fac ies and 1278 fenales and 1273
1784 fernales and 1532 nales of laboratory
f luorescent dusts and re leased on 30 Apr l l , 3Khano-Harnl. The reeults as abstracted by thethe orlglnal paper should be consulted.
trlnterrelatlonshlps among removaL sanpling and oark-release-recapture estlnates ofabsolute populat lon s lze were studled at rura l v l l lages ln PunJab Provlnce, Paklstan dur ingthe sprlug and prenonsoon seasons of 1980, and a nodel generated relatlng hand-catchrelatl.ve abundance to absolute populatlon slze. Removal sanpllng was found to serlouslyunderestlnate knowa numbers of narked adults released ln 3 cattle shed restlng sltes whllethe nark-releage-recapture nethod uslng the sinple Llncoln lndex did not dlfferslgnlficantly. A regreselon fornula nas generated to correct removal estimates to theactual numbers present and was used to estimate the slze of 32 populatlons ln rural PunJabProvlnce. Statlstlcally acceptable estlnates were related to hand-catch relative abundance(nunbere of uoaquitoes Douth-aeplrated by 2 collectors tn 15 nin) by l inear regresslon andprovlded resulte conparable to capture-oark-release-recapture estimates at a series of 7conpounds and accurately estfunated the nunbers of narked adults released ln 3 cattlesheds. The relatlve abundance oethod was coneldered sultable to estlmate nosquitopopulatlon slze ln rural PunJabt vll lagee, fron whlch Dan-vector contact ratea could becalculated. rl
Drof
males of stephensl were marked withMay and I June respect ive ly lns lde sheds at
authors are quoted belowt, but for deta i ls
I. quoted by pennlssl.on ofAssoclatlon fron the paper
I{.K. Reisen and the Journal of the @Releen & Mahrnood (1981-
vBc/90.3l.{aLlgo.3Page 119
In thelr etudy of the ecology of nalaria vectors and the vectorial capaclty ofAn. cu l lc l fac les specl .es A ln four v l l lages ln Kasur d is t r lc t , PunJab, Paklstan, Mahnood &fri iaii lEIZ"TTTEf- see under 4.5 above) eucceeafully establtshed the degree of man-vectorcontact through dlrect roan-balt capture. In each viJ.1age, all-night roan-bait-caPEures were
condueted nonthly fron Aprll, and buffalo bit lng catches ltere organlzed fron Uay toDecenber 1984. Four technlclans aspirated aJ-1 nosqultos landing on four hunan baitsthroughout the n lght . The s i te of co l lect lon depended on the s leeplng habl ts ot thepeople. Dur lng March-Apr i l , the habl ts were mlxed, wl th sone people s leeplng lndoors andothers outdoore. From late Apr1l to October, a l1 people s lept ouEdoors excePt dur ingperlode of raln. Durlng Novenber-December, they uoved lndoors. On the earne nlghts as thenan-bal t capture, one technlc ian col lected uoequl tos b i t lng a tethered buf fa lo.ColLectlons at dusk and dawn were contlnuous. Between dusk and dawn collections were madefor 30 nin every hour. An. cullclfacles was the nost predoml.nant anophellne oPecles lnhunan bitlng collectlons, feeding on rnan nost frequently ln Aprll, August and Novenber whenthe maxtmuu man bl t lng rates nere recorded: 10.3, 4.6 and 12.4 bt tes, / roan/n ight ,reepectlvely. Ln two of the four study vil lages, the Aprl1 nan-balt caPtures ltereconducted lndoors because of raln. The two lndoor collecElons gave a man bttlng rate of19.6/man/n1ght for cul.lclfacles, whereas the rate for cullclfaclee ln the outdoorc o 1 1 e c t 1 o n 6 a t t h e ; f f i ; f f i i 1 a g " s w a s o n 1 y o . r 3 / n a @ b 1 t n a nlnfrequently and no S!g!g! was caught btttng rlan except ln October and Noverober 1984( Gl/nan/nlght ln each of the two nonths). Buffalo-batt catches conducted concurrentlywlth nan-balt capture lndlcated that culiclfacles, g!ephen6,1 and glpjgg lrere extrernelyzoophll lc. The ratlo of buffalo feede to hunan feeds nas greater for ggltlggg! andstephensl than for cu l lc l fac les (eee a lso the resul ts of prec lp i t ln tests carr led out lnffiy under 4.9GIA;F-
Fol lowlng the study of Relsen & Ml lby (1986 - see 4.5 above), Relsen (1986) fur therreported on the lnpact of resl.dual house epraylng ln Pakietan. The observaElons were notspeclflcally deslgned to evaluate the nalarla control operatlons, as they were part of aprograltl le of studylng the dynanlcs of anophellne populatlons ln PunJab provlnce. Yet'continuoue populatlon nonltorlng ytetded lnfornatlon that enabled the aesessnent of thqlnpact of lneectlclde spraylng ln the study area of Sattokl and Kot Baghlcha Slngh Wallavll lagee ln Kasur dlstrlct, and Khano llarnl vlJ.lage, Lahore dletrlct. These vll lages weresprayed by the Malarla ControlrProgranme of Pakletan: Sattokl and Khano-Ilarnl eprayed wlthnalathlon 8t a Cosage of I glm', and Kot Baghlcha with fenttrothlon (Suulthlon) at adosage of L g/m'. Overall coverage was good and spray depoelts were readlJ.y vislble'on Eost oud-walled houses aud cattle shede. Mosqultos were collected weekly or blweeklyuslng the three methode (J.ndoor, outdoor and buffalo blt ing catches) descrlbed by Relsen &Ml lby ( f986 - see above). ALl . co l lect lona were nade for epeci f led t lne per lods ' and thedata converted to fenale per nan-hour lndex, transforoed to ln(y + l) and averaged bymonth. Data obtalned were back-traneforoed to geonetric mean (WlJ.l lans, 1947, i-). lDataof Khano-Harnl, Sattokl and Kot Baghlcha nere presented graphlcally as shown ln Ftgs' 15'16 and 17, respect lve ly . The resul t ,s showed:
- Khano-Itarnl: Thle vll lage was sprayed durlng the weeks of 28 July and 9 Septenber1976. Subsequently, lndoor restlng collectlons showed that anophellne fauna dlsappearedfrom houees and cat t le ehede ae shown ln F lg. 15. Nevertheless, 6ome specles pers is ted lnthe vll lage durlng the post-spraylng period, as indlcated by bovid-balt capture durlngAuguet and Septenber 1976 (k.. fenales/Ban-hour of 8 collectlons: annularls - 6,2,nlierrlnus - i3, pulcherrfuquH - 12.6). In cootraet, ullclfacies]Ei1Esl and g}.;1!i!g1sere not collected by bovid-bait catchee. The recovery rate of lndoor restlng densitieswas varlable aoong speclee. The abundance of annularis and lgfg$iggg lndoors reachedlts pre-spraylng leveLs by Noverober L976, f lve to slx weeks post-sPraying as ehonn lnFlg. f5(A) and (C). In contrast , cu l lc l . fac les contro l lasted longer than ant lc ipated ' andt h - p r e - s p r a y 1 n g d e n s 1 t y 1 e v e 1 w a s - i f f i d u n t 1 1 t h e n o n s o o n a e a s o n o f 1 9 7 8 , 2 6 n o n t h spost:spraying as shown ln Fig. l5(B). The recovery of gtephensl nae oore rapld thancullclfacjles, although pre-spraylng leve1 nas not reached untl1 the pre-monsoon aeason1978r2c nonttrs post-spraylng as shown ln Flg. l5(D). Long-tero numerlcal euppresslon
o fof
i:Tep'roduceffiy pernlss ionParasltology fron the paper
Dr l{.K. Reisen and Annals of Troplcal Medicine andRe iseu ( f 986 ) .
ofo f
vBc /90 .3! rAL/90.3Page 120
cul ic i fac ies and s.gs3$si was at t r ibuted to the ef fect of contro l , s ince the densi ty offf i l f i ff iTons oFlTFTwo- species at Sattoki, 16 krn to the south renained high durlng thepre-spraying per iod of that v i l lage f rom January L976 to June f977 (Fig. f6) . InKhano-Harni , $9pi tu was e l i ro inated dur ing L976, but ' re turned dur ing the monsoon seasonof . L977 as shown in F ig. l5(E) . I t has been shown above (Reisen & Mi lby, 1986) thatsubpictus d lsappears f ron Punjab dur ing January-June and reappears annual ly wi th the onsetoE rhe monsoon. Further, Khano-I{arni was sprayed for Lhe third tlne durlng the week'of2 l August 1979. Coverage was re lat ive ly focal due t 'o 1oca1 d l f f tcu l t ies prohib i t lng thespraying of s t ructures conta in lng e i ther aninals or ' food Products. Neverthelessr goodcontrol of cullcifacies and lgll j lglg was achieved. Recovery of annularls density wasrapid., u,rt !fr iEEl-at-a low--lEiEfrhan had been observed during the winter of L978-L979,whlle stepheJrsi and !g!g@!g were not affected by the spraying.
- Sat tok i : This v l l lage vras sprayed wi th nalath ion on 13 June and 24 July 1977.Coverage of the col lect ion s i tes was good, but sone cat t le sheds wi th ln a radlus of oneki lonetre were not sprayed. Contro l of cu l ic l fac ies was good but was of shor ter durat ionthan at Khano-Harni as shown 1n Fig. 16. Suppresslon of g!g@.! Itas consldered mlnlual,and post-spraylng densities were wlthln the range of pre-spraylng levels.
- Kot Baghlcha: The spraying of fenltrothlon decreased culiclfacies and g!93$.!densltles for a perlod of seven to elght rnonths as sholtn rn rTll. i7fE reco@6T-culiclfacies at Kot Baghicha was r0ore rapld, but the pre-epraylng 1evels of abundance were;" t ; f f i unt i l the fo l lowlng spr lng
In h ls d iscussion, Reise.r - r ( loc.c l t . ) deduced that d l f ferences in d lurnal re6t ingbehavtour lnfluenced the duratlon of anophellne control by resldual lndoor spraylng.A t t h o u g h o c c a s l o n a 1 1 y c o 1 1 e c t e d l . n a r t 1 f l c 1 a 1 o u t d o o r r e s t i n g s h e 1 t e r s , g @ ,stephensl , and.9g!g!g. were consldered essent la l ly endophi l lc (c l t lng Relsen, 1978 andG i s e n e u t t u y , - 9 8 6 - s e e u n d e r 4 . 5 a b o v e ) . o n t h e o t h e r h a n d , a n n u l a r 1 s a n d ! @fenales rest lndoors ln conJunct lon wl th b l t lng act iv i t ies, but large nurobers of thel rfemales and rnales could be collected by nechanlcal sweepers among vegetatlon. The twospecles r rere, therefore, c lassLf led as par t la l ly exophl l lc . I louse spraylng was found toel in inate the endophl l lc specles for long per lods, whi le par t ia l ly exophl l ic and exophl l lcspecies lcere col lected b l t lng hosts ln the v i l lage area, and they recovered to Pre-sPrayingdensi ty shor t ly af ter the lnsect lc lde ef fect iveness decl ined. Posslb le explanat lons fort h e d e 1 a y e d p o s t - s p r a y 1 n g r e p o p u 1 a t 1 o n o f t h e s t u d y a r e a s u y g g f @ 8 n d @ . !erere proposed by the author as follows:
(a) reduced specles d ispers lveneas and/or the geographlcal lso lat lon of the studyareaa prevented founders frorn enterlng the study eltes;
(b) the ef f lcacy of the res ldual ef fect lveness of the lneect lc ide t raa long last ing;(c) undercrondlng ef fects prevented populat lon re-eatabl lshnent despl te the
repetlt lve lmigratlon of dlspersed lndivlduals.
The author d lscussed each of these posslb l l l t les as shown'below.
I{hlle nalathlon spraylng elloinated culiclfacles and [email protected] at Khano-Harnl ,abundant populatlons of the two specles persleted atTattokl. Addltlonal vil lages and
surrounding cattle shed compounds were lnterspereed between these two study vll lages, but
were not sanpled for moequltos. Besldes shlch Bone cattle ehed coupounds sltuated near the
sprayed indoor capture statl.on at Sattokl were left uneprayed durtng L977-L978. Thus,
neither study area naa consldered geographically lsolated froo abundant sources of
culiclfacies and slephens,l. The two specles were shown at Sattokl and Kot Baghicha to
ei6per"" rore thai-Tffi-durlng their l l fetiroe (clt ing Relsen & Aslankhan, 1979; Relsen,
Mahnood & Azra, I98f - see under 4.4 above). Thus, the delayed repopulatlon of sprayed
areas could not be attrlbuted to reduced dlsperslvenesa nor to the relative geographlcal
lso lat lon of the study areaa, especLal ly as founders were col lected repeatedly at both,
sltes. Regardlng the resldual effect of oalathlon, it has bsen shown elsewhere that the
lnagocldal propert les of th ls lnsect lc lde deter lorates rapld ly on mud sur faces. Bioassay
tests on malath ion sprayed mud sur faces in Punjab a lso lndicated shor t - term ef f lcacy(c l t lng unpubl lshed data by M. Aslnakhan & S.D. Perez, Paklstan Medlcal Research Centre
Annual Reports). Although bioassay test6 nere not carrled out ln the present studyt
indlcatlons of the rate of decl.ine ln oalathlon effectiveness came from the observatlon of
Ftg. 15. Relatlve abundance (i- fenales/Dan-hour/nonth) of f lve
" tofh" l l t " mosquJ. toes col lected iest lng lns lde houees and cat t le
Khano-Ilarnl, Lahore Dlstrlct, PunJab provLnce, from January 1976(A) annularis; (s) g!!g! '1[ac:!g; (C) Pulcherrlnus;.(o) :*gEPl;M lndlCates the nonths when the vll lage nas sPrayed wlth z g m -
vBc/90.3UAL/90.3Page 121
speciee ofsheds atto June 1980.
(E ) subp l c tue .of nalathlon.
r978 r979
t
IIcoEagoEI
the rapld repopulatlon of the 6tudy sltee by the partlally exophll lc epeclee:-annularie and
pulchelrlnue lrhlch renained susceptlble to nalathlon (clttng Rathor, Toqlr & Relsen'*f f i ' 6 , r m = f r r e g a r d t o t h e t h 1 r d p o e s l b 1 1 1 t Y , 9 ! @ 8 n d @ 1 f e n a 1 e s a n dlmnarure srages were collecged repearedly rn tfiiTfiGFfri-int arEil[iffi the Post-spraylng
perlod. These founders, however, falled to becooe sell establlshed' Apparently, a-
crlt ical nunber of lndlviduals was necessary to lnlt late rapld populatlon growth and
recovery. Failure to exceed thi-s threshold denslty reeulted 1n undercrowdlng probleos'
ooet lt lely related to nate locatlon. Once the threshold level wae exceeded ln 1978'
cullcifacils, and to a leseer extent sgselrer.rsl, populatlone increaeed rapldly and then
renalned relatlvely constant, wtth ntiiffiT-nporal changee ln denslty levels' The
dlecussion was extended to the reactlon of stephensl to nalathLon. Khano-ltarnl recelved
two rouuds of nalathlon in lg76 and one rouffilfr9, whlle sartokl na8 sprayed twlce
d u r 1 n g t h e 8 u E n e r o f | 9 7 7 . B o t h @ a n d 6 u b p 1 g t Y s f r o r n K h a n o - I t a r n 1 ' S a t t o k 1 a n dKot Baghlcha proved Busceprlble to iffiETo-rr-wiren te#l-Erlng the sprlng and surer of
1979 (clt lng Rathor, Toqlr & Reieen, 1980) antl both speciea were- controlled by the third
round at Khano-Itarni. In contrast, 9I@,1. collected 8t the three study areae ln
Khano-Harnt durtn! the sprLng or t izE-fficeptlble to nalathlon, but popuratlons of thle
epecles fron all iht"" study areaa durlng 1979 contalned lndlvlduale reElstant to
nalathlon. rn terns of f leld observatlons, treatment fallures occurred during the thlrd
spraying round at Khano-Harnt durlng 1979, and durlng the Post-spraylng perlod of the
rnrttat-eprayl.ng round ar sartokl. Thue, the lnpllcallone of I :""1:t::::-:"nalathlon appeared three yearar or at Doat, elx wide-acale epraylng rounds ln PunJaD
province aftlr the onset of nalathlon applicatlon by the Natlonal l ' lalaria Control Program
l n 1 9 7 5 .
vBc/90.3MAL/90.3Page L22
Fig. 16. Relative abundance (I- fenales/nan-hour/nonth) of
(A) c i l ic l factes and (B) s tephens! co l lected rest ing indoors at Sat tok i '
Kasur Dlst r lc t ' Punjab pr i f f i [ t rorn January I976 to.J : rn: f9802
M lndicates the months when the vilIage was aPrayed with z 8 m
nalathion.
to
EIcoEa.g0Er!
Flg. 17. Relatlve abundance (i- fenales/oan-hour/oonth) of(Ai cu l lc l fac lee and (B) s tephEnsl co l lected rest lng ins ide cat t le sheds
ar K;m;frmSingh WafE-, fasur Dlstrlct, PunJab province'-5.oT
January L977 to June 1980. S lndlcates the nonths when I g n - of
Sunlthlon was applled.
t9T7 t978 tgxt t980J A J O T J A J T O T J A J O T J A J
J A J O ' J A J O I J A J O I . ' A J
tgTt l97E t979 t98C'
sI
vBc/90.3MAL/90.3Page 123
4.8 Sanpl lng oosqul toe ln f l lght
Reports on thepresent geograPhlcal
In Saudl Arabia, New Jereey l lght t rape nere operated ln the Qat l f oasis (Eastern
provtnce)about twlce nonth ly t ron g o. tob.r L948-2 July 1950-by Daggy (1959) ' [The author
d1d not show the s i tes of t -he l lght t raPs, probabl 'y outdoors] ' Dur lng th ls per lod, 1613
a n o p h e 1 1 n e 8 I { e r e c o 1 1 e c ! e d , 7 g 3 l o f w h 1 c h w e r e g ! g ! 9 E L , l 6 Z € l 4 , ^ a n d 4 . 7 Zpulcherrlnus. Fron adJacent daytlne lndoor resttng sEeJters a total of 2008 speclmens were
col lecred ln whlch the proport lone of the three epecles vere 96.62r 2.32 and l .1Z '
reapectlvely. The catches of the l lght traps were sornwhat erratLc, posslbly lnfluenced by
wlni, rnoonlight and other factors. ihe largest elngle l lght traP catch occurred ln the
fa l l : f t October.1948 and 8 Novenber 1949. Var lat lone t tere too great to accurate ly
determl.ne the Eeaeonal trends of anophellne deneltLee. As the l lght EraPB gave epecles
coDpo6itlon conparable to that of lndoor restlng shelters, lt was concluded that the New
Jersey l lght trap Day have a place ln the crude eanpllng of anophellne fauna ln thls area
of Saudl Arabla.
In lran, Zain et 61. (1986) carrled out an lnvestigatlon to aasess the efflclency of
the CDC J.ight traps over a l2-nonth perlod at Chelow (Hornozgan Provlnce). Thls vllLage
llee about l l kn fron the Gulf of Ouan and about 120 krn fron Bandar Abbae, the roaln port in
eouthern lrau. In thie are8, Btephensi and gl$!!.ll.a are the toaln vector8 of oalarla,
whlle two orher vectors: snper;,iff id d-tEffi were Frgg3lt ln relatlvely low densitles'
The nean lqaxloun ana p1ntffifi-eiEturee.ffiner are 40'C and 29"C, and ln wlnter 23oC
and l3oC, respectl.vely. The relatlve huuldity ranges fron 362 to 797 and the mean
annual ralnfall Ls about 152 on. Regardlng the eeaeonal prevalence, !IS$9!91 ls actLve
throughout the year, wlth two peake: one in Aprll-May and the other, whlch le hlghert
durinl August-Septeuber. Thls epeclee le consldered endophll lc and endophaglc, although lt
readliy bttea outdoors durlng the eumrer season when people and anlnals re6t and sleep
outdoois, wlth oaxlnun Uftft! actlvlty occurrlng befoie nldnight (eee under 4.614.7
above). ln. f luviatlUe haa a shorter perlod of actlvlty throughout the year wlth two
peake: oniltftffie-and the other fron Septenber to nld-Decenber. As also ehown above,
ihte epectee feeiE Lndoors and outdoora, rests ln both houeee and outelde shelters; lts
naxluqn bltlng actlvlty aleo occurE before ntdnlght. To conpare the yield of the l lght
trapa, eeveral entonologlcal technlguea were enployed einultaneously. These rtere:
- PSC: ln 3 houeee and 3 aninal eheltere located ln dlfferent Parts of the vll lage.- Man- and anloal-balt capture: two local men were eoployed ae bal.te and etatl'oned ln
dlffereut part8 of the vll lage; one experienced fletd collector collected btttng rnoequltoe
at eech statlon. Anlnal-balt capture wae nade concurrently on a cow tethered outelde lte
ehel ter .- Plt-ehelter collectlons: four pits were dug under trees ln dlfferent Parts of the
vll lage; noegultos were collected early ln the roornLng.
Seven CDC ltght traps were utl l lzed, f lve of whtch were oPerated at f lve flxed .stetlons and the other two were rahdonly placed at different sltes as followe:
Two traps were euependedrandonly selected slte) ;
fron thatched cell lnge ln anlmal sheltere (one flxed and one
Trro traps rtere suepended fron trees ln the houee yarde (one flxed and one randonlY
use of l lght traPe for eanpllnC g!!g!!3g!g and stephensi ln the
area cone only fron Saudl-Arabla, Iran and Paklstan'
tree ln the nlddle of the vll lage (flxed statlon);cell lng ln a house occupled durlng the ntght of
ee lec ted s l t e ) ;One trap was susPended froil a
. One trap wae suspended fron aobeervat ion ( f lxed stet lon) .
Electrlctty for the l lght traPs wgs Provlded by a 5-volt 'notorcycle battery'
Sanpllng by the ltght traps and other technlques extended frou Aprll 1984 to Apr1l
f985 (26 oUseivattote). Of a total of 5487 fenale and male uoequltoe, 2848 were
anophellnea and the renalnlng were cullclaea. The anophellnee ltere: 20f6 etglhgnsl (7IZ),
715 fluvtatllls (252>,117 other species (42) (glh8+, slElgl9i' !glgEiI,I:I999,
vBc /90 .3MAL/90.3Page L24
sergenl i i , and turkg4i ) . The-highest numbers of -g lgPhensi females were obta ined f ron PSC
in ani rnal shel rers (771) and by the l ight t raPs ( f f iTf ie exophi l ic f luv lagi ] is t :T i l : "
were mostLy col lected by the l ight t t " f , " (455) . L lght t raps were a lso usefu l ln ref lect ing
rhe seasonal d is t r ibut ion ot ,gg, i 'and f luv iat i i is . - ?oal -species,showed t l to peaks: one
in April-May and the other irrTt6E-.lanul$. ' l 's-fraphical1y presented' the l ight traPs'
the indices of pSC in anirnal shelters and cow-bait captlre gave nearly coroparable seasonal
t rends for both species. The densi t les of the two specles recorded by Che three techniques
rdere extremely Iow or n i l f romrear l -y June to la te October fo l lowing the appl lcat ion of
propoxur house "p;" ; i " ; -az
g/n 'z) on 27 and 28 May 1984, coupled wi th the ef fect of h igh
suDrner teDperaEure. wl th regard to the y ie ld of the l ight EraPs, the h ighest number of
mosqui tos ( fenales and nales of s tepheni + f luv iat i l is * other anophel ines * cu l lc lnes =
1258 or 67.77. of the roral were coltff i UyTiff ifrt traPs)' Tl" numbers of^gt*Pheesl
and f luv iat i l is feroales caught f rom anlnal shelEers r " . " t " "p"ct ive1y 57.62 and 84 '4% of
rhe tora l females of the two species col lected by the 7 l ight t raPs (714 and 455'
respect ive ly) . L ight t raPs were a lso the nost usefu l technlque for faunlst lc etudies ' as
they sarnpled aII t iown anophellne species ln the sludy area' PSC and cow-bait collectlons
showed.only 6 and 5 anophel ine "p"" i " " ,
respect lve ly Lut of 8 species recorded by the l ight
traps. The t\ro anophellne", "up"tpigit " "rri
g".g"ttttt were only captured by the l lght
rraps. The proportion of tea-liolE-eTiG fenaEs wasTlghest in PSC (832)' followed by pit
shel ter co l lect ions (57.32) and l lght t rap col lect ions (5L '77, , ) ' In conclus lon ' the l lght
traps were a useful tool for sanpling steptrgngt, f lgvlaIl l l 's ?"d :: l:t anophellnee' and
compared weLl wlrh orher adult sanplln;ffinTAueffi-Effielow area especlally in
detecting exophil ic species durlng periods of iow denstty. The tlne and labour-savlng
features and flexlbll l ty for use ln dlfferent sltuaElons would nake the cDC llght traP a
useful supplenentary technlque for entonological assessnent of malarla control Prograrnmes
Ln areas ttu." stephensl .nd 51g!g!!!!9 are inportant vectors'
In Pakistan, Sulenan' Reisen & Aslankhan (1977) indlcated that no in fornat ion nas
publlshed on the use of l ight traPs excePt a few rePorts deallng roostly wlth culicines'
The authors, therefore, rePorted on a trial with New Jersey and cDC light traPs whlch were
tested concomltantly with a serles of all-night bit lng catches at-Ghulan Mohaned cattle
shed, near Sat tok i v i l lage, Kasur d is t r icg, iun3ab province (see Relsen & Aslankhan under
4.6/4.? above). The t raPs l tere oPerated throughout the n ight at nonth ly ln tervals dur lng
1976. One New Jersey l ight traP nas suspended from a tree about 2 rn frorn the ground and
25 q east of the cattle "t"d,
and two COb ffgUt traPs nere susPended froro lhe eaves on the
east and west sldes of the cattle shed. The traps nere operated fron dusk to dawn wlth
collectlon containers changed at 2-hour intervals. As few specimens were collected durlng
each interval, collectlone were pooled over the entlre yeal !o determlne the tine of
attraction of nosqultos to tne rrgtrt traPs. A total of 522 females and 52 Dales of 14
specles ln f ive genera was colLected dur lng 28 t rap-n lghts ln 1976. Cx.- t r l !?eglg lhvnchus
rra6 most prevalent aDong feoale specimens lonseltutlng 56'82 of the total collected'
fo l lowed uy c, r r r " r lgg l . ; 1g4.42) a ia annutar ts (8.12) : Converselyr cu l lc l fac les was most
preva1ent(sr.zz)- i-n-onFnar""p""r ' I , ' f f i " ; ;- ; ; i i " ' " iuyc".. i rFg+FFgt,".9(L7.Iz,i " .
" i ipr"" (9.8 i ) , . r ,9- gteel rer ls i . (9.82) . Moequl tos l tere at t rCcted to l1ght t raPs
throughout the year, although durlng the coLder months only foui epecies were coltected'
Over 821 of the fenales and over 78I ot the nales were coliected durlnC th9 fi l l t half^of
the nlght with most of those contn! to l lght traPs between dusk and 2000h (44'72 and 42'77'
respectlvely). These tlnes colncided with nost mosqulto blt ing !"1!1"g Releen & Aslanlchan'
l97g - eee under 4.6/4.7 above) and sroarnlng rtrythns at sattokt (cttlng Relsen & Aslankhan'
1976; Relsen, Aslan & s lddlqul , Ig77 - 6ee 4.3 above) ' The cDC t raps col lected more
feoales than nalee, whlle the NeIt Jereey traPs collected uore males' Thls1tas attrlbuted
to t rap locat lon tn re lat lon to breedrni ef tes and.avai lable hosts ' - -The New Jersey t raP
was s i tuated croser to the agr icu l tura l f te ld rest l .ng st tee of exophl l ' ic specles (e 'g '
Cx. tritaentorhynchu", qa-pgSgq l, and Ae. caipfus) and was adjacent to a stagnanE
i*riffit#iti"*tffi5';ies and sevffinophelines during part or the
year, whlLe the CDC trape t"t"ff i " i" i-U."ia
feed troughs and were thus near the
bloodnear aource and restLng s l tes-of the endophl l tc epei les (e.g. , cgucl fac lgs." t t l -^
srephensi). This lras supported b; it" f""t ttrat ttre rnaSorfty'of fenJfEFEught by Ehe CDC
trap nere lresory fed, whlle nost females collected by ltt" 1t"t Jersey traP were unfed or
gravld, wi rh the except lon.r c* . t . . i t . " i i " I ry ! ! t tg : . 'Another posslb le factor could be the
d e g r e e o f 1 1 1 u n l n a t 1 o n p r o v i d e d b @ t r a P s ' b u t t h 1 s a s P e c t r e q u 1 r e s f u r t h e rinvestlgation. Thls trlal led the authors tL concludt thtt l lght traps seeD to be adequate
vBc/90.3MAL/90.3Page 125
tools for sanpllng noequl.toe ln Paklstan, although they-are far less productlve than
buffalo bttlng catchee whlch ylelded 18 873 fenale oosgul.tos conprising 18 epecles durlng
the saDe per lod of obeervat l .ons (c i t lng Relsen E Aslankhan, 1978 - see under 4.6/4.7
above). I iowever, l lght traps have the advantage of collecting both nale and female
noegultoe as well 8s 6ome phototactlc cullclne specles whlch are not attrected to bovld
b a l t .
4 .9 Hos t f eed lng pa t te rns
tabulated by Motabar, Tablbzadeh & llanouchchri (1975) ehowed thatranged fron 5.4 to LOZ and that of E!.@.! fron 5.4 t 'o 20.41.
Data of precipl t ln tests carr led out durtng the perlod 1971-1978 were tabulated byGarrerr-Jonee, Borehan & Panr (1980). Dats concernlng cullclfacles and 9,1!g$g! lncertaln countrles of the geographical area under review are reproduced ln Table 7.
Table 7. Resul ts of prec ip l t ln tests of b loodneal smeargof cullclfacles and stephensi ln certain countrles ln Aela
weetAFGiila, r97 2-197 4.
In I ran, the datathe IiBI of cullclfacleg
Country Soecles4
Onan cullclfacles
Af ghanl.etan
stephensi
Saudi Arabla Btephensl
Ye.ar SprayatatuS
r973
L97I!
1972-73197 4
I97L ex-DDT
No. smears givtug*ve reactlon
54
8 1r 5 6
t76r35
98
Z +ve forprlnate blood
37
DDT
RestlngblotoDe
H
H0
DDTDDT
HH0
54 . 5
2 . 30 . 00 .0 '
0 . 00 . 0
5842
Ho
The abbrevlaElons as explained by the Authors are:
N - never sprayed.ex-DDT + - an area naa last eprayed Dore than 12 Donths before eanpllng.ll - hunan and nlxed dwelllngs where oan Le avallable ae hoet throughout the nlght.
O - covers all daytlne-restlng bl.otopee where man ls not avallable at nlght.
l l l th the exceptlon of cullclfaciee ln Ouan, the data ahowed a very low or zero IIBI
for cq4qlfec:leq "od/ot
etepEa;-ffiffifghanletan and Saudl Arabla. Such results would
aeaefriliGifinarlon piffi?ly those lnvolvlng an adequate aample elze ln H blotoPe'
Ilowever, ft f i dlff lcult to flod an acceptable explanatlon ln the abeence of lnforoetlon on
the man:anlnal ratlo and whether anluals were ln close proxfunlty to the eanpllng blotopes
durlng the nlght before collectlon of noeguitos for preParatlon of bloodneal sueare.
In Paklstan, Releen & Borehan (1979) etudled host feedtng Pat ter t re of ooequl ' toa- ln
P u n J a b e x t e n s i v e 1 y , c o n p r 1 e 1 " g @ a n d @ . ! a n d o t h e r . a n o p h e 1 1 n e 8 ' 8 8 r r e 1 1 a st h e p r o b a b 1 e v e c t o r o f t h e W e e t N 1 l e v 1 r p e ' @ a l dCx. ir ltaenl.orhynchus. only the resulte of @ here. Locallt les where
i f i 5 , p E d f r f f i E G i 1 e d f o r b l o o d n e a 1 8 D e 8 r 8 ' t h e d a t e 6 o f e u r v e y s o f d o u e e t 1 c a n 1 m a 1 e 'and the nan:bovid ratlo recorded htere as follows:
YBCl90.3MAL/90.3Page L26
Kasu r d l s t r i c t i- Sa t tok l - I , March and Sep tenbe r 1976 ,- Sa t tok l -2 , l l ay 1977 , t a t t o 0 ' 64 : l '- Kasur , supplenentary col lect ions were carr led
shed at the outsk i r ts of Kasur, but no survey of donest ic
Lahore d is t r lc t :- Khano-I {arn i , March and Septenber 1976, rat io- Ah road Pa rk , MaY 1976 , ra t i o 6 ' 8 :1 '- Shah -d i -Kho i , Oc tobe r 1976 , ra t i o 2 ' 3 :1 '- Ko t Bagh i cha , Janua ry L977 , ra t i o 0 ' 07 : I '
out sPoradlcal lY f ron a cat t leanimals were made.
3 . 2 - 3 . 8 : I .
r a t i o 0 . 2 : l .
Fron March through Novenber, all hosts tncluding man remalned outdoors throughout the
night and were thus equal ly accesslb le to mosqui to bf i ing outdoor ' ' V l l lagers rare ly used
bed nets. Dur lng wlnter (Decenber-February) , both people and most domest lc anlmals rooved
lndoors ehortly after twil lght and remalnei instae throughout the night' Most houses and
cat t le sheds r rere at tached and of ten herdsmen would s leep ln the cat t le sheds ' Dur ing
nlnter , noet v i l lagers s lePt under heavy qul l t lng render lng then a lnost inaccesslb le to
nosqul to b l tes. f iorn. lanuary L976 to l ' lay 1977 rnosqul toe were rout lnely col lected f ron
cat t le sheds, houses and adJacent agr lcu l tura l f le lds ' Indoor rest lng noaqui tos were
collected by hand capture arra outaoor restlng species were collected by a rnechanlcal
aspl . rator . Col lect tons were usual ly oade Ln n id to la te af ternoon' Specinens were f rozen
upon return to the laboratory and ldentlf ied as to the specles on th: followlng mornlng'
F ieshly or la te fed speclnens were smeared on f l l ter paPer, a l r dr led at rooo temperaturet
and .s tored 1n a deslccator unt l l na i led for sero logical ldent l f tcat lon of the b loodneals '
The resul ts showed that of 1883 post t lve ly react lng sEeara of cu l r . l fac leg-(36- f - ron houses
+ 1847 fron cattle sheds) collected at Kasur, Sattokl-l and -2, Khano-Harni and Kot
Baghlcha, only l0 or 0.52 gave posl t lve react lon for nan (3 f ron Sat tok l - l ,3 f ron
Sattokl-2, and 4 rion rtranl-Harni). An addltlonal speclmen fron Sattokl-l contained a
ulxed rneal (posltlve for both man and bovld). The three man-posltlve snears and the one of
nixed neal f ioro sattokl-l were all. taken durlng the monsoon and Post-tronsoon seasons'
August-Novernber, while the three nan-positive smears fron Sattokl-2 and the four
man-positive 66ears fron Khano-l{arnl were collected durlng the wlnter and the pre-Donaoon
""."oo", February-May, prlor to nalathion spraylng. These roan-positlve smears were
collected durlng the-season of increased malaria lncldence. At Khano-Ilarni, LZ ot' 209
srnears col lected f rom cat t le sheds, and 5.62 of 36 snears col lected f rom houses were
poei t ive for man. Over 902 of a l l sut {qr jac les L loodneals were f rom bovlds ' Regarding
steDhensl . none of 817 6mear6 (73 tff i n-nd' 744 fron cattle sheds) reacted wlth hunan# '
antisera. In fl.ve vll lages, where stephensl was sanpled, over 957 of' the bloodneal soears
w e r e b o v 1 d - p o s 1 t i v e . n e i u r i e o f f f i f f i " " d e @ h a v e b e e n s h o w n a b o v e ( s e eunder 2.9 and 3.9, resPect lve lY) .
Io thel r d iscusslon, Relsen & Borehan ( loc.c i t . ) polnted out that the preponderance
of bovld feeds a6ong the iecognlzed vectors waa dtff lcult to lnterpret ln the l lght of the
recent resurgence oi nalarla in paktstan. Some assumptlons nere dlscussed. Apparently, the
appllcatlon of DDI houee spraylng provlded sufftcient evolutlonary stlnulus to eelect for
zooph1llsn as suggested by other authors elsenhere (clt ing Bruce-Chwatt, Garrett-Jones &
l{e i tz , 1966, and ih. l rbyr-1969 tn GuJrat State, Indla) . The t r is tory of lnsect lc ldal
spraylng ln the present study areaa Ln Lahore zone of PunJab provlnce of Paklstan fron 1963
to 1976 was g iven. Thus, l f lnsect lc idee do lndeed select for zoophl ly ' then suf f ic lent
lneectlcldal preeeure has been nalntalned durlng the PaFt 14 years to Prevent the reverslon
of vector populatl.ons to the level of anthropopttfty observed prlor to 1950' l lowever'
desplte contlnued lnsectlcldal spraylng and lh" tfgtt lncldence of zoophlly, consi'derable
malarla tranemlsslon occurred ln Lairori "on"
lncludlng the present study areaa'- l9l-t11"'the author6 gave the date of actlve case detectlon (ACD) carrled out durlng 1975-1977 tn
the flve study vll lages. Durlng 1976 wlth the appltcation of nalathlon house epraylng, the
el lde po ' l t iv l ty r r t ! (Spn) dropped f rom27.37 1; 1975 to 9 '247 ln 1976 (coropr is lng
p. v lvax ana p. fa ic iparur i , rn i ' the resul ts of January-June 1977 (P ' .v lvax only) suggested
that rhe SPR would be even lower Ln L977. The authors felt that gh;TIEET zoophll lc.
vector populatlons examlned ln the Present study could not malntain malarla transmisslon at
thle level. Speculative explanatlons lnclude the poselble exlstence of genetlcally
dlatl.nct vector populatlons which are highly anthroPoPhlllc, hence efflclent naLarla
vBc/90.3nal./90.3Page L27
I
v e c t o r a . R e f e r e n c e ! ' a a n a d e t o a t t e B P t s t o d 1 8 t i n g u 1 s h e y n p a t r 1 c r a c e s o f s g l @ ,and stephensl norphologlcalJ.y were unauccessful. A1eo, crosaes anong geographlcally
sepaEEEl-str4lna of stephensl LndLcated genetlc conpatlbll l ty (cttlng Rutledge, !{ard &Attk ley, lgTO' , and UTGEi lFan, Paklstan Medical Research Centre, unpubl lehed).
. It is worth notlng sope comments nade by Garrett-Jones, Borehan & Pant (1980) on theabove roentloned results of Relsen & Borehan (L979). Reference was made to the data of ACD
whlch lndlcated that active malarla transnlsslon waa taklng place in the study v1llages
durlng 1975-L976. Nevertheless, the proportlone of sanples of bl.oodneal soears that had
fed on nan nere very low ln a l l Anopheles specles colLected: 0.587. ln a tota l sanple of
1883 cul lc l fac les, L.LZ ln 95 f lwlat l l ls , 0 .72 ln 300 annuler ls and 0Z 1T 917 g!a!g! , ,- - - - : _ . - . *gO puffiEiffiF?nd 40 :,lbefcti'iT-Ttre-n-an:bovld r1t-19 rangeEEtween 0.64:1 at
-Sattokl. andy t l l @ a n d 4 u 8 u b D 1 c t u 5 . I n e m a n : D o v 1 o r a E 1 o r a n g e g D e t w e e n v . o . | ; r a L D a L L 9 [ f . '
6.8lTffiaa part. TE'16 6eens to have lntroduced 1ltt1e blas slnce practlcally all the
bltlng contact was occurrlng outdoors, where people and cattle sPent the nlght nlne nonths
of the year. That vlew nay not be entlrely valld, slnce the results of Kheno-Harnl showedthat t\ro of 209 bloodneal smeara frou cullclfacLee ln cattle sheds allrd 2 of 36 in houseswere pos1rlve for ruan. Even so, ttre qffi iplbw such apparently zoophil lc vectorpopulatlons could nalntaln a htgh 1evel of nalarla endeniclty ln the study v11lagee,remalns unexplalned. Garrett-Jones, Borehan & Pant (loc.clt.) further renarked that thlsls not a neir problen, slnce the revl.ew of Bruce-Chwatt' Garrett-Jones & Weitz (1966) showeda zero HBI ln cul{cifacles ln Indla, and the saoe Ln ltephensl ln Paklstan. Thle suggeststhe need ror a-?iEffiach to eanpllng of nosqultoFor-odneal anears ln eouthernAs1a, an approach whlch would begln nlth a careful counting of the blotopes avallable tothe vectore and the estlnatlon of thelr reepectlve deneltles. Speclal efforts nay beneeded to saDple adeguate nunbers fron huroan dwelllngs.
In thelr study of the ecology of An. cullclfacles specles A, g9gsgl and .g!g!g9.1 n K a s u r d l 8 t r l c t ' P u n J a b , P a k 1 s t a n , u a f r G o - E d ( l 9 8 5 ) c o 1 f f i - 5 1 o o d r o e a l e n e a r sof the three species restlng lndoors for preciplt ln teetlng. The hlghest ProPortl.on ofsnears of cullcifaciee glvlng poeitl.ve reactlon for nan was 3Z (of lgl posltive snears) lnS e p t e n b e r @ , 2 Z ( o f 4 8 p o e 1 t 1 v e s n e a r s ) g a v e p o e 1 t 1 v e r e a c t 1 o n f o r . m a nonly ln August 1983, but no nan-posltlve Bnears were found Ln tests oade during SePtenberI983-February 1984. At the eane tlne, no Dan-poeltive smeara were detected ln eubplctus-.
It ls useful to euonarlze the reeulte of a etudy on host feedlng Patterns of specleeA and B of the An. cullclfaclee conplex carried out ln Indla aa reported by Joshl et al.(198S). Sarnplel-ff if i ff is s.l. were collected restlng lndoore fron the followlngareaa durlug r985-19E7-
- Gopalpura, a peri.urban locall.ty tn Delht.- Gazlabad (weetern Ut tar Pradeeh), 18 v l l lages.- Bulandehahr (western Uttar Pradeeh), 9 vll lages.- Jaunpur and Ba1l la d let r lc ts (eastern Ut tar Pradeeh), 8 v l l lages.- Saran d ls t r lc t (Blhar) , 3 v l l lages.
In each vll lage, f lve flxed capture stations were selected comprLsing hunan dwelllngs andcattle shede. At each catchlng atatlon, noequltos were collected by hand capture every twow e e k s b y f o u r o r f 1 v e c o 1 1 e c t o r e . S a u p 1 e e o f @ w e r e b r o u g h t t o t h e 1 a b o r a t o r yfor processlng. Fron half-gravld female noequitos, ovarlee Ln Chrlstophers- etage III wereseparated fron whlch polytene chromosone preparatlons were oade for ldentif icatlon of thespecl.es of the An. cullclfacles conplex. Fron the aatle mosqulto, blood frorn the gut wassueared on l{hatnanTo. T fl l ter paper for bloodneal assay, and the rest of the nosquito nasstored ln a n lcrofuge tube for sporozol te detect lon [see resul ts of Subbarao et a l . (1988a)
under 4.11 belowl. Bloodneal eanples nere tested by count.er current lr"rnunoelectrophoresls(CCIE) (c i r lng Bray, c111 & K1l l lck-Kendr lck 1984) and gel d l f fueion (c i t lng Col l lnset a l . , 1986) techniguee uelng agarose gel .
[-TEG rfas-Eftten before the dlscovery of the el.bltng specles of the An. cullclfacl,escornplex (see VOL. Ir pp 40-45). As sholrn under 4.5 above, Mahmood, Sakal & Akhtar (1984)
shoned that cullclfacles nas the moet probable prinary vectol in some distrlcte of thePunJab where-ElEffias ldentlf led (see more detalls under 4.10 and 4.11 below.)2. See VOL. I , docuroent VBC/88.5-UAP188.2, pp. 49-50.
vBc/90.3ttAl/9o.3Page 128
Al though both techniques produced equal ly sensl t ive resul ts in 'detect ing ant igens up to 40
hours af ter the b loodneal , CCIE was quicker , as the e lect rophoret ic run was conPleted
wi th in 25-30 minutes and precip i t in arcs r rere sharper . Thereforer CCIE was used for
assaying the sanples and deta i ls of the technique were g iven. As d lscussed by the suthors '
a sr0a11 proport ion of the b loodroeal smears d id not react wl th e l ther human or bovlne
ant isera. These oosqui tos rn ight have fed on other anfunals for whlch the anl lsera tested
were not specl f lc . Resul ts of b loodneal analys la etere tabulated showing the percentage of
bloodneals of each of specles A and B positlve for hurnan, bovine and ml-xed (hunan + bovine)
ant isera. Br ief ly , resul ts of percentage posl t lve for hunan and n ixed are suomar ized as
fo l l ows :
Specles of An. cu l lc i fac ies conplexAreas
SPec les AZ Hunan Z Mlxed
Spec les BZ lturoan Z Mlxed-
Tota l tested
I4
D e l h l 1 . 3Ghaziabad 2.2Bulandshahr 3.5Jaunpur & Bal l la 0.0Saran 0 .0
ffip-6?-ucea uyAesociatlon frou
466 34345 382833 493
6 3320 7 5
0 . 22 . 24 . 00 . 00 . 0
0 . 00 . 80 . 60 . 30 . 0
0 . 00 . 32 . 00 . 00 . 0
The above data clearly ehow that both species A and B were largely zoophll lc, as only
a snall proportlon of the bloodneals were posltive for human antlsera. The HBI was
calcglated Ly addlng the number of hunan and Dlxed posltlve antlgens. The valueE of HBI of
"p""i.s A and B were cornpared by the chi-square testr assuulng that specles A and B have
egual preference to feed on hgnans. Thls lndlcated that ePeciesrA had a s ignl f lcant ly
h igher HBI than species B: f - = g.5, P<0.01 In Ghazlabad, and 1L ' = I3.2 ' P(0.001 ln
Bulandshahr. As shown in the above data, the proportlons of specles A and B varled in
dt f ferent areas. Specles A was the predonlnant species tn Delh i and ln v l l lages of
Ghaziabad constttuting rnore than 902 of the sanple examlned. While 1n Bulandshahr the
proportlon of specles A was 62.87", lt was only 1.82 in Jaunpur and Ball la and 0Z in Saran'
i r respict tve of th ls var lat lon, specles B renalned less anthropophi l lc ln a l l the areas
studied. This was taken to lndlcate that specles B has less preference for hunan b lood
than specles A. This dlfference was observed throughout the year. Seasonal varLation ln
the HBI of specles A was observed when the samples collected ln 1985 and 1986 were pooled'
As shown ln the tabulated data and noted by the authorsr the l lEI of specles A was low(0.0-0.04) dur lng wLnter ( la t ter par t of November to February) and autmer monthe (0.0:0.04
ln Apr l l -June), and e lgnl f lcant ly h lgh dur lng July , August and SepteroUer (0.11 ' 0.08 and
0.06; respect lve ly) . i te t ts t o f speclee B was zero throughout the year excePt ln Septenber
and october when it was 0.02 in each of these two uonths. The authors further Polnted out
that ln Gopalpura, Delhl, and dlstrlcts of Ghaziabad and Bulandshahr, malarla ls endenlc
and specles I hae been lncrinlnated as the prfunary vector, whereas in Jaunpur and Saran
digt r lc ts oalar ia le a loost absent [c l t lng Subbarao et a l . ( f98Sa) - see under 4. l l be low'
and Subbasrao et a l . (1988b) - see under Subeect lon (11) ,1 belowl . The ProPort lons of
bloodneale that were posltlve for oan as revealed by the Present study nere conParable to
those recorded earllei ln cullclfacies s'1' (sunoarized by Ranachandra Rao' f984)' The
auchors tabulated the data-iff i ff i l analysis of speclee A andrB collected frooa u t n o r E t a D u l a f ' e q L I l e q l t L a t u r u l e v s u s o ! q r . o 4 t e ' e v ^ e l ' s s - - - ' - - " - l -
dlfferent restlng altee ln Ghazlabad dlstrict ae ehottn 1n Table 8-.
pernlssl.on of Dr It. Josht and the Journal of the AmerLcan Mosqulto Control
the paper of Joshi et aI . (1988).
vBc/90.3UAL/90.3Page 129
T a b 1 e 8 . B 1 o o d o e a 1 a n a 1 y s 1 s o f @ s p e c l e s A a n d lcol lected fron dl f ferent rest lng sl tes ln vl l lages of dlstr lct Ghazlabad
(Flgures ln parentheses are observed nuobere)
Rest lngs l t es
No .tested
Species A-Proport lons with
Hunan Bovlne Mlxed No.(H ) (B ) (H + B ) t es ted
Soecles BProport ionsantlgens of
Hunan Bovine( H ) ( B )
wl th
Mlxed( H + B )
Ca t t1e shea l 8 l 0 .02 0 .87 0 .08(4 ) ( t sa) (Ls)
612 0 . 0 1 0 . 9 9 0 . 0( 1 ) ( 161 ) (o )
Ilunan dwelllng L42 0 . 0 4 0 . 9 3 0 . 0 1 1 1 6 0 . 0 0 . 9 9 0 . 0( s ) 1 3 2 ( 2 ) ( l l s ) ( o )
Coroparar lve chl . -square value of 7.9 (P<0.01) ind lcated that the proport ion Po6l t lve agalnet
huoan and bovlne antleera dlffered slgnlflcantly ln human dwelllnge and cattle sheds for
species A. fhe proportlon of olxed posltives was hlgher ln cattle sheds than ln hunandwel l lngs ( I t - 6 .25, P<0.02) . Presence of undlgested b lood f ron an ear l l .er conpletebloodneal was ruled out becauee the noequltoe used were ln the half-gravid state and the
CCIE le not sensltive beyond 40 hours of blood feedlng. The nost probable explanatlon for
the preeence.of nlxed posltlvee ls that the nosgultos whlch fed on human blood nent to
cattle sheda to cooplete thelr bloodneal on cattle. In all theee vll lagee, cattle eheds
and hunan dwelllnge are sltuated ln cloee proxlolty, and durlng the rainy seaaon nost ofthe huuan dwelllngs became nlxed dweltings. Thls nay explaln the htgh progortloos of mlxed
feeds observed ln sore vll lages and the slgnlflcantly htgh HBI recorded ln July' Auguet aad
SepteDber (eee above). The HBI of speclee A varled between vll lages and wae related to the
proportLona of hunan and cattle populatlone. Sfuollar f indinge were rePorted by other
workere for cullclfaclee s.1. ln the past and recently ln sone areas of Indla. Finally,
the authore ;@aT[at aa epeclee A was ehowa to be the prloary vector of oalarla ln
areas where species A and B are eyrnaptrlc (ctttng Subbarao et al. ' 1988a)' thepredonlnantly zoophll lc behavlour of epeclee A can be explolted to reduce nalarlatranenleelon by LncreaeLng the aninal populatlon.
4.10 Longevl ty
In lran, Quralshl, Faghih & Eshghy (1956) whlle conductlng observatlons on the range
of fltght of etephenel, dqg-rntned the duratlon of the gonotrophic cycle and longevlty of
atephenel taUffiEh P". Infornatlon on the fllght range was shown under 4.4 above.
i[tf116t also ahowed that the ftrst gonotrophlc cycle wae coropleted ln 3-4 daye and the
eecond 1; 6-8 daye. Radloactlve mosguitoa nere captured only durlng the flret nlne daya
after each releaee, but the nunbere caught after the 6th day wae too eroall to be of any
value ln deternlnlng the 1oortallty rate. Fron the graphlcally Presented data' 502
nortallty occurred ln labelled noequltoe between 3 and 3 Ll2 daye of releage.
In the tabulated data presented by l lotabar, Tablbzadeh E Manouchehrl (1975) on
ecologtcal parameters of nalaria vectors 1n lran, the nuubers of gonotrophlc cycles wae
ahown to be up to seven ln cullclfaciee and up to nine ln g!g!g,1'
In Paklstan, Rel.sen, Aela6khan & Naqvt (1976) ln addltlon to studylng the restlng
behavlour of cullclfaclee, etephensl and other anophellnes Ln Lahore dletrl 'ct (eee under
4.61h.7 abovefEffiir At8'ert;Efona on the rate of ovarian developnent. A eerlee of
all-ntght restlng collectlons nere nade gt Ghulan ltohanoad cattle ehed near Settokl vll lage
durlng 19-29 August 1975 followlng the proceduree deecrlbed prevlously (eee Releen et al ' '- Lg76 - aee under 4.6/4.7 above). Feualee collected were claeetfl.ed accordlng t 'o the
blood dlgestloo stages and dlsaectlons oade to deternlne the ovarl'an stages and to examine
the spernatheca. An. cullctfallgs feuales apparently euerged durlng the firet half of the
nlght and iroredlatfifmafie-cattLe ghed to reet. The percentage of unfed femalee as
well ae feuales wtth ovarles ln Chrlstophere- etage I, wae hlgheet before uldnlght and
decreased durlng the early nornlng feedtng peak. That these lndlviduale left the shed to
feed was aleo lndlcated bi the laige nunber of freshly fed and late fed lndlvlduals and the
percentage of fenales at stage Il a66.2-71.32) collected durlng the early hours of rhe
norntng juet after dawn. Sone of the freehly fed feuales were considered to have taken a
vBc/90.3MAL/90.3Page 130
part la l b loodneal ( I5 .27") . 0 f the f reshly fed fenales wi th a par t la l b loodneal lwo out often were found to be unlnseroinated. The quant i ty of b lood lnblbed dur ing Ehese par t la l
feeds was apparent ly lnsuf f lc lent to conplete ovar lan developnent , s ince a sna1l percentageof the populat lon took a second b loodroeal . These lndlv iduals were found to have f reshblood ln the n idguts anter ior to the wel l d igested rennant of the prevlous b loodneal , andthel r ovar ies had developed past the ear ly s tage I1 rest ing stage. This rest ing stage a!which the second bloodoeal was taken was attalned by the amount of blood irobibed durlng thef l rs t b loodneal . Females wl th pract lca l ly enpty n ldguts and developing ovar les were a lsotaken dur lng conconl tant buf fa lo b l t lng col lectLons. The authors pointed out that nul t ip lefeeding dur lng suspended reproduct lve act iv i ty nas descr ibed for overwlnter lng cul ic i fac iesln India (c i t ing Rao, 1947). I lowever, the authors consldered that thei r observat ionssuggest nul t lp le feedlng nay a lso occur 1n cul ic i fac les dur lng gonoact lve per lods. Dur lngt t r e f t r s t d a y a f t e r f e e d 1 n g , t h e o v a r 1 e s n a f f i g e I I I , d e v e 1 o p 1 n g t o 1 a t e s t a g e I Vor ear ly s tage V dur lng the fo l lowlng n lght . 0n the second day, the ovar les developed tolate stage V, the d lgested b loodneal rennant d lsappeared, and ln the evening fenalesegreesed to ov lposl t . Thus, the length of the gonotrophlc cyc le i . gg l i " l f . " i * appearedto be 40 hours durlng the prevail lng tenperature and hunldlty lnslde the cattle shed(teuperature range = 26-32uC and RH range E 88-1002 Sinllar results were obtalned withsubpictus except that the percentage of lndlviduals acqulring a second bloodrneal wae higher
T.n- ovarlan developnent ln .g!g1ggg9. would also seen to be about 40 hours. Slnllarreeul ts were a lso obta lned wl th etephensl lnc ludlng the tak lng of mul t lp le feeds. Snal lernumbere of unfed feoales at ovarian stigC I were collected restlng lndoors. Thls suggestedthat newly energed fenales renained outdoore untl l thelr ovarles natured to stage IItalthough theee fenales were not found ln the habitate sanpled. Thls view was furthersupported by the h igh percentage of unfed stage I I fenales col lected rest lng lndoors.Ovarian developrnent to stage II was followed by a nocturnal feedlng fl lght and a oornlngcrepuscular lngress for rest lng. Al though d l f f lcu l t to ln terpret f ron the d lssect lon data 'the gonotrophlc cycle appeared to be of the sane duratlon as colonlzed laboratory 9!93$]1.frorn PunJab whlch was prevlously estlnated to be 48 hours under the saue tenPerature andhunldlty condltlons.
Fur ther , Relsen & Aslaokhan (1979) in Paklscan conducted a nark, / re lease/recaptureexperlnent rtth:g!g,E! at Ghulao Mohannad cattle shed, near Sattokl vll lage during MayL977. In addl t lon to observat ions on d lspersal of th ls specles shown under 4.4 above'longevl ty and re lated aspects nere studled. Br ief ly , the naxlmun longevi ty of 'narkedfenales and nales recaptured was 12 and 13 days, respect ive ly (nean longevl ty 3.24 and3.26 daye, respect lve ly) wt th the nean dal ly surv lva l belng 0.865 and 0.926' resPect ive ly .Populatlon elze lras estlnated for the flrst f lve days after release uslng Llncoln lndexnodified by Balley (f95f) to account for survlvorshlp, and the posltlve and negatlvenethods of Jackson (1939). Eetftnates of population size at the tlto cattle sheds nearestthe re leaee polnt ranged f rorn 1294.7-2551.7 for fenales and f ron 481.6-1374.3 for Dalea 'conslderably less than the elze of the releaeed cohort. On the duratlon of the gonotrophlccycle, the authors suggested that the firet bloodneal nas apparently taken on the firet oreecond nlght of l l fe regardless of whether or not the fenale was lnsenlnated. Most of theunoarked feoales whlch cane to feed on bovlds were lneenlnated, but natlng nay haveoccurred when the feuales travereed the dlstance fron the polnt of eoergence to the site ofthe hoet. Alternatlvely, unnarked vlrgln feoales nay have first come to rest in the cattleehed and nated elther lngreeslng at dawn or egresslng at dusk to feed. The flrst markedpaaous fenalee sere collected restlng tn the cattle shed on the thlrd day after release andbltlng bovids on the aecond evenlng after release. Parous fenales four days old collectedrestlng (3 days after release) mret have fed on the night of releaee and ovipoelted on thenlght precedlng the date of recapture, 1.e., egg Daturation probably requlred about 40houre. Paroue fenales three days old (2 daye after release) roust have oviposlted on thesaoe evenl.ng they were collected atteoptlng to blte bovlds. I{hen four days old (3 daysafter release), all feualee collected sere elther parous or gravld. These flndlnge agreedwell with those of Quralshl, Faghlh & Eshghy (1966) who collected parous feoaLee three daysafter releaee, and Relsen, Aelaukhan & Naqvl (1976) (eee above) who suggested fron thedissectlon of restlng feoales that ovarlan developnent requl.red approxlnately 40 hoursdurlng the hot, rtet DooaooD a€88oo.
Releen, Mahnood & Parveen (1980) dld a nark/release/recapture experLment wlth cohortsof cullclafclee of known age durlng the monsoon neason of 1978 at Khano-Ilarnl ln anafarfoue area in Lahore dlstrlct, to deternine the duratlon of the gonotrophlc cycle and
vBc/90.3l.tAll90.3Page l3 l
estlnate the survlvorehlp of cullcifacles and Lte populatlon sLze. Malarla had been ahealth problen ln Khano-Ilarnt-tn-ttre past, with 30 cases of P. vlvax and I44 cases of P.falclparun detected tn 287 blood slldes examlned fron the enffi lage by the Natlonai-Malarla Control Progranme durlng 1975. Two rounds of nalathlon during the sumner of L976ef fect lve ly e l ln lnated cul tc l factes f ron Kahno- l larn l (see under 4.6/4.7 above), andc o n 8 e q u e n t 1 y t h e n u n b e r f f i - c a a e 6 d e t e c t e d d r o p p e d t o t h r e e P . v 1 v g a n d o n e P .Vivax in 47 and 192 slldes exarnlned Ln 1977 and 1978 respectlvely. The vll lage was notEffied durLng L977 and 1978, but cullcifacles dld not successfully repopulat; the vll lageunt l l the onset of the 1978 uonsoon seaaon (eee Flg. 15) , when both rest ing adul ts andlarvae were rout lnely col lected ln rnoderate densLty. Dur lng Septenber-October 1978, threeof 24 blood slldee taken fron lnhabltants of Khano-Harni were found posltlve for P. vlvax.The followlng nethods r{ere used:
(a ) Coho r t , p roduc t l on and na rk ing :0n 22 'and .23 Augus t 1978 , 193 fena le cu l l c l f ac leswere collected restlng in cattle sheds at Khano-llarnL and Kot Baghlcha. speclnffiFl tght ly ether l .zed, ldent t f led and re leaaed lnto 3.8-11tre paper car ton cages, where theywere offered 3Z sucrose .ln vlaLe lt ith sponge wlcke, a cup llned wlth fl l ter paper forovlposltlon, and at night a laboratory Douse as a source of bloodneal. The progeny nerereared'ln the laboratory under standardized conditlons. Pupae forned were placed lntoerergence glaeees. The followlng afternoon, the energlng nales and fenales (about 12-18houre old) were ltghtly etherlzed, counted and then dusted wlth fluorescent dust (dlfferentcolour dal1y for f ive daye. Dueted adulte were placed lnto 0.9 l ltre cartons, the tops ofwhtch were covered wlth fine gauze through which a pledget soaked wtth 3Z sucroae solutlonwae placed. To deternlne the effect of duetlng, 25 dusted and undusted oales and fenaleswere releaeed eeparately lnto each of 3.8-11tre cartone contalnlng 3Z sucrose ln vlale wlthsponge wlcke ln the lnaectary (I5:8 LL:DD), wlth one hour slnulated dusk and dawn,tenperature 28 + 2" C and relatlve hunldlty 75 + LlZ). Dead noequltos were recordedda1ly.
(b) Release: After dustlng, noequLtoe were transported to Khano-Harnl, held Ln acsttle ehed untl l dusk and then releaeed by renoving the gauze tops of the cages. Cagepwere agltated to lnduce noequltoe to fly, but were not Lnverted. After 15 nlnutes, thetoPs were replaced, and noequltos that falled to dlsperse were couuted ln the laboratoryand eubtracted fron the nunber dusted to deternlne the actual nuobers releaeed. Moequltoewere released at the entrance of a cattle ehed where large nurobere of cti l l .clfaclee werecol lected, and at a breedlng e i te a long a dra ln.
(c) Recapture: Fron the afternoon of the flrEt release, recaptures were roade atdalty Lntervale uelng the followlng nethoda:
- Iadoor aneeper: One coll.ector aspl.rated noagultos restl.ng ondebrle ln three cattle sheds uelng a nechanl.cal sweeper. These eheds nerenany cullclfaclee reeted on the floor and lower walLe.
the floor andeelected because
- Hand capture: After f lnlshtng the eweeper collectlona, two collectorsaepl.rated uosqultoe restlng on wa1ls and cell lngs of aix sitee productive forcull.clfacl.ea. A1l. collectlone were nade for 15 nLnutee per collector per elte per diy.
- Outdoor sweeper: The grase and buehes near the release site at the rmrglne ofthe dral.n nere awept wlth the nechanlcal aneeper for 30 ninutes.
- Bovld balt: Startlng 15 ul.nutee after aunset, three collectors aeplratednoequitos attracted to buffaloes tethered at three sLtes.
- Swarne: For a 30rinute perlod Btartlng 15 nlnutes before aunaet, onecoll.ector gearched for nale anarrts whlch were collected wlth an aerlal ineect net.
All collectl.ons rtere returned to the laboratory (each ln a eeparate carton cage ln whlchthey were offered a cottoD pad soaked wlth water) and held ln a cold roon at 5" Covernight. The next mornlng, the epeclnena rdere etherlzed, examlned under ultravloletl lght for f luoreacence, ldentlf ied and counted. To reduce the lnfluence of removaleaupllng on populatlon abundance, 310 fenale and 121 Eale unnarked speclmens were releasedunoarked at the slte of. the lnlt lal releaee (the entrance of the cattle ehed), after allrestlng collectl.ons were conpleted.
vBc/90 .3MAL/90.3Page 132
- Dissect ions: A11 recaptured fenales as wel l as unmarked fenales col lected on
9 , 10 , l l , 2 l and 22 Sep te rube r we re d i ssec ted ( re leases began on 8 Sep tenbe r a t t he ca t t l e
shed and on l0 Septernber at the breeding s i te) . Mat ing was determined by the presence of
sperrnatozoa in the spermatheca. The b lood d igest lon stages were scored as UF, F, or grav id
by external examlnat ion of the abdonen. Ovar ian development Isas c lass l f ied by Mer-s method
(1936). The number of prev ious ov iposi t ions was detern lned by the number of d l - la tat ions '
and the null iparlty was confirmed in unfed females by exanining the degree of col1lng ln
the t racheoles of one ovary (see Det inova, 1962).
For s tat is t ica l ca lculat ions and deta i led data, the or ig inal PaPer should be
consulEed. I t is suf f ic lent to g ive the outcone of th is s tudy as summarized by the
authors. The recapture raEes of nales and fenales of cu l lc l fac les re leased at resElng and
b r e e d i n g s i t e s w e r e s t a ! 1 s t i c a 1 1 y c o n p a r a b 1 e , b e i n g r e @ . 8 Z a n d 8 Z o f t h especimens col lected rest ing ln houses and cat t le sheds. l la t ing occurred nost ly on the
night following the eveninl of release when the fenales were about two days old.
Inseminat ion rates for fenales re leased at re6t lng 'and breeding s i tes were 6tat is t ica l ly
cornparable. The in l t la l gonotrophlc cyc le took four days. Subsequent cyc les occurred at
Z-day interval-s with refeedlng occurrlng on the same night as ovipoeitlon. Constant daily
surv iva l est inated f ron the decl ine ln recaptures per day was 0.568 for fenales and 0.676
for oales.. Fernale daily survlval estlnated by vertlcal age-gradlng technlque ranged froo
o.472 to 0.g20. Hor lzonta l l l fe tables l rere calculated f ron the decl lne in recaptures and
fron vertlcal age-gradlng technlques, and lndicated that fenale or male l lfe expectatlon at
emergence was Less than 2.5 days. PopulaElon s ize was calculated us lng Bal ley-s uodi f led
Linco1n Index, Jackson-e posi t lve and negat ive nethods (Jackson, 1939) and I tO-s
nodl f lcat lon of Jackson-s posl t lve nethod ( r t6, 1973). These calculat lons gave an average
vary lng f ron 1045.5 (g-L2 Seprenber) to 1048.6 feroales (9-12 Septenber) , and f rom 449.1 ( f3
Sep te rnbe r ) t o 1323 .7 na les (9 -16 Sep tenbe r ) .
The authors discussed the relatlonship of the present and previous flndlngs of
e c o 1 o g 1 c a 1 s t u d l e s t o t h e e p 1 d e n 1 o 1 o g y o f n a 1 a r 1 a a n d g e n e t i c c o n t r o 1 o f # 1 'P u n J a b . T h e y p o i n t e d o u t t h a t t h e s e - " t , ' d 1 " " h a v e g e n e r a 1 1 y s u g g e s t e d t h a t # ' r snot an, efflcient vector of rnalarla. Although endophll i", Sg!191!# fenales obllgatorlly
egress at dusk and typ ical ly feed outdoors on large domest ic aninals , especla l ly bovlds 'prec ip i r in rests at Khano-Harnl ind lcated that only 1.67" of 245,cul lc i fgc ie9 fenales had
fed.on nan (c i t lng Relsen & Boreham, 1979 see 4.9 above). Sin l lar resul ts have been
reported f ron other rura l areas in iak ls tan and India. In addl t lon, fernale probabl l i ty of
aaify survival has been shown to be low, whether estlmated by horlzontal
narkTrelease/recapture methods (clt lng i.uesell & Rao, L942c) or vertlcal age-grading
studies (c l r lng Si ra laby, 1965) agreelng wt th the reeul ts of the Present sEudy. Thus,
females feeding on a gametocyte carrlei durlng the flrst two days of ltfe would have to
survive unti l nlne to ten days of age to tranBmit the infectlon to a suitable hunan hoet'
The authors further polnred L,tt tft. i thelr data suggest that less than lZ-of cu1L91'f?.clee
fenales would be expected to survive to thls age. However, once the females attain th18
age, further expectatlon of l|fe nay be ellghtiy enhanced. Thu.s, a low Percentage of hunan
teeie and a low probabll ity of daily survlval coupled wlth a relatlvely sna1l population'
would aeeo to lndicate that malarla transnlsslon by cullcifactes at Khano-Harni would be
statlstically inprobable. The authors, however, felFthat-the pereLstence of ualarla
transoisslon in areaa where cullclfacies blonomlcs aeema lncoopatlble, presents an
lnterestlng parado4 and a eubJect offi i ther lnvestlgatlon' Regardlng genetic cont:ol ' ,the
r e d u c e d s 1 z e o f t h e 1 n d 1 g e n o u s @ p o p u 1 a t 1 o n c o u p 1 e d w l t h a 1 o w n a 1 e a n d f e n a 1 eprobabll lty of survival, a trtgtr rec@ale- of the released adults and reduced vagll lty
and fl lght range (cttln; nussetl et ;1. , Lg44 - see under 4.4 above) would seem to make
cul lc l fac les a sui table target for genet lc contro l '
Mahnood 6 Relsen (1981) studled the reproductive activlty and survlval of
cullcifacies and stephensi durlng winter ln iunJab. To supplenent fleld observatlons' the
duration of , the glnffioiElc cycle was deterolned under cool and normal tenPerature ln the
i;;;;;;;;.1- ri lra observarions nere carrled out by nark/rerease/recapture exPerloents
a t K h a n o - H a r n 1 v i 1 1 a g e . o f f s p r 1 n g o f S a t t o k 1 J . a b o r a t o r y s t r a 1 n e o f 9 g 1 @ . . d
rc;E'ffi document vBc/88.5 - MAP/88.2, pp' 81-82'
vBc/90.3ltAL/90.3Page 133
stephensl were roarked wl th a date-specl f lc f luoreecent dust and t ransported to the,v l l lage,
i i i?Esed lnside a cattle shed durlng nld-afternoon as descrlbed above. Froo 12 to 15
February J.980, a tota l o f 2385 fenales and 1921 roales of Sgl lc f fac i "J , as wel l as 8796
fenales and 5730 males of gggltrensl were released inslde the cattle shed. Recapture was
done by col lect lng noequl t5FEst lng lnelde the re lease s l te and adJacent houses ' and by
balt capture on bovlds as descrlbed above. More cattle sheds and houses were Lncludedprogressively to lncrease the nurnber of recaptured nosqul toe for d lssect lon. The nethods
of d lssect lon were as descr ibed above. For s tat ls t ica l ca lcul .at lone, the or ig lnal PaPershould be consul ted. The recapture rates were L77 and 7.22 for fenale and nale
cul ic i fac les, respecl lve ly , and 13.37. and 8Z for female and male stephel ls l r _resPect lve ly .ff i; iz-urvlval raEes calculated fron pooled released cohorts were low for both
specles, as were the l l fe table expectat loo of l l fe at re lease (hor lzonta l eurv lva l was
calculated froro the pooled recapture rate standardlzed for roan-hours of eollectlon efforts
and regressed as curv i l inear funct lon of t i rne) . The h lgh in i t la l loss ratea l tere
at t r ibutedr ln par t , to reproduct ive act lv l t les, enlgrat lon f ron the re lease s l te , and/or
renoval saropllng, but not to the effects of cool temPeraturea on survival, slnce dusted
fenales held ln cages wtth 3Z aucrose and placed ln the release shed for three days
exhtblted l ltt le rortality. Once mated and fed on b1ood, female exPectatlon of l l fe for
both species lncreased and actually reached a maxlnurn at 5-7 daye after release.
Subsequent nortality lncreases seened to be assoclated wlth ovlposltlon and refeedlng.
A total of. 266 and 85 cullclfacles and 489 and ll2 stgS! Iras recaptured by restlng and
b 1 t t n g c o 1 1 e c t 1 o n s , r e l ! @ T h e s e w e r e d 1 s s e E f f i e t e r D i n e c h a n g e s l nlnsenlnation, ovarlan developoent and parous rate wlth tloe after release. Moet fenales
inbibed a partlal bloodroeal on the nlght of releaee (652\, but dtd not nate. Uatlng aleo
dld not occur on the evenlng of day I, although by the afternoon of day 21 67.92 of the
females appeared partial: ly fed-. The requlrenent of a partlal bloodneal followed by a
replete bloodneal to stimulate ovarian developnent beyond stage IIa was.$euonstrate! tn
cul lc i fac les under laboratory condi t l .ons (c t t lng Reisen & Mahuood, f979) ' . The nedlan
ffi;-ron release to ovarlan development beyond 6tage IIa was 3.1 days' The flrst
lnsemlnated fenale was collected on the nlght of day 2, nith the nedlan tloe of
lnsenlnat lon belng 5.7 and 2.9 days for rest lng and b l t lng feualee, reepect ive ly .
Gonoactlve females apparently had a greater chance of contactlng nales than did feroalee
renalnlng unfed and/or insemlnated fenalee fed roore readlly than unlnseminated fenalee.
A posslble explanatlon for the delayed lnseninatlon ltas the extrenely low relatl 've
abundance of the lndlgenous cullclfacles populatlon (only two unnarked fenalee were
c o 1 1 e c t e d ) . T h e r e f o r e , f e n a i l h a d t o w a 1 t u n t 1 1 t h e 1 r c o n c o n 1 t a n t 1 y a t b 1 t n g .nales became sexually llature. This wab ehowu by the abaence of oatlng aDong 25 palrs of
narked cullclfacies held ae controls ln the releaee ehed fron 19 to 23 February. Ovarlan
aevelopiEi,Eft-Gle V requlred a mlnl.mum of four days, but the nedlan tlne for conpleElon
of the flrst gonotrophic cycle was 9.6 days, wlth the firet Parous fenale detected on
day 8. Sone ienales took an extraordtnarlly long tlne to mature the flret batch of eggs
ani exhlb l ted gonocrophlc d lecordance aa deEcrtbed by Rao (1947), 1.e. , eupplenentary
bloodneals were taken before oviposltlon. Fenales with ovarlee at stages III to V were
taken in blt lng collectlona, and BoDe resting fenales whose prlnary foll icles had developed
to etage IV or V, had thelr ovarles developed^to 6tage IIb and IIIa, reepectLvely. Slullar
observations were uade ln the lncubalor at l8'C for fenales whlch had been offered a
reetrained laboratory mouae dally fron emergence to flret ovlpoeltlon. 0f 49 survlvlng
fenales diseected, 43 were unfed and unlparous of whlch 2, 39 and 5 fenalee had thelr
prlnary foll lcles developed to stages IIa, IIb and IIIa, resPectively. fhese females were
null lparous and unl.nsenlnated wlth thelr prtnary folltcles at stage V and their secondary
foll icles aE stage IIb wlth btack vlecous lemnants of prevlous bloodneale ln the nldgut'previous laboratory observatlons at 28 + 20 C and fleld etudles durlng au@er by the
authors had suggeeted that secondary foTllcles do not develop beyond stage IIa untl l after
ov lposl t lon and-refeedlng. DevelopnenE of the fo l l ic les to ' I Ib or I I Ia at co lder
tepperacures rra6 attrlbuied to supplenrentary blood feedtng and prolonged ovarlan.
naturatlon. Slnllar patterns of insen:lnation, ovarlan developnent rtere observed ln
stephensl.. The nedlan tlne of lnseninatlon for resti.ng aod bltlng females was 2.7 all.d 2'2,
Effiely, eonewhat fagter than observed ln cullclfacles. However, lndigenous -@,1were alrlady abundant and therefgre sexually naEiE-Glea-ere present Ln the etudy area
when the narked vlrgln fenales were released. In support of thls, no hatlng was detected
among 25 palre of slephensi controls held ln the releaee ehed, euggestlng that the
I . See VOL . I , pp . 80 -81 .
vBc/90.3ual/90.3Page 134
concurrent ly re leased stephensl contro ls held in the re lease shed, suggest lng that theconcurrently released stephensl nales roay have requlred longer than four days to becomesexual ly Eature, as observed in cul lc i fac ies. The in l t la t lon of oogenesis beyond stage I Iaand the duratlon of the flrst go;'m6;frff icle ln stephensi also required less tlme thanobserved ln cul lc l fac ies. The f l rs t parous fenale of q lephelqs i was col lected f ive daysafter releasil i?$-Gl 12 all recaptured fenales wer-ff is, suggesting that thesecond gonotrophlc cycle was of conparable duratlon a6 the first cyc1e. Sor" 9!*391feuales a lso exhlb l ted gonotrophlc dLscordance as females a! ovar ian stages I I I to V wererecovered f ron b l t lng col lect ions. However, the eecondary fo1l ic1e tn a l l fernales nere notdeveloped beyond stage I Ia . Ut l l lz lng the est inated nedian developnenta l t ines, theauthors could calculate the probabl l l ty of dal ly surv lva l of q lephensi up to spect f ic l1 fehls tory events for subsanples of 166 and 94 unnarked fenales concurrent ly co l lecEed rest ingand b l t lng. For the rest ing col lect lo ins, surv lva l to lnseminat ion, the in l t la t lon ofoogenes l s and pa rL t y was es t l na ted to be 0 .9 I9 , 0 .908 and 0 .816 , respec t l ve l y . Us lng theoethod of Davldson (1954r 1955), the probabl l i ty of da11y surv lva l for nuJ. l iparoua fenalesfron stage I Ib to V was est lnated to be 0.733. The d l la tat lon-regression method provlded alower est lnate of l l fe- t lne surv iva l , 0 .680. Sln l lar resul ts were obta ined for fenalescol lected b l t lng bovlds, where surv lva l to lnsenlnat lon, and par l ty was 0.888 and 0.787,respect lve ly . For b l t lng fenales, the Davldson nethod and d l la tat lon-regression oethodgave cornparable est lnates (0.822 and 0.813), respect ive ly and were general ly h igher thanthe estLnates for the rest lng feroales. The oLdest unnarked stephensl female d lssected had3 d l la tat ione and was preaurnably 15 days o ld. Fron these observat lons, i t appeared thatthe greatest populat lon losses occurred dur lng ov iposi t lon and refeedlng, s ince st lmatesbased on parlty data were less than estlmates baeed on natlng or the lnit iatlon ofoogenesls.
. Fur ther , Mahmood & Reisen ( loc.c l t . ) expta lned the nethod they adopted fordetermlnLng the duratLons of the gonotrophlc cycles. They used thernal surnrnatlon nodels ofthe foro v - ( t - t^ )k , f i t ted to the aval lable data obta lned f rorn the lncubator ,lneectary and eelecEed re lease/recapture exper lments, usLng least squares wi thgc = gonotrophlc cycle.
gc, = the nean or nedlant ' o t e n p e r a t u r e b e l o wt - theoretlcal therual
"8a,k - a thermal constant or the nurnber of degree days above t^ requlred for thecornplet lon of gcr . Stnce a d lsproport lonate ly large segenent"of the cul lc l fac lesand perhaps the 6tephgnsl populatlons rest outdoors durlng the pre-gravld perlod (ovarlanstage N to I Ia) , the duratLon of the ln l t la1 gonotrophlc cyc le was calculated f ron 6tageIIb to ovipositlon. Ovlposltlon of both epecles occura only at nlght and seens to be underthe control of an exogenous clrcadlan rhythn caueed by the transitlon fron l lght Eo dark.In nature, endophll lc gravld fenales leave cattle shed restlng sites at dusk, ovlposlt, andthen refeed the sane nlght, slnce uany late-ntght blt lng feoales have thelr ovarles withfoll l .cular sace. In support of thle, unfed paroua fenales were rarely collected restinglndoors. !hus, above certeln threshold tenperaturea, the gonotrophlc cycle remalns at twodays ln parous fenales regardless of the ovarlan Daturatlon rate, alnce fenales wlth fu1lydeveloped ovariee renaLn at thelr dlurnal restlpg sltes untl l f l lght actlvlty^corooences lnreaPonse to exogenous cue. In agreement, at 27- C ln the lnsectary and at 37-C at KotBaghtcha (unpubllshed data) the gonotrophlc cycle 1. g1;!g!!g1"" took about two days (v =0.:). Therefore, the propoeed thernal suumatlon oodel was restrlcted to tenperatures below28- C.
As ahorn under 4.4 above, ReLsen, Mahnood & Azra (1981) carrled outcapture/nark/release/recapture experlnents at Kot Boghtcha vll lage, Kasur dlstrict, PunJabprovincer Pakletan durlng Novenber 1979 and May 1980, lnvolvlng cullclfaciesr ggg3$lgl andsubplctue. In addltlon to obeervatl.ons on dlspersal, some ecologlCal parameters wereestlnated. The rnethods and procedures adopted are shown under 4.4 above. A sumary of theftndlngs followe:
t tne ln days fron stage I Ib to ovLpositLon,2 8 o c ,nlnlnun below whlch ovarlan developnent w111 not occur,
- l lorlzontal eurvlvorshlp: I lorlzontal suvlvorshlpthe recapture rate of date-speciflcally oarked cohortscul lc l fac les, surv iva l est inates nere:
wae estlmated fronof iu l lc l fac ies and
the decl lne lns tephens l . For
vBc/90.3MAL/90.3Page I35
Novenber
Fena les 0 .71 IMa les 0 .651
M"I .
0 . 6 6 00 . 5 5 9
Thus eurvlval estlaates were hlgher dur:[ng November when envlronmental conditlons ltere morefavourable ( reduced temperature and Lnc:reased re lat ive huuld l ty - see 4.4 above). There
was no slgnlflcant dlffeience (P)0.05) between the survlval of rnarked and unnarked
cul lc l fac les females held 1n 3.7 l l t re cagea ln shed 6 for a 2-day per iod as contro l .f f i - " r v 1 v o r s h 1 p e x c e e d e d h o r 1 z o n t a . L a n d v e r t 1 c a 1 s u r v i v o r s h 1 p d u r i n g N o v e m b e r , b u t w a sless durlng ltay when the naxlmum lndoor temperature exceeded 36" C, Dlfferences between
control and nark-recapture estlmates of survlvorshlp Ln Novenber Presunably reflected theadded r lsk of reproduct lve act iv l ty of Ehe re leased nosqul tos (ov lposl t lon and refeedlng) .
Dur ing May, adul ts r rere tnost of ten col lected rest lng near the f loor under debr is tpresunably eeeking cooler, nore hunid n:Lcrohabltats, thus avoidlng the heat of the day.I lor lzonta l est lmates of surv lva l of ete lphensl adul ts agreed wi th est loates for
cullclfacies. Too few rnarked subpLctus ltere recaPtured to estinate horizontaL;ffiit.
- Vertlcal eurvlvorshli l: The authors explalned that lf the population age structurels relatlvely etatl.onary and lf each agre-elass can be sanpled rePresentatLvelyr then thenumber of lndlvlduals scored ln each age-class should form a reaeonable facslnlle of thepopulati.on eurvivorshlp curve. The aeerumptlon of a etatlonary age structure nay have beenvalld, becauee populatlon relative abundance was hlgh in May and Novernber, and sl.ncedlssectlona were carrl.ed out on subeanp,les of feoales collecred over a ehort perlod of four
days. In prevlous observatlons pre-gra'vld cullcifaciee and perhaps stephensl Td gpj:Shave been found to be partlally exophll: lc.
-In-EFe preeent study, oufdoor resting adults of
all three epecles were collected durlng both Novernber and May, of which slgniflcantly(P<0.05) greater proport lon of cu l lc l fac ies fenalee rest lng outdoors r tere Pre-gravld(Novenberi 0.56 pie-gravtd/totafGffiff i tdoore veraua 0.17 lndoors; Mayz 0.67 outdoorsveraus 0.09 lndoore) . To conpeneate for th ls d lscrepancy, pre-gravid fenales were delqtedfron the null l.parous age-clase ln the vertlcal survlvorshlp calculatlons. The followlngeetlmates of vertical survl.vorship were calculated:
Gonotrophic cyele ln days 4Surv lval to ls t ov iposi t lon(nethod of Davideon,1954) 0.931Survlval during whole llfe(calculated by dllatatl.on-regressLon Dethod)Maxlmum longevityln daye
0 . 8 2 1
2
0 . 7 9 7
0 . 7 8 0
28.7 18 .3
cul lc l fac lesnoveilF-@
8teDhen8lg
2
0 . 7 6 0
0 . 5 9 6
14.2
subplctueNovember
4
0 . 9 5 4
0 . 7 9 1
2r.3
Eetinates of vertical eurvlvorahlp approached the values observed at Khano-Harnl durlngNoveuber 1978 (- 0.843, citLng Relsen, lHahoood & Parveen, 1982) but nere greater thanegt iDates of Kot Baghlcha dur ing Vay L979 ( - 0.667, c l t lng Baker et a1. ' 1980) or lngouthern Indla during May-October (- 0.707, cl.t lng Ruseel & Rao, 1942b>. The above dataehotred that the naxloun longevity of cullclfacles wae 10 days longer durLng Noveober thandurlng May, even though fenales conprEEEE:ffinotrophl.c cycles durlng uay (S dllatatLonsln Noveuber veraua 7 ln May). Wlth regard to gg.g$.1, vertlcal eurvlvorshlp at KotBaghlcha waa aore than that observed at Khano-EffiJune (- 0.703). Longevlty estlnatesfo" Splglgl were sllghtly greater thari estlEates uade at Sattokl (- 12 days, clt lngReteen e Aslaukhan, 1979 - 8ee above).
- The relatlon of the flndlnge to malarla traneroissl.on: The expectatlon of lnfectlvellfe (EIL) wae calculated accordlng to the fornula of l lacdonald (1957), P'
-lnP
vBc/90.3MAL/90.3Page 136
The durat ion of sPorogony was est ioated by the thernal summat ion Dethods suggested byDet inova (1962) which presumed that the min i roal developnenta l threshold teroperature forP. v ivax was I4.5oC and for P. fa lc lggg 16oC, and the number of degree-days fo l lowingZ i j i ? i t i v e b 1 o o d n e a 1 r e q u i f f i ! i 6 g o n y r r a s 1 0 5 a n d l 1 1 f o r P . v i v a x a n dP. falciparun, respectively. Mosquito body temperature was assumeE'-I-E!! 'roxlmate that ofthe mean indoor temperature measured concomitant ly wi th rest ing col lect ion. Thernographlrac ings recorded in the centra l ly s i tuated shed in the study area (shed 6 - see 4.4. above)indicated that the dai ly range of indoor tenperature was Lg-2zo} and 30-36oC dur lng theNovember and May exper imenls, respect lve ly . By adding n to the age at which the f l rs tb loodrneal was taken (cul lc i fac ies: 3 days in November, I day in May; s tephensl : I day inMay; .subpictus: I aay-i-ff i68), it was possible to calculate a th;;;;If;J nininalln fect ive age (MIA), assuning that the in l t la l b loodneal was taken f rom a ganetocytecarr ier . By subst i tu t ing the MIA v61ues in the surv lvorshlp curves expressed by thedilatations equations, the percentage of the populatlon surviving to the MIA wascalculated. In agreetrent wl th the ant ic ipated increased rate of nalar ia t ransniss ion lnsunDer, a greater percentage of cullcifacies fenales survived to t 'tIA durlng May.
The calculated est inates of the expectat lon of in fect ive l l fe (EIL) were shown asfo l lows:
cul lc i fac les
rEP . v i v a x 0 . 2 0 0 . 9 5' 0 . 0 6 0 . 7 6r. raJ.clParum
EIL in days
stephensl
I9T
0 . 3 40 . 2 4
subpictusN o v . .
0 . 0 90 . 0 2
The authors pointed out that the estinates for cullclfaciesr g!.ephensl and.ry!g!g!gwere considered low when conpared with 4g-. ganbiae. s. s, lnfected with !: j" lclp.t* i"Tanzanla (EIL = 1.35) and An. arablensls in Northern Nlger la (EIL = 7.L4) , and nay havereflecred rhe lnstabil ity ;ff i-E-rural punJab.
Relat ion of the f lnd ings to the prospect of genet ic contro l in Punjab was d lscussed,for "which the origlnal paper ehould be consulted.
Reisen, Mahnood & Parveen (1982) car f ied out capture/nark/ re lease/recaptureexperlmenEs at Khano-llarnl vll lage, Lahore dlstrlct, Punjab, Pakistan wlth a vlew todeternining the seasonal changes ln survlvorshlp and populatlon slze of gllg!!g!9g'stephensi and glplgg. The nethods and procedures adopted were as follows:
- Collectlon, marklng and release: Restlng nosquitos were collected indoors by twocollectors uslng hand capture for l0 ninutes each day. Captured nosqultos were etherlzedtident l f led to the specles, dusted wi th a date-specl f lc f luorescent duet and p laced in as l te-speci f lc 0.5 l1 t re hold ing car ton euppl led wi th a nater-soaked cot ton pad unt l lre leased. Af ter the f l re t re lease (day 0) , co l lect lons nere exposed to an u l t rav lo letl lght to identlfy recaptures. 0n days I and 2, unmarked and narked mosquitos were dustedwlth a date-speclflc colour and released before the onset of dusk on the 6ane day at theslte fron whlch they were collected. As ln prevlous experlnente, nosqultos unable to f1yfrou the cartona were aubtracted fron the nunber collected to calculate the nunberreleased. The capture/nark/releaae procedure was repeated for three consecutive days,followed by 3-5 days renoval sanpllng. The procedure ita6 repeated once each nonth durlng1978. Addltional speclnens were collected from the southern sector of the vil lage on day0, and were ether ized, dueted and p laced ln a 3.8 l l t re car ton cage, wl th a wet cot ton Padon the gauze top of the cage and a sponge wick ln a vial lnslde the cage. The cage wasplaced in a selected house, and dead adults of each speciee ltere relroved and recordeddally. Numbers of adults allve on the last day were used to estinate survlvorship.
- Dissect ions: Sarnples of up to 100 fenales of each specles col lected dur ing renovalsanpling were dtssected ueing the procedures described prevlously (see Reisen, I ' lahnood &Parveen, f980). Parlty was determined lnit lally by the ovarian tracheole nethod 1n the
vBc/90.3MAL/90.3Page 137
unfed fenalee, but thle was found to undereetluate the proportlon paroue, elnce refeedlng
occurred on the sane nlght of ovlpoeltion. Therefore, comenc{ng ln June, the nuober of
prevloue ovlpoeltlona wae deterntned by the dllatatlon nethod (see aleo below)'
- For s tat ls t lca l ca lculat lone, the or lg lnal paPer should be coneul ted '
Br tef lyr thequoted below-:
ttAdult anophellne nosqultoee were collected resting lnslde houses and cattle
sheds at the rural vll lage of Khano-Harni, PunJab Provlnce, Paklstan' durtng 1978.
Anopheles stephensl was collected throughout the year' and ehowed blnodal populatlon
t n c r e a s e e a u r t | E f i e s p r l ' n g a n d p o s t o o n a o o n 8 € a 8 o n a . @ a n dAn. subplctus were ftrst collected at Khano-Ilarnl at the onset of the mongoon aeaaon
ifrlnl6?tifTons of both specles exhl.bited eharp lnttlal increases, followed by
decreaees related to floodlng and then lncreases durlng the PostEonaoon aeason.
An. eubplctus populatlons eubeequently decllned wlth the onset of cold weather'
6EoTffii-o-pui.lfor, elze eetluated by Balley-s nodlflcatlon of the Lincoln Index did
not dlffer eignfffcantly fron con,currlnt estinates calculated by lt6-e nodLfl 'catlon
of Jackeon-e foeltlve and negatlv'e roethode. Tenporal Patterns ln populatlon. slze
agreed wtth cirangee Ln the relatlve abundance (nuuber collected per uan-hour) of
AI. cul.tcifacles and 49:99$!, bu-t not Ag-gpglggg: co11:"tlon ofErafaEGTiice daETiiGffiFed, ln part, uy tenperature-related changes lnmosgulto reetLng behavlour, whtth affected sanpllng efflciency. The regreeelon of
the nurnber of firnalea ln each gonotrophlc cycle on feoale age provlded the noet
approprlate estlnate of eurvlvorsrhip for epidenlological PurPoses. Davldson-s nethod
provfaea sllghtly hlgher estlnates, since eurvivorshlp durlng the null lparoua perlod
was neasured. It-orlzontal survlvorshlp baeed on the recePture rate of oarked
epecl.nene provlded lower estlmatere, eLnce logsee due to enlgratlon and sanpllng were
lncluded. rl
Relsen et al. (1982) reported on observatlons by nark/releaee/recapture experloente
carrled out at Kot Baghlcha vtUage, PrrnJab, Pakl.stan to study the reproductlve and restlng
behavlour of cultctJai.lee durlng June 1|'979, aB a follow-up of releasee uade during Aprll
and l lay of t lEEi-@E Aa eun''norlzed by.the authorar 9323 fenal'ee and 7548 nalea'
laboratory reared p"og"ty of wlld caught cuitctfactep fenalea were releaeed ae pupae ln a
eelf-narklng devlce pi.""a ar a breedrng EIEfiAFEFe vlllage. The nunbers of uarked
adults collected r"stltg indoors durlqg the flret afternoon followlng release were
dlsproportionately lowei than the numbere taken ln subeequent recaPtur€S. In addltlon' the
proporito., of vlrltn and null lparoua unoarked fenales ltaa unexPectedly low, lndlcatlng that
about half of the newly "t"tg"d
populatglon oay have rested outdoors' Relatlvely few
palrlnge were obeerved at oale swarna rphl.ch forued at, duek ln bovld ghede, lndlcatlng that
rost ratt.,g occurred eleewhere or at dlfferent t lmes of the nlght.
Releen et al. (1986) studled the seasonal changee ln age structure and eurvivorehlp
o fna tu ra1popu1a t1on8o fs@,E ! *E !and -CJ r , t r 1 tgen1o lhynchus . : : }P1 "d - f ' : 'seven vtttages in Lahore aia raeur-eGrritiE-ffiJab, P;klstan Tion Januaty L976 to June
1 9 8 o . o n 1 y t h e r e s u 1 t s o f @ s a n d e t e p h e n 8 i a r e s u o n a r 1 z e d . T h e n e t h o d e a n dprocedures etere a8 followe:
- l lo8qulto collectlone: Collectlng procedurea ttere deecrlb'ed by Releen & Mtlbyj 1986
(eee under 4.5 above). Moequl.tos were co1l"ctea restlng lndoore and outdoore ln late
afternoon and biting bovld balts 30 nl'nulee after sunset' Moequltos were offered water on
a cotton pad ln the fle1d and then taken to the lsboratory allve where they were held
[email protected]'-'by pernlsslon of Dr W.K. Releen and the Journal of l{edlcal Entonology fron
the plper of Relseo, Mahnood & Parveen (1982)'
outcoDe of these experLments ItaE given ln an abstract by the authors ae
vBc/90.3MAL/90.3Page 138
overnight in a cold roon (5o c) . The
as to species and sex, and subsamples
For rest lng sanPlesr g wasbltlng populatlon g nas the
fo l lowing nornLng, mosqui tos were eLher ized, sor ted
of up to 50 cul lc i fac ies and gg@i d issected '
- Dissect lon nethods: The reproduct ive system was extracted in a drop of
physlo loglcal sa l ine, the ovar ies d isrupted as descr ibed by Hi tchcock (1968) ' and then
observed under a compound ro icroscope at 100-200 x wi thout a covers l ip ' spernathecae were
examined for sperma Eozoa. ovarian developnent was classified using the nethod of
Ch r i s tophe rs (19 l l ) as nod i f i ed by Mer (1b36 ) . The b lood d iges t l on s l ages were c lass l f t ed
as pre-gravid, btoodfed and gravld. In i t ia l l 'y , par l ty was determlned for fenales in
ovar ian stages N to I Ia by the ovar ian t racheole nethod, but as posqui tos were found to
feed on the n ight of ov iposi t lon (c i t ing Reisen & Mahnood , L979) ' , prev ious d issect ions
of rest ing females were considered UiasIa unfed nul l ipars. Af ter June 1978, the roethod of
polovodova as nodi f led by Hl tchcock (1g68) was adopted, a l lowing par i ty detero inat ions to
be oade on nost rest lng fenares as wel l as preni t t ing the assessment of the physio logical
age by counting the nunber of dilatatlons'
- Contro ls : The abl l i ty of fenales to form dl la tat lons as wel l as the abl l l ty of the
dissectors to detern lne the Presence of d i la tat lons was ascer ta ined by d issect ing a ser l 'es
of fenales of known physlo logical age. The abl l i ty of each d lssector to d ls t lngulsh 0- ' l -
and 2-parous naa aeterlfnea in a blin<t test usi'ng laboratory reared females whose
physiological age was unknosn to the dlssector. An effort was made for each test to
include conparable numbers of unfed, fed and gravld feroales ln each of gonogrophlc cycles
0 , I and 2 .
- ca lculat lons: The probabl l i ty of dai ly surv lva l \ tas est lnated by three nethods '
( a ) s l : u s e s t h e t r a n s l t l o n f r o o n u l l i p a r o u s t o P a r o u s s t a t e s w h e r e
L /c" l
= P ' - - ' ( f o l l ow lng Dav ldson , Lg54 l l 955 ) .
wl th P = the proport lon Parous, and'g = the durat lon of the gonotroPhic cyc le '
the t lne f rom energence to f i rs t ov iposl t lon, whl le for the
t loe f ron b lood feedlng to ov iposi t lon or refeeding '
( b ) I ,
dal ly eurvivi l
: uses the number of feoales ln all gonotrophlc cycles to estlnate a eingle
value. s2 nas est iDated f ron the back- t ransforned s lope of a regresslon
eguat lon of the forn In (1, + l ) = a + s l t t , where y l tas the nurober of fenales in
dl la tat lon c lass 1, a was' th" in t " r "ept Ar lcohort s lze at the star t , and t r to t : :1 t " 1" . .
days fron "r"rg"rr."
to the nldpolut oi each gonotroPhic cycle. The goodnes^s of f iE of the
lgg-Ilnear regresslon nodel to the data was E*pressld Uy ttre coefficient of determination'
r - , and the regresslon coef f lc ient , 8? was tes ied- for s lgnl f icant departure f ron 0 by
analys is of va i lance ( foLlowing Sokal '& Rohl f ' 1969) '
(c) survival dgrlng each gonotrophlc cycle was calculated using the nethod of
Serv lce ( f973 & 1977) ' . The numbers ln each d l la tat lon age-c lass ' t ransforned to ln(Y1
+ l ) r were f l rs t p lot ted at the u ldpolnt of the durat lon 6f each gonotrophlc cyc le ' The
polnt6 were then connected wlth a siratght edge and a facsloile of the survivorship
conetructed. The nunber of feuales entlrlng each age-class was estlmated for each
gonotrophlc cycle fron the back-traneforned data'
The results as diecussed by the authors are suuarlzed ln the following:
( l ) C o n t r o 1 s : M o r e t h a n 8 0 Z o f c u 1 l c 1 f a c i e s a o d g u n k n o w n s w e r e s c o r e dcorrecrly tnro rtretr dtlatatlon clasee!ff iff i lErty wZffiGgulshed correctly for 972
and 992 of the unknowae. Ilowever, the accuracy of dlssectore decreased to 927 and 952 for
l-parous and to 512 and 487 for 2-parous. The nost accurate deterrnlnatLon was obtained
wlth unfed females, and the least accurate nas encountered with gravid fenales' where
]ffii:T p. 8o-81.2. See PART I , SECTION I I I (D) Ln docuoent vBc/85.3 - l lAP/85.3 ' PP' 28-3L'
vBc/90.3l,rAL/90.3Page 139
euccessful deternl.nation was dependent upon locatlng degenerated foll lcles. Laboratory
fenales were harder to deterr0lne than were field-collected females whose external
appearance such as general colour, lose of scales and wlng-wear lnmediately alerted the
dlseector to the re iat ive age of the specimen. In addl t lonr Parous f le ld-col lected fenales
always had a h lgher proport lon of degenerated fo l l tc1es, and the ovar ies appeared looser
and more heavlly plgmented than laboratory females. Atteropte^were nade to test the effect
of b loodneal eourcei and to p lace fenales 1n a cold roon at 5" C af ter ov lposlEion, but
these methods dld not funprove the appearance of the ovarles or dllatatlons. Experlroental
procedures prevented laboratory reared fenales fron refeedlng on the nlght of ovipositlon
and perhaps thls alteratlon of the normal gonotroPhic rhythn conEributed to the problens of
detern ln lng the physto logtcal age ln laboratory adul [e correct ly . The accuracy of
deterglnatlons of iteld-collected fenales was also lndlcated by the general- agreenent of
the resul ts of prev lous hor lzonta l nark/ reLease/recaPture and ver t tca l d issect lon est lnates
of survlvorshlp of all three species. Moreovei, the fornatlon of dilatatlons in marked and
released fenales of knwon age whlch ltere recaptured and dlseected, always approxinated the
chronologlcal sequence suggested by laboratory observatlons on the duratlon of the
gonotrophlc cyc les (c i t lng Mahnood & ReLsen, f98f) .
(2) Seasonal changes. ln reproduct lve status and age 6tructure:
- cu l lc l fac ies: A tota l o f 8875 femalee col lected rest lng l -ndoors at Sat tok l '
Khano-Harnf aiffi|frilnfcha vlllagea nere dleeected fron January L976 through June 1980 to
deternlne the reproductlve status. Fewer fenales were dleeected fron Khano-Harnl (n -
1753) than f ron Sat tok l (u - 3510) or Kot Baghicha (n = 3602), and these l tere s lgni f lcant lyyounger as they conslsted of more vlrgln and pre-gravld fenales. Khano-l{arnl wae sprayed
wlth nalathlon three tlnee durlng the present Etudy eesentlally el. lnlnatittg g$cifaclesfor per lods of up to 26 monthe (c l t tng Releen, 1986 - aee under 4.614.7 and Flg. l5B
above). Col lect lon s l tee at a l l three v l l lages were located near posl t lve breedlng s i tes '
thus the proportlons of newly energed fenalei resting lndoors ltere exPected to be slt011ar.Relatlvely few pre-gravl.d and virgln females were collected reetlng lndoors, agreeing with
Releen er a}. (1982) who eetlnated that approxlnately half of the pre-gravid fenales rgst
outdoors (eee above). Durlng January-June 1980, l l9 exophtlic fenales were collectedrestlng ln a pit ehelter dug at about 100 o fron one lndoor reetlng collectlon elte at Khot
Baghicha. Slgnlflcantly Dore vlrgln, pre-gravld and null lparoua feoales were collectedrestlng ln the plt shelter than lndoors (P<0.00f). The fed and gravld parous feoales
collected reetlng ln the plt shelters were recorded durlng wl.nter and early spring when-condltlone were cooler and danper. As the reproductl.ve statue of g1191&S1"e ln the'threevll lagee w9e relatlvely slollar, theae data were pooled to deplct eeaeonal trends as shnon
ln Flg. 18^. No ceesatlon of reproductlve actlvlty !ra8 obeerved durlng the year asvlrgln, fed, gravld and parous were found every Donth. Gonotrophic dlecordance occurred
durlng winter (cttlng Mahnood & Releen, 198I - see above, and Rao, 1947 ln Indla) when thegravld group wlth Stage V foll lelee lncluded fenales wlth fresh and/or dlgeeted blood ln
the gut. The reluctance of feroales to ovlpoelt durlng wlnter was reflected by theunexpectedly high proportl.on of gravid feoales collected in January (Flg. f8) when thegravld to fed rat lo wae 1.2:1. Aest lvat lon aB reported by But t lker (1958) ln Sr l Lanka wae
never obeerved ln PunJab. Fron January to Decenber L977, 574 females collected bltlng
bovlde durlng early evenlnge nere dlssected. 0f these, L77 'tere vlrgln, 497 trad foll lcles
ar stage I and nere presuoably finblblng thelr f lrst bloodneal. A further 297 }l.ad foll lcles
at stage8 III-V and were coneldered to be refeeding durlng a gonotroPhlc cycle. Slnce the
tloe of peak bltlng actlvlty of cullclfacles ehlfte to early evenlng durlng wlnter' Inore
b 1 t 1 n g f e n a 1 e e w e r e d 1 e s e c t e d d u i G @ ( D e c e n b e r - F e b r u a r y ) , a t i n e w h e n m o r e v L r g } nfenalee reet lndoore (Flg. l8) and gonotrophlc dlgcordance delays the onset of parlty.-
There ie a nuch lower proportlon of gonotrophlc dlecordance (1.e., nultlple feedlng) durlng
fTIgt.-I6;-T9 and 20 are reproduced by perulsslon of Dr W.K. Relsen and the Annale of
Troplcal Uedlc lne and Paraal to logy f ron the PaPer of Releen et a1. (1986).f f e n a 1 e s t a k e m o r e t h a n o n e b 1 o o d n e a 1 d u r 1 n g t h e 1 n 1 t i a 1
gonotrophlc cycle and exhlblt gonotrophlc dlscordance, then parlty has to be delayed
chronologlcally. The parlty rate lncreaeed at thle tlne, Decenber-January, becaueealtbough fegalee delayed the onset of parlty, they aleo l lved longer after becoolngparoua. In addltlon, cooler tenperatures undoubtedly delayed larval developnent and
reduced the recrultrent rate as well, resultlng ln a hlgh Parous rate Ln wlnter oonths(pereoual couounl.cation, Deceober 1990).
vBc/90.3l.rAll90.3Page 140
Fig.lg. Tcmporal changes in thc rcproductive status (fanuary 19T6toJune 1980.)
and p".ity (f uly 1978 toJirie 1980) of An. culicituics collccted resting indoors in Punjab
provincc, Pakistan. -
' E, gravid; l, bloodfed; El, Pregravid.
i[**t -o-.-.Ats.-'-. ]E IOOoI
t so
J F M A M J J A S O N- - . . r - @ | . ) @ - F n F @ NN o . a \ i r ) ( D \ t @ F o N O | o r )dissected qt .o o 9 9 o I @ () sr (o
Fig.19. Temporal changcs in thc rcproductive status (fanuary 1976 toJunc 1980)
and parity (Iuty tgZA oJrinc 1980) of-An. stephcnsi collectcd resting indmn in Punjab
provincc, Pakistan.. E , gravid; I, bloodfcd; tr, Prcgavid'
nf,nnnnnnnnnJ F M A M J J A S O N D
NO. FRRSX$EPbE$Edissected \' F- @ - () sl cl ro ol ro g \t
D@NrO
flnnnnnnflnn
20F
"L':F"V;-.--\/f
r.-tt-t'...2t 2-1f
vBc/90.3UAL/90.3Page l4 l
the oongoon (Augusr) . From July 1978 to June 1980, 6007 cul lc l fac les females col lected
restlng Lndoors were dlssected to deternlne the nunber of-d:l latatlons. EstLnates of the
parous rate rfere baeed on the number of null lparous, adJusted to account for the 502
lxophl ly exhlb l ted by the pre-gravld fenales, for exarnple, Ln July 1978, of a tota l o f ' 29
cul ic l fac les females, 24 vete nul l lparoue, 2 pre-gravid and 5 Parous. Thus the parous rate
i,a-ftff i ;ed as 5/(Zg + 2) = 0.161. The durarion of gonotrophlc cycles I and 2 or uore
wae coneldered to be four and two days, respectlvely, when the mean nonthly tenperature was
above 20o C. Only 67 of. the fenales dlesected survlved to conplete more than three
gonotrophlc cyc les I l8O/3000 parous feroales] , and were euf f lc lent ly o ld to t ransnl t a
i taSnodlum ln iect lon. The o ldest fenale was col lected ln January 1980, and was estLnated
fi-iff i ;nplered elght gonotrophlc cycles durlng a perlod of 80 days. These results were
conparable ro those oUtainea 1n lnd1a by Afr ld t , MaJld & Shah (1940) us ing
roar i / reLease/recapture nethods and Ruseel l & Rao (1942b) re leaslng narked eul lc i faglee ln
an outdoor cage. In the present study parlty renalned relatlvely constanf aeasonally with
s l lght lncreases dur lng wlnter (Ftg. 18) . Par l ty l tas not corre lated wLth nean nonth ly
rero lerature (3 = -0.261) or to ta l uonth ly ra lnfa l l ( r - 0 .233 df - 21, P>0.05) . l lean dal ly
survlval calculaeed fron the parous rate accordlng to Davldson's roethod (e, - 0'84!) wls
elgnl f lcant ly h lgher than surv lva l est loated throughout l l fe by the-regree6lon n9!h9q-(82-= d.OAO). Siasonal changes !n both est fuoates were wel l corre lated ( r - 0 .714r P<0.01) af id
were hlgheet during wlnter. Both survival estlnatea nere lnversely correlated wlth nean
temDera tu re ( s , : r = -0 .502 ; 6o : r E -0 .662 ' P<0 .01 ) bu t no t t o ta l r a l ' n fa l l ( s l -
-O.Z3g; 6^: r '= t -0.311, P>0.05t . Age-epecl f tc l l fe tables were then calculat€d uelng the
nunber ofzfeoales scored ln eacb dllatatlon age-claes dullng the nonths when the mean
monthly tepperature exceeded 20o C and the duratlon of g' I 4 days and g, ' 2 daye
for i - 2 to w wl th w being the o ldest age-c lass ( f fg . 20A). Af ter adJui t lng the nunber of
null iparous for the proporiton-exophll lc, the observed nunber of null lparous feDalee agreed
wel l wi th the nunber est i r la ted f ron the regresslon funct lon l ln(y i + I - -8.37-0.41t1r
{ - 0 .937, df - 7 , p(0.011. Al though the f t t ted log- l lnear regression funct lon
explalned iZ.tZ of the varlabll lty observed ln the nunbers of fenales scored lnto each
dliatatlon age-clase, the observed survlvorshl.p curve appeared sllghtly elguold.wlth
dleproporttoiately gi""t"r survlval ln the younger (0- and l-paroua) and older (5- to'
A-parous) age claseEs. The sllghtly stgnold shape of eurvlvorshlp curve agreed well wlth
prevtoue li ie table studlea, and undoubtedly contrl.buted to the dlfferences observed
between s, and s2 estlmates.
Flg . 20 Suwivorship curves for (A) Ar: ctlicilocict ^nd (B\ Aa- stcplnri-collectcd rcrt'
ing during thc warm scarcn (April to Novembcr)'1-numbcr of fcmales rored into
."ih dil",i,ior, "ge
ctas.s, i, plotted as a function of c-hronologicd age at the midPoint of
cach gonotrophlc cycle, ,r. O-O, ohc-rved^ lurvivorship curve 6ttcd by a
,".lgfriia. 'O-
-O, c".riiincar rcgrcssioo function 6ttcd through a and thc mcaa of
l.(r,i l) aid t. Curvc l-or An, stcphasi6tted through gonotrophic cyclcs 0-{'
I
r 7II
l 6^ l- l
+ l ss lc l 4- l
' 3
2
I
oB n z . O 4 6 8 | o 1 2 t 4 t 6 ' € ? o 2 2
Age (doys)I ro 12 14 16
vBc /90 .3MAL/90.3Page 142
l. Anendoents of theee stateEents maoe
coruDunlcatlon, December 1990)'af ter consul tat lon wl th Dr M'K' Reisen (Personal
vBc/90.3MAL/90. 3Page 143
tenperature exceeded 20oC and the duratlon of the gonotrophlc cyclee were gl = 4 daysand g. , - 2 days wi th I - 2 to w, (Ftg. 208) . The preeunpt ive adJustment of ' the nunbersof prE-gravlds by trro seemedrapproprlate to the nurnber estlnated by the regresslon functlon[ t n 1 y . , + l ) = 9 . 0 0 - 0 . 5 7 t 1 , t ' - 0 . 9 8 3 , d f - 5 , P < 0 . 0 0 1 ] . F o r a g e c l a s s 0 t o 6 , t h eobser0ed aurvlvorshlp agieed well with the fltted curvil inear regreeslon curve explalnlngmore than 982 of. the variabiJ.lty. Survlvorshlp was relatlvely constanc for age classes 0to 6, but lncreased for fenales conplet lng e lx gonotrophic cyc les, s lnce yt )y ' .
(3) Conparleon of survivorshlp estlnatlon procedures: The authors surnmarized thatsurvlvorship was calculated ln the present study by three nethods:
(a) e, based on the parous rate;(b) s f , a regreselon of the number of fenales c lass i f ied ln to each d l la tat lon
age c lass on t ln6 ln days;
(c) age-apeclfLc eurvlvorehlp durlng each gonotrophic cycle.
The nethod of s, wae euperlor, elnce lt was based solely on the parous rate whlchcould be rapldly and Accurately detemined by the ovarlan tracheole nethod Ln conblnatlonwlth the i l l latatlon technlque. Slnce the populatlon lras dlvlded lnto tno categorles,estlnates could be nade fron dlseection of moderate eample slzes. I lowever, as can begathered fron the ellght slgnold nature of the eurvlvorehip curvee (flg. 20), survlvorshlpdurlng the null lparous perlod nay be sllghtly hlgher than durl.ng subsequent gonotrophlccycles, even accountlng for the dlfferentlal reetlng behavlour of the pre-gravlds. Ingeneral, the authors felt that the sl oethod probably overeetioated eurvlvorshlp durlngthe parous perlod and would provlde htgher estlnates of longevlty durlng the lnfectlvellfe. Conversely, the s" nethod waa Eore dlff lcult to perforn, requlring a large nunberof tedlous dlseectlons whlch were subJect to greater error ln lnterpretatlon due todlssector-a error and/or reproductlve anoualles. The elope of the fltted regreesioneguatlon and coneequently the survlvorship estlmate, waa extreDely sensltive to the nurnbersof older females whlch usually forned less than 102 of the fenale populatlon. AdequateestLnates thus requlred the dlssectlon of large numbers of fenales. On the other hand,a, was calculated by a least sguare flt to the data and provided a slngle eurvlvorshlpeEtinate. The eerles of age-speclfic eurvl.vorehlp estlnatea nere also eubJect to thetechnical and eaopllng probleus descrlbed for er. However, thle approach was noreneanlngful blologlcally, slnce lt dellneated th6se perlode of l l fe nhen nortallty was .thegreatest. I lhen coupled wtth data of gonotrophlc cycJ.e-speclflc fecundlty, theee estloatessould perult the calculatlon of net reproductlve and populatloa increaee rates.Age-apeclflc survivorshlp rates were usually varlable and thus it wae cumbersome to makeconparieons auong populatlons over tlne and 8pace. In addltlon, the rellabll l ty of eachestl.uate decreased ae the age lncreaeed due to progreselvely snaller sample el.zee.
Rel.een & Borehau (f982) attenpted to estl.rnate the vectorlal capaclty of gul.lclfaclesand g!@,1 Ln a rural aree of PunJab, Pakletau. fhe study wae carri.ed out durlng 1978at Khano-Harnl. where Releen, Mahnood & Parveen (f982) conducted rnark/release/recaptureexperlnents to determlne the eeaeonal trends ln populatlon slze and survlvorshlp ofcullcLfacles, stephenei and.g!p;!gg (see above). l ' lalarla !ra6 a publlc heal.th probJ.en atKhano-Harnl durlng 1975, when 30 cases of A. vlvax and 144 caaea of P..1!glg!pgg weredetected among 287 btood elldee collected t-y-iff ie case detectton.
.EGffi i-e posltlvlty
rate in 1975 wae hlgheet durlng the noneoon and poatnonaoon seasons, whlch was typlcal ofthe well-recognl.zed geasonal pettertr of nalarla caaea ln PunJab (clttng Zulueta, l luJtaba &Shah, 1980). Ae nentloned abover Khano-Harnl. wae sprayed on 27 July and 16 Septenber 1976wlth nalathlon at a rate of.Zg/n-, which ellninated cullclfacfesr ggg!9gg.1 and.g!2!g$from the vlllage durlog the remal.nder of. 1976 and nolETTffi c6iffitry, tEfrGEErof casee decreaged draEt lca l ly ln 1976 (3 P. v ivax and 4 P. fa lc lparun ln 57 s l ides) , L977(3 P.'vlvax tn 62 elldee) and 1978 (r p. viFix-rrra0 srraff!@n'uer L977, [email protected] the study erea, brt gg4lgl$lg wae etl l l not routlnely collected untl l thenonaoon aeaaon of 1978. The proceduree adopted ln the preeent Btudy were:
vBc/ 90 . 3MAL/90. 3Page 144
- Vector densl ty in re lat ion to man: Since previous exper ience showed that d i rect
nan-bai t capture r . " . rot successfu l under condi t ions prevai la lng in Punjab (see Reisen
et a l . , Lg76 arrd others, under 4.6/4.7 above.wi th the except ion of Mahmood & l ' lacdonald '
1985) the authors resor ted to indi rect measures of man-vector contact ' Dai ly female
Anopheles populat ion s ize was caLculated us ing Bai ley-s (1952) roodi f icat lon of the L incoln
lndex. This was d lv ided by the census of the hunan populat lon of the v l11age to der lve
vector densl ty i .n re lat ion to man. Thls was then nul t ip l ied by the nan b i t ing habi t (HBI X
f requency o f f eed ing ) .
- Host feeding pat terns: Depending upon mosqui to catches t uP to 100 b loodfed fersales
per species were sufsaroplea f ron col le" i ron" pootea f ron a l l rest ing s i tes. Bloodneal
smears were resEed sero logical ly for ident l fy ing the hosts by prec lp i t ln tests ' Thus, the
subsamples tested conpr ised a mixture of epeci rnens col lected f ron both houses and cat t le
sheds, and were presunably rePresentatlve of the entlre bloodfed female populatlon on the
day of sanpl ing. Both f r lsh ly fed and late fed females were tested to avoid any b ias due
to possib le changes in host feeding Pat terns at d l f ferent t ines of the n lght ' Females
tested or lg lnated f roo pooled lndoor reEt lng col lect lons f rom four cat t le sheds and 12
houses. Dur lng summer, v i l lagers s leep out ; ide ln-cour tyards near_ thei r donest lc anloals
w l t h o u t b e d . n e t s . D u r l n g w i n t e r , n o s t . v l l l a g e r s s l e e p l n h o u s e s w h l l e t h e l r a n i m a l s a r ekept in cattle sheds, allhough sleeptng quarters are occasionally shared' Prevlous
observatlons showed that the indoor t"It irrg anophellnes egress tt 1::! ' feed outdoors and
lngress at dawn for resglng (c i t ing Akiyani , tg74; netsen et a l " 1975; Reieen & Aslarokhan'
Lg78 - see under 4.6/4.7 above). i , r t tor rgh sanple s izes were smal l dur lng sooe monthg' the
fenales tested presumably rePresented th; host feeding Pat terns of the 'ent l re b l t tng
populatlon at the norlhern sector of Khano-ttarni and .*tbfa"a some of the sanpllng biases
dlscussed by Garret t -Jones, Borehao & Pant (1988 - see under 4.9 above)
- I l u m a n a n d a n i r o a l p o p u l a t l o n c e n s u a ! A c e n s u s o f t h e a v a i l a b l e h o s t s l n t h e n o r t h e r n
sector of Khano-Harnl durlng septerober 1978 showed thst there were 102 people' 37 bovlds
(cat t le and buf fa loes) , and a number of donkeysr goata, dogsr cats and b l rds '
: ca lculat ions: The synbols used ln Present lng the data were def ined ae fo l lows:
a = anthropophil lc lndex [It ls neant to be l lBI, and should not be confused with
- the a of Macdonald (1957) whtch le the nan b l t lng habl t (see above) l '
B = bovid populat ion s ize detern lned by household census '
b = proportion of bovid-posltlve bloodmeals aBong all poslttvely reactlng meals'
BB,= b;vla blt lng rate ln ienales per bovld host per nlght'
EL= l i fe exPectat longc - durattln of the gonotrophlc cycle -
? Ln aunEer and 3 in winter.
I l = hunan populatlon slze deternined by houaehold census'
HB. - huoan Uftfng rate = fernales Per l lan per nlght---f, - i,rr"rion oI eporogonic cycle ln the !*g,;rheles host'
P-- dally fenale Anopheles poiulatlon glz#Fn-Lted by'Balley-s (f952)
E nodificatlon of Lincoln Lndex'
e = daily i"r.r" Anopheles survlval esti 'ated vertlcally by the dllatatLon
regression uethod'vc E vector la l capacl ty '
The authore deflned the vectorlal capacity a9 the lPotentiall nunber of oalarla
[eecondary] lnfectlons a glven .r""tot to"qrrlto tonfa-ai"i ' ttUt't" p"i ltttttttated prlnaryl
case per day. The fornul" of Cari. ia-.lorr"" (1964) and as applled by Mollneaux' Dletz &
Thomas (1g7g) in the Garkl p.o1""t, iortpern Nlgerla, West Afrlca qtaa applied but the
spnbols shown above were ueed as follows-:
l. Dr t. Mollneaux, Chlef OPeratlonal Reeearch/CTD exPlaLned that the above fornula of
vectorlal capacity as presented bi lt "
.,rtt ots ustng dlfferent synbols ts the 6ame as
2 -L /E
Garret t -Jones (1964) wi th HBa = na; HBaa c ma-; e = p;2 n| t t A D O I-1og.P
-n,/Ee Pn; E = !; .-nlEg =
-1og"Poo
-1og"P
vBc/90.3MAL/90.3Page 145
vc - (HB^a)("-olEu)\ " - t e l \ 5 e '
where HBa - (Paa)/gcH);E - ( -1n s)- l ; e - the baee of narura l logar l thns.
In thls relatlonehlp, the lndex a wae lncluded twlce to eccount for the vector havlng torefeed to t ransro l t an acquired ln fect lon. The durat lon of the sporogonic cyc1e, n, wa6calculated through using the heat sunmatLon nethod (ln Detlnova, 1962). The rnlnLnaltherroal developnenta l threshold for P. v lvax was 14.5"C and for P. fa lc iparun was16'c. As sholrn above, rhe human ur@Te !ra6 calcutared as ETI-(?.4'II(EcH).
For conpar lson, the bovld b i t lng rate nas calculated as BBa-(Pab)/ (gcB)
The resulte as dLscussed by the authors were as follons:
(a) Anopheline seasonal patterns: the authors euonarlzed the flndlnge of Releen,Mahnood & Parveen (L982 - see above).' An. stephensl wae collected throughout 1978 wlth ltsdensity lncreaslng durlng the late spring (Aprl1-May), early uonaoon aeaeoo (August) andautunn/It lnter (Novenber-Deceober). An. cullcifacles and glplgg dld not colonlze rheetudy area untl1 the onset of the noi?,6Til?iTi-s lnllate .t@?td-?arty August.gcullglf?cig.populatlons lncreased ln Auguet and Novenber-Deceuber, whlle subpEEI;populatlons increaeed durlng September, but then decllned wlth the onget oF ttre coolervteather ln Novenber-Decenber. The populatlon elze of all specles decreaeed durlng monaoonfloodtng ln late Auguet-early Septenber, when all breedlng places were lnundated by runofffron dralnage canale. Fenale dally eurvlval estLDated vertlcally by the dllatatlonregresslon nethod, was hlghest for all three speclee durlng the cooler oore hunld Donths.
(b) Itoet feeding Patterns: Preclplt ln tests ehowed that a enall proportlon ofcullclfacles and glgp$gl had fed on !ran, a - 0.048 and 0.009, respectlvely, but nonan-posl t lve waa detected ln ,eubplctue.
(9) Vectorlal capaclty: Estlnated paranetera were tabulated ae ehonn here LnTab le 9 ' .
Table 9. Estfinated nunber of hunan and bovld feede per host per night andestl.Dated vectorl,al capacl.ty f or L vivax and P. falclparunAn. cullclfacles aqd An. etephenel at Khano-Harnl for nonthe1976 when human feedlng was detected.*
ofduring
P. vbat P. falciparumTeur
Morrn CC) P, H& n v c ' b B B r
At. ailicifacicsArg. 31.7Scp. 30.0Oct. 26.1Nov. 20.6Dec. 18.3
Aa. stephmsiNov. 20.6Dcc. 18.3
27t4.4 0.077 1.025417.0 0.l u 0.227242.E 0.053 0.063817.6 0.049 0.115
1419.9 0.022 0.102
4123.8 0.024 0.32325E3.1 0.016 0.135
2 .16 6 .u2.68 6.772.t4 9.045.86 17.335.40 27.42
3.28 17.33t.75 27.42
l .0l x l0-t5.40 x l0-r1.05 x l0-'2.57 x l0{?.55 x l0-t
1.29 x l0{5.41 x l0{
7.08 6.43 x lo-t7.93 3.50 x l0-l
10.98 {.22 x l0-!24.34 {.55 x l0-r47.i l 1.79 x I0{
24.94 1.09 x lo-t47.il 2.46 x l0-l
0.923 33.E60.8E9 5.010.E95 2.940.882 6.500.933 I1.93
0.929 34.510.967
' 22.s0
. Column headings: Temp = mean daily Gmpcraturc in shed l5/3; Pr = m€an ! -Population size estimated by the Urrcoln
lndex; a = anthropopiagic iniex; H&, human biing rate, = (P,aVGc H) with gc =-2 days from Aug.4ct. and 3 days in Nov'-
Dec., and H = I02 humans; E. life expccancy, = l/-in s6 with s6 estiiraterl by thi dilatation regr.ession.method; n = the duration
ot sporogony at the estimaiJ mean'Jaily ti-p.'"t,rr.i "c,
vitorial capaciiy, = (HB,a)(e-!'EE); b = bovid feeding index; BB1,
bovid biting rate, = (Prby(B gc) rvith B = 57 buffalocs and cattle.
. i .Ta-6.iFild 10 reproduced by peroleslon of Dr H.K. Releeo
Entonology fron the paper of Relsen & Borehan (1982).and the Journal of Hedlcal
vBc/90. 3MAL/ 90 . 3Page 146
For cu l i c l f ac les , t he es t t na ted roan b i t i ng ra te , HB , v ras a t a max imum o f 1 .025[ w r i t t e n " f f i t ' e t e x t a s l . l 8 4 - D r W . K . R e 1 s e n , p E r s o n a 1 c o m m u n l c a t i o n , l 9 9 0 ] b i t e sper Dan per n ight in August as shown in Table 9. The HB. then decl ined because ofchanges in both P, and a. The proport ion of rnan-posi t ivE feeds was lowes! dur ingDecenber when the-v i l lagers s lept lndoors under qui l t .s , and was h ighest dur ing sumner whenthey s lept ouldoors wl th rn infuoal cover . In contrast , the proport ion of bovid-posi t ivefeeds renained re lat lve ly constant , ranging f ron 0.882 in Novenber to 0.933 in Decenber.Slnce the bovid populat lon s ize was constant , BB* was d i rect ly proport lonal to P* andnas constant ly greater t .han HBr. The expectat io f i o f l i fe of cu l ic i facJes was 1of i ,ranging f ron 2. f2, in OcEober tE 5.86 daysin Novernber. fne anr i t te sporogoniccyc1e, n, nas shor lest ln August and longest In Decenber. The vector ia l capacl ty washlghest dur ing Septernber and lowest dur lng November-Decenber. Theoret ica l ly , in fect lvefeeds dur ing August , Septerober and October would be ref lected in the h igher s l ideposi t lv l ty rates dur lng postmonsoon season (c i t ing Zulueta, Muj taba & Shah, 1980). For
[email protected], the incidence of human feeds were 1ow during November-December, although theferoale populat ion s lze was large. No nan-posi t lve feeds l tere detected by precip i t in testsdur ing the rest of the year . As shown ln Table 9, the est inated HB, ' was 0.323 tnNovenber and then decl . lned to 0.135 dur ing December when the populaElon s ize decreased.Slnce bovid populat lon s ize renalned constant and the lnc idence of bovld-posl t ive feedsremalned 0.9 throughout Novernber-Decenber, the BBr presuroably paralleled changes ln thestephensl populat lon s lze. Dur ing Noveober and DEcenber when the expectat lon of l i fe waslow and the durat ion of sporogony was longest , est imates of the vector ia l capaci ty ofs tepheng! were correspondlngly low. With regard to gubpictus, despi te a large populat lonof thls speciee found restlng ln and around houses during the helght of the malariat ransnlss lon Eeason, no nan-posl t lve feeds hrere recorded, thus lndlcat lng that thevector ia l capaci ty of Sbplctug was equal to 0. Prevlous d lssect lons for nalar la parasi testhroughout the Indo-Pakistan subcontlnent have indlcated that Splglgg plays lLttle or noro le ln nalar la t ransuiss lon (c l t lng Watta l , 1961 and Das, Reuben & Banta, L979). Theauthors considered that cu l i .c l fac les_ vector ia l capacl ty best f l ts the repor ted pat tern ofrnalar ia t ransnlss lon at Khano-Harni , and th ls specles should be regarded as the speciesroost l lke ly to be lnvolved ln nalar ia t ransnlss ion. L i fe table calculat lons by Reisen,Mahnood & Parveen ( f980) , and the f ind lngs of oark/ re lease/recapture exper inents by Afr id i ,Maj ld & Shah (1940) and Russel l & Rao (1942b) suggested that surv iva l nay not actual ly beconstante 1.€. , once a female reaches a cer ta in age, 1ts l l fe expectancy oay actual lyincrease. If these fenales bocone non-gonoactlve or exhtblt lncreased frequency ofgonotrophlc d lscordance wl th the onset of cooler .weather as suggested by Rao (1947) andMahnood 6 Relsen ( f981) , then nalar la t ransniss ion may be somewhat changed. The authorsfurther polnted out Ehat the extremely hlgh lncldence of bovid feedlng by al1 species ofAnopheles at Khano-Harni, as well. as at other Punjabl vll lages (cit lng Reisen & Borehan,1979), nas a cr l t lca l factor ln reduclng vector la l capaci ty . I t is qui te posslb le thatbovlds served to dtvert host seeklng fenales fron humans and thus the degree of oan-vectorcontact becones reduced. A reductlon of the proportlon of bovids in relatlon to human inruraL PunJab would be expect,ed to lncrease the rate of malarla transulssion. Changes lnthe degree of huuan feedlng by nornally zoophll lc vectors were lncluded anong the factorsconsldered responslb le for nalar ia epldenics (c l t lng l {acdonald, 1953). The authors fur thershowed that the pooled vectorlal
stephensL at Khano-Harni were less than 1.34 X lO-2 for
P. vlvax and 8.58 X lO-3 for P. falclparun. The estlnates for l:-€"1"1p* transmlsslon1@1f""t* and tephensi-ffiGf,G6btalned durlng or SusffiETeputed monaoontransnlselon seaaon, were loner than thoee recorded io &-gg}!gg. s.1. and &-@!g "tuneprayed rural vLllages ln troplcal Afrlca as shorn ln Table 10.
Obeerved dlfferences would suggest the range of vectorlal capaclty values for vectorslovolved ln unetable versua etable malarla, respectlvely. Flnal1y, the authors concludedthat ln PunJab changes ln the hunan blood lndex and/or vector populatlon slze andsurvlvorshlp would be necessary before nalaria transrnisslon rates could increase toepldenlc proport l .ons. Studies lnvest igat lng posslb le geographical varLat lon ln thevectorl,al capaclty of cullclfacles and stephens.l are lndicated ln areaa supportlng htgh andlow levels of nalaria E!€nfiiffi; to el[ffichanges ln the conponents of vectorLalcapacl ty necessary to support nalar ia t ransmiss lon.
capacl t ies for cu l lc l fac les and
Table 10. Conparat lve est inates of vector la l capacl ty (vc)degree of hunan feeding (a) and longevlty (E) ofrural vll lages 1n Pakletan, Nlgerla and Kenya.
vBc/90. 3MAL/90.3Page 147
f o r P .nalarla vectors at
tc (R-{NGE)Loceltrres
AnophclcsSPECIES
Khano-Harni, Pakistan*
Kankiya, Nigeria**
Garki, Nigeria**'
Kisumu, Kenyartr
culicifaciesstephcnsi
gambiae
gambiac
funcslus
gambiae
funestus
0.0480.009
0.75
0.9r0.97
0.9460.991
3.653.52
7 . r44.266.35
6.006.00
I
l
1.8 x 10-6 to 6.4 x l0-3
3.0 and 16.2
0.006 to 21.74
0.016 to 22.25
*Present s tudy, a and E calculated f ron tota lsr VC = year ly range for both speclescoroblned.
**Garrett-Jones & Shldrawl (1969) unsprayed vll lages.' ***l lollneaux, Dletz & Thonas (1978) ungprayed vll lagee
ys. r yearly ranges fof both specl.es conblned.
As shown under 4.5, Uahnood, Sakal & Akhtar (1984) carrled out a survey to deternlnethe dletrlbutLon of specl.es A and B of the An. cullctfacles conplex ln PunJab provi.nce,Pakl.eran. subsequenrly, they selecred ttre ?6ffiffi!-6ffi111agee ln Kaeur dletrlcr forlntenelve obeervationa on the vectorlal lnportance of cullclfaclee conpared wlth gg*@!and !g! ,: Devkl , Saharanke, Baghiana Kurd and l(hanEe. Fron Eheee vll lages I}t, f6;n9and 109 apeclnene were examlned cytogenetlcally, 8nd all were specles A of the An.cullclfaciee conplex. Sarnples of guitctfactes, stephensl. and.g!g!g5gg. taken f6i-the fourvll lages were dleeected to deternlne the parous rate uslng the ovarlan tracheole Dethod,and for count lng the nuuber of d l la tat lons (Det lnova, f962) . Calculat lons were as fo l lows:
(a) duratlon of the flret gonotrophlc cycle (followlng the nethod of Mahnood andRe lsen , 1981 , eee above ) : v - l / gc ;
- fo r cu l l c l fac les : v - ( t - 12 ,6>/29 .7 .8 . 9 ) 4 3 . 4 .
( fol lowlng Davldaon, 1954).of pre-gravlds;
Egtluatee of the duratlon of the first gonotrophlc cycle and expectation of l l fe were madeunder the tenperature conditlone prevall lng ln each vll lage durlng the collectlon perlodwhtch extended froo Novenber 1982 to January 1983. Eetloatee of the duratlon of thes p o r o g o n 1 c c y c 1 e e f o ' 3 @ 8 n d 3 s w e r e c a 1 c u 1 a t e d f r o n t h e t a b 1 e s 1 n c 1 u d e dln Det l .nova ( f962) .
Therresul te for gul lc l fac lesr 's tephensi and subplctus were tabulated as shown h6re lnTablee l l^ , 12 ' and 13 ' , respect lve ly . Mosqul to col lect lons shoned that cu l lc l fac les(epeclee Ai wae the Dost abundant anLphellne specles present and ubplctuFiff iG inKhanke vll lage which nas aurveyed ln January 1983. In addttlon to the relatlve abundance,a conparl.eon of the age structures and llfe expectancies of the three specles suggestedthat cullclfacdes was the nost probable prlnary vector. Ae an example, at Baghlana Kurdwhere l lore than 607 of, the fever patlents (148 exanlned) were posltlve for oalarla, thecullcLfacles populatl.on wa6 Dore than tnice ae large as that of [email protected] and more than l0tlnes as great aB that of g!p$. AE shown ln Tables l l, 12 and 13, 347 of culicifacl.esparou.s fenales had ovlpoelffiE; or Dore tlnes whlle only 6Z and L27 ot stepffiT-iiFsubplctus, respectlvely had done so. Addttlonally, more than 902 of the nalarla-posltlveP a t 1 e n t 8 t n t h e v 1 1 1 a g e w e r e 1 n f e i t e d w l t ' h P . f a 1 c 1 p a r u n , a n d 1 t w a s o n 1 y g l @ t h . t
i @ l 2 a n d l 3 a e w e 1 1 a s T a b l e l 4 a r e r e p r o d u c e d b y p e r n 1 s s 1 o n o f t h eTrgnsact lons of the Royal Soclety,of ,Troplcal Medic ine and Hyglene f ron the paper ofl lahnood, Sakai & Akhtar (f984) - (the present addresses of Dr Mahnood and Dr Sakal couldnot be t raced).
( b )p -gc( c )
- for stephensl. and !g!g!g!gg: v - {g-;
probabl l i ty of dal ly eurv lva l , S - P- '6- ,proportlon parous adJusted by the number
- duration of the first gonotroph{c cycle.expec ta t l on o f l l f e , E - ( - l ns ) ' .
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vBc/90. 3MAL/ 90 . 3Page 150
had a l l fe expectancy greater than the est lmated durat lon of the sporogonlc cyc le forp. fa lc iparuro. (see the resul ts of d issect lons of the three anophel lne specles for
oalari.a-I- fnfectlon under 4. l1 below) .
Mahnood & Macdonald (198 5) dur ing thel r s tudles ln four v i l lages in Kasur d is t r ic t
P u n J a b , d 1 s s e c t e d s a r n p 1 e s o r @ ( s p e c i e s A ) , ^ : | e p h 9 I r s 1 ? " d . W c o 1 1 e c t e dr"siirrg lndoors monthiy rroro liftiffiBTto December 1966. They deternined the
insenlnat lon rate, the stage of ovar lan developnent us ing Chr ls tophers- nethod as modi f ied
by l ter (1936). fhe nethod of Polovodova, oodl f ied by l t i tchcock (1968) was used for par l ty
detern lnat ion. Dlssect ions a lso lnvolved the detern lnat lon of oocyst and sporozol te rates
(see under 4. l I be low). The durat ion of sporogony was calculated by l {oshkovsky-s heat
sunraat lon nethod ( tn Decinova, L962) based on teDPeratures recorded at the lndoor rest ing
sl tes. The resul ts showed:
- P r o b a b 1 1 1 t y o f d a 1 1 y s u r v i v a 1 : S u r v 1 v a 1 o f @ a n d 9 ! s ! s i w a s h i g h e s t
dur lng wlnrer mont-hs: O.gO-b.97 and 0.81-0.92, respEct lve ly . 11!h g1*49!" ! ' - t t "proUaUtt t ty of dat ly survLval ranged betneen 0.77 l -n-October 1983 and 0.93 ln November
1984, a per lod when th ls species was aval lable for co l lect lon.
- Expectat lon of ln fect lve l i fe (EIL) : The authors polnt lng to thei r tabulated data
lndlcated that the EIL of cultclfacies lras generally longer than that of st9PhePsi and
conelderably longer ttran tI ifr?@gg. From theee data, the EIL for the three specles
wae shown as followe:EI I , (days)
steDhen6lP . v . P . f .
2 .49 2 . r l2 . 48 2 .101 .04 0 .794 .02 3 .52r . 56 I . 204 .43 3 .37
[Theee flgures are much hlgher than those,recorded by Reisen, Mahoood & Azra (198f -
see above) partlcularly lf the data of l{ay are coopared. The present authors (Mahnood &
Macdonald, loc.ct t . ) a fa not d lscues the reasons for such d l f ferences. Perhaps the
dlfferencea were due to varied sanpllng procedures, for Relsen, Mahmood & Azra (1981)
derlved thelr data froo coll-ectlonTnark/releaee/recapture over a 5/day perlod, whlle the
present authors dlseected eanples collected longltudlnally frou August 1983 to Deceuber
1 9 8 4 1 .
l lay 1984JuneJulyAugustSeptenberOctober
cul lc i fac lesrc5 .74 . 5 . r 82 .16 1 .851 .97 1 . 613 .28 2 .824 .04 3 .4 r4 .43 3 .27
subplctusP . v . P . f .
r lsr t .z t1 . 6 4 1 . 2 72 . 7 0 0 . 0 4
- Vectorlal caPaclty: Thiscapaclty of thle apecies rangedbltlng nan deeplte 16 man-nlghtsP. falclparun tn August 1984.
[l lere agaln the values of the vectorlal capaclty of cullclfaclee calculated ln the
present etudy for August 1984 are nuch hlgher than those estlDatea-Tor the saDe species Ln
i,rgu"t f978 it Khanolltarni, Lahore dletrlct by Relsen & Borehao (f982 - eee Table 9). Two
obvloua reagona Day accouoi tot thls dlfference. Flrstly, Relsen & Boreham estinated the
nan bltlng rate by an lndLrect nethod as 1.025 blteg/nan/nlght ln August 1978 (Iable 9)'
while Uahnood & Maedonald uslng dlrect nan-balt capture ln the Present study recorded
4 . 5 b 1 t e e / n a n / n 1 g h t t n l u g u s t t 9 8 4 . S e c o n d l y , t h e e x p e c t a t 1 o n o f 1 1 f e o f . w . 1 a seetipated to be 2.16 daye Ln Auguet 1978, whl.le the estinate oade by Mahnood & Macdonald in
the correspondlng nonth of 1984 vae 7.82 days. However, eooe cllnatlc and other
envlronnental factors that prevalled ln 1978 in the etudy area of Lahore dlstrlct (Relsen &
Borehan, 1982) anal that of Kasur dlstrict ln 1984 (Mahroood & Macdonald, 1985) nay have
lnfluenced the dlfferencea ln the estlnated Paranetersl '
lndex wae calculated for cullclfacles only. The vectorlal
fron zero ln June 1984 (when-no SCLi!9e91-99. were caught
of col lect lon efforts) to 0.:zaE?@ and 0'281 for
vBc/90 .3MAL/ 90. 3Page 151
4. I l Natura l ln fect lon
In lraq, records of eome workers clted by Macan (1950) showed that of 289 gg#,1fenalee col.lected 1n Shatt-Al-Arab durlng October-November L942 two had sporozoites and one
had oocyets g lv lng a sporozol te rate of O.77" and a tota l ln fect lon rate of 12. Bet \ teen
Seprenber and Decernber 1941, 287 $S2$.1 fenales were d lssected and one (0.352) was found
iniected with eporozolres. MacanJfTlrnecl that the dlstrlbutlon of malarla 8nd 9!@,!concided eo closely that there can be l ltt1e doubt that 1t was the only lnportant vecto! in
the alluvlal plain regl.on of Irag. No newer recorda are avallable fron Iraq.
In Bahraln, Afrldi e UaJld (1.938) lndlcated th.t g!s!s.l was the only species found
tnfected wl th nalar la paraei tes ln nature. 0f t l42 fero i les of th ls specles d lssected, 8
were found wi th gut ln lect lon and only one r faa found eporozol te-posl t lve (0.092) ; the tota l
ln fect lon rate belng 0.72.
In Oman, Shldrawl (1982 - unpubllehed report to !lHO) reported the results of
observatLons made durlng 28 Vay-L6 June 1982 to verlfy the operatlonal lnpllcatlons of DDT
resletance aa reconmended by an external evaluation tean tn 1981. The observatlona were
carrled out 1n Shinae, Batlnah reglon whlch had recelved l0 rounds of DDT spraying wlth
poor coverage. At A1 Ghawabl, a eprayed vil lage, 15 cu1!qtlg9-19-q (Il fron oan-balt
t.pt.g", I iron PSC and 3 fron exlt traps) and-li ste;T6-Bf(E-Eon nan-balt capture, 7
f ron PSC and 4 f roo exLt t rapa) were d issected and onEEul ic l fac ies (6.72) ( f ron bal t
capture) and one etephenel (5.32) were sporozolte-poaltlve. Shldrawl pointed out that
theee resulte trav-ZGt efgnlflc,ance ln that they represent the ftrst records ofs p o r o z o 1 t e - p o s l t 1 v e e p e c 1 u - n e 1 o g g 1 @ a n d . @ . 1 i ' l 0 n a n , a n d E e c o n d 1 y t h e y c a n efron a aprayed are8. A11 pereonnEl who acted as collector-bal.ts were questloned aa to
whether they had taken a prophylactlc dose of chloroqul.ne. Thoee who had not nere glven
the recounended doee. It was reallzed later that one collector-balt who claloed to have
already taken hls dose before departure fron Muecat, dld develop P. vivax nalarla 20 days
after the bttlng catches took place, and was accordlngly treated.
In Iran, Motabar, Tablbzadeh & l.tanouchehri (1975) l lsted records of sporozolte rates
ae follonsz 4.77 for cullclfaclee durlng epl.denlce, and 0.512-L.762 fot 9!99881. Thep h y s 1 o 1 o g t c a 1 a g e w a e - @ l E 1 c c y c 1 e e f o r c u 1 l c 1 f a c 1 e e a n d 9 f o ' g g @ . ! .
In Afghanletan, Ramachandra Rao (1951) worklng ln Laghnan dlstrlct of the Easternprovince recorded a eporozolte rate 6t O.t+Z fr Sgllg!!g!99 (768 dieeected) but no
l p o r o z o 1 t e p o s 1 t 1 v e w a e f o u n d 1 n a s a n p 1 e o f 2 8 2 - @ d 1 e s e c t e d . A s a h o w n u n d e r 2 . l 1a b o v e , h e c o n e l ' d e r e d s @ 8 n d g g ! @ ' t o b e P r o v e n v e c t o r 6 1 n L a g h n a n a r e a .
In Pakletan, i lul1lgan & Bally (1938) durlng thelr lnvestlgatlon on nalaria and lts
v e c t o r a 1 n Q u e t t e c a r r i e d o u t w e e k 1 y d 1 s s e c t 1 o n s o f s @ b e t w e e n 2 5 J u 1 y a n d 9o c t o b e r l 9 3 5 . o f a t o t a ] ' o f 8 3 5 e p e c i m e n e d 1 s s e c t e d f f i p o s 1 t 1 v e f o r o o c y s t e a n d 2 . 3 7were posltlve for sporozoitee. Gland lnfectlons were found between I August and 25
September, and lt le probable that thie was the perlod durlng which condltLons were most
favourable for ualarl.a transoisslon by cullci jacles durlng the oalarla aeason of 1935. No
lnfectlons were found ln thls species aftei-25 September, and ae the nunber of adults of
t h l e s p e c l e s E h o w e d a n a r k e d d e c 1 1 n e a f t e r t h a t d a t e ' l t 1 s 1 o p r o b a b l e t h 8 t @na8 responslble for nalarl.a tranern{eelon after that date, at lea6t to any appreciable
degree. The loweet lnfectlon rate in cullclfactes waa found ln sarnples collected fron
ouidoor resrlng slres. Thte le tn etraiiGiEii6T-to elollar observatlons on superplctuswhlch ehowed a'hlgh lnfectlon rate arlong adults collected reetlng outdoors. The
explanatlon of thie dlffereuce ln the infectlon rate between these two specles 1les 1n the
fact that cullcLfacles ie lese prone to resort to outdoor restlng ehelters after taklng a
b 1 o o d n e a 1 E 1 a n @ c t u s ( e e e u n d e r 2 . 6 | 2 . 7 a b o v e ) . T h e a c t u a 1 n u n b e r s . o f @collected restfiE:Aiffi;;; were much enaller than thoee of euperplctus, and a hlgherproportlon of cuilclfacles were newly energed (see aleo under [.6/4.7 above).
vBc /90 .3MAL/90 .3Page 152
In lGrachi c l ty , Pakistan, Husaln & Tal lb l ( l '956) rePorted the resul ts of a long
s e r 1 e s o f d i s s e c t i o n L . o n s t e D h e n s i a n d @ c a r r 1 e d o u t f r o m N o v e m b e r l 9 4 7 t o M a y1 9 5 1 . D u r 1 n g t h i s p e r i o d - ; i a T s s e c t @ f e n a 1 e s w i t h n e g a t 1 v e r e s u 1 t sfor gut and g land infect lon. I t was only ln t tovenbei 1949 that thel r at tent lon was
d i r e i t e d t o @ a s a p o s s i b 1 e v e c t o r a s 1 t o c c u r r e d 1 n s u f f i c i e n t 1 y 1 a r g e n u m b e r sin two vrrraffi-ta rtran and Barai Khan where an epidenic nave of oalaria was observed.
of 19 chi ldren 2-10 years of age exarnined, 15 were posi t lve fot ! ; j4*9,^and one had
a n ixed infecr lon ( f . fa fc fparun + P. v ivax) . Dur lng November 1929- l lay l95l , 9869
culiclfacies were dGGtffiZ-ao Ftound sporozoite-positlve, givlng a sporozoite rate
; f f i e a u t h o r s c o n c 1 u d e d t h a t t h e s e p o s i t 1 v e f i n d 1 n g s s h o w e d f o r t h e f 1 r s t t 1 x 0 e t h a tcul lc i fac ies ls the pr lnc lpal l f not the only vector of nalar ia 1n the Karachl area ' 0n
a f f i n d , t h e a b s e n c e o f g u t a n d g 1 a n d i n f e c t 1 o n s 1 " @ . ! l n d i c a t e d t h a t t h i sspecies ls not the pr lnc lpal vector ln the c l ty area '
Fur ther , Kuraishy, Lar l & Bokhar i (1960) carrded out DalarLa surveys ln Karachi c l ty
and localit les eurro,trri ing it durlng 1954-1959. They concluded Ehat the city ltself was
;;;"-;;-i;s" f."" fron nalarla, and that one or t lto ca6es detected nay be considered of
outslde origin. Only locallt les outslde the clty area were malarlous provlded that
breeding grounds for the Anooheles vector were avallable.
Later, Rahman & Muttallb (Lg67 /L968) carried out a oalarlometrl 'c survey lncludlng
exanlnatlon of the collaterals of nalarla posltlve caaes ln dlfferent areas of Karachl city
during Aprll-August 1966.. They recorded a spleen rate uP to 34'37 and a paraeite rate uP
to 15.52 wl th 6even caaea of posi t lve ln fants detected. Entonological eearches reveatred
th.t e!.9i,]!s1. and subplctus were. the only anophellne species encountered elther as adults
or l=affiff i f i l f ferent parts ot lne city surveyed. Ot 204 8g-e.?hen91 dissected ln
July-August 1966, there was only orr" "plroroltl-posltlve
(0-A--A thorough search for
cullclfacies lncludlng balt caPture was conducted but not a single specloen of thls species
encountered. In thel r conments on the f lnd lngs of Husain & Tal lb i (1956) ' Rahman &
l.tuttalib (loc.clt.) polnted out that these authors worked at a tfune when lltt le knowledge
was avallable on nalarla ln the clty, hence the rlght place and tloe for the lnvestigation
rras not based on epldeolological grounds. Moreover, cullcifacles has now become extinct ln
the two vil lages where its sporozolte-poeltlve speclniiff iZTbeen encountered' Regarding
the findlngs of Kuraishy, f.art t Sukhail (1960), Rahnan & Muttallb stated: "These workere
weri so nuch blased that rnalarla in Karachl was only assoclated ltlth A:--gllggg#' thet
t h o u g h o n 1 y @ ' ! a n d @ w a s a v a i 1 a b ] ' e a r o u n d t h e l r p o s 1 t 1 v e f a } c i P a T u ncases of rhe crty-iEfrenr lmrG,;-ffi from Karachl to Pathan colony 1n search of Lcul lc l fac les and assoclate r la lar la wl th l t . l r
Further, Rahnan et al. (Lg67/Lg68) contlnued the lnvestigatlon of the roalarla
sltuatlon and anophellnes in dlfferent areaa of Karachl clty during Septenber-october
f956. In no locailty was the spleen rate negatlve. The spleen rate varled fron 2'57 to
522 with the overall rate being 18.f2 for the whole area surveyed ln the clty' The
paraslte rate varled fron 0Z t; 66/ Ln dlfferent areag, wlth the overall paraslte rate
ietng 12.42. Entonological eearches carried out durlng l-15 October 1966 by hand caPture
and psc ln houees of oalarla pstlents and nelghbourlng houees revealed the Preeence of only
etephenel and gggllstus. sallvary gland dleeictlons t .e carrled out on sanplee collected
fron rhree.r".",t! l iEta l lne, oiroirgttat and Pathan colony' of a total 505 @1
dlssected, 1.192 l tere EPorozot te-posl i l . t " , hut none of 2015-sgrbPlctue.d lssected nere
poeltlve. Thus, the lnvestlgatlone of Rahuan & ltuttaltb andEffi iTt al ' ( loc'ctt ')
demonstrated wl.thout any douit that nalarla transulsslon was golog on ln Karachl' clty and
th"t glgs,I was the prlncipal vector'
As mentloned above (see under 4.lO), Mahdood, Sakal & Akhtar (1984) carrl 'ed out
Lntenslve observat ione ln four v111ag"" in Kasur d is t r lc t , Punjabr .Paklstan, where
specles A of the lga""tt"tttq."oipf"t was identlf ied-, and stePhensl and subpl'ctue also
exlsred. In additlon to age-graclng of saoples of the three eF'eli|ffi'ee undiriiffiTd-
above), subsamples of the;hrae "p.-"1."
collected restlng lndoors fron the four vll] 'agee
were dLesected for deterninlng the lnrnedlate and delayed infectlon rates, lhe results of
which are auromarized ln Table 14'
Table 14. Ionedlatesubplctus
Soecles
and late lnfectlon rategfron 4 PunJabl vll lages
IInmediate rate-
Gland- +
vBc/90. 3MAL/90. 3Page 153
ln cul lc i fac iee. etephensl andfrou Noveober 1982 to January 1983.
,Late rate-
Gland- + Z
Gut- + 7 .
Gut- + Z
cul lc l fac iesstephenslsubptctus
5219 3
104
2 .26 . t5 .4
6983343
0 . 300
932L75222
0 00 0
253I
L266
200
2 . 6 9 3 3 2 6 2 . 71 . 7 r 7 80.4 221
f - I lonedf i te rate = mosqul tos held at 5 'C and d lseected the day af ter co l lect lon2. Late rate = rnosqul tos held ln lncubator (26oC) for 7-9 days before d iseect lon.
Ae dlscuseed by the authors, desplte the fact that gggEIgL and g!g$g9 ehowedhlgher Lnnedlate gut lnfectlon ratee, neither spectes waa sPorozolte-posLtlve ln the
lnnediate dLseectlone. Wtren Eubsanples of the three specles were incubated at 25oC for
7-9 days before d leeect lon, only cul ic i fac lee was found n l th sPorozoi tes. I t lalntereeting to note that the late-fEfeccton rates for both gut and sallvary glanda of
cul lc l fac ies were e ln l lar to the lnnedlate gut tn fect ton (2.62 ar td 2.77 vereus 2.22,
?espectGit), suggestlng that there naa no preferentlal nortallty of lnfected oosqultos lncomparlson wlth unlnfected onea. 0n the other hand, although both 9!93!Sg! and gglglgge h o w e d h 1 g h e r l n u e d 1 a t e g u t 1 n f e c t l o n r a t e E t h a ' @ ' n o l ' n d 1 v 1 d u a 1 o f e l t h e rspecies ris eporozoite-posltlve ln late dlseectlons. Th-se observatlons suggest that f leld
collected stephenel and gg!g[gg, nere characterlzed by low survlval and, even under
optloal coi?iEl6ie--1n the lrrcuEator. Sone hypothesee ltere Put forward:
(a) ttre two specles do not l lve long enough to allow conpletlon of the eporogonic
cycle,(L) ttrere la preferentlal uortality of Lnfected lndtvlduale, and,/or(c) noequltos cannot fully support the sporogonlc cycle of the etratn(s) of the
malarl.a parael.te exletlng ln the study vll lages.
one of the g!.@1Thue, the fleld and
vil lagee cullclfaclea
Regardlng posslbt l l ty (c) , L t wae lnterest lng to note thatfenalee contained degenerated oocyste ln late gut dlesectl 'one.laboratory obeervatlons support the assunPtlon that ln the etudy(specles A) was the prlnary nalarla v€ctoE.
In the etudy vll lages of Kaeur dlstrlct, PunJab, Pakietan, Mahuood & llacdonald (1985)
nade a eerlee of uonthly dlseectlong from August 1983 to Deceober 1984, to deterulne the
o o c y 8 t a n d e p o r o z o i t e r a t e e . O f a t o t a 1 o f ' 4 9 4 6 a n d 8 4 4 3 f e n a 1 e e o f @ ( e P e c 1 e sA) i teeected, the oocyst and eporozol te rates were 0.592 and 0.32, reepect ive ly . More than
3 5 0 0 a n d 2 7 0 0 f e r o a 1 e a o f 8 t e P h e n 8 1 a n d @ ' , r e s p e c t l v e 1 y c o 1 1 e c t e d f r o m t h e s a m evlllages, were dlesectedr-i6Eo-rozotte:p'oElElve speclnens nere found, although oocysts
were detected ln the two epecles. The abeence of sporozolte-poeltlve epeclnene ln
stephensl. could be explained by tte poor ecological paraoetera such ae lte low EIL and
E@ low nan biting ratee. Slnllarly, the low EIL and extreDely low uan-bltlng rate
rake .g'1931gg, unllkely to be a vector of nalarla ln PunJab, Pakletan, although lt le
coneld-ff i i-a recogntzei vector ln Indonesla and g Bugpected vector ln Pondlchery, Indla'
Spo rozo1 te -poe1 t1 ieepec1neneo f@were reco rdeddu r1ngAugus t -Novenbe r l 983 '} | a y r 9 8 4 a o i A . ' g u " t - N L v e o b e r r g a a @ l E s P o r o z o 1 t e r a t e ( 1 . 4 Z ) w a g r e c o r d e d 1 n e a c hof August and Septeober 1983. The authore concluded that conelderl'ng the reeulte of
anophell.ne abundance, eurvivorshlp, nan-vector contact and natural lnfectlon reported ln
the present etudy, culiclfaclee (lpecles A) should be regarded ae the prlncipal vector of
n a 1 a r 1 a 1 f n o t t h ; 6 ; i F ; f f i t h L s t u d y a E € a . S p o r o z o 1 t e r a t e s o f g g 1 @ , E I L . a ewell as lnfanr paraette rsteg (cLtlng Peivez et al. r 1985) lndlcated thEt the naJor nalarla
traneoieslon 1n PunJab extends froo July to Decenber, whlle a nlnor eprlng traoanleelon
seaaon occura ln Aprll and early Hay.
v B c / 9 0 . 3trAL/ 90 . 3Page 154
As shown under 4.5 above Subbarao et a l ' (1987) s tudied the seasonal prevalence of
the s lb l ing specles A and B of the Ai . c91r9r fac19s conplex in three v i l lages around Delh i '
India: Arthala, Basantpur and Mandoi!ff i- lGternine th! role of the two sibling species in
nalar ia t ransnlss l .on, ovar les f roro the hal f grav ld fenales were used for species
identlf icatlon, and at the saEe time the sane oosqultos were exanined for the presence of
sporozol les ln the sal lvary g lands. The resul ts were tabulated as showns here in
Tab le 15 ' .
Table 15. rncr in inat lon of s lb l ing species of the AnoPheles cul lc l fac les
conPlex ln two studY vll lages'
August specles A
fo r spo rozo i t es i den t l f i ca t l on Sp ' A Sp 'B( " t )
4453
unsuitablespec les Aunsuitable
specles A
7 7 . 8 2 2 . 2
6 0 . r 3 9 . 9
SePteEber-october 1983
Basantpur SePteober-october 1983
249
243
Although the dissectlons nere not extenslve, the date clearly lndlcates the role of
epeclee A ln nalarla tranemisslon ln Arthala and Baeantpur' In Mandorat
sporozolte-posltlve specimens rtere not ldentlf led to the specles of the cooplex'
subsequenr ly , Subbarao et a l . (1988a) t r led to detern lne the suscept lb l l l ty of f le ld
p o p u 1 a t 1 o n 6 o f s @ e p e c 1 e s i , a n a B , u s 1 n g 1 r n n u n o r a d l o o e t r i c a s 8 a y ( I R M A ) . S a n p 1 e sof S,1gg weffiGted fron vil lages ln tf,ree dlstrtcEs Ghaziabad, Bulandshahr and
ShahJahanpur ln western Uttar Pradesh, fnifa durlng July 1985-October-1986' Monoclonal
antlbodles (nAbs):l. lAbs 2F2 and 2Al0, rott"tt recognlze a ipecles-speclflc repetlt lve ePltoPe
on rhe clrcunsporozolte proteln "f L. ; i;;* and-P: fal ' l?aruq
:l-I i11"l orlgln was tested
by the clrcuneporozol.te preclpltatf6iiEfiEfon anE-loffieactlons were obtalned for
both parasites. Indlvldual dried nosquttos, which-irad been ldentlf ied to slbllng aPecles'
nere e66ayed for Plasnodlun lnfectlons ustni a 2-slte IRIIA as deecrlbed by Zavala et a1'
(L982' , 1983) wi th n lnor Dodl f lcat lons '
- D l e t r l b u t l ' o n o f s p e c l e s A a n d B l n t h e s t u d y a r e a s 2 3 T 3 4 " " r r " r t ? i r f f f : T l : : ^ : " ' "
collecred fron rhe three etudy af"ti i" l", of whlch -6538
epectnens GiEJ[ltable for specles
identlf lcatton. ru all vi l lages in whlch collectlon" r.r" t-.1", ggllgifacles speclee A and
B were sy.patrlc. The relatl.r" ptopottlons of-epecles A qnd f reESffiTTt-tfrazlabad
dl'tr lct durtng dlfferent nonths are shown ln Talte t6(a)r' The proportlon of each
epeclee varied dependlng upon the nonth' wlth specles A predonlnating throughout the year'
D a t a o f s h a h J a h a n p u r a n d B u l a n d e h a h . ' " " n o t l n c l u d e d b e c a u e e n o s q u l t o c o l l e c t l o n a r ' e r e n o tcarrled out regularlY.
- P . v l v a x a n d P : f a l c l P ? T P n l n f e c t l o n r a t e S l n s p e c l e s A a n d B : I n d l v l d u a l
cullclfacles ldenttf led to slbllng spectea, were aasey"i fot th: P:9::1"" 9!:;^talcie?iur0
ffi:ffi iiiro"ort" anrlgena. The resulrs are shlwn in Table l6(b). of 5336 epeclmens
of epecl.ee A aseayed, 27 vete lnfected wtth !*!g and 16 wlttr t ' falclparun' of the 27
lnfecred Eosquiros, one was posltive for epoifiG of both e; vIILx .nd 9j-[41lry'
Ot LZO2 epeclmens of epeclee B aeeayed, only one wae poeltlve-E5i 1;'lvax sporozoite
anrl.geu. The overall infectlo., rri"" ior epectes I aia B were O.gFffdTOgZ,
respectlvelY.
l. Reproduced by perrnlselon of D1-+. subbarao and the Indlan Journal of ualarlology froD
the paper of Subbarao et a l . (1987) '
i .=si l ' i i t l -r l ]"""r"nt vBC/88.5-MAP/88.2, under 2.e, PP' L7 r-17-2'- ' ^ - t - - ^ 6 I
3: iiirl!'iui;ri'iiti;';;'i;i;i ;'..p'ia"""i-lt F;i"slon or Dr s'K' subbarao and the- . u . . - {an6 f *an the oaoer o f
i# ; : ; i ; " ' ; ; ' i - 'n 'y- i soc ie-y r - 'prcar
uea-c-ne o n. 'gr .ene, r rom rhe paper
rao et a
vBc/90.3MAL/90 .3Page 155
- Seaeonal dletrlbutlon of P. vlvax and P. falclggg among species A and B conbined:As shown ln Table t6(c), noequltoffiE a wrEfrTl-iliEfrere collected fron May toOctober, and wlth P. falciparun fron August to Decenber. The hlghest percenfage of
was recorded in oosqul tosnoequitos lnfected wlth elther P. vlvax ot !:;!g}gltgcol lected in Septenber.
A e d 1 s c u s s e d b y t h e a u t h o r s , g @ 1 s t h e o a J o r v e c t o r o f n a 1 a r 1 a 1 n r u r a 1areas of nor thern Indiar 'where species A and B were previously found to be prevalent .Sallvary gland dlesections of cullclfaclee coll.ected frorn a few vil lages around Delhl1 n d t c a t e d t h a t s p e c 1 e s A w a s a @ " e c t o r o f n a l a r 1 a , b u t t h e r o 1 e o f s p e c 1 e s Bcould not be establlshed due to the low nunbers of thla species exauined (clt lng Subbarao,Adak & Sharma, 1980r, and Subbarao et a l . , 1987 - aee above). Sfunl lar ly , ln Paklstan,speclee A, havlng shown a eporozol.te rate of. 0.37, Itas consldered the prinary vector ofnalarla, whlle the role of epecies B could not be ascertalned (cit ing Mahnood' Sakal &Akht.ar, f984 - aee above). In southern Indla, eporozolte ratea recorded ln specles A and Bwere 1.027 and 0.312, reepectlvely. The authors consldered that the Present study coulde e t a b 1 1 e h u n e q u 1 v o c a 1 1 y t h a t s p e c 1 e s A 1 e t h e ; l ' r 1 n a r y v e c t o r o f b o t h P ' l @ " ' dP. vivax ualarla in western Uttar Pradesh. The fact that ouly one spEiiiEi@cles BGe-ffiftfve for P. vlvax sporozoltes, and none for P. falclpprun sporozoites, lndlcateethe poor efflclency-E epeclis B.ln nalarla transolsslon ln thls ar€8. A recent etudy haslndlcated that epecl .ea B le lees anthropophl l lc than epecles A (c l t lng Joshi et a l . ' 1988 -
eee under 4.9 above), but thls ls not eufflclent to explain the poor vectorlal efflclencyof species B. Thle poor vectorlal efflclency of apecles B becoDee nore obvloue when datafron ShahJahanpur are analyzed eeparately. 0f 369 epecles B epecirnens assayed fron thlsdletrlct, oue was poeltlve for 3r.3!9, whLle two of only 35 specl.es A speclnena ttereposltlve: one for P. vlvax and one for S:_jgfglig. Slnce whole mosqultos sere ueed tnthe present aeeayr-ifiEalEclmens posttrffiffi6?olte antlgen lury have lncluded eooelndlvlduale havlng nature oocyste only, wlth no eallvary gland LnvagLon. P. falclparuoeporozoLtea rBcovered fron nature oocysts glve poeltltre reactlone ln IRI.IA (clttng Coll lnset aI . , 1984) ' . The authors fur ther polnted out that thei r reeul te lndlcate that act lvetransrlieelon of P. vLvax occurred fron Uay to October and that of P. f"$!3gg fron Auguett o D e c e u b e r . T # f f i 1 n g s a r e 1 n f u l . 1 a 8 r e e D e n t w 1 t h t h e o b a e r v @ G o f L 3 sand P. falciparun ln study areas, 1.e. the peak of L vivax ls fol. lowed by 3ja_l$g. *pea t< -G iE i f f i ouahurye ta1 . , l i 83andSharuae ta ITT9E3) .Thepreeen tE@ehoned that when both P. vlvax and P. falciparun are present ln the aaoe connunlty, theaaDe Doagulto can supp6iF@?ogonyTr-66Tf,-llEEiee at the eane tlne. The.authors alsoreferred to a recent study carrled out Ln certal.n dletrlcts of Uttar Pradeetr trhere oalariaLncldence le hlgh. Both epeciee A and B were present, with epecles A predonlnatlng [clt lngSubbarao et a l . , 1988b - aee under Subeect lon (11)r l below]. In contraet , ln cer ta lndl.etrlcte of eaetern Uttar Pradesh and Blhar, where oalarla was alEoet non-exletent'cullclfacles populatlone congleted alnost exclusl.vely of specles B. Thte explalns therelatlvely uore efficlent vectorlal efflclency of epeclee A, conpared wlth the Poorefflclency of speclee B observed ln the present study. Studies carrled out on ther e s P o n a e a o f s 1 b 1 1 n g e p e c 1 e s o f @ ' t o 1 n e e c t 1 c l ' d e e e h o w e d t h a t s P e c 1 e s A 1 s m o r eauaceptible to DDT than epecles B lcit lng Subbarao, Vasantha & Sharroa, 1988 - aee under4.12 and Subeection (11) belowl. Ag the present etudy haa shown that specles A ls thep r t o a r y v e c t o r o f 3 . : - l @ 8 n d . l g g 1 n n o r t h e r n I n d 1 a , s u 1 t a b 1 e m a 1 a r 1 a c o n t r o 1etrateglea alned at controll lng thle epeclee can be planned.
4.L2 Vector reeletance to lnsect lc ldes
It ls not, Lntended to glve full revlew of the chronological developnent of vectorreeletance ia countries concerned ln the geographlcal area under revlew as relevantluforuatlon can be found {n the monograph of Brown & Pal (f970). Only certaln paPers areselectlvely revlewed here.
ill3eeToil!' pe. 42-43.2 . See VOL . I , unde r 2 .9 , p . 173 .
vBc /90 .3MAL/90 .3Page 156
Table roaRelative proportions by month of A. culicifacies species A and B collected in Gbaziabad district
Months"
No. A.culicifacbs s.l.
collectedNo.
identified
Sibling speciesSpecies Apercentage
Species Bpercentage
Jan.Feb.Mar.Apr.MayJuneJulvAug.Sep.Oct.Nov.Dec.
1091 1 8867
18691738182926282Z9r259224L7977
1090
2 l24
247477635533
I 105839690273234294
95 '09 1 . 698.899.698.997'996.290.18 1 . 978.462.06r.6
5.08.4t .20.4l . l2.r3 .89.9
l t . 12t.638.038.4
"Mosquito collecdonswere made from JulY 1984 to October 19t6.
Tablcl6b,Prcvelcncc of P. rlvzt td P' fticipnm rporozoitc
;,G;;$tttt spccicr of A. culicifeciao er dcrcnincd bv IRMA
Siblingspccics
No. Positivc forrssaycd P. oitut P. falcipann
AB
5336t202
27 (0'5%)l(0'0t%)
l6(0.3%)0 (0%)
Teblc t6cTreoroi$ion dylenicr of netrri,e s dctctuhcd by lR.f,lA il rrcer rhcrc l' culicilzcbs rpccicr A eld B uc rynpatdc
No. mosquitocs Pocitivcfor sporozoitcs of
P. lalciPatllrllr
Ovenllsporozoitc
incidcocc (%)No. mcquitorsseYcd(spccicsA+sPccicsB) P. oiog,x
Jen.Fcb.Mrr.Apr.MryIuncIulvAw.scp.Oct.Nov.Dcc.
00006 (0.93)b{ (0.52)l (0.0t)5 (0'45)
l0 (1.3t)2"(0'29)00
00000007 (0.64)5 (0.5e)3'(0'44)0r (0'x)
00000.93o.520.081.092.070.7t00.34
2l24
3614Ttgan5
l196ll0l72667t2t9ar4
'tf*qui.o ollcctions scre oedc froo tuly lgtf to Octobcr l9t6'
?crccotegcs ia Porcothcscs"AsingtcryccicsAm*qoitowrspcit irrcforsporozoitcsofbothP.oi?[t l frP.faleiprut.
vBc/90.3UAL/90.3Page 157
In l rag, Zulueta et aI . (1968) rev iewed the appearance of DDT res letance ln 8tephen6lln the southern reglon. For two years thle reelstance appeared to be conflned to the soallarea in Lhe northeast of Saudl Arabta but durlng 1957 tt epread to practlcally all areas ofthe dlstrtbution of stephe.nsi in southern Iran and Iraq. The replacement of DDT bydleldrln lnlt lally oet wtttr euccesa. The DDT-reslstant gggl!991, whlch tn 1957 hadreached high deneitles producing nalarla epidenlcs in the plalns of Khuzetan Ln Iran, wasdrast ica l ly reduced ln nunbers lnnedlate ly af ter the ln t roduct lon of d le ldr in . The ef fectof thle lneectlclde waa so pronounced that by 1958 stephengL could not be found lnKhuzestan p la ins in I ran and southern l raq. In 1959, however, d le ldr ln res letance lnstephensl nade lts f lrst appearence ln the foothtl ls of the Zagroe nountalnE ln Iran. By1960, l t had extended to a par t of Khuzestan p la ln and the fo l lowlng year Lt spread toalnost a l l the area of d ls t r lbut ion of s tephensi ln l ran, I raq and Saudl Arabla. Thlsposed a serloue problen to rnalarla eradlcatl.on canpaigne Ln Iran and Iraq. The dteldrinreslstance, as ln nany other instances, was of a very hl.gh order, renderlng dleldrln andother cyclodiene compounds operatl.onally ueeless. On the oEher hand, resistance to DDT waeof loq order ae obaerved ln the fleld and ln the laboratory (clt lng Davideon & Jackeon,l96t) ' I t was, therefore, possib le to u6e DDT agaln for house spraylng agalnststephensl.. Thls wae done ln lraq ln 1953, after an outbreak of nalarla ln Baarah clty; andfn ulew of the favourable resulte, the whole Southern reglon of lraq was aoon eubJected toDDT house spraylng. In 1965 when the Central reglon reverted to the attack phaae due to awldeepread reeunptLon of ualarla traneoiesl.on, DDT was agaln applled, brlnglng practlcallyall of the area of etephenel dtetrlbutlon Ln Iraq under DDT houee epraytng. A cooparleonof the results of eueceptfbtl lty tests carrled out on etephensl in Iraq fron March 1958 toOctober lg6Tr indicated, ln broad terms, a decrease of the levele of DDT res letance f ronthe south to the northern part of the country. The higheet level of resletance waaobeerved ln the extrene south of the country, ln the Fao area, whereae ln l{ashash (Baghdad)
tn 1965 there wae barely an lndlcatlon of DDT reelgtance. In general, there wasno oaJor change ln the level of DDT reslstance ln each locallty studied. The exposure tothe dlagnostic doeage of 47 DDT for one hour produced nortallt les above 202, when rnsqultoetested had been collected fron unsprayed prenlseo. It wae only tn Novernber 1965 that 8slgnlflcant increaee of DDT reeletance wae observed ln Btephensl. ln Basrah Llwa. Thedlagnoetlc dosage gave Bortallt les of, 1O.27 ln Gezlra (near Baereh ctty), 2.42 ln Fadghlya(further south) and no rnortallty ln Fao Manlaha. In thle last locallty, even prolongedexpoaure of 4 hours to 4Z DDT gave onJ-y 2.57 nortallty. Theee reeults nere confl.rned bythe Roes Instltute, London, uslng oaterlal raieed fron egg batches aent fron the fteld.The te6ts carrled out by thle Instltute lndlcated a nuch hlgher level of DDT reeletancethan had been prevl.ously observed eleerrhere 1o *Ih"*!. The lncrease of DDT reslgtancecotnclded wlth a l0-fold lncreaee of g!@1, EEnefEyTn Baerah Ll.wa, and a epread of thespecles beyond lts nornal l luita of dleE;lEutlon in lraq; epecl.nens were found as far northae Klrkuk Llwa (eee a18o under 4.5 above). Thue, for three yeare elnce lte relntroductl 'onln 1963, DDT had been used ln the aouthern part of lraq wlthout eelectlve Pressure bringlngup any vlelble Lncreaee of reelstance level ln ggsnst. Frou the field and laboratoryteats, lt appeared that the populatlone of etepfri lF-Fao and other areaa of Baerah Llwa
were then approachl.ng honozygoeity for ttre 6TIS@ and anctllary genes responelble for
DDT resletance. Such a degree of reslstance coobl.ned nlth high densltlee of g!9$$!, n.a
a narked effect on the epldeulologlcal eituatlon. Malarla tranell leelon whLch had been
reduced ln Bagrah Liwa eince the relntroductlon of DDT ln 1963, lncreaeed desplte good
spraylng coverage and satlsfactory eurvell lance operations. Thle adveree eituation naapartlcularly clear ln Fao locallty, desplte thorough spraylng operatlons and thelntroductlou of eupplenentary meaeures such ae the appllcatlon of a thtrd annual DDT
epraylng round and two nass radlcal treatDenta, there was a oarked lncrease ln trao8Elsslon
during the eecond half of f955.
As lndlcated by Zahar (1974), aaeessltent of the nalarla sltuatlon ln southern lraq
ehowed an alnost equal paraelte lncldence throughout 1965-1967, durlng whlch perlod the
houee resrlng density oi ggSf,lggl was generalfy low except in 1966. DDT epraytng
continued durlng f968 wttlG-if-preciable reductlon of nalarla transulgelon. In factr I 'n
that year a ualarla outbreak occurred ln a group of vll lages Ln Baerah Llsa. An
entonolollcal Lnvestlgatlon na8 carried out durlng 1958 ln vll lagea vhere lndlgenous casea
l . See VOL . I , uode r 2 .6 .3 , pp . 99 -100 .
vBc/ 90 . 3MAL/ 90 . 3Page 158
had been recorded to deterro lne the operat lonal i ropl lcat lons of DDT res ls tance in s tePhensl(c t t lng Zahar, unpubl tshed repor t to WHO, 1969). The epraylng coverage in the area Isas
est iEated at about 842 dur ing the lnvest igat ion. In sprayed rooDs, s tePhensi nas caPtured
from unsprayed sur faces, but some were found rest ing on sprayed sur faces. The mean
densi t l .es of g3g$. ! were 5.2/unsprayed room. Suscept ib i l i ty tests showed 26.52
nortality wttl- l l trour exposure to 47" DDT aroong specinens collected fron unsprayedprenlses. Two nlghts of ex i t wlndow t raps col lect ions showed that the maxi ,mun exodus of
stephensl f ron sprayed prenises took p lace 2-3 hours af ter sunset . Gravid fenales
f in f f i ied a large proport l -on of t rap col lect lons, Lndicat ing that s tephensi f enales were
conpLet ing thel r gonotrophic cyc le ln the sprayed prenises. Morta l i ty af ter a 24-hour
holdLng per lod ln unfed and fed fenales was 302 and 147", respecEively . At- the same.t ine- ,
the parous rate recorded in sanples col lected f rorn sprayed prenlses was 532. Assumlng that
the gonotrophic cyc le was 2 days, the probabl l l ty of dai ly surv lva l was about 0.726.
Durtng d lssect lone, a number of fenales l tere found to have 3-6 d l la tat ions, conf i rn lng that
stephensi had a h igh surv lva l rate wi th in eprayed prenlses. For cornpar lson' a Parous rate
f f i t v 1 n g a p r o b a b 1 1 i t y o f d a i 1 y s u r v i v a 1 o f 0 . 7 7 5 w a s r e c o r d e d i n s t e p h e n s 1 1 n a nunsprayed urban area Ln centra l I raq where t ransuiss ion had recurred. This f igure ls very
c lose to that est lnated for the DDT sprayed area. In v iew of the above resul tsr l t was
declded to replace DDT wtth nalathlon ln Basrah Llwa. Subsequent observatlons throughout
L969-1972 sholred a good responae under nalathlon spraylng, and 9!93@,1 has become very
scarce except where lnhabl tants refueed spraylng or oPerat lonal defects occurred. The
supporting epldenlologlcal evldence reported to WHo lndicated that transroission has alnost
been lnterrupted. In 1968, a eoall area comprislng two vll lages waa sprayed wiEh ProPoxuras a t r la l . Caees c lass l f led as lndigenous Etar ted to appear shor t ly af ter the secondround of propoxur spraylng. I lowever, lnvestlgations carrled out durlng 1969 conflrrned that
these cases lrere actually relapsee that had posslbly not received radlcal treatmentprevlously and that t ransnlss ion in the area had ln fact been interrupted by propoxur
spraying.
Iyengar (1977a) expla lned that fo l lowlng the subst l tu t ion of nalath lon for DDT inTheqar pro.rinc", the entlre Southern reglon ltas put under nalathlon epraylng in 1972r as
well as four focl ln the Central reglon where DDT reslstance ln stePhensl had beenrecorded. Epldenio logical lnvest lgat lons carr led out s ince then showed that t ransmlss ionln the Centra l and Southern reglons has been lnterrupted. Suscept lb l l l ty tests carr led out
on .1g3l$,1 durlng 1973 and 1975 showed that thls species lra6 stl l l susceptlble tonatiE5iiEth alnost conplete nortallty obtained wlth one hour exposure to 5Z nalathlon.More recent tests ehowed sqne survlvoro at lhls dlagnostlc dosage. The tenPerature durlngthe expoeure perlod was 21oC and fell to lSoC durtng the holding perlod. Iyengar drewattention to the fact that oalathlon, l lke sone other organophosphorous compounds has aposltlve tenperature coefflcient whlch could have accounted for the few survlvors. It wast
therefore, suggested that teats with oalathlon ehould be repeated and the situatloncarefully watched.
In a epecla l lnvest lgat lon on the euscept lb l l l ty of nalar ta vectors to lnsect lc ldeeln lraq, Uanouchehrl et al. (1930) tested saoples of qtephensl. fron the Southern reglonwhere nalathlon hae been applled at a doeage of 2 g/m- Ln three rounde per year slnce
L972. Durlng l larch 1978, sanples of stephensl collected fron Moawiyah locality in Basrah
Llwa ehowed 502 oortallty wlth l-hour exposrlre to 5l nalathlon. When the exPosure tloe etaslncreaeed to 2 hours, 1O0Z nortallty was obtalned. The valldtty of the oalathlonlnpreguated papere were auapected as they were 5 nonths old (explry date Aprtl 1978), but
when eanples of pulcherrlnua fron the same locallty were exposed to the dlagnostic dosage
of nalathlon, 106ffi@ was obtalned, lndlcatl.ng that the test PaPers were stl11
ef fect lve.
In a repor t on the nalar la 6 l tuat1on ln l raq dur lng 1984 and 1985, Oesl (1986)
nentloned that susceptibtl lty tests carrled out at different areaa of the country reveaLed
that nalathion was stt1l effectlve [No detatls were glven; probably the author Eeant that
ualath lon was st i l l e f fect lve agalnet a l l vector specles ln the countryJ. Fur ther , Al i(1987), whl le repor t lng on the nalar la s l tuat lon ln I raq dur lng 1986, nent loned that af ter
nany year6 of Lnterruptlon of roalarla transnlsslon ln the Al-Tanln nuhafadha (= province)
vBc/90.3MAL/90 .3Page 159
ln the northern regton, and Basrah and Mlean rouhafadhas 1n the Southern reglon,
transnLsslon recurred ln a few vll lages. Innedlate renedlal rneasures were applied to
prevent ghe spread of transuisslon fron these snall focl . High densltles of .@.! were
iecorded ln the Southern reglon especially ln Basrah and Thekar rouhafadhas, as well as
moderate densltles of thls vector 1n the Central and Central Euphrates reglone.
Suscept ib l l l ty tests carr led 6ut dur lng 1986 on stqPhensl ehowed 1002 morta l l ty wl th
propoirr. ThL sane level of nortallty nas obseriEE-]iTl vector epecies exposed to
natattrton, wlth the exceptlon of gggg!93g1 whlch ehowed a sltghtly lower nortality, 957".
[No deta116 nere g lven] .
In Iran, following the appearance of dleldrin reslstance, DDT spraylng was
relnt roduced ln 1963. As rev lewed by Zahar (L974), cont lnued evaluat lon of DDT spraylng ln
1965-1967 showed that DDT reslstance h g!gE391 wae lncreaslng, and that transnlsslon
pereLsted ln southern I ran as ln eouthern I raq. ' Malath lon l taa therefore t r ied ln I ran,
inlt lally on a vll lage scale. In 1967, it wae declded to sPray DDT ln one round ln the
sprlng and natathlon ln a second round later ln the year ln the l lttoral and plaln areaa.
Cl t lng a progre3s repor t f roro the Inst l tu te of Publ lc HealCh Reeearch, Teheran ( f967) '
stephensl denslty ln the coastal. plain, deeplte DDT epraying ln the sprLng, showed a steady
Til i?EFfrom June untl l Septenber. Transnlselon persleted ln a vll lage ln the coastalplaln, where the denslty of 9!92$.1 vae 15.2/roon and the proportlon of dangerous femalee
reached a uaximum ln Septenber 1967I Dlseectlon of 136 steohensl fenales gave a sporozolte
rate of 1.472. At the eame tlne, l0 caees of L-g!S tnfectlon were detected ln the
vll lage. Iu 0ctober, after applylng nalathlon, a marked reductlon ln house restlng density
was observed. However, eince seaeonal ehangee lntervened, Lt was dlff lcult to draht a flrn
concluElon on the Eucceas of nalathlon appllcatl.on ln Septenber-october. In 1958, the
regLoen of apring DDT and autunn roalaEhloa spraylng rounds ltas rePeated, though the latter
epraylng wae advanced to start ln nld-Auguet. Through the perlod 1965-f968' suscePtlbll l tytests carrled out oo stephenel ehowed a steady deterioratloa of the eueceptlbll l ty level to
DDT, mortallty fall lng 1n 1966 to 15.72 after l-hour expoaure to 4Z DDT. High paroue ratas
uere recorded durlng August (68.82) and Septenber 1967 (79.32), wlth a probabll lty o! dalJ'y
surv lva l of 0.83 and 0.89, reepect lve ly , before ualath lon was appl led 1n October 1967. At
the sage tloe, the nortality ol extt-window trap collectlona waa not Dore than 72. Theparoua raEea recorded ln July and August 1968 followlng DDT epraylng were 552 and 582
reepectlvely, 1.e., lower than before. Paraeltologlcally there ttas a slowly rlelng trend
ln the uonthly parasl.te lncldence, but at a lower level than 1n the yeare when only DDT was
applled. Collectlon of lndoor restlng noequltos by PSC ehowed that the denslty ofstephenel in houeee uas generally loi; no !-!Sg!ggg,! nas captured 1n nlght catches or byiliiii6ffiaps. It wae concluded that underTE-Tegloen of two annual. rounds of DDT
spraylng, there was a narked .butld-up of gl3plgl denelty conblned with lncreaelnglongevity, whlch led to perel.etence of trEi6fEElon at a falrly htgh rate. Under the DDT
and nalathl.on reglneD, there waa a deflnlte ehortenlng ln the perlod of vector actlvlty and
reductlon ln the height of denelty, resulting ln a nuch lower rate of transmleelon.Malathlon reduced th" g!Sg$,! populatlon drastlcally and lt wae declded to replace DDT
entirely wlth oalathl.on.
The ftret lndlcatlon of nalathlon reelstance ln stephensi ln lran caue fron
laboratory eelectl.on of a populatlsn ln whlch fteld testlng with the dlagnostlc dos?gefalled to glve complete k111 ae reported by Manouchehrl, Zalnl & Yazdanpanah (f975)-.
Later, nalathlon reslatance fo g@1, wae conflrned by field testlng 11 Bandar Abbas
aree, aouthern lran as reported-5iEil;ghehrl, ZataL & DJanbakhsh (f976)^ andManouchehrl, DJanbakhsh & Rouhani (1976)'.
Eehghy (f978) checked the Busceptlbll l ty leve1 of gg@,! to nalathlon tn selected
locallt lea 1n BorazJan, Kazeroun and ManaeanL countiea ln Fars provlncer southern lran
durlng 1977. The area has been under na'lathlon epraylng elnce 1968, at a dosage of
2 g/^1 in l-2 rounde per year. In receut years carbaDste and organophoephorus conpounde
have 'been
applted for the control of paLn pests. The dlagnostlc dosage of 57 nalathlon for
one hour gave 9a.L-98.92 nortallt l i ' and thle wae interpreted a8 tolerance of g!g@L to
nalathlon. To obtain baee-llne data for propoxur, etephensi waa exPoaed to 0.IZ propoxur
l . See VOt . I , unde r 2 .6 .3 ' pp . 103 -104 .
vBc/ 90 . 3l, lAL/90. 3Page 160
for 5, 10, 15 and 30 minutes. The last exposure per lod produced 1002 nor ta l l ty ln a l l
local l t les tested. Later , Eshghy, Ladoni & Javadian (1985) conf i rned the presence of
nalath ion res j .s tance in s tephensi ln the same count ies of Fars prov ince f rom tests carr ied
out during July-August lff iE;; 'osure to 57 Ealathion for one hour gave nortallt les
ranging t ron 14.87. to 89.87. The species l ras suscept lb le to ProPoxur but renalned h ighly
res i .s tant to DDT and d ie ldr ln .
Recent ly , Manouchehr l & Yaghoobi-Ershadi (1988) repor ted the resuLts of checking the
suscepttbil i ty level of s[939.! to propoxur in five vil lages ln Mlnab county, I lornozgan
province, "orrlh"rr,
Iran.-ff i i l lages are located about l l-20 km frorn Bandar-Abbas. In
I lormozgan province where Stephensi proved res is tant to_DDTr,d le ldr in and malath lon '
propo"u, house spraylng h;;G;;-pplied at a dosage of 2 g/m- Ln two rounds Per year
" f r , " " 1977, and Lp io Ipr i l 1986, the area received 8-18 rounds of spraylng wl th th is
insectlctde. In order to build up the population denslty of s3!9gg1 for collectlng
suf f ic lent mater ia l to be tested, the malar ia contro l uni t was requested to delay the
applicatlon of propoxur in the test vll lages and a surroundlng area of 3 krn radlus for a
nonth ln the sprini of every year (fron 1980 to 198-6) whlch colnclded wtth the start of the
seasonal activlty If "t"ptt"nst
in the ar€a. Thle ariangenent was based on the fact that
the probabll ity ior nEilff iansmlssion occurrlng in March-Aprll ls very low' Tests nade
anrr,r"l ly durlng Aprll frorn 1980 to 1986 with one-hour exPoaure to 0'12 propoxur gave
complete k111 in s tePhensl . I { i th 3O-nlnute exPosure to 0. lZ propoxur ' Dor ta l l t les ranged
berween 96.17 "1affi i tt
1976 (bef ore rhe appllcatlon of propoxur) and ln 1986 (after 10
years of propoxur spraylng), thls exPoaure gave 99.32 and 992 Ln Roknabad vll lage'
iespectively. The Lstlnated LT.n ln Minab county ranged betlteen 7'6 and 14 nlnutes ln
Dje. - - i t " " ' " t rguies were near l lu .o.parable ro the range of 5.7-11.2 n lnutes recorded af ter
l0 years of propoxur spraying. To c lnc lude, the authors st ressed that af ter 10 years of
propoxur spraylng tn southero l r " r r , s tephensl renalns suscept ib le to th is lnsect lc ide ' In
order to lnvesttgare rhe potentlal f;;GGGplng resistance to thls lnsectlclde,-.9@1
has been put under selectlon pressure with propoxur ln the laboratory at Teheran Unlverslty
which is out of the distribution range of this vector specles. The authors flnally
renarked upon the records of lnsectlctde reslstance ln anophellne nosqultos tabulated ln
the reporr of rhe wHO Expert cornnirtee (!ff io, 1986 - TRS. No. 737) whlch lncluded Iran anong
coungries ln whlch stephlnsi has shown reslstance to ProPoxur (see Table 17)' They
enphasized that the-6i$Elrlrutlon whlch follows the susceptlbll l ty leveL of mosqultos to
lnsectlcldes in Iran ls the Departnent of Medlcal Entooology and Vector Control, School of
public Health, Unlverslty of Teheran, and thle departDent found no evldence of propoxur
resistance 1" g.!glh"*l. in the field ln lran'
Zalnl 5, l.tanouchehri (1973) carrled out susceptibll i ty tests durlng Uay 1973 on
culiclfacies, the maln veccor of nalarla in Baluchestan. Sanples of +L!g!!gglg.werecollected from unsprayed hunan dwellings and anlnal shelters ln Sald Abad, Khelrabad'
eltuated at about 25 kn weet of Iranshahr and Hit, about 200 kn north of Chahbahar'
Boutheaet of Iran. Thls area has been under house spraylng wlth DDT for about l0 years'
dleldrln for three years and nalathlon for the last itvt ytars' Following the appllcatlon
of DDT ln 1959, the densl ty of cu l lcLfac les decreaeed sharply ' Suscept lb l l l ty teste
c a r r 1 e d o u t l ' n I 9 6 3 s h o w e d t h a t r . c @ w a s 0 . 5 D D T . I n l 9 6 4 a n d I 9 6 5 ,Baluchestan naa eprayed wlth dletd?Yn, aii-iiiii-T56'7 to 1973 wlth DDT and nalathlon' ttto
rounde of each lneectlclde per year. Durlog thls perlod of l0 years, the denelty of
cullclfaclea was so low that lt naa not po"itbl" tL collect sufflclent numbers for
f f i t i t . e t r , . g .ByAp r t1 .May1973 , t hedene1 tyo fw - tn l l 1 t . y11 } : c " .Lncreaeed to 500 ana 5 Per unsprayed and eirayed room6, reelEctlvely' Sueceptlbll l ty teetg
carried out with 4z DDT for one hour at t{t i, -sald
Abad and Khelrabad gave Dortallt les
rangLng from 397 to 437. Prolonged exPoaure of 4 hours to 4/ DDT gave 702 uortallty'
Tests wlth dieldrin and nalathlon ehowla th"t S1I."1"" was qul'te eusceptible to both
1 n s e c t 1 c l d e e . E p 1 d e n l o 1 o g i c a 1 1 n v e s t l . g a t 1 o n s m d u r l ' n g t 9 7 I , t h e a n n u a 1 P a r a s 1 t elncldence (ApI) in Iranshahr and Chahbihar was l0 and 0.4/f000' respectlvely, and durlng
1972 the API increased !n the tlto areas to 38 anal 4/1000' resPectlvely' The authors
thought that the deterloration of the eplderoloLoglcal eltuacion was possLbly related to the
appearance of DDT reelstance fo gg!!g!!3g!g'
vBc/90. 3MAr/90. 3Page 16 1
Manouchehr l , Zaln l & Javadlan (1975) fur ther checked the suecept lbt l t ty level of .
cu l lc l fac ies to DDT 1n the same local l t ies ln Balucheatanr aoutheast l ran. Dur lng
;pffiff74, tests with l-hour expoaure to 47 DDT in lranshahr and Chahbahar gave 16'422
rort.l l ty. Wtren the exposure tixne lraa lncreased to 2 and 4 hoursr the Dortallt les
increased to 30-4 lZ and 46-582, respect lve ly . The uosqul tos tested were coLlected f ron
unsprayed shel ters when the densl ty was 100-200/room, whl le ln the sprayed shel ters, the
densi ty was 5-12/roon. The epidenlo loglcal s l tuat lon cont lnued to deter lorste; the API
dur lng L972-1973 reached 38-31.8/1000 and 18.5-9.9 ln I ranshahr and Chahbahar '
respect lve ly . An. cu l i .c i fac les reoained suscept lb le to roalath lon and d le ldr ln .
Recent ly , repor ts of suscept ib l l l ty tests sent to WHO fron I ran ehowed that
cul lc l fac iee in Sistan and Baluchestan ts s t l l l res ls tant to DDT, ea teats carr led out in
IqE6-iff id-5|.77 and 58.67 tn the tlro area8, respectlvely' wlth l-hour exPosure to 4Z DDT.
In Saudl Arabla, as ln Irag and lran, DDT resletance ln stephensl ln the Eastern
provlnce was recorded ln 1957 whlch necessttated replacenent of DDT wtth dleldrln.
Subsequent ly , d ie ldrLn res letance appeared ln s tephensl . ln 1961. Accordlng to L ln ( f986 -
unpubllshed asslgnnent report to Wtt0), due to tEe aoutle reeistance ln etephenel, ualarla
control Eeasures vere shifted frorn house spraylng to larvlcidlng ln the oases of the
Eastern provlnce. Fron 1962, Par ls green dust was ueed, but d lscont lnued ln 1964 unt l l
July f965. Thereafter, lt was applted ln the forn of susPensLon, but due to operatlonal
d l f f lcu l t les Par is green suspension was replaced by d lesel o i1 f ron 1969. Fron 1971,
te6€pho6 nas lntroduced wlth excellent resulte. Ite exteneive appllcatlon contlnued untl l
June 1978 in deflned area6 around vll lages of Qatlf oasia. Thls was suPPorted by lntenslve
entonologlcal evaluatlon and stri.ct survell lance actlvit les. After dlecontlnuatlon of
larvlcidlng operatlonsr.nonl.torlng of vector denslties has been contlnued by noblle tearo8
and an annual blood Eurvey ln new agrl.cultutal areas waa carrled out.
In UAE, the report of the Ministry of l lealth on Malarla Control (1980) showed that
teDephos at a concentratLon of 0.125 ppE gave conplete ktl l ln 3rd lnetar larvae of
stellensl ln SharJah locallty aud the East Coaet durlng Xarch and Decenber 1980. Tenephos
I-as-ff i i-used ln UAE for larvlcldlng breedlng placee of ,1 and cullclfaclee.
Reports corrnnunlcared to WIIO showed a hlgh Level of DDT rEEffiiG fn Eiiifr-e?gTllGrval
teit) ln SharJah and Ras El Kheina (aduLt test) tn 1983. Slnllarly' cullclfaclee ehowed
reelstance to DDT ( larval test ) ln the East Coast ln the 8aD€ j€aro
In Oman, Shidrawl (Lg76 - unpubllehed report to WnO) exanlned the resulte of larval
euscept.lblltty wlth temephos on Eltctfacles. The hlgheet concentratlon ln the l lHO teet
k 1 t a t t h a t t 1 r o e w a e 0 . 0 2 5 P p E 6 m 7 _ t h 1 e g a v e 3 l Z n o r t a 1 1 t y 1 n c u 1 1 c 1 f a c 1 e elarvae. Repeatlng rhe resr wlrh thl.e concentratlon Ln Decenbet L9i5, h;-5Gi;E?-512 klll
whlch Dore or 1es6 conftrroed the above reeult recorded prevlouely by the I{IIO Technlcal
Offlcer. Shldrawi further attenpted to double the concentratlon but the results were
lnconclusive. He cautloned that lt would be rather futl le to try to lnterPret the results
of tenephos solution, wlth lts hlghest concentratl.on belng 0.025. [See below for furtber
teste I .
In another vlslt to 0oan, Shldrawl (f982 - unpubllshed report to l l l tO) revlewed the
results of Eusceptlbtl lty rests carrled out on culfcuqqlgq 1n Shlnae, Batlnah region fron
1975 to 1981. Baee-tlne larval susceptlblffty EETiaiff id out ln 1975 lndlcated that
cu11clfacle6 nas hlghly eueieptlble to OOt but reslettnt to dleldrin. Sl'nce 1976' DDT
f f i " g h a s b e e n a p l p 1 l e d a t a d o s a g e o f 2 g / m . i n t w o r o u n d s P e r y e a r u n t 1 1 1 9 8 1when only one round r."
"ipit"d naklng I t;tal of tO rounds. No teste could be done after
1 9 7 5 u n t i 1 O c t o b e r N o v e n t L i l 9 8 0 w h e n p r o n o u n c e d r e e 1 s t a n c e t o D D T 1 . . @ ' " "recorded. This nas further conflrned by tests on cullcl iaeies carrled out durlng
october-Noveober l98I when a l-hour .*p'o"o." to aZ-bEI-lEffinLy 27 uortallty and. even ,prolonged expoaure of four hours dld not produce more than 12.52 oortallty. Only a eDall
L"t"f, 6f tO etephensl could be tested, and all survlved the l-hour exPosure to 4Z DDT' In
D e c e m b e r r s s @ E g s E g w a s t e s t e d w l t h I - h o u r e x P o s u r e t o | Z n a 1 a t h 1 o n 'lZ fenltrotnronai?-61'iF!?opoxur which gave 982, 1002 and 96.22 uortalltles'
tespectlvely. Shldrawl (ioc.ctt.) concluded that vector reelstance to DDT cooblned wlth
vBc /90 .3!{AL7 90. 3Page 162
low spraylng coverage were responslb le for pers ls tence of malar la t ransmiss ion ln Shlnae
area. f-trerifore, tf,e lnpact oi veclor resistance alone can be deteroined only when
spraylng coverage ls rnalntained at a leve1 above 90%' With thls ln nind, it was
recom'ended to spray the l lth round lrith DDT uslng different fornulations to ensure the
acceptabi l i ty of th l local inhabi tants. Entonological /parasi to logical evaluat lon should be
pursued tor at least s lx rnonths af ter the l l th spraying round. I f t ransniss ion pers ls ts
despl te good coverage, a change of lnsect ic ide wi l l become lnperat lve. As replacenent
tns lc t tc ides, deodoi lzed rnalath ion or feni t roth ion should be g iven the f i rs t choice '
Infornatlon obtalned froro the Minlstry of Agriculture, Oman, indlcated a more lntenslve
select lon pressure ar ls ing f ron the r id" . rse of a var lety of insect ic ides for pest contro l '
Farld & Mulr (i985 - unpubllshed report to WttO) who visited Oroan durlng March-Aprll
l9g5 rev lewed the act lv l t les of the nalar ia contro l progranme [See Subsect ion ( i l ) under I
belowl . Examlnat lon of resul ts of suscept lb l l l ty tests carr led out dur lng 1982-1984 showed
that DDT res ls tance exls ts ln g l : ls1 lgSlsq at vary ing degrees, ln a l l local i t les tested '
Mortalit les obtalned on the afagnosffi losure of. 4% DDT f or one hour varied fron 0Z (in
Shlnas and Bayah) to 93"A ln Suweiq. As regards S!93bg9.1 , tests perforned in 1978 and l98I
indicated the presence of DDT resistance ln ttrfsTfff i-also. Wlth regard to lnsectlcides
other than DDT, culicifacles appeared to be susceptlble to fenltrothlon' whll 'e there was
soroe lndlcatlons of reslstance to dleldrin in shlnae, to propoxur ln Baya and Yankul and to
nalathlon in yankul. The few larval te6ts carrled out ln Yankul and Sohar in 1982 as well
as those perforred at Masana-a, selb and Dank tn 1983 lndicated that cullclfacies was
suscept lb le to tenePhos.
In a further vlslt, Mulr. (f987 - unpubllshed report to WI{o) exarnlned the results of
suscept lb lL l ty teste carr ied out ln 1986, which showed that whl le cul lc i fac les and
s t e P h e n s 1 c o n t 1 n u e d t o b e r e 8 1 8 t a n t t o D i T 1 n s e v e r a 1 a r e a a , t t r e t 6 @ e m a i n e dffi i IISfe to nalathlon and propoxur Ilocallt les not roentlonedl. I lowever' recent tests
nade wtttr penoethrln.indlcated the presence of pernethrln resistance ln cullclfacies at
Seeb. Mutr renarked that thls was;ot surPrlslng, slnce ln several occaiGffif i his
field vlsits pernethrin eroulsif lable concentrate was found to be ln use in agriculture'
Larval tests showed that cullclfacles remalned susceptlble to tenephos'
I n a m o r e r e c e n t " , m M u 1 r ( 1 9 8 9 - u n p u b 1 1 s h e d r e p o r t t o w H o ) p o l n t e d o u tthat dur lng 1987, 13 adul t teste and three larval Eests were repor ted ' The adul t tests on
cullclfacles revealed the continued presence of DDT resistance (L6-472 mortallty' sooe
resls tance to fenl t roth lon (63-100Z nor ta l i ty) , poselb le inc lp lent res is tance to nalath lon
(95-f002 rnortaltry) and susceptibll l ty to pernethrln (one local' l ty only). Two tests nade
on d-thall indlcated the presence of DDT reslstance (202 Dortality) and suscepttbil l ty to
t"G;I;;: Durlng 1988, only two adult tests were performed. One test 9n glephehs,l_
lndlcated reslgtance to DDT and the other test on guug1lacfes suggested sooe reeistance to
pernethrLn (842 nortaltty).
In Mghanletan, Cullen (1978 - draft assignroent rePort to l{I lO) noted the dlstrlbutlon
o r@land@and- the1 r re8Ponse to1nsec t t 9 l q : : . t . s t e? t . t i ? ! r= - : : " ^ : o : "uto Efiifrf! restfiiiffi-D5T wlrh no regresslon to suscepttblllty EEtEr withdrawal of DDT
spraylng ln- 1973. Thls was clearly shown ln Khoet unlt Ln 1977 (four years after
dlscontlnuatlon.of DDT epraylng) wiren only 82 uortallty nas observed ln thls specles wlth
"*po",rr" to 47 DIII for one hour. Thts epeciea waa found reoistant to dieldrln, probably as
a reeult of uelng l lCH ln agrlculture and for locust control ' as nel'ther dleldrln or HCH had
been uaed for noiqulto conirol 1n Afghanlstan. It ts aPParently, stl l l susceptlble to
malathion, althou;h 2 survlvors appeired ln a batch expoeed to 5Z nalathion for one hour
whlch calls for constant nonitorln!. fui. cullcifacles was aleo found to be hlghly
realarant ro DDT as.wett aa ro arerarriid-rcT6&Flcultural l":_9f HCH as noted ln
stephensl above. Like gtgpFensl, there has been no regre8slon of DDT reslstance ln
Effitee; resrs wttFTilexpoaure to 47 onJ_fn lternand unlt ln 1977 gave 24'37"
ilff i though DDT epraylng was wlthdrawn ln 1973. ltn', cullclfgcleq tl l"t::d hlqhll
susceptll le to oalathlon. Houee spraying with nalathton haG been found effectlve agalnst
cullclf acl.es.
Eehghy & Nuehln (r978b) Lnveetlgated the 6uscePtlblltty of $clfactes to
lnsectlcldes tn ltelnand provlnce, sourhwest Afghanlsian wherl a nETlffi-l!?ay1ng trlal
na8 conducted (eee Eshghy & Nushin 1978a under 4.6/4.7 above) ' In 1976, a ser les of ,
suscept lb i l l ty tests was per formed on cul ic l fdcLes in three d l f ferent local l t les ' The
v B c / 9 0 . 3MAL/90. 3Page 163
average nortl l ty recorded wlth l-hour exposure to 47. DDT'ranged frorn 3.L to 26.87. When
the eiposure tine na8 lncreased to 4 houre, the Dortallty range wae 50-55.1% On Ehe other
hand, Lultclfacijg appeared eueceptlble to dleldrln as 0.82 concentratLon for one hour gave
t0OZ n6iEiff ifesl6 naae Just before the eecond round of nalathlon epraying (the flrst
r o u n d w a e a p p l 1 e d 1 n r 9 7 5 ) s h o l ' e d t h a t @ w a s g u l ' t e s u s c e p t 1 b 1 e t o r o a 1 a t h i o n a sl00Z nortalfty was obtalned 'rtt1. 3.22 roaTiffin-ET one hour or 57" nalathlon fot LlZ hour.
In paklstan, Aklyana ( 1968 - unpubllshed asslgntnent rePort to WttO) iodicated that 1n
Novenber 1963, cuilclfacles was found reslstant to DDT for the flrst t lne In two locall ' t ies
ln Sla lkot zone. 5f6beqne"t1y, suscept tb l l l ty tests were ln tensl f led ln a l l zones under
DDT spraylng for nalarla eradlcatlon. Durlng 1963-1966' cgllglfaciee and-g!33$g! were
found re6l6taut at var ious levels to DDT ln 20 and 16 1oca1l t lee, respect l 've ly , in several
zones. In L957, a tota l o f 63 suscept lb l l l ty tests ln noet of the zones under operat lon '
indlcated the presence of DDT reslstance ln cullclfacies in eeveral areas, but thls dld not
po6e any serlous problen towarde lnterruPtlon of ualarla transnlsslon.
Rathor , Toqtr & Relsen (1980)I who carr l .ed out suscept l l l ty teots ln n lne d l f ferent
area6 ln punjab, polnred out that the appearance of DDT reslstance ln $l!1Jklg_anagteohinsl ha-e causea dlff lculttes to the nalarla control PrograDne ln Paklstan. ,DlT.wasGfifry Ehe Ealarla eradlcatlon progranne fron 196l to 1975 (at a doeage of L-2g/n' Ln
trro rounds per year). In 1975, DDT tta6 partlally replaced by IICH to wht'c| resletance
rapldly aevetopla. In 1976, oalathton was lntroduced at a doeage of Lgla' Ln tno rounda
per year, and recently fenltrothlon (Sudthlon) was lntroduced ln eone areaa of Pakl'etan.
iurrlntty nalathlon ts belng used for ualarla vector control ln Pakistan. In thelr
susceptlLll l ty testlng gur*' iy, the authors ouspected the Presence of lnclplent oalathlon
r e e l s l a n c e t , . g g g P @ ! . . I { 1 t h r e g a r d t o s g l s , t h e . t a b u 1 a t e d . d a t a s h o w e dg 8 . 7 7 - g g . g Z u o @ r n l - h o u r e x p o 8 u r e t ' 5 z D a 1 a t h 1 o n , w 1 t h a n e s t l ' u a t e d L T ' n o f 2 0
uinutes on 5Z nalathl.on. Thle speclee ehowed complete ausceptlbll l ty to fenltidthton and
p r o p o X 0 r o T h e a u t h o r s r e E a r k e d t h a t @ s h o w e d n o r n a 1 s u e c e p t 1 b 1 1 l t y t oorganophoephorue and carbanate conpouiiiilITE-iegresslon llnes constructed fron pooled
daia ehowea tfgt elopee and low LT.,, values, but eone odd Eurvlvors were observed ln
culLcl.faclee and !g1g$1g and tHey could be reslstent lndlvlduale. Further tests reere
;E?6ffiGii-tor tEEiffi-ilEcies uslng the proggny of such eurvlvore to detect lnclplent
reeletance to oalathion. Rathor & Toqlr (f980a)^ conflrred the Preaencerof nalachlon
resletance lD.Sng! by laboratory eelect lon. Rathor & Toqlr ( f980b)- at tenPted to
1 s o 1 a t e a D D T f f i i E I 5 r e f r o m w 1 1 d - c a u g h t a n d 1 a b o r a t o r y 8 t r a l n s o f g l @ .Although DDT apraylng had been dlecontlnued fot aeveral years, laboratory selectlonlndlcated no reverglon to DDT eusceptibll l ty. On the field slde, a recent rePort on the
nalarta sltuatlon 1n Pakietan, 1987 conmunicated to I{IIO/EURO' showed that suecepttbll l ty
teste lndlcated the preeence of nalathlon reel.stance ln dt€phensl in nany dlstricts' whlle
cullclfaclee remalned generally susceptlble to nalathlon excePt ln a few areas ln tno
eGEiliA;-G PunJab. No vector regletance to fenltrothlon wae detected.
In Indla, Subbarao, Vasantha & Sharna (1988) reported the reeults of a field
experlnent conducted to etudy the lnpact of houee spraylng with DDT or IICH agalnst
cullclfacles populatlone ehowing reeletance to these tito lnsectlcldes, and at the same
f f i P a r e r e a P o n e e e o f s 1 b l ' { n g s p e c 1 e e A a n d B b y e x a n 1 n t n g t h e 1 r p r o p o r t 1 o n s l neprayed vt l l lgea lse l Subeect l .on (11) , I be low]. The exper loent was carr led out ln 1984 in
Lonl b lock of Ghazlabad d let r lc t , Ut tar Pradesh 8tate. In th ls etudy, the euscept lb l l t ty
of cullclfaclee e.1. to lnsectlcldee waa deterulned, exposlng half-gravld fenales to 4Z DDT
or ffiGEffii for one hour, or 47 dieldrln for two hours, wlth nortalltles scored after24 houre holdfng perlod. For cytogenetl.c ldentlf lcatlon of slbltng epecieer treated
noequltoe, whether knocked down of not, were renoved Lonedlately after the expoeure perlodt
wlthout oalntalntng the standard holdlng perlod, elnce that would have made survlvors
becone gravld, and hence uneultabl.e for cytogenetic tdentlf lcatLon. Fernalee of
cul lc l fac l€8 5.1. were found to be 802 res ls tant to DDT (202 nor ta l l ty) and a lnoet.ff ieslstant
to dleldrln (2.77 nortallty), and completely Busceptible to nalathlon(10b2 nortallty). Speclea ldentlf lcatton of 91 epecluene eurvlvlng or knocked down by
exposure to 47 DDT showed 402 nortallty tn specles A and 6Z roortallty ln epecles B'
tndlcat lng the d i f ferent l .a l reaponse of specles A and B (P<0.01) . The resul ts of tests
carrled out on cultclfacles s.l. showlng nearly total reslstance to 47 dleldrln and
I . See VoL; I , under 2 .6 .3 , pp . 105.2 . See VOL. I , under 2 .6 .4 , pp . 124.
vBc/90.3MAL/90.3Page 164
conplete suscept ib i l i ty to 5Z nalath ion were taken to indlcate s ln i lar l ty in the
suscept ib i l l tyTresis tance status of species A and B to these two lnsect ic ides. As the two
species are sympatr ic ln the study v i l lages, they have been under the same insect ic idal
p i " " " , r r " o f the spraying schedule of the Nat ional Malar ia Eradicat lon Programrne. Taking
into account the fo l lowing features: (a) species A is the predominant nember of the
An. cul ic i fac ies complex in nor thern India, (b) species A is a more ef f ic ient vector (see
t r r f f i I ( c ) t h e 1 e v e 1 o f s u s c e p t 1 b i 1 i t y t o D D I i s h i g h e r t h a n i n s p e c i e s B ' t h eauthors suggested that spraying DDT would be more ef fect lve than HCH. On the other hand,
nalath ion would be an ideal replaceroent lnsect ic lde, but the costs of operat ional use of
rnalathion is about 6 tLnes more than DDT in India. Thereforer the authors recommended the
use of DDT, par t lcu lar ly s ince recent exper ience has shown that nalar la inc ldence could be
brought down by DDT spraying 1n areas in India where cul ic l fac les s.1. Ls res is tant to DDT
and HCH.
The last tero reports of the WHO Expert Cornmittee on Insectlcide- TRS. No. 655, and WHO, 1986 - TRS. No. 737) suDmar ized the records
resistance in anopheline mosqultos. Records Pertainlng to [email protected]
reproduced here in 1able 17.
Table 17. Insect ic lde res is tance 1" S:1g11" i f . "1* s .1. and An. s tephenslln Asia West of India.
(see co.-enta on some records below rnarked with asterlsks)
Res is tance (wlio , I 980of lnsect ic ldeand cul lc l fac les are
Spec ies
cu l i c i fac ies
stephensl
DDT
Afghanlstan,I ranrOman,PakistanrUAE
Afghanlstan,Iraq rOoan,Pakis tan, SaudiArabia, UAE
HCIT
Afghanlstan, OmenPakistan
Afghanlstanr l ran,I raq rOnan,Pakls tan , Saudl-Arabia
Ornan: temephos*UAE: tenephos*,chlorpyr l fos
I ran: malath iontfeni t roth ion tlodofenphoe tchlorphoxlu, phoximIraq: nalath lon,fenl t roth lonPakistan: nalathion
Carbanates &others
oDan: carbamate
Iran: carbanates**
*Wlth regard to tenephos reslstarrce ln cullcifacles in Oman and UAE, theee records
cane fron rests carr{.ed out wlth 0.025 ppn, tfhlEEf-oncentratlon of temephos hltherto
provided in the lHO test kit (eee Strfarawf, 1976, under Oman above). Tests should always
be carried out wlth the dlagnostlc concentiatlon of 0.25 PPn teoePhos and Shldrawi agreed
wlth this (personal connunication, 1990). In fact' tests perforroed wlth thls concentratlon
ln 1gg3 and lgg6 ln onan lndicated that cullclfacles remalned suscePtlble to teoePhos as
shown above.
**Concernlng carbaoate reslstance ln stephensl ln Iran, the orlgln of thls record
could not be t".""d (Shldrawl, personal coufiGIltton, 1990). As shorrn above the recent
report of Manouchetrri C Yaghoobi-Ershadl (f988) conflrned that .g!9i@,1 ln southern Iran
renalned suscepr lb le to pr ipoxur ( f976- f986) , despl te 10 years of appl icat lon of proPoxur
house spraylng t l t lce Per-year (see deta l ls bbove under I ran) '
In the l ist of epecles and countrles where lnsecticlde reslstance has had
eptdenlological or economlc lmpact and/or neceseltated a change ln'control operatione (If i lOt
1985 - TRS. No. 737) , DDT res is tance ln cul lc l fac les ln Afghanlstan, I ran, ornan and
pakistan, as well as DDT reslstance rn sEine-nsr rrrlfghanlstan, rran, rrag and Pakistan'
and nalathlon reslstance in stephensl ln Iran were lncluded.
Ln the same rePort (l l tto, 1986 - IRS. No. 737) the available findlngs on resistance
mechanrsms tn anopheilnes and culiclnes were suntnarrzed. The data pertaLnlng-to gt:p!:nsr
1n rhe presenr geographical area, and the only data g lven lot " :1 i "15." r " "
s '1 ' ln India,
belng adjacent to the present geographlcal area are shottn ln raDle Io'
vBc/90. 3l'{Allgo.3Page 165
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vBc /90 .3! . rAL/90.3Page 156
Detai ls of genet lc and b lochernlcal and other s tudles on lnsect lc ide res is tance are
shown i n VOL . I - see unde r 2 .6 .3 , pP . 98 -121 fo r SP l9ns1 , and 2 '6 ' 4 , PP ' I 2 l - I 30 f o r
cu l l c i f ac ies .
5. The An. ganblae comPlex
T h e @ c o n p 1 e x 1 n t h e g e o g r a p h 1 c a 1 a r e a u n d e r r e v i e w i s c o n f i n e d t osourhwest Arabia tS."ai-n'r"i i", f"r."-anl Southern Yemen - aee Fig. f) an area regarded as
a neer lng p lace o i t t re Afrot roplcat , ta tearct ic and-Or ienta l fauna' An' arabie ls1s-1"- :n"
only uenber of the cornplex "o
i"t i ientlf ied fron thls area' and has been regarded as the
uaJor vector of nalar la . The d is t r ibut ion and ldent l f lcat ion of arablensis and i ts
northern and ea'tem linits have been shown in PART Il ' Only new-GffiTfon ls added
here. Thevasagayi i CfSAZ - unpubl is t " i . "pot t to WHO) br ief ly v ls i ted the ls land of
socotra, southern-i"i"r, durlng z5 reiruary - 2 March 1987 to study the rnalarla situation
and deternine the vector reeponslble for nalaria transmlsslon' Actlve transmisslon ltas
noted fron flndlng 10 lnfants Positlve out of 38 exanlned' At Qalansia' PSC yielded 15
arablensls and Il An. cuuellgcles aatgngngis [nunber of roous exarolned not shown] ' In
F f f i r r i y , - i " i va1su rveys revea1ed thep resenceo farablensls, cullclfac1e adenensls and nultlcolor. The itrst two specles are nost probably
ffii'rffi li".iiiE=n-aoresrlc and garden werls around lladlbo
locallty. rne nain w"ai C= valley) whlch runs through Hadlbo town contalned many suitable
breedlng sites for the tno vectors, but no larvae r"i..r,"o,tntered. The breedlng places
were regularly treated wlth ternephos. In Qalansla, arablensls was found breeding in a
swallpy part of a strea'. rt" pr.""r,ce of "raprgnsls-iEiG4'
the flrst record of a
meuber of the A".-;;;r." "orpi"*
oi-soc2t?ffi i6 wtr1le old records refer to the
presence of cu l lc l fac les aalenensts onry '
In a more receot vlslt to Socotra, Farld (1988 - unpubllshed report to I.IHO)
accompanled by a natlonal tear0 to.s"""" the nalarla eltuatlon in the lsland' found only
cullclfacles adenenste as larvae and adults in several locallt les lncludlng those surveyed
by Thevaeaga{au ff i";;r-a.i-iuo""l. Thus, rhe record of arabtgnsls ln socotra,alalts
conflrnatlon-. [For lnformatlon on the nalarla sltuatlon tn-socotra, eee subsectlon
( t t ) , I be low l .
6. Secondary and suepected vectors
6 . r A n . d - t h a l l '
As shown 1n VOL. II4, under SECTION II ' d-th811 le widely dlstrlbuted ln the
present geographical area, but 1t wae LncrlmfnEfq.d-i? a secondary vector of nalaria only ln
Iran. lr lanouchehrl, Ghiaseedln & Shahgudlan (Lg72> showed that-d-Fha+l occurs ln the
aoutherB part' of Zagros, in the p"o.rlrr""" of Bandar Abbae, uatirEfrEfin' Khuzestan' Kerman
Shahan, Fars and froi ttre coaat of itre Perelan Gulf to Hauadan, 1410 n above eea leveI' In
October 1965, durlng epldenlologlcal/entooological studtee ln the hlghland area of Bandar
Abbas, southenr lran, 800 u above eea level, lt was observed that although the denslty of
the g@1. populailon, the-maLn nalarla vector ln the eouthern part of lran' was aloost
zero, oalarla tranarnlsston 8t111 p"i"i"t.a. Therefore, @! was euePected as belng
iffie-oADenr vBc/85.3 - !'lAP/85.3, PP' 2L3-223'2. see rl ir t , 9. 2L4.3. Dr G.A. Farid afflrred that speclal attentlon na8 pald to flnd-arablensls ln places
surveyed Ln Socotra, but not a slngle speclmen could Le found - th;;-l#Eord of
Thevaaagayan could not Ue conflroed (Personal coomunication, October 1990)'
4. VOL.-Ii, document VBC/90. 1-MAL/90'f '
vBc/90.3UAL/90.3Page 167
responsib le for t ransmlseion. Fenales of d- thal l were col lected by PSC dur lng October.1965fron the vil lages of Gohrah and Glshan, neiFB-.nd.r Abbas. Mosgultos were tranaported to
the laboratory ln an lce box and kept ln a ref r lgerator unt l l d lssected, when 2 out of 143specl.nene were sporozolte-posltive. At that t ime nalarla preval.ence in the humanpopulatlon was 9.82 (approxiroately 802 P. faLclparun and, 2OZ 3_. vival) and the indoorrestLng densl ty of d- thal l ln 'Gohrah was 20/room. Precip l t ln t .ests carr ied out onbloodroeal srnears of-6a-hs caught in houses showed 20i,, poeltive for man. During the Pastl0 years, 4165 b loodneal snears taken f roro d- thalL were tested by the Inst i tu te of Publ icI lea l th Research. 0f these, L5.62 were posl i l iEEr nan, but the HBI depended on the area,vary lng f ron lZ ln lzeh, a sheep rear ing area, Eo 257 in Bandar Abbas. In Septernber 1966,sporozol te-posl t lve d- thal l was repor ted f ron Sarkeverdan v i l lage near Borazjanr and inOctober 1967, the auFhois found 2 sporozol te-posl t lve d- thal i speclnens out of 96 d issectedfron Gohrah and one out of 100 f ron Gishan. Fron these resul ts , l t was establ lshed thatd-Ehal l ls a secondary vector in eouthern l ran.
Manouchehr l & Rohanl (1975) s tudied the ecology of d- thal i ln southern l ran to assis tfuture planning of rnaLarla control. The study covered the followlng aspects
- Breedlng habl tat : The preferred breedlng s i tes ln l ran nere the pebbly narg ins ofr lvers and st reaoe, 6eepages'wl th s tagnant i ra ter , r lce f le lds, p l ts around spr lngs wi thoutvegetatlon, hoof-prlnte and poole ln drled river beds. In Bandar Abbae area, larvae lterefound i.n pools along stony river beds, without vegetatlon, and ln Buehehr larvae were foundln olneral lrater. Breedlng natere were found to have tenperatures ranglng betrteen l3o Cand 28 o C wlth a pll of O.i-9.0. Larvae nere more abundant durlng Septenber-October' aperlod which te at the end of the hot aeason ln southern lran.
- Seasonal dletrlbution! In the coastal area of the Perslan Gulf fron Abadan toBandar Abbae, the denslty of d'thall was negll.gtble. In Lnland lowland areas, such aeShabankareh, adulte of d'ttratl were actlve fron March to November, wlth two peaks: one ln-May and the other tn SeIEfrEE. In htl ly areaa of the eouthern part6 of the Zagroe chaln,adult d-thall were ruore abundant and very acElve, startlng the seasonal actlvlty ln earlyMay, rff ig a peak ln nld-Auguet, and then gradually decreaelng. The speclea lta6 absentdurlng the wlnter monthe (Decenber-February).
- Restlng behaviour: An. d-thall. was found re6tl.ng ln hunan dwelllngs, aninalehelters, food atores aod tdffi i i6ors, lt wae collected restlng on walle, hanglngclothes and splder webs. The adulte were eensltlve to l lght, and often dleturbed bytorchllght. Outdoore, they rrere cornlnonly found ln natural shelters such as holee ln rl.verbanke, rodent holes and old rulned Qanats (explalned by the authors aa a comtIton Iranlannane deecrtblng a serles of welle bullt on a hll lstde or sloping laod to brlng theunderground water to the surface)
- Exodus frou housee: In July-August 1970, obeervatlone by outlet wlndow traPs ltereconducted. Of 765 d-thall fenalee caught by the traps, L71 were unfed, 627 bLood fed' 16Zhalf-gravld and 6Z EFAni:
- Bltlng behavlour and bltlng'cycle: In vll lages at Khesht ln $azeroun, southerri lranuan- and cow-balt captures nere organlzed durlng April Noveuber 1970^. Catches began at1700 h and ended 8t 0600 h. Bl t lng of d- that i on nan star ted at 1800 h and cont lnued unt l lO40O h, wlth a peak between 2000 ana 2tbb-f,I-lbout 902 of the bltes took place ln thef l rs t hal f o f the n lght (1800-2400 h) and onLy 2.57 ln the three hours before sunr ise. Oncow, the bltlng pattern waa more or lees the sane, but the number of bltes on cow was uuchgreater than the number of bltes receLved by nan. Of 1137 d-thall collected durLngApril-Noveober, about 762 were caught on con and 247 on nanffiseasonal bttlng activityof s$l! began ln early Aprtl and contlnued untl l early November, wlth a peak lnSeptenber.
- I lost preference: In Fahlldn, Kazerouu, southern lran two Magoonand corrbait were used for collecting anophellnes from May to Decenberehowed that 87.57 of. d-thall were collected froro the trap wlth cow andof human balt.
fffi-E'sults appeared ln a paper publlshed later(1976) on the blttng cycle of .@,1., $!g!!}!g and
by llanouchehrl 'd- thal l - see
traps wlth hunan-1965. The resul teonly 12.52 f ron that
Djanbakeh & EshghYunder 4 .6 /4 .7 above .
vBc /90 . 3MAL/ 90 . 3Page 1 68
- Relat lon to malar ia: The authors indicated that d- thaf i ln l ran has been susPectedas a vector of nalar ia s ince 1957, when one sporozoi te-p6f f i speci roen was detected inKazeroun (c i t ing Ghadlr lan & Ghlassedl-n - unpubl ished repor t ) . In 1958, in Behbahan,Khuzestan, where a nalar ia epidenic was repor ted, l l00 d- thal t were d lssected wl th negat iveresul ts . However, th ls was at tempted when the roalar i . E l?26T" ceased af ter d ie ldr lnspraying, and the nosqui tos d issected were a l l co l lected f rom caves outs ide the v l l lage.The records of sporozol te-posi t ive specinens obta lned ln October f965 by Manouchehr i tGhiassedln & Shahgudian (L972 - aee above) were surorDar lzed, . A year la ter , 1 ,n Septernber1966, three sporozoi te-posi t ive specimens were found ln 39 d- thal i d lssected ln theBorazjan area.
- Suscept ib l l i ty to lnsect ic ldes: Al though the southern par t of I ran has been sprayedwi th DDT s lnce 1952, and subsequent ly wi th nalath ion s ince 1968, d- thal i renalnedsuscept ib le to both insect ic ides; the LC'O for DDT and nalath ion i tas est inated at 0.3 and0 .34 , respec t i ve l y .
As par t of ecological s tudies on oalar la vectors ln l ran, Eshghy et a1. . (1983)
reported the resul ts of observat ions on the b i t ing behavlour of d- thal i . Nlghtobiervatlons by direct balt capture were conducted fron June to F6-5?r L978 at t\tovil lages: Gaw-shakl and Bakesh-dodangueh in Mamasanl area, southern Iran. In thls areatDDT spraylng nas alternated wlth naLathlon spraylng durlng March, May, August agdSeptenber. Fron 1968, roalath ion spraylng has been appl led at a dosage of 2 g/n ' ln tworounds per year. At each vll lage, four local lnhabitanta Itere hlred to act as hunan balts,and two'cons nere enployed as animal baits. A11 catchea ltere nade outdoors as inhabltantsrest . and s leep outdoors wi th thel r anloals dur ing the hot 6eason. Catches were carr ied outar l0-day inrervals extendlng frorn 1800 to 0500 h. The seasonal blt lng actlvlty of 1!]!!3l!were found to start in the rolddle of May or beglnnlng of June, reachlng a peak durlngAugust-SepEernber. During the period of observaElons, the mean nunber of bltes per nightranged f ron 0.0 to 2.2 on man and f ron 0.0 to 47.5 on cow. I t was a lso observed thatd'thall was active betneen 2000 and 0300 h on man wlth 1ts blt lng peak occurring betweenffin'a 2400 h. on cow, the activiry exrended fron 1800 to 0400 h, wlth the peak ofbit lng occurring at the sane period as that of nan. Conslderlng the four quarters of thenlght , the f i rs t and th l rd quar ters appeared to have equal b i t lng act lv l ty . The lowestact iv i ty occurred dur ing the four th quar ter of the ntght , whl le the h ighest bt t lng act lv i tywas seen dur lng the second quarter . Thls pat tern of the b l t ing cyc le of d- thal l wasslollar to that observed in Khesht, Kazeroun area in 1970 (cftlng t 'tanouchdffFjanbakheh &Eshghy (L976 - Bee above). Thus, lt seems that the frequent appllcatlon of nalathlon hasnoE changed the bltlng behavlour of d-thali for the Past l0 years.
Some Lnfornation on theUanasanl area nas lncorporated
6.2 An. nul t lco lor
response of d'thali to fenltrothlon and roalathlon epraylng lnunder 4.6/4 i ibove - aee Eshghy et a l . ( f973) .
As shown under SECTION II of VOL. II l, ryfglgg}g le wldely dlstrlbuted and extends
lts distrlbutlon fron north Mrlca eastwardly up to Paklstan ln the Preaent geographlcal
are3. Although lt exlsts ln practically every country in thls area, lt has not been
incrlnlnated as a vector of nalarla. In lran, Eshghy (L977) lndlcated that nultlcolor lswldely dlstributed in nost provinces extendln! fron the eea level of the coaEiG-ofBandar Abbas ln the south to an altltude of L22O ro Ln Sabzevar areaa of the northeast. He
descrlbed tt as an lnland and coaetal saltwater breeder. Its larvae were found ln enall
pooLs wlth or wlthout weeds, ln stagnant oI f lowlng naters and ln shallow welle. Larvae
were also found in saline rrater pools ln the desert with a sallnlty up to 62. In sooe of
such pools, the sallnlty was so hlgh that crusts of salt were formed around the edgee.
Adults of nultlcolor are regarded a6 strong fl lere and can disperse wlth the wlnd to a
disrance uiG-TZ-G. They readlly enter houses and blte oan at nlght. It nas only ln
1955 that one multlcolor fenale nas found wlth oocysts at the vil lage of Mahnood-abad
Moslen tn SabzG]i6Gly, northeat of lran, but no sporozoltes were found ln the sallvary
glands. Thus, mul t lco lor in I ran remalned a ausPected vector .
I f f i c u m e n t v B c / 9 o . L | t | A L / 9 0 . l ' s E c T I o N T | , 2 . 2 . 4 , p . 7 4 .
vBc/90.3MAL/90.3Page 169
A s m e n t 1 o n e d 1 n s E c T I o N I I o f v o L . I I , g @ h a s b e e n a s u 8 P e c t e d m a 1 a r 1 a v e c t o rin the Medlterranean Basln only on epldenloloElEtl-Erounds, although lt was lnfected
experlmentally ln Egypt.
6 .3 An . se rgen t i l
The d isrr ibut lon of sergent l i ls shown 1n Fig. 5 of SECTION I I , VOL. I I I . A l though
i t has been recorded f ron at t countr ies of Asla west of India, there has been hardly any
infornat lon on l ts importance ln the eastwardly par t of l ts d ls t r lbut lon. In Pakletao,
Mul l lgan & Bai ly (1938) who recorded sergent l l for the f l rs t t lne ln Quet ta area lndlcated
that Ehe nunbers of adults captured durlng thelr survey, formed lZ of the total catch of
a1l species and only 14 speci rnens were ldent l f led f ron larvaL catches. Al though a Provenvector of rnalar la ln the Middle East , sergentL l d ld not occur ln euf f lc lent ly large nunbers
in Quetta to be consldered of any pracEGal lnportance ln oalaria transoiesiou. Only slx
specinens were d lssected but none was found infected.
It ls only ln the lrest aud southwest of Saudl Arabla, Northern Yenen and Southern
Yenen that sergentll has been consldered a vector of lnportance based on the avallable
epideniologfElfffience and the knowledge on Lts role ln nalarla transnission ln several
countrles of the Medlterranean Basin. In the Wegtern province of Saudl Arablar sergentll
was the only known vector exlstlng ln the ltedlna-Khaibar area where no E-Ep!!g s'1'
exlsts. In valleys near Khaibar, 9.€!.1! was found resting ln caves. In the
southweetern part of Saudl ArablarG-Eonsldered a secondary vector next to ara-blensis
and it has become the Dore conmon vector ln resldual focl of oaldrLa tranenieslon ln
valleys of the l l l jaz raountalns
In Northern Yeoen, sergentll was found repeatedly ln localit les-ln the Central
tt lghland plateau where oaTi?lfi laseo nere reported, and lts Presence ln slgnlflcant
denslties durlng nalarla epldenice polnted strongly to lts poaslble lnvolveroent ln nalarla
transnisslon. In the regton of the foothll ls and ulddle helghts of Yemen, $abienglsrepresented the uaJor . '"ctot. It was associ.ated tlth ry,!11, !!:9Ig!! ' pharoengls and
fluviatl l le, coneldered suspected vectore. Slnce the laet ttto EPecleE were rare 1n En18
iEF-n, it was suggested that the exact role of ggntlt and d-thall ln nalarla
rransmtselon ehouil be inveerlgared. rn rhe arti-61[6!E6-fron EFlTiteau to the Arabl'an
d e s e r t , @ " ' d g ! ' l ! r ' e r e r e c o r d e d 1 n t w o 8 e P a r a t e a r e a 8 1 n t h 1 s r e g i o n , w h e r ehypoende i f f iET ra foc f f i t ec ted .Ma1ar1aPreva1encewa8coEparaE lve1yh tghe r1narabl.ensl.s areaa than ln the g#g.ll ar€48.
In Southern Yeoen, arabLensle wae coneldered the most lnPortent vector' whlle
seggentil was regardea ae-ii,65EIiflnportant ln sooe lnland 8a€a8. It wae suggested that
ff i;E iuportance of sergentl. l aa a vector of nalarla ehould be detetmlned, beariag ln
ulnd lte refractory respEfrff iouse spraylng ln other countrlee of the Medtterranean
BasLn.
For uore det6tls on the dlstrlbutlon of eergentll Ln eouthlte8tern Arabla and relevant
references, PART I' should be coneulted.
6.4 An. subplctus
An. subplctue hae been recorded ln Afghanlstan and Paklstan aa an anophellne epecies
aesoc1ating the niln vectors of nalalra. Infornatlon on lts blononlce cone8 chiefly fron
paklatan where lntenslve studles on the naln nalarla vectors cullclfaclee and ggg@! and
assoc1ated anophellne epecles have been carrled out. Sorne aepecEs of the bl'ononlce of
subplctus have already Leen-lncluded ln the above revlen deallng with cultctfacles and
;G f f i ; i l n Pun jab ( i ee 4 .2 , 4 .5 , 4 .6 /4 .7 , 4 .10 and 4 . r r ) ' ,
In addltlon, a nark/release/recaPture experlment {nvolvlng $!{ctue waa carrted out
by Releen, Hahnooi & parveen (1979) at the vll lage of Khano-I{arnf.Efro-aletrlct ' In
t-hle area, subDictus was found breedlng ln oost collectlons of standlng rtaterr especlally
i - ' fr i- iX,Ecunent vBc/90.r-uAL/90'1' sEcTroN II, under 2'2'4, 9' 77 '2. pART I, document vBc/b5.3-MAUb5.3, sEcTIoN III(F) southwestern Arabla, 9p.2L3-222'
vBc /90 .3l'rAL/90. 3Page 170
sroal l eutrophic ground pools. The exper inent was carr ied out 'dur lng Septenber 1978 at the
end of the monsoon ratny season when the seasonal population abundance was highest' As
sunrnar ized by the authors, the dai ly surv iva l rate est imated f rom the recapture sequence of
roarked adul ts was 1ow (0. I92 for maies and 0.343 for fernales) . Surv iva l of feroales
est lnated by several age-grading rnethods ranged betneen O.347 and 0.628' Both stage- and
age-speci f i t t f te tables were calculated f ron ver t ica l age-grading data detern ined by the
di la tat lon technlque. Fenale and nale populat lon s ize was est inated by Bal ley-s
nodl f lcat lon of the L incoln index ana founa to be 4478'4 and 6106'8, respect ive ly ' Th:authore polnted out that a l though subplctus was occasional ly found natura l ly ln fected in
some areas of the lndo-paklstanl suEffi?nt (clt ing Russell, Rao & Jacob, 1939; Roy,
1943; l la t ta l , 1961), l ts zoophl ly and Low surv iva l rates ln PunJab, Pakl -s tan would seem to
negate Lts lnvolvenent in malarla transmission. sluilar concluslons were also ruade in
Indla based on laboratory t ransmiss ion and longevi . ty s tudles (c i t ing Roy, 1943 and Mehta '
1931 , respec t l ve lY ) .
res ls tance in anophel{ne oosgul tos tabulated ln the
on Insect ic lde Resletance ( f f f iO ' 1980 - TRs' No' 655 and
that g.g$jg 1s reslstant to both DDT and dleldrin in
geograpElca1 irea under revlew'
The records of lnsect lc ldereports of the ExPert ConultteeWHO, 1985 - TRS. No. 737) showedAfghanistan and Paklstan ln the
Subsec t l on ( i l ) EPIDEMIOLOGY AND CONTROL OF UALARIA
l . Epldero lo logical s tudles and contro l oqerat ions
As shown in the PREFACE of thls series (tn VOL. I), lt ls not lntended to glve a
hlstorlcal account of the past shlft lng of areas frorn phase to phase, under the forrner
global nalarla eradlcatlon Programne. It ls sufflclent Eo outl lne the naJor setbacks
caused by technlcal and/or "d.irrl"t."t lve
factors that haropered the progress of prevlous
nalarla eradlcatlon and Present nalarla control Progrannee' Enphasis wtll be laid on the
current nalarla control operatlons whether stl11 undertaken by a vertlcal progranne or
through pHC in any forn of horizontal servlces and not neceasarlly PIIC systen sensu
Etr lc to. Regardlng lnsect lc lde test lng for malar la contro l ' on ly large-scale f ie ld t r la ls
ff i-""ir i i ir"al sone of which have already been shown under the aPProPriate subject
headlnge of SubEeciLon (i) VECTOR BIONOMICS above. l{ut or vil lage ecale trlal 's wil l not be
deal t wi th.
Dependlng on the avallabll lty of relevant reportsr lnfornation ls conplled-.by coyntry
novlng fron the west to the eaetern lftnlt of the geographlcal area under revlew (ASIA IIEST
Of INDIA - F lg. I ) . In th ls area, as shown ln the md i f th . 8tat16t . quar t . ( I { t tO l?90) on
the l{orld Malarla Sltuatlon ln 1988, Bahraln, Kuwalt and qatar contlnued to be free of
lndlgenous nalarla as wll l be shown tn dedtatl below'
In f5$r a ueeful blbllography of lLterature on rnoequlto and rnosqulto-borne dlseases
lncludlng papers on -alarla and it6 vectora hae been preeented by Mohsen et a1' (1989)'
Thts blbllography l lste a serlee of papers by offlcere of the Endenlc Dieeaees Instltute '
Baghdad, lncludlng those of Dr G. oesr and others on the nalarla sltuatlon in Iraq and
related problene ierlodlcally. 0n1y eelected papera are auooarlzed here wlth epecial
reference to the nalarla eltuatlon ln recent years. For the hietory of roalaria and 1ts
contro l 1n I raq before 1946 and Later f ron 1946 to 1952, three PaPers by Pr lngle (1954b
1955a & b) ehould be coneulted.
Ossl (1969) revlewed the hlstory of anElnalaria actlvlt les whlch were lutenslfled
Btartlng frorn 1946 and descrlbed the tltnattc condltlons and the geographlcal regl'ons Ln
Iraq. In 1952, the'Governnent and WI|O organlzed a malarla control demonstratlon proJect ln
Suleloanlya Llwa to study the epldenlologlcal Bltuatlon and to asaeaa the effect of DDT
houee spraylng under toeat condltions ln northern lrag. By 1954, !!9 spraylng operatlons
were expanded gradually to cover the entire Northern reglon' By 1955, the epraylng
operatlons tfere extenala to the Central and Southern Reglons and ln- 1957 ' the Government
declded to enbark on nalarl.a eradlcatlon wlth the collaboratlon of WttO and UNICEF' Iraq is
dlvlded lnBo three reglone based on the topography of the country (see Flg' 2b) as follows:
vBc/90.3MAL/90.3Page 171
- The Northern reglon: Thls ls generally a mountainous area wlth large lrrigated'
val leys in which "ot ton,
r lce, wheat , bar ley and other croPs are cul t ivated. The western
part of th le region le bordered by a deser t . Vectors of rnalar ia are: sacharovi and
superpiCtus. Transmiss lon season extends f roro May to ear ly Noverober.
- The Centra l reglon: This represents the a l luv ia l p la ins of the Ttgr is and theEuphrates. East of th is reglon occurs the footh i l l region of the I ranian mounta ln ranget
and to the west the reglon is enbraced by the deser t ic Arabian p lateau. Malar ia vectors
a r e : . @ a n d s t ' e p h e n s 1 . T r a n s m i s 6 1 o n 8 e a s o n e x t e n d s f r o r o A p r i 1 t o 0 c t o b e r w i t h t w opeaksffiTl-SepreiEl:dEtober ILater, this reglon was deflned as the Central and the
Centra l Euphrates reglons] .
- The Southern reglon: Thls ls somewhat s ln i lar fo the Centra l reglon ' but l ts
eaetern par t does not extend to the footh l l ls of the I ranlan mounta ins. On Lts l testern
s lde l ies the nater less Arabian p lateau. In the Southern regl .on, extenslve marshes occurand a large network of canals ex ls ts , and as the reglon ls low ln a l t1 tude, vast areas of
irs land ger \rarer logged by tldes. The only known vector 1" 9!98991. Transrolsslonsea6on extends f ron Apr l l to Decenber wi th two peaks as ln the Centra l reglon.
Regardlng c l lnat ic condl t lons, a deaert lc type preval ls over x lost of I raq. The
aulroer nonthe are dry and hot, and wlnter oonths are cold wlth occaslonal ralns. The neandaity naximum tenperature exceeds 42oC during July-Auguetr and the Dean daily rnlninunte6perature ln January ls nearly OoC on the alluvlal plalns and drops to bel.ow zero in
the northern uountaLnoue reglon, Relatlve huoldity varies fron month to oonthr In July theRH ts 1or, becones relatlvely higher ln the foothll ls and along the course of the Tlgris
and Euphrates rlvers, and reaches a conslderably higher level ln the southern areaa.Rainfall ls conflned to wlnter nonths (Novenber-March): the Zagros hll l range in thenortheast recelvee a conparatlvely hlgher ralnfall (about 250 nn annually). A rapid dropls observed as one Dove6 souEhwardly to the a l luv la l p la lns where ra infa l l regis ters 113 nnannually and becones rouch less ln the southeaatern areas near the Gulf.
Oset (1977) rev lewed the oalar la s l tuat lon in I rag dur ing l97O-1975. In 1970, act lvefocl exlsted all over the country, and there was wldespread transnlssion ln the Northernreglon. The nunber of nalarla caaes detected in the Northern reglon was 9450 ( 45 085sl ldes exanlned),2451 1n the Centra l reglon ( f87 298 exanlned), and 2336 ln the Southernregion (273 894> exanined. In ear ly 1971, as spraylng coverage in the Northern reglonlnproved, effectlve operatl.onal measures suceeesfully counteracted the epread of nalariatransmiselon and malarla prevalence steadlly decllned. In 1972, nalaria casea in theNorthern reglon decllned by 337 and ln the other two reglons by 882. 0n the other hand'the nunber of blood slldee collected lncreased and thls trend was observed 1n subsequentyears. Followlng the ioproveoent ln spraying coverage, efforte were dlrected to enhancesurve{ l |ance act lv l t les wl th fu l l co l laborat ion of heal th eerv lces. Every heal th centrewas requl red to take b lood anears at a rate of at least l0Z of the tota l dal ly at tendants.By the end of 1973, rapld lnprovement ln the nalarla sltuatlon lras lndicated fron conpletelnterruptlon of malarla trausnieslon ln the Central and Southern reglons for the first t lneln the h letory of the oalar la eradicat lon progranme. However, act lve foc l s t l l1 ex is ted ln
four areas ln the Northern reglon. Condl t lona nere, therefore, favourable for ln terrupt lngmalarla tranenlssl.on throughout the whole country and the plan of actlon was, therefore,deslgned to achieve this obJectlve. However, thls taek could not be accoopllshed due tounforeseen clrcuustancee nhlch resulted ln the developnent of unsettled condltions ln theNorthern reglon. Therefore, the plan of actlon t.or L974 had to be nodlfled to lnplenentepeciflc neasdree alned at nalntalnlng the galns achieved ln the Central and Southernreglons. Due to accesslbll l ty problets, very l irnlted operations could be lnplenented lnthe Northern region. At the beginnlng of L975, settled condltions ltere restored ln theNorthern reglon and the Government gave highest prl.orlty for rnalarla control operatlons in
that .reglon. Wlth full cooperatlon of all concerned i.ncludlng the nll l tary healthservices, sprayLng operations rrere conducted carefully wtth a vlew to achleve oaximunposeib le coverage. Specla l at tent lon wae paid to spraylng and survel l lance act iv lEles ln
campe and vll lages of returnees (persone dlsplaced due to unsettled condltlons In theNorthern reglon and returned to thei r or lg lnal v l l lages) . In the other two reglons, s t r ic tvigllance was malntalned for detecting inported iofectlons from the Northern reglon which
vBc/ 90 . 3MAL/90. 3Page 172
were increaslng wi th the Dovenent of the populat ion. Despl te a l l e f for ts , there was a
rising trend in the nurober of cases ln the Northern reglon coupled wlth an lncrease ln the
nurnber of cases in the Central and Southern regions which were in a state of interruPtionof nalar la t ransrn lss ion.
In a p rog ress repo r t by Oss i ( 1978 ) , t he na la r i a s l t ua t l on l n I r aq was desc r i bed .Malar ia s taf f wi th the cooperat ion of other heal th personnel and the Chief Medlcal Of f icers
of the Muhafadhas (= prov inces) endeavoured to s t rengthen v ig l lance and provlded bet ter
superv is ion for ear ly d iagnosis of a malar ia focus, and for lnp lenent lng lnnedlate measures
to prevent the spread of in fect ion and to keep the parasl te reservoi r as low as possib le.
In the autunn of L976, transmlssion was re-established ln Abbastyah and Kufa nahlyae (=
local l t ies) in Najaf Muhafadha in the Centra l reglon, but i rnmediate reuedia l measures kept
these foci under control. The sane strlct Deasures were fuoplenented ln 1977 and
transmisslon was contained and renalned locallzed in a l iroited area. Because of huge
projects being established in various parts of the country under the Econonic Developnent
Plan, an ln f1ux of workers f rorn other Arab countr les, Indla and Pakistan entered I raq.
Soroe of these workers cane froo areas known to be endenlc for roalarla. Strlct screenlngprogrammes have been applled on these workers, by exanlnlng thelr blood and glvlng thenpresunptive treatment. Those found poeLtlve for oalarla Parasltea were glven radlcal
treatgent. As these workers represented a threat to areas freed from oalaria transrolsslon,
supplenentary measures \rere lnplernented through cooperatlon between the l lalaria Dlrectorate
and other governmental departnents and non-governnental agencles. This inplled that none
of the lnconlng workers can start worklng wlthout submitting a certlf lcate issued by the
Endenlc.Diseases Branch of the nuhafadha concerned, lndlcatlng that his blood is free of
malarla parasites. The areas where these laboure.rs were worklng have been kept under
strict supervlslon. This also lncluded areas occupled by returnees fron the Northern
region. Repeated blood surveys were carrled out perlodlcally and epldemlologlcal and
enionological tnvest igat tons were undertaken accordlngly . These coordlnated ef for ts proved
to be successful and there has been no evLdence of resuroptlon of roalaria transmleslon.Despite varlous dlff iculties that faced the programme, there have been some lmproverlentsto.rely: the nunber of nalarla cases decllned by 38.32, whlle the nurnber of blood slldes
examlned increased by 18. lZ conpared wl th f lgures recorded 1n 1976.
As the malar ia eradicat lon prograrnme,progressed, at tent lon was drawn to the ro le of
the general health servlces ln detectlon of nalarla by Abul-Azlz & Chowdhury (1965). These
authors presented data showing that the contributlon of passlve caee detectlon (PCD) by the
general healch services (GllS) constltuted one thlrd of the total slldes collected ln the
consol ldat lon phase area ( lO7 638 ln 1964). In the Centra l reglon the rat lo of s l ldes
collected by PCD to those collected by ACD was l:9, whlle the contrlbutlon of PCD 1n the
Northern and Southern regi.ons nas as ittgtt as 37.52 of a total slides collected (262 36L)'
This hlgh rate was nostly due to an epldenic outbreak that struck the area and dlsrupted
the ACD actlvlt les. Uorlover, the proportlon of positlve s11dee collected by PCD was 5Z of
the tota l e l ldes col lected in the whole of I raq (235 809), whl le only 0.42 were posl t lve ln
eLldes collected by ACD. It was regrettable that sone resPonelble Peraons held the ldea
that so long as the nalaria eradlcatlon servlce exlsted, lt ehould take care of all aepects
of lte prograpne. The value of PCD by GHS needs thorough appreclatlon. Efforts were belng
made to encourage PCD by.GHS staff. In eorne areaa, better cooperatlon has been obtained
through educatlon, explanatlon and persuaeion, whlle ln other areas the cooperatlon has
been llnlted. The authors stressed that personnel of GHS Ehould feel that this
collaboratlon Ls part of thelr duty and ls not a favour, in that the ethlce of rnedlcal
practlce necessltate that a patlent should be properly dlagnoeed and treated and ln nany
i".r.r caaea the dtagnosls can only be done by blood exanlnatlon. GIIS should deal wlth a
rnalaria case ln a slnllar nanner ln which lt deals wlth any other lnfectlous dleeaee' The
national malarla eradlcatlon servlce should Lnstruct the dlepensarles and prlvate
physlciane on the proper technique of taking thick blood smears from fever or Dalarla
lusp".ted caaee. There ls another lnportani role of GIIS. At the tirne of disasters euch as
high fLoods or disturbed conditlons rtrtct dierupt the ACD activlt les, GIIS can take over
these tasks. For exanpLe, ln those days in the Northern reglon Ithen 8urvell lance teaEa
could not reach their lssigned areas, lnformation on the rnalarla casea, though not
couplete, cane only fron GiS. Another aspect of ualaria detectlon and operatlons ls the
role of the a11ny health'servlcee. They can play a valuable role ln l lnlt lng the spread of
vBc/90.3HAL/90.3Page 173
nalarLa t ransqiss lon ln area6 of n lL l . tary operat lone by-Protect lng the aruy and people.at
rlsk through undertaklng antlnalaria Deaaurea by uslng prophylactlc drugs and radlcal
treatment, actlve caee detectlon, epraylng the caEps and nearby houses wlth the asslstanceand advLce of the malar ia eradlcat lon serv lce.
Nlaz l (1978) descr ibed the p lana for ln tegrat ion betneen the heal th eerv lces and themalar la eradicat lon prograpme 1n I raq. A p lan of act lon was developed for rura l heal thservlcee to cover geographlcal-ly the lnhabitants of rural areaa by a network of healthunlts each servlng a populatlon of 20 000. Each health unit le composed of one prlnary
centre and at least four secondary centres each serv lng 5000 people. At tached to theprlnary centre, sone rooblle teaos cover renote areas. Whl1e thls plan of actlon was being
implemented, lt was reallzed that it provtded roostly curatlve and health insuranceservices. At the sane tlue, wlth the asslstance of I{I10, three Denonstratlon Centres were
establ lshed as p l lo t proJects to prov ide basl .c heal th serv lces to the lnhabl tants.Evaluation of these servlces was carrled out by tearns conblnlng natlonal and tnternaElonalexperts, and lt wae found that these services were effective and recommendatlons rtere nade
to generaltze thls experlence throughout the netltork of heal.th centree ln lraq. The baslc
healt.h servlces that were lntended to be genetEllzed conslsted of:
- Maternal and chlld health;- School heal th serv lces;- Envlroarental eanltatlon;- S ta t l s t l cs ;- I lealth education;- Coomunicable sldeaee control;- Curatlve nedlcl.ne and health insurance.
Accordlngly, a new plan of actlon was prepared whlch lncluded the eelectlon of one
health unlt ln each provlnce and to provlde lt with the equlpnent and staff to carry out
the above ment{ .oned tasks ef f ic lent ly . In h ie conclus i .ons, Nlaz l ( loc.c l t . ) Polnted out
that roany ways and neana have been trled to lntegrate or coordinate the work of the DalarLa
eradlcatlon progranne and the rural health servicee. SouetLnes, these efforte werefrultful, but on other occaslons, these atteDpts were dleastrous for the nalarlaeradlcatlon prograruE. The new plan of actlon was based on the real neede and ensures the
gradual lntegratloa of the ualarla eradl.catlon actlvlt les aa the baslc health eervlcee
develop to take over the blggest part of roalarla eurveil lance actlvlt les. l lhile the baslc
health eervlces are being developed, the malarla eradlcation Progralule w111 contlnue to
undertake the whole set ; f ant loalar ls act lv l t lee, and eventual ly l t w111 restr lc t l tee l f
to seasonal lnagocldal meaeures nhen the bastc health servlces becone capable of taktng
care of the whole rnalarla survell lance oPeratl.ona.
Oesl (1982) reported on the actlvlt lee of the oalarla eradlcatlon prograooe durlng
1978 as fo l lows:
Spraylng operatlons:
The Northern regloD: It was planned to cover this reglon wlth two rounde of DDT
epraylng, followed by natntenance of epraylng coverage. Speclal attentlon was glven to:
tbcaift ies of Ll-€"l"fpa:gg lnfectlon, areae of prevlously known hlgh endenlclty, and areae
borderlng netgE6ourtog countrles wlth the followlng exceptlons.
- Some desert areas ln Nlnawa and Tanl.n uuhafadhas were sPrayed partially wlth one
round of DDT spraylng.- The hlgh nountalnous areaa recelved one round of DDT spraylng.
Special attentlon was gl.ven for deallng wlth dlff icultlea encountered ln the Northero
reglon ae follows:
(a) Suoner huts (kno1ro locally ae kaprae): These are teDPorary eheltere lnhabl'ted by
farners durlng harvestlng crops.
vBc/ 90 . 3MAL/90. 3Page 174
(b) Stone houses: These houses have crev ices between the stones and h igh roofs. They.
r rere sprayed at a low speed to a l low bet ter coverage and penetrat ion of the lnsect ic ide
uslng a lso extenslon lances for h lgh roofs.
(c) Ground f loor rooms: These are used for donest ic anlmals. They are usual ly dark
and the v ls lb l l l ty dur ing dayt ine is rather poor . Therefore, torch l lght or a lantern had
to be used dur lng epraYing.
(d) Replastered houses: A large nunber of v l l lagers whl tewash or rePlaster the wal1s
of thei r houses. Heal th educat lon i . coop". . t lon wl th the local adminis t rat ive bodies and
associat iona was sought to overcone th is d l f f icu l ty '
(e) Inaccessib l l t ty of mounta inous areas: Due to heavy ra infa l l and snow, oany
mountainoua areas ro"." noE accesslble during the tine of the first spraylng round'
Therefore, accesslb le areas such as p la ins and val leys were sprayed f l rs t . Later when
cl i roat ic condl t ions loproved, the inaccesslb le areas were covered, and th is usual ly
occurred af ter 2-3 weeks.ThLs year, nalntenance of spraylng coverage started 15 days after the comnencenent of the
baslc round instead of the end of the round, so that spraying coverage was completed prlor
to the date of ProPagat ion of vector populat lons.
The Central and Central Euphrates reglone: Spraylng oPerations covered 10 nuhafadhas
as fo l lows:
(a) Flve nuhafadhas: Baghdad and Anbar frorn the Central regton; Qadlsiya, Muthanna
and Kerbala from the Central Euphrates reglon. A11 these ldere covered by stand-by teans
whenever requlred.
(b) Dia la nuhafada (Centra l reglon) nas covered by two par t ia l DDT spraylng rounds.
(c) Wasi t l luhafadha (Centra l reglon) waa covered by two par t ia l spraylng rounds,
whlle two nahlyas (= localtt les): Shelkh Sa-ad and Shahabi were covered by nalathion on an
errcrgency basls.
(d) The followlng nahlyas ln Salah El-Dln nuhafadha (Central reglon) were sPrayed by
two partlal spraylng rounds: Sulalnan, BeBr Anarll, Nogol, Touz Khourmatoo and QadirKaram. Other nahlyas of this nuhafadha weie covered by DDT on an energency basls whenever
lt was found necessary.
(e) Babtl nuhafadha (Central Euphrates reglon): Kefel nahiya was covered by two
partlal DDT rounde. Other nahlyas ltere covered on an emergency basis.
(f) NaJaf nuhafadha (Central Euphrates reglon) was sprayed with two complete DDT
rounds as 1n 1977.
The tsrget tn 1978 na6 to protect a populatlon of : 154 018 ln the Central reglon'
and 140 552 ln the Central Euphrates reglon, with speclal attentlon to locallt les ln whlch
nalarla caaea were detected partlcularly aoong forelgn workers who entered the country.
The spraylng coverage ln the two reglona wa6 qulte satlsfactory desplte refusals which were
overco6e by contact wlth local authorlt lee and organlzatlons, aE well as health educatlon'
The Southern Reglon: The three southern nuhafadhas: Basrah, t ' t isan and Theqar recelved
three partial nalathlon spraying rounds and roaintenance spraying, wlth speclal attentlon to
locallt les where malarla caaea were detected durlng the prevlous year anong returnees from
the north, and locallt les of prevlously known endenlclty. The target was to Protect a
population of 539 267 fot each spraylng i.n all three nuhafadhas. The spraying coverage ltaa
fair ln Baerah and ll lean ouhafadhas, but rather poor Ln Thegar nuhafadha due to refusals
and whltewashlsng of walls after spraylng.
Surve l l lance actlvlt ies :
Further expanslon and strengthenlng of survell lancethle, the eurvell lance agents were re-dlstrlbuted ln order
act iv l t les l tas Dade ln 1978. Forthat they could cover all areas
vBc /90 .3r.{AL/ 90 . 3Page 175
of the Northern region even ln the farthest vll lages. Instructlons were glven to all .physlcians of the Endenic Dlseases branches of the northern nuhafadhas to pay nore frequentvielte to other physlclane working ln the curatlve centreo and to explaln to then thelmportance of co l lect lng b loode s l ldes for ear ly d iagnosls of mal .ar la . A11 nedlcal andpararoedical personnel were brlefed on thls aspect. Due to the lroprovement of the nalariaepldenlologlcal sltuatlon tn A1 Tanln nuhafadha and because of the roanageable nurober ofrnalar la cases detected, a l l na lar la casea were radical ly t reated and epldenlo logical lylnvest lgated and th le appl led a lso to cases detected ln other nuchafadhas of the Centra land Southern reglons. ACD contlnued ln Waslt and Kerbala ln the Central reglon, ln
Qadlsiya and Muthanna in the Central Euphrates reglon, and Basrah nuhafadha ln the Southernregion. PCD further strengthened and lnproved and lt was undertaken by the wldelydls t r lbuted network of heal th serv lce eetabl lehnents or through act lvated passive casedetect lon (APCD) by the survel l lance agents stat loned ln heal th centres. Survei l lanceagents also uslng blcyclee ln some parts of the country vlslted vil lagee surroundlng thehealth centre at a radl.us of 2.5 kro. This was undertaken after the peak of Eornlngat tendance at the heal th centre l tas overr 1.e. af ter l t 00 h.
Antllarval operatlons: These operatlons contlnued to be applled ln and around Basrahc r t y a @ . D 1 e s e 1 o 1 1 n 1 x e d w 1 t h 1 1 n e e e d o l 1 w a s a p p 1 1 e d a t a d o s a g e o f5-7 cc/mt once a week.
Entonologlcal actlvlt les: Theee lncluded epot-checklng on vector deneltlee lnprevlouely known-oc:[, routtne obeervatlone at f lxed lndicator vll lagee and lnvestigatlonsln localttLee where nalarla case6 have recently been detected. In addltlon, susceptlbll l tyteeto were carrled out on the oaln vectors ln all reglons.
Epldenlo loglcal evaluat lon: In 1978, I 831 494 b lood s l ldes were col lected f rou a l lnuhafailhaE oE-whichT5TT wEie posltlve for nalarla paraeltes. These flgures rePresent asllght increase ln the number of blood elldee collected and a decrease oi about 302 ln thenunber of poeitlve cases conpared wlth 1977 (5 069 cases). The oaJorlty (92.22) of thesecasea nere recorded ln the Northern reglon. 0f 184 caaea detected ln the Central andCentral Euphratee regl.one, 98 were loported fron wlthin the country, 69 lnported fronabroad, and 17 caaea of dlfferent age-groups classlfled as Lndtgenous. These lndlgenouscaaes were detected 1o Abbaelyah area lu NaJaf nuhafadha, and Oesl (loc.clt.) thought thatthey were probably caaea renalnlng froo the prevlous tran8nlsslor a€aaoD. In the Southernreglonr g3 casee were detected dur lng 1978, of whlch 21 were lupor ted f ron.wl th ln thecountry, 59 lnported fron abroad, 5 were not classlfled due to lnconplete infornatloni and8 lndlgenoue. Finally, Osel suDmarl.zed the epldenlologlcal Bltuatlon as follows:
- Malarla tranenlesion continued ln the Northern reglon, especlally ln the prevlouslyknown endeo|c areaa. There lraa no evldence of renewed transnlsslon.ln other areas, andthere wa8 a uarked decllne ln the nunber of cases detected.
- Interruptlon of tranenl.eelon in the Central and Central Euphrates reglons has beennalntalned, although the nunber of lnported caeee lncreased.
- Interruptlon of tranenlselon ln the Southern reglon has been naintalned, but thenumber of tnported caees Lncreaeed, eepeclally thoee conlng fron abroad. The etghtlndigenous. caaee detected durlng the eecond half of 1978 were belng lnvestigated.
- The total number of lnported caaes froo abroad dlagnosed and radlcally treated was128 !:-g!lg.
' They were followed up and kept under strtct supervlslon.
Ossi (1983) revlewed the progrese of the rnalarla eradi.catlon prograrone durlng1978-1979. The progratme waa progresslng sat ls factor l ty despl te Dany d l f f lcu l t les ' notablythe probten of forelgn workere conlng fron nalarla endenlc areaa ln other countries. Inf978 (8 Donths) , 188 oalar la cases lnpor ted f roro abroad were detected ' radlcaLly t reatedand followed up under strlct eupeivlslon. They caoe froo elght countries, but the naJorltywae f ron Indla.
In a more recent repor t , Oesi (1986) rev iewed the progress of the oalar la eradLcat lonprogranne ln Iraq durlng 1984-1985. He eophaslzed that the prograrnrne was paseing a very
vBc/ 90. 3MAL /90 .3Page 176
cr i t lca l per lod due to the war wi th I ran and l ts d isastrous condi t ions, par t icu lar ly theacute shor tage of personnel for malar la act lv l t ies. Therefore, the basls of nalar laeradicat ion pol icy was !o mainta in the gains that had been achleved before the war, bys l rengthening survel l lance act iv i t ies ln order to secure ear ly d lagnosls and t reatnent ofmalar la cases wl th in tensive ef for ts to be d l rected to nalar la cases imported f ron abroad.Notes were g lven as fo l lows:
Spraying operat lons: I t was p lanned to cover the o ld known foc l in four nuhafadhas (=provinces) in the Northern region by three rounds of nalathion spraying plus spraylngnaintenance, but the coverage nas fa l r due to the shor tage of labourers and otheradrnln is t rat ive problems ln v l l lages where the malar la foc i were located. No sprayingoperat lons were p lanned for the renaln ing 14 provinces of the country. However, cer ta lnfunds were a l located ln the budget each year for emergency spraylng operat lons, i f theepidenlo logical s l tuat lon ao warrants.
Survei l lance act lv i t les: Survei l lance has been st rengthened to cover a l l par ts of thec o u n t r @ 1 1 h e a 1 t h c e n t r e s ' o u t P a E 1 e n t c 1 i n i c s a n d d 1 s p e n s a r 1 e s w e r eobl lged to col lect b lood sLldes f ron fever and suspected cases, at 1ea6t f ron l0Z of thedal ly at tendants. Fore lgn workers f ron nalar ious countr les cont lnued to be kept underst r ic t superv ls lon. In 1984, I 405 228 b lood s l ides were col lected f ron a l l prov lnces. 0ft h e s e , 3 3 4 6 w e r e p o s 1 t 1 v e f o r n a 1 a r i a p a r a s 1 t e s : 9 6 . 5 7 " P . v i . v a x , 2 . 4 Z ! l l . @ ,o. IZ P. malar lae and lZ roLxed lnfect ions. 0f the 3 346 nalar la caaes,87.L2 were detectedtn ttrff i6ff i-reglon, 9.L7" tn the Central reglon, L.6% tn the Central Euphrates reglonand, 2.22 tn the Southern reglon. In 1985, L 252 864 b lood s l ldes were col lected f ron a l lprovinces, of which 4 452 were posittvez 991l P. vivax., 0.72 !:_l3lg!lry (a11 lnPortedf r o o I n d i a ) a n d 0 . 3 Z n i x e d i n f e c t 1 o n s . o r t n f f i m a 1 a r t a @ e r e d e t e c t e d 1 nthe Northern region, 57" tn the Central reglon, 0.32 ln the Central Euphrates reglon andL.77" 7n the Southern reglon. A11 nalar la cases recelved radlcal t reatment . The fourP. fa lc lparun cases detected ln 1984 (3 f rom PunJab and f rom Or lssa/ Indta) and l lP. f -a lc iparun cases detected in 1985 (5 f ron Zanbla, 2 f ron Sudan, I f roro Uganda and 3 f ronGalff i-?ound resistant to chloroqulne, and Ehus treated wlth Fansldar Ithe nethod ofdetect lon of ch loroqulne res ls tance was shown Ln a paper by A11 (1985)-(see belowl . Tol l lust rate the nagnl tude of the problern of lnpor ted nalar ia f roo abroad, Ossi ( loc.c l t . )showed that ln 1984, the nunber of cases lnported fron abroad was 408 or 12.27 of. the totalnunber of cases detected and ln 1985, the nunber of lnported cases was 290 representing 77of the total number of cases detected ln Iraq
Antllarval o$rations.: These contlnued to be applled ln Basrah provlnce ln thes o u t h e @ h o s , b u t d u e t o a s h o r t a g e o f 1 a b o u r e r s , t h e s e o p e r a t 1 o n s c o u 1 dnot be carr ied out accordlng to p lane.
A fur ther progress repor t on the malar la s i tuat lon ln I raq ln 1986 was Presented byA11 (1987). Ite euphaslzed that due to war condltlons and dlfferent constralnte, lt l taa notexpected that the roalaria eradlcatlon prograone would nake good Progresa. On the contrarytlt was kept ln nlnd that renewal of nalaria transnlssion partlcularly ln old focl waspossib le, s lnce a l l potent la l epldenlo loglcal factors necesaary for t ranenlss lon of nalar ianere preaent . Therefore, under such cr i t lca l condt t lone, a l l e f for ts were d l rected tonalntain the galns that had eo far been achleved. The conetraLnts that faced the progrannewere outl lned ae folloss:
- ehortage of personneL;- shortage of vehlclee;- shortage of the lneectlclde (nalathion);- mass populatlon movenents;- the lnflux of paraslte carrlers through forelgn labourere conlng from malarLouscountrLes;- adninlstratl.ve dlff lcult ies.
The resul ts of var lous act tv i t les in 1985 were as fo l lows:
Spraying operatlone: It,rras planned to cover cerEaln known focl ln the Northern reglon by
@ a y 1 n g r o u n d e , b u t u n f o r t u n a t e 1 y o n 1 y t h e f l r e t r o u n d w a s a p p 1 l e d d u e t o
vBc/90.3UAL/90.3Page L77
the lack of nalathlon and the shortage of labourers. Even the spraylng coverage ln thlg
slngle round was unsatlsfactory ln quallty and quantlty'
Survei l lance act iv l t les: I 363 918 b lood s1ldes were col lected by d l f ferent nethods f ron
f f i s e , 4 l 5 6 s 1 1 d e s w e r e p o s 1 t l ' v e f o r o a 1 a r i a p a r a s 1 t e e a n d r a d i c a 1l reatment was g lven accordlngly . 0f these posl t ive caaes 3976 or 967 wete detected ln the
Northern reglon and a l l were P. v lvax c lass l f led ae lndigenous excePt three cases lnpor ted
fron abroad (2 fron rndia ana-iEi-sudan). The renainlng 180 cases were detected ln the
other three reglons and were nostly lnporEed froru wlthin the country and from abroad'
After nany years of lnterruptlon of rnalarle transnlsslon in Al-Tanlu nuhafadha In the
Northern regton, and Basrah and }l lsan rouhafadhas ln the Southern reglon, resurnption of
transmlsslon took place 1n a few vll lages whlch were prevlously known focL' Iornedlate
renedLal trea6ures ,"r" eu"cessful in preventlng further spread of traner0lsslon and
fol1ow-up observatlons contlnued ln these vll lagee'
Lnported malarLa: 143 cases of lnpor ted nalar la f ron e lght countr les were recorded 1n-19g6. A1I these were detected in the Central , the Central EuPhrates and Southern rerglonst
slth the exceptlon of three case6 detected ln Nlnawa rnuchafadha of the Northern reglon'
i i i".i"""-ii l;;; cases were P. vlvax except 17 whlch were mixed lnfectlons (P: Ylval.+ll'tlllio"iilii'""u io-i. !.i"tre-"..:oi'-.t'!-e. r.i"ii.l"' ca6ea, rgur (z troo-ii?Ta,-tfron pakletan and f fr6'ii7antf. oved reeleta;E to Ehloroguine and nere treated wlthi i " ;-f f i ." ' .atrro-i l7i i6TiJ-i-rovedree1eff i ;ogu1neandrreretre8tedr'1thFansldar .
Entonoloslcal actiYl l igs: In the Northern reglon, h1ql.9"fr:I :^::-:": l i" : I1^T:% --ad-h;ober.
In rhesuperpictus prevaiGifi the uneprayed areae, eepeclally !n Septenber a
ffi;ffiChiates reglon, hlgh d-nsltiee of pulcherrlnus nere recorded' whlle uoderate-f f i h r a t e s r e g 1 o n , h 1 g h d l n s 1 t 1 e e o f p u 1 c h e r r 1 n u s r ' e r e r e c o r d e d , w h l 1 e u o d e r a t edensltles of thls suipected vector prevalled-ffiGEral and Southern reglone' l l lgh
densltles of stephenei Irere recorded ln the Southern reglon, eepeclally ln Baerah anil
Theqar nuhafaEffi is vector also occurred ln ooderate densitlee ln the central and
Ceniral Euphrates reglon. It extended 1ts dlstrlbutlon to Waslt and Baghdad nuhafadhaa ln
the Central reglon.
Antllarval operatjons: Accordlng to the plan of actlon of 1986, antl larval operatlons were
affiA'f lo. afiTic"rlon in zakf,o ln the Northern reglon, uslng dleeel/ltneeed o11 DLxture'
and ln Baerah 1n the Southern reglon, uslng tenephoe, but operatlone could not be fulf l l led
in Zakho due to the shortage of iabourere and adnlnlstretlve dlff lculttee. However'
encouragl-ng reeults ,rere obtalned with envlronmental nanageoent ln Zakho through the
"oop"r"i lon of local authorl.tLee by dralnlng and fl l l lng ln ttater collectlons'
To sumnarlze, the malaria sltuatlon ln Iraq ln 1986 was aE follows:
- Malarla transmlsslon conllnued ln the flve ouhafadhas of the Northern reglon,
especlally the old known foci. Tranenlsston was resuoed ln Al-Tanln mrhafadha after
conplete lnterruPtlon in the last few years. These foci are now under control '
- Transnlselon contlnued to be Lnterrupted ln the other reglone (Central, Central
Euphrates and Southern regLons) but wtth Eany cases lnported fron wi'thin the country and
from abroad. However, tranernlselon itas renewed ln two vll lages ln l l isan and Basrah
nuhafadhae and lnnedlate renedlal neasuree ttere applled.
All (19g5) dtecueeed the problen of lnported nalarla ln lraq. Thousande of forelgn
labourers have been enlerLng thl country s1nce L977 to work ln different proJecte of the
Natlonal Developroent plans. A large number of these labourers come fron malarloue
countr les, hence consldered probabie paras1te carr leret rePreaent lng a threat to areas
where malar la t ransro lss lon has been lnterrupted. tnpoi ted-c€ae6 foroed l3Z, 302;352 277'
and 12 .32 of the tota l nunber of nalar la calee detected ln I raq dur lng 1980' 1981, L982,
l 9g3 and 1984 , reepec r l ve l y (2S f5 ,264L , 3326 ,2422 and 3346 ' r e8pec t l ve l y ) ' The EaJo r l t y
of the ltrported cases was 3S; the nunbei of P. f?lclparuP caseE-recorded ln the above
Denrloned f lve years was ZlF], SS ana 81, resllcEively' Arnong lheee there were casea
p roven ro be res l s tan t t o ch lo roqu ine :5 f n f i g f , 5 1o 1982 ' 3 l n 1983 and 4 t n 1984 '
Str ic t measures were appl led to detect and t reat lnpor ted caaea as fo l lowe:
vBc /90 .3MAL/ 90 . 3Page 1 78
(a) A c | rcu lar le t ter nas 6ent to a l l Endenic Dlseases physic ians ln a l l prov incest
accompanied by a l ls t o f measures to be undertaken, and a l is t o f naLar ious countr ies where
chloroquln-res is tant P. fa lc iparuo ex is ts . Physic ians and a l l malar la Per6onnel were
instructed to nalntali-affi-Eatch on the arrival of foreign labourers ln thelr areas
and to take proropt act lon towards thei r detect lon and t reaEment as necessary.
(b) A request was submit ted to the Residency Department to supply the Malar ia
Dlrectorate in Baghdad and the l lalaria Branches ln the provlncesr nalDes and addresses of
fore lgn labourers arr iv ing ln l raq f ron malar lous countr ies (a l1st of malar ious countr les
was provided to the Residency DePartnents) .
(c) A team f rom the Malar ia Branches lnnedlateLy v ls l ts the p lace of work of fore ign
labourere, contacts the manager of the pro ject expla in lng the purpose of the v is l t and the
importance and the advantages of roeasures undertaken. A thick blood snear ls taken fron
each forelgn labourer and presuDptlve treatment given at the same time (4 tablets
chloroquin/ fSO rg base + 2 tablets of pyr luethanine/25 rng) '
(d) The blood sll.des are exaolned wlthout delay, wlthln three days by the malarla
laboratory ln each provlnce.
(e) As aoon as the results are received, the nal-arla survell lance agent givee radlcal
treatr0ent to the patlents ln thelr locallt les, and these Persons are usually followed up
for slx nonths (a blood sllde 1s taken fron each once a nonth)'
(f) A11 P. falclparun case6 are glven chloroqulne over 3 days wlth a 7-day
observatlol perffi i i l :E.st). If the paraslte count renalns excessively hlgh or the
pat lent Ls severely 111 and comes f roo an area of suspected chloroqulne res ls tance,Fansldar ls g lven ln a s lngle dose.
(g) Blood surveys are repeated twlce wlthin a 3-4 week lnterval. Survell lance
act lv i t ies are st rengthened ln a l l ne lghbour lng local l t ies.
(h) Entonologlcal lnvestlgations are carried out in the whole area lncludlng the
locallt lea of fuoported cases and neighbourlng locallt les. Dependlng on the results and in
the l lght of the eplderdologlcal lnvestlgatlon, approprlate Deasures are applled.
Shihab et a l . (1987) repor ted on an lnnunologlcal /parasi to loglcal survey ln areas
where nalarla transnl.ssion has been lnterrupted ln lraq. The obJectlves of the survey
Itere:
(a) to asseas the Lomunologtcal status of the young populatlon, which oay lead to
detectlon of any nalaria transnl86lon;
(b) thlck blood sneara nay show fresh malaria cases;
(c) to apply renedlal meaaures ln newly discovered focl.
Sanples were collected during October l984-February 1985, and October I985-February
1986, correepondlng wlth the non-transmlsslon aeasoo. Prevlous focl of malarla were
eelected fron the Central, the Central Euphrates and Southern reglong. From each region
about 1000 persons nere examl.ned each year. A total of 6000 thtck blood anears and 6000
blood sanples on Whatoan No. 3 fl l ter paper were collected frorn prlnary echoolchlldren(5-12 y"ais olal). The thlck snears were exarn{ned wlthln two weeks of collectlon. Clrcles
of blood on fl l ter paper nere placed tn plastlc bags and etored under -2OoC untllproceasLng. Two contiol groupl were chosen and exarnlned accordlng to the advlce of
br Davtd Catty (ctttng p"i"otit conlunlcatlon, 1985). Each grouP conslsted of about 100
p€EsoDBo ?he first gioup covered 100 prtnary echoolchlldren froo a hlgh standard dlstrlct
ln Baghdad clty. Blood sanples were tested Ly enzyne llnked ln'nuno-sorbent assay (ELISA) '
The sicond group covered 105 persons fron all age-groups 1n a known focue of nalaria ln
vBc /90 .3MAL/90.3Page 179
Zakho, nor thweet of I raq. Thtck b lood sneare and b lood 6pots were taken f ron each Pergon.P. vivax antlgen for IFA test lras prepared fron a fresh P. vivax case fron Zakho areal,f i iGg to it" insrrucrlons of or cltty. rn both rFA E;FA;fr ELrsA, there were alwayeposltlve and negative controls. A11 thtck smears and earnples of the second control group
frorn Zakho (regarded as posltlve control) were examlned. AlL the 600 Ehtck blood smearswere examlned nlcroscoplcally and found negatlve. Because of the negatlve results of theth lck b lood auears, the shor tage of nater la l for ELISA and IFA test , l t was declded toexanl.ne only 102 of the 6000 sanples by IFA test. ELISA ltas run on 200 saropLes collectedfron Ulsan, Southern reglon and a l l gave negat lve resul ta, excePt three doubt fu l casea.Exaroination of 409 sanples representlng the renalnlng nunber of l0Z of the total 6000samplee collected were examtrned by IFA test wlth negatlve results. The 100 sanples
collected frorn schoolchlldren ln Baghdad (negative control) were all negatlve by ELISA.The positlve control group fron Zakho focus consisted of 105 thlck blood sxnears and 104blood Bpots on fl l ter paper. Mlcroscoplcal exanlnatlon of the thlck amears revealed onecaee of P. v lvax ualar la (0.952) In a chl ld aged 8 years. The IFA test run on 104 sanplesgave eevfifrEElves representing 6.72 posltlvlty rate. The fl l ter paper of the nalarlacase dld not contaln enough blood to be tested by the IFA teet. In concluslon, the authorsconeldered that thelr surveys supported the vlew of the succeas of the nalarla eradlcatlonBeasurea ln the Central, Central Euphrates and Southern regione. I loweverr thle does notDean that new nalarla focl wll l not occu!. In fact, elx lndl.genous caae6 and threeecattered caaea were detected ln the autumn of 1986, respectlvely, ln Basrah and l ' l lsanprovlnces ln the Southern reglon, for whlch lonediate reroedial Deaaures were applled. Thtsgives an alarm elgnal as aLl factors for reeuuptlon of nalarla transnleelon exlst ln theSouthern reglon, vl.z: the non-funnune local populatlon, the preeence of a reservolr ofi.nfectlon aDong forelgn labourers and fron Ealarlous areaa ln the Northeru reglon, and therielng deneity of the maln vector, 4l:-g!Sp!ggl.
In an unpubllshed docunentae f ollo\re:
- Populat lon: 15.7 n l l l lon
by Far ld (1987), the country nalar ia prof i le of I raq was-
Populatlon at rlsk: 4 nll l lon
- No. s l ldes exanlned: lsee f lgures by Osel- No. P. fa lc lparurn caae6:- P. fa lc lparun res letance- t9 chloroquine:recorded Ln lnpor ted caeesl . -
r984
( 1e86)81
Nelther
1985 1986
and A l i (1987) above l l33 .15
suspected nor reported [onlY
- Vectors of nalaria accordlng to thelr vectorLal Lnportance - wlth lnforoatlon onvector reel.etance to lneectlcldes.
@sls:An. sacharovl - DDT/dleldrtnAn. suoerDlctue-I'n. uaculloennle
Southern reglon:
An. etephensl - DDT/dleldrln/ualathlon
- Maln vector control roeaaures: I louse spraylng wlth roalathlon, and larvlcldlng withteroephoe.
Case detectlon: Le qulte efflclent through ACD and PCD.- Developnent of PHC at perlpheral level: Good.
. - Developnent of PHC at referral level: Acceptable.l lalarla control: la well grganlzed and decentral-lzed ln lts organlzatlon, but
technlcally dlrected centrally.- Malarla tralnlng centres: Avall lable ln Baghdad.- Tralned lnanponer: Avallable.- Speclal problens: Inportatlon of nalarla and populatlon moi/ement.
l. Anended by the wrlter.
9entral reglon:
Ah. iuperpic tusAn. stephenel - DDT/dleldrln/oalathlonAn. pulcheirlnus - DDT
vBc /90 .3MAL/90.3Page 180
From recent ln fornat ion comnunicated to WHO/EMRO, data on the status of ant inalar ia
act iv i t ies in I raq dur ing 1988 show the fo l lowing: (populat ion: n id-year est imate in
1 0 0 0 s ) .- Tota l PoPulat ion: L6 L26- Populat ion of or ig lnal ly nalar ious areas: L6 126- populat ion of a." i " c la ined to be f reed f rom malar ia: 12 438- P o p u l a t i o n P r o t e c t e d b y e x t e n s i v e h o u s e s p r a y i n g c o v e r a g e : 3 6 8 4- Popu la t i on p ro tec ted by o the r an t i - vec to r measu res ( l a r v i c i d i ng ) : I 580
- Populat lon under survei l lance: 15 018
As summarized in the rePort of the I .J1d h l th s tat is t ' quar t ' concerning the wor ld
n a 1 a r i a s i t u a t i o n i n 1 9 s 8 ( w n b , t g g o ) , t n @ s e s r e c o r d e d i n I r a qincreased f rorn 3700 in 1987 to 6800 in 1988 - a l l were P' v ivax-cases excePt 108 i ropor tedI I I ( j I e a s E g l f u u J , v v L L L L r v .
p. fa lc ioarum f ron abroad. Near ly aLl the cases occurr-ec l - in a few new inPortant foc i inr . I d l L l Y a l s q r t v u
previously nalaria-free areas of Erbi l and Al-Tamto ot:"11:::-1"-:1""Y::::"-: :?::: ' -TltP r s v r v s e r J
about 200 cases were detecEed in the centra l , Centra l Euphrates and southern regions ' Dost
of then iorported. Renedial Deasures have been iroplenented to lnprove the sl-tuation'
In Kuwait, no indlgenous malaria cases have been reported and the country ls
considered nalar ia- f ree, but has been exposed to an in f lux of inpor ted cases ' Hi rat
Behbehani & Al-Kandarl (1935) noced the presence of gtePhensl and Pulchglrin9s -11 Xu13it
and thought that the hosti le clfuoatic conditlons durlng May-October,Itould not allolt Ene
survival of the trro vecEors to the conpletion of the slorogenic cycle lsee Subsectlon (1)
VECTOR BIONOMICS, under 4.2 above and also for the threat posed by the extension of the
breeding of " t "p i " i " i j .
These authors carr led out a s tudy of inpor ted nalar la in Kuwal t
dur lng 1980-1983. The populat lon of Kuwai t in 1980 l tas esEimated at r 356 000 involv lng
562 000 Ku\raitLs and 794 000 non-Kuwaltis. The .movenent of people froro and to elJenic
nalar ia areas in other countr ies Poses a threat of inpor ted malar la- ln Kuwal t ' The study
conpr ised in- and out-pat lents whose b lood was sent to the parasl to logy laborator les of
four 600-bed hospl ta ls and one 250-bed lnfect lous d iseases hospi ta l ' These laborator ies
provide a 24-hour serv ice for the d iagnosis of rnalar ia ' In i t ia l ly , a th ick b lood f i ln s ta ined
wi th Giensa f ron each pat ienE was exanined to detect the Presence of rnalar ia parasi tes, and
a th in b lood f ihn on a separate s l ide f ixed in methanol and a lso sta ined wl th Giemsa was
examined for the ldent l f icat lon of parasi te species. Dur lng the course of the studyt a
rapid nethod was developed involvini the fixaiion of the thick f11n with acetone' a thln
fi ln on the sa'e sllde fixed with nlthanol, both stalned concurrently with Glensa' The
sul tabl l i ty and val ld l ty of th ls nethod wis d lscussed previously (c i t lng l l l ra & Behbehani '
l9B4). This nethod enabled the reporting of the resulls of exanination of the thick fl1n
within 45 nln of recelving a blood sanpti. Inforrnation recorded for each Patient
compr ised: na6e, age, sex, nat ional - i iy , n f " toty of t ravel and per iod of res ldence ln Kuwai t
before the clinical attack. Because Li f.ttg".!e diff lculties and other factors' not all
the infornatlon was always avallab]e, parti lulir ly that the travel hletory of sone patients
indlcated that they had been to eeveial countries and therefore, the orlgln of lnfectlon
was listed as undetermlned. As eunnarized and dlscussed by the authors' the number of
inpor ted nalar la caaea in Kuwal t rose f rom 87 ln 1980 to Sba rn 1984, 1.e. , an lncrease of
57 .g%. O f 658 l npo r ted cases d lagnosed ove r a 3 -yea r pe r l od (1980 -1982 ) :590 (89 '672 ) we re
p.-r i . , "* , 66 ( lo.03z)_pr-I?tcloagui, a elngle """L
(o.rs7") of .3:-pglg,r .e from the rvorv
Coasr, and one case (0.152) ot tr"ii i";;;;i;" or p. vl'vax attaf,ffi?rum fron
Afghanisran. rn 1982, a roral of 419 loported "."ffi"o
(1.62-tTiffiIEG were infected
abroad. of 504 cases recorded in 1983, i . ovale was ldent l f led ln two Pat lenta: one-from
Cameroon and the other from Tanzanla. lE---._gy41". ls generally restricted to West Afrlca'
the authors suggested the t",r" g.ottaphlcaT iGfifU"tfon of thle speceie should be
verl f ied. A history of the pat ienis strowea.that nalar la infect ions nere acqulred tn 38
countrles. Of the 590 P. vlvex cases , 88.647. orlglnated fron Asia west of India as well as
Asla incluar.g r'ir1,"gfriffitr-lnd 6rl Lanka, a"a ot the-66-:;i9]clParuT ":"::1,:1'032origtnated from Asia west of fnafa, ZZ.73"l ftom Asla, and' 22'Z5Z-TronTroplcal Africa' As
can be aeen, Dost of the cases t"a. do. to !. vivax, and to a lesser extent to
p. falciparun, refLecting the prevalent speFs-E-the endenl'c zonea where the infectlon
had been acquired but this sltuatton roay change accordlng to the rnajor source of the
forelgn workers. Most of tt" p. .'i"'* i";;;.::1q1Tt:1^1'?:.1"1:: ::?"o::1.'i?trilrrndla':fi";i":;:-;;il"r*;?'pl'r.il;ffi"""-"iiii"lt"d r.o' Asia and Asla e'est or rndla
(lncludtng the Arablan penlnsula) as well as iroplcal Africa' Analysls of age and sex of
vBc/90.3UAL/90.3Page 181
patlentB showed that nales outnunbered feoale patlents. Thle sltuatlon uay change wlth the
increaslng number of housenalds being enployed tn the country frorn endenlc areas of Asla'
Analyele of a"t" of 1983, though Uased on a l lnlted nunber of cases, ehowed an lncrease ln
the nunber of cases orlginatlnt tror Indla. Thls probably reflects the resurgence of
p. falclparurn due to th; changlng epldenlologtcal plcture ln that country. P. f-alclparuitr
lnfectlons were dlstrlbuted throughout the year wlth a eltghtly hlgher number of cases ln
October whlch nay be at t r lbuted to the arr lva l of s tudents f ron Afr lcan counEr le6 at the
start of the scholastic year. In contrast, LjlS cases showed a seasonal peak between
llay and October, the hottesE and drlest partaffiyear' The heat streas nlght have been
a factor in prec lp i ta t lng a c l in lca l at tack of an ln fect lon prevlously acqulred ln the
endenlc zone abroad. P. falclparurn cases usually presented thenselves within 14 days of
their arrlval in Kuwalt. Attentlon was drawn to the lnportance of delayed attacks of
P. vlvax, and 1n a snall proportlon of recrudescences of 3j=13]g!4g1$ ln eeml-inmune
Fa1;;;;.
- irpt""t" is ofien- placed on a hlsrory of "receiln-travEl wlth rrfeve! of unknown
or lg ln" . Thi ; should a ler t the physlc ian ln a non-endenlc area to a poselb le d lagnoeis of
nalaria. The tlne lnterval lnvolved ln establlshlng a hletory of "recentrr travel' in
clinically suspected caae6 of nalaria needs to be more clearly deflned ln each geographlcal
area, elnce ln the Present 6tudy, recent travel wag ehown to be as long as 15 nonthe ln
""""" of !:.g, and about one year after the travellers returned to Kuwalt. Between
l9g0 and i3E3frfne caaea of lnduced nalaria were detected. There nere aeven caaee of
t r a n s f u e 1 o n o a I a r 1 a ( s 3 @ a n d 4 P . . v 1 v a x ) ' a c a 8 e o f a c c t d e n ! a r r . t a 1 c 1 p minfecrlon, and a case oFEi!6ill-nalarlaffi-P. vlvax. Undoubtedly, wlth the rlelng
influx of lnported ualarla caaea ln Kuwalt, and theEiElnued need for blood donore, there
may be an urgent need for a revl.ew of blood transfuelon pollcy and the surveil lance
sy6tep. Regardlng deaths due !o r1a1arla, only two Patiente wlth a laboratory dlagnosls of
rnalarla dted durlig the perlod of the Present study. In only one case' death was
atrrlbuted to renal conpilcatlone due to 3: faklP3SD caaes as a donlnator, the fatallty
r a t e w a 9 I o w c o n p a r e d w 1 t h h l g h e r r a t e 8 r i - G - e r n n u r o p e . S 1 n c e 1 9 6 0 , n a 1 a r 1 a t o g e t h e rwlEh other lnfectlous diseasee becane notlf lable ln Kuwalt. No autochthonoue cases have eo
far been recorded. The posslbll l ty, however, of lntroduced nalarla traDsElsslon arletng
fron euch a large nuuber of lnportei """""
ln the past four yeara has been dlecussed' Ae
rnentloned above, the authors havlng recorded the hlgheet nullber of cllnlcal cases of
oalarla durlng the drleet and hotEeet part of the year (ltay-October) coneldered lt unllkely
that adult anophelinee would survLve to ttre coopletlon of aporogony. In thelr corcluslonst
the authors consLdered that Kuwalt ehould renaln a vulnerable areS'
Hira et a l . ( rg87) repor ted on an lnvest lgat lon carr led out on caaea of t ranefuslon,
accldnetal and congenttal nalarla detected ln Krnratt durlng 1980-1984. The uethods and
proceduree adopted are outl ined brlefly below:
- Induced lnfectlons Acetone-flxed, Glenea-stalned thick and thln blood fl lne of
patlentg wlth a preeuoptlve dlagnosla of nalarla were exanlned aa deecrlbed above'
patlents wlth nalarta were lnterviewed to deternlne the 8ource of lnfectton, especlally
those fron the surglcal and oaternlty warde, to exclude lndlgenoua tran6mleelon'
- Indlrect lnmunofluoreacence (IFA) test: Sera fron patlents wlth proved
p. falciparuD and p. vlvax lnfectlons were collected durlng the perlod of antlnalarlal
therapy. ueually tE;fe=r 3rd day after laboratory dlagnoele' Sera were stored atjio6i'iti.ii-.""'."a for anrloararra anrlbodles. Li3l.@ echlzont antlgen-cott"d --elldee were obtalned connerclally frors a laUoratffi-fiftift. The grocedures of the IFA
test were descr lbed.
- Sera of healthy Kuwaltle: Sera were obtalned fron 45 lndlvldualE with an age
ranglng fron 3 nonths io ror" thau 40 yearg. They were 1nlt1811y ecreened at a serun
di lu t lon of l :20 and 1:40. Posl t lve speclnene were fur ther ,d l lu ted and exanlned' to
determine the end Polnt.
- Sera of blood donors: A11 potential blood donore were lntervtewed about thelr
general state of health and recent l l lneee. Thoee frou nalarl 'a endeolc zonea were
queetloned, and lf they had a htstoiy of oalarl 'a' they were reJected' LeLehoan-stalned
thtn blood fl lurs l rrere examLned eelectlvely to excludl rnalaria. fo avold btae, eera of 284
coneecutlve blood donors were collected at the Central Blood Bank and frou tlto general
hospltale and ecreened by the IFA teet'
vBc/ 90 . 3MAr/90.3Page 1 82
As d lscussed by the authors, lhe resul ts are summarlzed in the fo l lowing:
- Transfus ion nalar la : Eight cases of t ransfus ion- lnduced lnfect lons r {ere d iagnosedin four years: 4 P. fa lc lparuro (2 Egypt ians, I Kuwal- t i , I Pakls tanl and I Indian) , and 4P. v lvax ( l Egypt lanr 2 Paklstanls and I Sudanese). The authors thought that e ight casesof t ransfus lon malar la over a 4-year per lod were probably an underest imate, s lnce onlythose cases whlch nere suspected af ter laboratory examinat lon, were fo l lowed up. Tracingand lnvest lgat ing such cases was d l f f lcu l t because of a lack of s taf f , inappropr latelaboratory fac l l l t les, d i f f lcu l ty in locat ing b lood donors in a h ighly nobi le populat lon,and fa l l lure to acknowledge t ransfus ion ln fect ion. The authors descr ibed the case oft ransfus ion nalar la ln the Kuwai t l c l t lzen for whon Ehe donor could be t raced. A Kuwal t lfenale aged 23 year6 had g lven b l r th 2 weeks ear l ler at a pr lvate c l ln ic before she wasadnitted to hospital wtth cornplaints of falnting and post-partun haeroorrhage. As she wasanaenlc, she was transfused wlth a unlt of whole blood on the 2nd and on the 3rd day anddischarged on the 6th day at which t ime she was afebr l le . On the 10th day af tert ransfus lon, she becane febr l le , and was re-adnl t ted to another hospi ta l on the l5 th dayafEer t ransfus lon. On the l9 th day af ter t ransfus lon, b lood sent for haenato logicale x a n 1 n a t 1 o n r e v e a 1 e d r 1 n g f o r r n s a n d g a n e t o c y t e s o f L l @ . S h e w a s g 1 v e nchJ.oroqulne and dlscharged four days later. Investigatlons showed that there was nohletory of travel outside Kuwait. One donor, a 27-year old nale fron Uganda was traced.He donated blood 30 days afler returning froro Uganda. Exaroinatlon of hls blood at 48 daysaf ter h ls geturn revealed the presence of r lng forns of Pj fa lc iparuh at a densl ty of{102 pe r m- .
- Malar ia ant lbody levels ln pat lents wl th s l lde-proved nalar ia , heal thy KuwalEls,and b lood donors, neasured by the IFA test : Sera of pat ients wl th conf l r roed P. fa lc lparuna n d P . v i v a x w e r e a s s a y e d . 9 6 % o t ' t h " @ 6 e r a w e r e p o s 1 t 1 v e , t h e g e o m e t r 1 c n e a nt t t r e ] @ w a e I 0 2 8 0 . W h i 1 e a 1 1 s e r a E f f i x P a t i e n t s , o e r " r e a c t 1 v e , t h e G M T w a slower at 505. Ot 46 sera of healthy Kuwalttsfiff ire posltlve wlth Gl'fT belng 38, while451 of. 284 sera of a consecutlve group of blood donors were also reactive with GMT being51. The low t i t re of ant ibody ln heal thy Kuwai t ls probably ref lects post ln fect lon dur ingtravel ln endenlc areas. The h igher mean t l t re of b lood donors was due to the fact that437 of. the donors were fron nalarla endenl,c countries. The rlsk of transfuslon malaria lnKuwalt was calculated as 79 per nil l ion unlts of whole blood drawn, an unacceptably highfigure for a non-endemlc country.
- In addl t lon to casea of t ransfus lon roalar la , one case accidenta l syr lnge-needleLnfectlon and a case of congenltal nalarla were descrlbed.
In concluslon, the authors suggested that blood donors with a history of roalarla orrecent travel to an endeolc zone should be ecreened by the IFA test. Where the risk ofus lng nalar lous b lood ls unavoldable, e.g. r l f the donor has a rare b lood group, thephysician ehould be advlsed to glve an antloalarlal drug to the reclplent on the eve oftranefuslon and for the next 4-6 weeks. The sera of donors and reclpients should be frozenand tested by the IFA test lf need arlses.
Sher et e l . (1988) repor ted on a caae of P. ovale nalar la d lagnosed n lcroscoplcal lylu Kuwatt. A 27-year old man froro Kuwalt vleltmat hospltal in February 1986conplalnlng of headache and lntenolttent fever over the past l0 days. He gave a hlstory ofgolng to Saudi Arabla (Makkah and Medtna clt lee) by car on 17 January 1986, returning toKuwait on 25 January 1986. He gave no hietory of vlslt i.ng Afrlca. The typical eynptons ofP. f lvax or P. ovale nalarl.a were noted. After treatnent wlth chloroqulne, the paEientrecovered and was dlecharged eubsequently. I l le blood f1ln was sent to the MalarlaLaboratory for conflruatlon of the dlagnosls. The thin blood fl ln was flxed Ln nethanoland stained wlth Qlanss. About 2O% of. the erythrocytes Lnfected wlth parasltee nere ovalln ehape and eome had flubrta, el.ther on one or both stdes and there were large clunpe ofSchuffner-s dots on most lnfected erythrocytes. These characters conflrned that theepecles was Lg}g. The growing trophozoLtea were conpact, not amoebold, dlfferlng f roothe correspondlng stage of P. vlvax. Schlzonts had elght merozoltes, arranged Ln a rosetteform. Thls further conflrned the lnfectlon as belongtng to P; ovale and not P. vlvax [Aphotograph waa presented lllustratLng the rlng stege, tioptroEr-na a gaoeil6lffiTl
vBc /90 .3UAL/90.3Page 183
The authors polnted out that P. ovale ln fect ion Is general ly known to be conf lned to
Afrlca. Ae Makkah and ltedlna-ffi l f lglous centres, people come fron all over the world
for p l lgr inmage and r l tua ls every year . The authors postu lated that a vector ln Saudi
Arabla became lnfected f ron a carr ier of P. ovale ln fect ion f ron t ropical Afr ica whi le
res ld ing in Saudi Arabla. Most microscoplsts f lnd l t d i f f icu l t to d ls t inguish between Loval -e and P. v lva,x parasl tesr-par t icu lar ly s lnce the general funpression is- that_ovg]gi lFfa tsEnEtned to Afr lca. The authors acknowledged the cooPerat ion of Prof . H.M.
Gl l les for conf i rnat ion of the specles ldent l f icat lon.
I l i ra et a l . ( f98S) repor ted on microscopical ly conf i rned cases of lnpor ted nalar la
diagnosed dur ing l98l -1985 at a 600-bed d ls t r lc t general hospl ta l ln Kuwai t serv ing apopulat lon of 250 000 out of a tota l o f 1.7 n1111on. The nethod of processlng and sta in ingof thlck and thin blood fl lns nas as descrlbed above. There was a substantlal annuallncrease ln the nuober of lnported caees over the 5-year period of study, as the number of
cases lncreased f ron 25 tn l98L to 84 in 1985, 1.e. , a r lee of 336%. About 747. of thecaaea were lnpor ted f ron the Indlan subcont lnent . Of a tota l o f 307 lnpor ted cases
dlagnosed dur ing 1981-1985r 87.297. were P. v lvax, L2.05"A P. faLclParun,0.33" l L .11g1! i ' "odO.332 ( l case) n ixed P. fa lc iparum and P. v lvax. There were no fata l i t les due to roalar la .A 1 1 b u t o n e p a t 1 e n t w @ 3 g g g @ d t o t h e s t a n d a r d d o e e o f c h 1 o r o q u i n e . T h eonly exceptLon was a Swede who wbrked ln Tanzanla where he had been under chloroquineprophylaxls for one and a half years. After a few days ln Kuwalt, he was adnltted to thehospital froru a private cllnl-c, ln a seml-comatose atate. He did not resPond to tnit laldosee of chloroqulne but recovered conpletely after the adnlnlstration of qulnlne eulPbateand Fansldar. This was probably a true caee of chlorogulne-reslstant 3:jglg.ltgIgg' asthere was lndisputable evldence of the preaence of euch stralns ln East Afrlca. Otheraspects of the study were revlewed by the authors as dlscussed in an earller study by l l lratBehbehanl & Al-Kandart (1985 - see above).
In the unpubli.ehed docunent of Farld (1987), the country nalarla profl le of Kuwaltna6 aa fo l lows:
- Populat lon 1.7 u l l l lon
- No. elldes exanlned- No. posl t lve s l ldes- No. P. fa lc lparun caaea
Populat lon at r lek: Nl l
1984Sibt
50499
1985NA589
58
1986-ilT-NANA
- P. fa lc lparun res letance to chloroqulne: Not repor ted- Vectors of nalarla accordlng to thelr vectorlal inportance - with
vector reels tance to lneect ic idee:An. stephenel - (no euscepttblltty teete reported)
- uati-iffiffii?rol meaaures: Space spraylng for oosqulto vectors- Caee detectlon: PCD and exarnlnatlon of forelgn labourers- Developnent of PHC at perlpheral level: Good- Developnent of PHC at referral level: Good- Malarla coutrol prograr"rne: ' ls lntegrated wlth PIIC- Halaria tralnlng centreE: Not avallable- Tralned oanponer: Adequate - nalnly expatrlates- Speclal problene: Inported nalaria
lnfornatlon on
of d lseases
In Bahraln, malarla had been endenic accordlng to the report of Afridl & Majld(1938). Dffn'I Qg77) - unpublished reporr to t{Ito) pald a vlslt fron 29 January to4 February L977 to aeslst the natlonal authorit les ln aesesslng the nalarla situatlon lnthe country. The hlstory of nalaria coutrol Ln Bahrain was reviewed. Control roeaeuregafuulng at aource reductlon and larvictding of vector breeding places were applled since1938. Resldual house spraylng wtth DDT wae applled for the flrst t lne ln 1947. Slncethen, a full ganut of organochlorine lnsectlcldes and aome organophosphorua conpounds suchas fenltrothlon have been utl l lzed for house spraylng or fogglng. At the same tlme, oillarvlclding has been applied, whlle dlazinon and others have been occaslonally used for afew weeks durlng the peak of nosguito densLtles. These anttrnalarla meaaurea neresuccessful in reduclng nalaria transmleslon to a negllglble level as reflected by the
v B c / 9 0 . 3I,!AL/ 90. 3Page 184
d l scove ry o f on l y two l nd lgenous cases l n 1973 , none l n 1974 'and th ree l n 1975 . S lnce 1975 'the sltuation has changed and control of nalaria has becone lncreaslngly dlff lcult asindlcated by the detect lon of 35 lndLgenous case6 Ln L976. The factors that contr lbuted toth is lncrease were as fo l lows:
- Large increase ln the area of vector breeding: The rapld developnent that has takenPlace in Bahrain qras accompanled by f rant ic bui ld ing act lv i tLes which in turn created p l teand depressions ln whlch water s tagnated due to an lnef f lc ient or of ten non-exis tentdra inage system. At the sane t lme, land f l l l ing act iv l t les reached a peak, and large areasalong the seashore rrere belng reclalxned. This caused blockage of the exlstlng dralns andformat lon of natura l seepages.
- Increasing denand of labourers corolng Dostly frorn malarlous areas: It ls expectedthat lnnlgratlon of labourers from Dalarlous countrles wil l contlnue and poselbly increasefor years to come. The nunber of lopor ted cases has lncreased steadl ly , reachlng 573dur lng L973-L976. The prevalent parasi te specles was P. v ivax contr ibut lng 957" of a l llnfecilons, the remalnlng 52 beln! P. falclparuro. No AG.;f P. rnalar:Lae or L 6va1€ haveso far been detected.
The present actlvlt les as observed In L977 conprlsed the followlng:
- The control of rnalarLa falls under the DLrectorate of Publlc Health. Under thesupervlslon of the Dlrector of Publlc l leaLth, the head of the Cornnunlcable DiseasesDePartnent ls responsible for the epldenlological aepects of the nalaria control progranme,whl1e the head of the EnvLronnental ltealth Departnent, asslsted by the lnsect controlsupervlsor, organlzes the activit les of rnalarLa vector control. The actual luplenentatl.onof these act iv i t ies ls ef fected by labourers auperv lsed by heal th inspectors operat lng f ronheal th centres s i tuated in d l f ferent par ts of the country. Dl f f lcu l t les are belngexperlenced ln recrultlng local labourers and pJ.ans have been nade to f111 the gaps atper ipheral 1evel by lopor t ing fore lng labourers.
- Antl-vector Eeasures consl.st of larvlcidlng uslng oll (sornetlmes nlxed withres idual lnsect ic ldes) , dra lnage, f i l l lng ln of breedlng p laces and ut l l lzat lon of Ganbusiafish for biologlcal control. I louae spraytttg wlth dieldrln and fenltrothlon le carrle-a-mtwice year ly Ln selected areas. Street fogglng wl th res ldual lnsect lc ldes Ls a lso carr ledout for the general purpose of lnsect control.
- The laboratory of the oaln Salnanla hospltal ls responslble for blood examlnatlonof slldes taken frorn suspected nalarla caees. Three polyvalent nlcroecoplsts are utl l lzedpart t ine for thls purpose. Radlcal treatment ls given to all posltlve cases wlth etandarddoses of 4-aulnoqulnollnes and 8-anlnoquinollnes accordlng to the epecles of Elasnodiunfound. Recently, all labourere conlng fron nalarlous countries are glven preffi-treatment ln a elngle adult dose of 600 ng of 4-anlnoqulnollues + 50 Eg pyrlnethanlne Prlorto receivlng a work pernlt.
- The publlc health unlt of the Bahraln Petrol Conpany (BAPC0) carries outantlnalarl.a actlvit les wl.thln Lts own area by o11 larviclding, houee epraylsng wlthdleldrin on outsLde walle of prenlsee, occaslonal fogging and radlcal treatment of posltlvecaa€s. Laboratory facll{ l les are aval.lable wlthin BAPC0 health unlts and euspected nalarlacases are n{croscoplcally checked.
Del f tn l ( loc.c l t . ) oade the fo l lowlng.remarks and suggest lons:
(a) Epldenlologtcal conslderatlons: The ralny season extende from Decenber to Aprllbut vector breeding Ls dependent on ratn only durlng the latter part of the rainy aeason.The nain aource of vector breedlng cones from hunan actlvl.t les as shown above. The otheraources of breedlng are the so-called rrgarden areastt where lrrlgatlon of vaet paln grovesLs uncontrolled, and fresh water breedlng places provlde ldeal sltes for breedlng ofstephensl throughout the year; lt ls to be noted that Bahraln ls rlch ln underground freshwater. There appears to be two perLods ln the year when malarla transnlsslon takes place:durlng Aprll-June and SCpternber-December, the latter betng the perlod of highest
transnisslon. As roentlonedtendency of th ls sPecles toradlcal t reatnentr so as tohlgh nalar logenlc Potent ia l
above, the prevalent lnfectlonre lapse, rnalar la contro l has toavold re lapse of caeesl addlngof the country.
vBc/90.3ual/90.3Page 185
ls due to P. vLvax. Due to theensure th;;7;ffrstratlon of
nore dinenslon to the alreadY
(b) Anti-vector measures: House spraying ls applled twlce per year before the t\to
t ransmlss ion seasons. However, coverage has been Poor, &ost ly due to refusal of the
populatlon to have thelr houses sprayed. Moreover, tt ls not known what lnpact spraying
had on vector populat ions, s ince no est lnates nere systenat ica l ly oade of vector denel t les,
nor have "n"""pt ib t l i ty
tests been carr ied out . Structures to be eprayed should be those
where vectors are expected to rest . I t ls doubt fu l that spraylng of outs lde wal ls can have
an i ropact at a l l on the vector populat lon. I t 16 a lso essent ia l to Promote bet ter
coopeiatlon of the populatlon to tnprove spraylng through an effective health educatl 'on
programme. Regardlng larvtctdlng, the present forroulatlon could be lnproved by addlng a
to*I""rrt (22 cieosote) and a epreadlng agent to the o11. Although the efforts nade by the
vector control unlt to reduce breedlng of nalarla vectors are to be conrnendedr only a
modest inpact on the lnnense problen can be exPected froro larvlcldlng oPeratlone. The
achLevement of successful oalarLa control ln BahraLn lles ln findtng a solutlon to the
problen of an inadequate dralnage systen. At present, wherever a bulldlng le under
tonstructlon, land excavatlon creates condltlons favourable for underground water to
stagnate. Aithough contractora are required by law to ft l l ln depresslone followlng
"orpl"tiol of the bulldlng, thls hae rarely been done and the water reDslns etegnant. Land
reclamatlon along the seashore le addlng nore dlnenelons to the problen of poor exletlng
dralnage systema. The lrrigatlon of ttgarden areastt should be elther renovated or
dlsconilnued, elnce lt does not appear that the econouic beneflts fron unattended paln
groves would balance favourably wlth the daroage that the Present lrrlgatlon le cauelng to
the health of the populatlon.
(c) lteasuree agaLnst the paraslte and laboratory facll l t les: The neln probleo le the
contlnuou8 lnflux of garoetocyte carrlers lnto the country. As l[entloned above, lt has been
declded to glve a prelunptfvi (sfngle dose) treatment to all labourerE coolng froo
nalarloue countrlei, enterlng Bahraln for the first t loe. In vlew of the fact that the
great naJorlty of funported caseE are due to 3*!g lnfectlone, it la more aPProprlate to
iaa to the 60b ng bale chloroqulne, 45 ng of-i@ine instead of 50 ng pyrlnethanlne'
Another rDeaaure which would enable further depletlon of the reservoir of lnfectlve caae8
would be rouElne blood exaolnatlon for nalaria paraeites before leeulng work pernlta'posltlve caaea should recelve Etendard radlcal treat!rcnt. Exlsting laboratory facll l t ies
for olcroecoplcal dlagnoels of ualarla are, however, lneufflcleot to coPe lttth the routloe
Bcrutiny of ltre labourere. It wae eetlnated that about 30 000 blood elldee Per year would
be col lecEed f roo labourere, PCD, and epldeolo loglcal lnveet lgat lone ln eelected a!€aa' A
rdninun of Ehree mlcroscoplste should be recrulted to eope wi'th the exanlnat{on of these
elldes. ALl patlents euepected of nalarLa and for whoo the results of blood exanlnatlon
cannot be obEalned on the eame day, ehould lmedlately recelve PresunPtlve treatDentr to be
followed by radlcal treatment lf ualarla la conflrned. I i l trenever poeelble, Patlents nay be
requested to undergo blood exanlnatlon at least once before each of the two Daln
transoiselon aeasona ln the courae of a year'
Ae ehown ln Subsectfon (1) under 4.5 above, Shldrawl (L979 - unpubllehed report to
WI1O) vlelted Bahraln durlng Novenber 1978, to aaseaa the entonologlcal sork of the oalarla
control progranc. Based on a brief aurvey and dlecueglona wl'th natlonal authorlt leet he
roade detalled reconoendatlone, of rrhlch reference ls oade to:
(a) Tralnlng of at leaet one natl.onal Pest Control 0fflcer ln roedlcal entoEology wLth
speclal enphasls on taxonogy and nonLtorlng the susceptibll l ty leve1-of vectore of dleeases
to lnsectlcldes. The entonologlcal etaff ihould be tralned to ldentlfy t le larval and -adult epeclmene to the specles, lnstead of the current Practlce of classlfylng the eanplee
Lnto cullclnes and anoPhellnee.
(b) Screenlng thecolnllon lneectlcldee and
(c) Establ lsh lng acoordlnatl.ng all vector
present eueceptlbll l ty levels of various target lnsects agalnst
deterulnlng the nost effective ones.
natlonal Vector control conrnlttee to be reeponel.ble for
control aad preventlve neaeurea, and lnlt lating leglelatlve
vBc/ 90. 3MAL/90.3Page 186
procedures to l ln l t the lnpor tat lon, sa le and use ofas shonn above.
insect ic ldes to those found ef fect lve
(d) Establ ish lng two nobl le f le ld teams for rout ing surveys of a l l potenr ia l breedlngplaces on a for tntght ly basis . A11 hrater co l lect lons in the local i ty are to be lnspectedfor larvae and a l l , posl t ive breeding p laces should be e l ln lnated by permanent neans such asdralnage, f t l l ing in , repal r of leaks, d lvers ion of the f low etc. I f the posi t ive breedingplace is too large to be e l in lnated by nechanlcal rDeans, seeding wl th larv ivorous f ish(Aphanlus d lspar was found by Shidrawi in Bahraln) should be the second choice. I f bothnechanical and b lo loglcal nethods cannot be appl ied, use of o11 larv lc ides ro ixed wi thfenth lon can be used in h ighly pol lu ted water . Tenephos should be used ln wat .ers for hunanand donest ic purposes.
(e) e nunber of f ixed adul t day- t lne capture stat ions should be selected lnrePresentat lve v l11ages and should be surveyed once nonth ly to est inate vector densl ty . I fthe densi ty of 2 fernales per room pers ls ts , contro l operat lons should be re-exanined andhouse epraying rnay have to be applled, particularly ln rural areas.
Oddo & Payne (1982 - unpubllshed report to l{ ltO) vlslted Bahrain froro27 October-7 Novenber L982 to assess the nalarla sltuation froro 1979 onwards wlth specl.alerophasis on the role of the large forelgn populatlon on the roalarla prevalence. Records ofinpor ted oalar l .a showed the fo l lowlng nunber of casee: 274 In I979r 255 ln 1980r 274 Lnl98l and 232 up to 30 Septernber 1982. The roaJor i ty of these lnporred cases (932)originated fron countrles of South East Asla and the renainder from countrles of theEastern Medi terranean Reglon. The nunber of P. fa lc fgru. ln fect lons recorded dur lng th lsperiod totalled 13, and the renainlng cases wffito p. vlvax wlth two cases of mlxedlnfectlons of P. vivax and P. roalarihe. Regarding the effi6@rcal actlvit ies, theslruarlon." rE!'offiby strlE?iilTifr9 - see subsecrlon (i) under 4.5 abovel siirrpreval ls conpr lsLng: ' inspect lon of breeding p laces and the repor t lng of the presence orabsence of nosqulto larvae, and the recordlng of the speclmens as belonglng to Anophellnlor Cul lc ln l . The general lnpresslon g iven by these records that there nas a progresslvedinlnutlon in the number of breedlng places posltlve for anophellnes over the four yearper lod under rev lew. The probable reason for th ls 1s the urbanlzat lon of the cul t lvatedareaa and the wldely repor ted drast lc drop ln the nater- tab1e. In the absence ofstandardlzed quant l ta tLve densl ty Deasurernents, t t nas not possib le to s tudy the dynarnlcsof larval and adult populatlons. The varlous ualarla activltLes lrere as follows:
(a) Case detectlon: Durlng the perlod under revlew, naLarla screenlng was nalnlybased on compulsory notlf lcatlon of cllnlcal nalarla by nedtcal practlt loners, and by pCDaEong outPatlents at hosPltals and PIIC centres. The nunber of blood slldes was very low;the ABER wag less than lZ, even if only the months of nalarla transnlsslon nereconel.dered. However, the posl.t lvity rates were relatlvely high (8.62). This was due tothe eelecttvtty of thls type of screening whlch concentrated on referred suspected cases ofnalarla' The total number of slldee collected by all centres durlng 1979 - up to 30Septenber 1982 was lI 906 of whlch 1028 were posltl.ve. The naJorlty (672) of. these camefron Salarunia Medical Centre which was the focal polnt for the detection and treatoent ofoalarl.a aud other dlseases for all the lsland. This was facll l tated by the short dlstanceetravelled and the ease of coununlcatl.ons throughout the tsland.
(b) Blood surveys: The second source of blood slldes wae provlded by two type6 ofcollectlone as followa:
- epldenlologlcal lnveetlgations around each conflrned nalarla case;- randon.blood surveys Ln those areas where the transulselon rlsk was hlghest.
fhe randon collectlona nere carrled out only ln 1979 and the flrst half of 1980, and werellntted exclusively to the foreigu populatl.on. The epldenlological lnvestlgatlone werecarrled out from 1980 onwarde ln all areas/regLons of the Lsland, but the proportlon of thepopulatlon exanlned varled conslderably and covered alnost exclueLvely the foreignpopulatlon. Theee surveys produced only tno caaes of Ljlgl, both of which were detectedln 1980 .
vBc /90 .3MAL/90.3Page 187
(c) Drug adnin ls t rat lon:
- Preeurnptl,ve treatnent waa glven to all lnmlgrants fron endeuLc nalarlous countrleswhen t.hey reglstered on enterlng the country. Treatroent durlng the period under review was
based on the adrninistratlon of a slngle adult dose of 600 ng of chloroqulne and 45 ngpr lnaqulne. Dur lng the per lod 1980-f98f , 42 000 lmnlgrant workers recelved presunpt lve
treatment .
- Radlcal treatnent was adnlnlstered to all posltlve cases. In 3:lgl4t3g1!lnfectloos, the adult dose wae 1500 ng chloroqulne and 45 ng priloaqulne spread over 3 days,
and for ry1lyg, 1500 ng chloroqulne over 3 days slmultaneously wlth 15 ng prinaquLne over
14 days.-Al-thollgh some tests were nade at the SalananLa Medlcal Centre to deternlne thepresence of GCPD deflciency, these were nade at the request of nedlcal Practloners and not
as part of a systenatlc evaluatl.on of this deflclency. There have been no rePorte of drug
reslstance to chloroqulne or other cornmon antfunalarlal drugs.
(d) Mtcroscoplcal exanination of blood slldes for nalaria: As nentioned above, the
naJorlty of PCD blood slldes were exarolned by the Salananla Medlcal Centre. However, eoueslldes (409f) were exanlned.by three non-governnental hospltals and also, nore recently, by10 PltC centres with laboratory facll l t les. The slldes collected durlng the randon surveysor epidenlologlcal inveetlgatlone around the confirroed ca6es, totall lng 22 O63 veteexaolned routtnely by the Publtc l lealth Laboratory. The procedures of blood slldepreparatlon, etalning and exanlnatlon dlffered somenhat in varlous collaboratlnglaboratorles wlth the exceptl.on of the Salananla Medical Centre. In thls centre, thlck andthtn blood fl lne nere prepared and etained with Fleld and Lelshnan atains' respectlvely.In recent nonths, eone Glensa-stal.ned thtck fl lne were prepared routlnely duringlnveetlgatlons of poeltlve c8s€Eo Blood exanlnatlon perlods, however, were notstandardlzed. All the laboratorles aeen had excellent facll i t les for nalarl.a roicroscopy-but some new, and relatlvely new nlcroecopes had tnpaired resolutlon due to ol.shandllng andlack of routlne cleanlng by the nlcroecoplst and servlclng by quallf led technical staff.No eysten of sllde referral for croee-checklng exlsted and the oaJorlty of posltlve slldesand all the negative slldee were routlnely diecarded after exarnlnatlon.
Frou all the above obeervations and examlnatlon of data, Oddo & Payne (loc.cl.t.)
made a serlee of recooraendatione. The basls of theee le that lndlgenous malarla caees lnBahraln are rarely €ncountered and the convictlon would be that, if the approprlat-e stePsare taken to.enaure that the reintroductlon of oalarl.a by lnnlgrants and travellere iseffectlvely curtaLled, and the poeslbll l ty of the Lntroductlon of resl.etaut atralns ofP. falclparirn neutrall.zed by the efflclent contalnment Eeaaures, then nalarla transnlsslonFIff not E-re-eetabllehed ln Bahraln. Of theee recomnendatlone, reference ls nade to thefollowlng:
(a) fo eetabllsh a Dalarl.a unlt ir ithln the Dlrectorate of Publlc Health conslstlng ofa nedlcal offlcer (nalarlologist), a senior techntcal offlcer (entonology/parasltoJ.ogy)r 8fteld operatlone coordlnator, and secretarial eupport. Thle snall speclallet actlon grouPehould be reeponelble for planning, coordlnatlng and evaluatlng all nalaria actlvlt lescarrl.ed out by different sectlons of the Dl.rectorate.
(b). To ratlonallze and standardizestalnlng, exardnatl.on, deterul.natlon ofellde collectl.one.
the procedures for co l lect lon, proceselngtparael.te denslty, recordlng and reporttng of blood
(c) lo pursue studlee ctrrrently underteken by the Publlc ltealth Laboratorles foreatabllehl.ng facll l t ies for systenatlc lnrounologlcal ecreenlng of expatrl.atee andcollaterale of the confl.rned nalarla caeies when epldernlologlcal conslderatlone eo rtarrant.
(d) To eetabllsh a capabll lpy for nonitoring P. falclparurn realstance to conrnonantlnalarlal drugs, partlcularly chloroqulne.
vBc /90 . 3l.{ALl90.3Page 188
(e) Io reorganize the entoxoologicalprov ide adul t and larval densi ty data ofpotent ia l breeding p laces, and to moni tori nsec t i c i des cu r ren t l y i n use . IAn . s te
act iv i t ies of the Insect & Rodent Contro l Uni t
the vector longi tudinal ly , to check the actual
the susceptibiHty level of the vector to the
hensi was the only species incr iminaled as the
t oand
maln vector of malar ia in Bahrain - - f f iubsect ion ( i ) under 4.11 abovel .
( f ) To inprove in quant l ty and qual i ty Ehe procedures for case detect ion in both
indigenous and fore ign populat ions. Taklng in to account the ex isEence of a wel l -developed,
staf fed and equipped-network of PHC centres, the epidenio logical survei l lance should
cont inue to be based pr inc ipal ly but not exc lus lvely on PCD on condi t ion that the sanple of
Lhe populat ion should be nore acceptable f ron a stat is t ica l s tandpoint . For th is ' i t ls
suggls iea that b lood examinat ion should cover a l l pat lents wl th fever , or recent h is tory of
fever , who at tend c l in ics, heal th centres and hospi ta ls . The annual average nunber of
blood slide examinations for nalaria should not be less than 35 000 corresponding to l0Z of
the tota l populat ion.
(g) To study rhe possib i l i ry of establ lsh ing a systemat lc b lood sanpl lng of a l l
innigrint workers and their fanil ies fron rnalarious areas on entry lnto Kutait '
(h) To rev ise the epidenlo loglcal invest igat ion forn in order to obta in prec lee
infornation on the movetrents of innigran! workers or travelldrs within the nalarla endeEic
country. This information assunes pirt icular lmportance when lt concerns !,--!.alclparuntsince not all areas of countries where chloroquine resistance has been recorded are
af fected. Moreover, the avai lable data f ron previous epldenlo logical lnvest lgat lons showed
that the sanple of collaterals exaoLned around each confirmed case lsaa not always
suf f lc ient to be star is t ica l ly acceptable. Therefore, i t ie proposed that the e ize of the
popu.lation to be sanpled should r".ch 80-100 persons for each confirned case lrlthout
d i f ferent iaElon betneen the Bahrain i or non-Bahrain i populat ion of the area Lnvolved'
( i ) To establ lsh ACD by nonth ly house-to-house v is l ts ln the local l t ies where an
acl lve focus has been detected. This should cont lnue unt l1 there ls ev ldence that the
focus has been e l in lnated.
( j ) to ensure the ef fect ive neutra l izat lon of iopor ted malar ia cases, three
poss lb i l i i t l es a re o f f e red :
- Treatment of all inmigrants on entry to Bahrain wlth Fansidar.- Radical treatroent of all ionlgrants wlth chloroquine and prloaqulne'- ACD on a monthly basls covering area6 where lnmigrants reside in Bahraln'
(k) To establlsh a systematlc follow-up of each conflroed case by nonthly blood
examlnation for a perlod Lf 6 nonths 1n the case of P. falciParqln lnfectlons and 12 nonths
for all other specles of human Plasnodia.
(l) To organize the nonltoring centre for the deternlnatlon of the prevalence of GCPD
deftciency tn dtfferent ethnic g.otp" of the populatlon, bearLng ln nlnd that
8-anlnoqulnollne is wldely used ln the radlcal treatnent of a1l nalaria lnfectlone'
ln an unpubllshed report to lf i tO, AnJawi (1084?) brlefly revlewed the hlstory of
malaria and its control ln Bahraln sLnee the surveys of Afrldl 6' MaJtd (1938)' It I 's worth
notlng that in 1959 there nas a sharp lncrease 1n tnalaria incldence whlch was estinaEed to
have affected 5Z of the populatLon. Most of the cases occurred durlng October-November and
came froro the northern vil lages. In Ehat ybar nosqulto density increaBed earller than
normal due to a nlld sunmer and the "r.rg"r,""
of resistance to HCtt hitherto belng used for
nalarla control. Regarding the situatton in 1983, a total of 302 inported cases were
notif ied and there nas one case classified as lntroduced' As ln previous yearst - the
naJority of rhe Loported cases ori.glnated fron Indla (69.22) and Pakistan (24'2"/") wlth a
few cases fron t[alaysla, Bangladesh, Sri Lanka and some counttleo of the Eastern
Medlterranean Region. In order to show the volune of the immlgrant populatlon, the author
showed that durlig 1983 a total of 80 355 resldence perrnits -Itere lssued to various
categor les of worfers f ion South East Asla and l {estern Paci f lc regions ' wi th the largest
vBc/90. 3l,rAL/90.3Page 189
proport lon f ron Indla (73.6%) and Paklstan ( lL .5Z>. The nunber of ind lgenoue malar la cbseshas shown a decl ln lng t rend s ince 1959 when 329 cases were not i f ied anong a populat lon off48 000. In 1979, no indigenous cases nere recorded in a populat ion of 341 000. However,the year 1976 was an excepl lon for the nunber of lnd lgenous cases nul t ip l led to 35 wi thlnpor ted nal .ar ia cases reaching 538. The sharp increase ln roalar la t ransmlss lon ln 1976na6 attrlbuted to the sudden rlse in the number of lnported cases from highly nalarlaendemlc areas on the one hand, and to sooe fa i lures in vector contro l on the other . Thlsfa i lure in vector contro l was due to some envl ronmental factors associa led wl th rapideconomic developroent. The author further pointed out that Bahraln has remained free ofnalar ia t ransniss lon s ince 1979, but as shown above, the country 1e cont lnulng to receivean inf lux of lopor ted cases. The ant lnalar ia serv lce forns a major par t ln theEnvironmental Heal th Depart roent . The serv lce ls nost ly an operat lonal unl t whlch recelvestechnlcal support f ron the Head of Envl ronmental Heal th, the Head of Comunlcable Dlseaees,as wel l as f ron an epldenio logtst for assessnent of malar la survel l lance act lv i t ies, andfron the Head of Public Health Laboratory concernlng the dlagnosie and confirroatlon ofcases. Vector controL conslsts of larv lc id lng, l ln l ted res idual house spraylng, fogglngand ULV appllcatlon. A11 these neasures are carried out regularly to control stephensl thepr lnc lpal vector Ln Bahraln. For larv lc ld ing, a n lx ture of d lesel o11 wl th 0. lZ Tr i tonX-45 as a spreadlng agent ls appl led ln a l l s tagnant water co l lect lons every 7-10 days.T h e 1 a r v 1 v o r o u s f 1 " h A P t ' g @ . a r e u t 1 1 i z e d o n a v e r y ] . 1 n 1 t e d s c a 1 e i n n a t u r a 1sprlnge and sone lrrlgatlon channels. Ellnlnatlon of noequito breedlng sltes 1s beingundertaken ln cooperatlon wlth the Munlclpallty and the Mlnlstry of Publlc Works. Inaddltlon to antl larval oeasures, 6ome vll lages whlch are sltuated near uosqulto breedlngaltes are sprayed wlth nalathlon twlce per year (April-May and Septenber-October). Forfogglng and ULV appllcatlon, synthetlc pyrethroLde are ueed. Malaria eurveil lance Iscarr led out by the wldel f d iet r lbuted heal th centree, hoepl ta le, pr lvate c l ln lcs and Labourcllnlcs. Conpulsory notlf lcatlon to the Publlc l lealth Dlrectorate when the dlagnosl.s of acase ls conflrned by the laboratory. Innediately after conflrnatlon epldeulologlcal andentoroologlcal lnveetlgatlons are started to classlfy the caee and appropriate Deasurea areapplled ln the locallty lf the case ls proven or even suspected to be contracted localIy.Blood aoeara are collected frorn collaterals at an average of 80-100 slidee for every caee,and a thorough search for the presence of anophellne rooegultoe le done In the area wlthln aradlus of I ku around the case. A progranme of follow-up of ualaria caaes after radlcaltreatment has started thls year, whereby blood amears fron casee w111 be checked everyEonth for one year ln the case of P. vlvax and for 6 nonthe ln the case of P. falciparun(see the above recomendatlons)
Iu the unpubllshed docuoent of Farld (1987), the country nalaria profl le of Bahrainwae ehown as follows:
- Populat ton: 0.4 n l l l lon Populat lon at r iek: Nl l1984 1985 1986
- No. s l ldes exanlned: l0 854 6 998- No. posl t ive s l idee: 363 227- No. P. fa lc tparuu caseat 20 13
6 8032s2
) iworted
- P. falcl.parun reel.stance to chloroqulne: Not reported- Vectors of nalarla accordlng to thetr vectorlal lnportance - wlth lnforroatlon
vector resLetance to tneect lc ldes:An. s tephenel - (no suecept lb l l l ty tests repor ted)
- Maln vector control neaaures: Larvlclding, houee epraytng wlth oalathlonr and ULVappllcatlon wlth pyrethrolds.
- Case detectton: PCD and speclal post6 for Lnnigrants- Developnent of PHC at perlpheral level: Very good- Developnent of PHC at referral level: Very good- Malarla control progranne: is part of PHC syeten- Malarla tralning centres: Non-exlstant- Tratned nanpoerer: sufficlent- Specla l problens: Inpor ted nalar la
vBc/ 90. 3MAL/90.3Page 1 90
Fron lnfornation conmunlcated to I{Ho/EMRO, data on the status of antlnalariaact lv i t ies ln Bahrain ln 1988 show the fo l lowlng: (populat ion: n id-year est inate in 1000s) .
- Tota l - populat lon: 473- Populat lon of or lg lnal ly nalar ious areas: 473- Populat lon of areas c la ined to be f reed f rom malar laz 473- Populatlon protected by extensive house spraying coverage: 25- Populat lon protected by other ani t -vector neasures (Larv ic id iag) : 473- Populat ion under survel l lance: . 473- No. funported cases: 170 (nain ly f ron South East Asia and t ropical Afr ica) .
In $!gr there hae been no evldence of malaria transmisalon although r{,n. stephensi asa potent la l vector ex ls ts [see Subeect ion (1) under 4.2 and 4.5 above] . Based on a repor tf ron the Min is t ry of Heal th, Doha, .a note on nalar ia survei l lance in Qatar was preaented byWHO (1983 - Wkly Eplden Rec.) . Dur ing L982, L82 nalar ia cases were repor ted cornpared wi th116 cases ln 1981. 0f these case6 f53 (842) were caused by L. v lvaxr 26 (L4i ( ) byP-. falciparun and 3 were mlxed lnfectlons. A11 caaea were lmported, no6t1y fron India(477) and Paklstan (347>. An lncreased lncldence 1n the age-group 25-34 years and the facrthat 150 cases occurred ln oales polnt to the funportance of the lnflux of young workersfron malarlous areas. The nalarla unlt, which has recently been strengthened, works 1nclose cooperatlon with the nlnlstrles of ounlcipallt les and of publlc works. Anong theactivit les of the unit were the fl l l lng and levellng of ponds (Doha Cornlche, Fareej AbdelLziz, El l landasa street, Gafeeri area and the Northern Unn Saeed Roundabout), thelarvLcldlng of breedlng places where glgephensi larvae nere encountered (northern dlstricts,Doha and surroundlng area), regular country-nlde search for and inspectlon of rdateraccunulatlon throughout the year, and epldenlologtcal lnvestlgations ln the area ofdetected nalar la ca6ea. Other act lv l t les of the malar la unl t lnc luded staf f t ra ln lng, thecollectlon of cllnatologlcal data and the plannlng of an entonologlcal survey to be carriedout by exPerts durtng the oosquito breeding season (second half of March and fronnld-Septenber up to Novenber) . In an edl tor la l note, i t was polnted out that Qatar lsconsidered to be nalaria-free and connendable efforts are undertaken to naintaln thisstatus. However, in vlew of the lnflux of labourers fron areaa where chloroquine-reslstantP. falclParun exists, special Eeaaures nlght be consldered such as the parasltologicalbLood exarnl.natlon of these speclal groups on arrlval, followed by adequate treatnent andfollow-up of posltlv€ cas€6o Facil lttes for ln vl.vo studies for P. falglg drugsenslElvlty should be nade avallable as well iE-EI-e provlslon of Eiiiifrd- ana ttrird llneantinalarials. Such preventlve meaaures should be strlctly enforced ln all States of theGul f area where rnalar la t ransmlss lon st l l l bccurs [par t lcuLar ly ln countr ies conslderedreceptive and at the eame tlne vulnerable to Lnportatlon of nalarla cases frooP. fa lc lparum chloroqulne res ls tant areasl .
In a br tef v ls l t to Qatar dur lng l -10 February 1984, Far ld (1984 - unpubl lshed reporrto WllO, ln Arablc) revlewed the records of malarla loported cases reglstered ln 1983 asconpared wlth 1982. He also checked the cllnlcal/epldentologlcal lnvesclgatlons carriedout oD four Qatarl natlonale who gave a hlstory lndlcating that they were probably lnfectedwhile vlslt lng nelghbourtng countrles. As a result of this revlew, he nade recomoendatlonsto strengthen the sntlnalarla unit and to traln the laboratory staff worklng Ln the nalnhospltal and others working ln the central laboratory. To relleve the out-patlent cllnlcsof the naln hoepltal and other health eetabllshuents from the heavy workload created byAslan workere eeeklng treatnent, Farid (loc.clt.) recoomended the followlng:
(a) to glve every worker couing frou Indla, Pakletan, Sri Lanka, Bangladesh, Burma,Thalland and the Phll lpplnes an adult doee of 600 ng chloroqulne (4 tablete) and 45 ngprLnaqulne (3 tablets). These doses are to be gl.ven by the health lnspector of the port ofentry. Each worker should f111 tn a forn reglsterlng hls name, natlonality, date ofarrlval and drug adnlnl.stered. Instructloos (ln Arabtc and Engllsh) should be printed onthe forn lndlcating that ln case of fever, the person should report to the neareat healthestabllshnent and present hle foru.
(b) To follow up every patient who had recelved a blood transfuslon ln hospltal, bytaklng a thlck blood soear ln case of fever appearlng three days after recelvlng the
vBc/90.3MAL/90 .3P a g e 1 9 1
blood. This is necessary because nany of the blood donors come fron Aslan countrles where
n a 1 a r 1 a 1 s e n d e n i c . T h e p r e 6 e n t r o u t 1 n e o f s c r e e n 1 n g t h e d o n o r s w h o n a y o f t e n b easynptogat lc by exarnLnlng a th ln b lood f l ln , does not ensure that they are not ln fected '
I t is possib le to reduce the lnc ldence of t ransfus lon nalar la , by g iv lng the donor four
tablets of ch loroquine four hours before donat lng h ls b lood. A11 donors coming f ron
countries where chloroqulne-resistant Llglgjtg exist should be excluded.
(c) A1I n icroecoplcal ly conf l rned cases of P. v lvax should be t reated wi th chloroquine
p 1 u s p r 1 r o a q u 1 n e t o o b i a 1 n r a d 1 c a 1 c u r e . C a s e s o @ : h 9 : } d b e t r e a t e d w l . t hctrtortqutune wlth a dose of prirnaqulne to tttt tfre ganetocytes of thls specles' A note on
treatnent schedules Itaa annexed to the report'
In the unpubl lshed docunent of Far id (1987), the country nalar l 'a prof l le of Qatar was
shown as fo l lows: (NA o not avat lable)
- Populat lon: 0.3 ro l l l lon Populat lon at r lsk: Nl I1984 1985 1986
- No. slldes examlned z 4 142 NA- No . pos l t l ve s l l des : ' . 198 208- No. i . fa lc lp"run caaea: 34 L9- p. rl i ff i 'ponse to chloroquine: Not rePorted- Vectore of Dalarla accordlng to vectorlal lnportance
lnported
- with Lnfornation on vector
NA1843 l
res ls tance to lnsect ic ldes:An. s tephensl as a potent la l vector
- Main vectorGTErol meaeures: Space spraying and larvtcldlng nalnly for rooequlto
nulaance- Case detect lon: PCD- Developoent of PHC at perlpheral level: Good- Developnent of PltC at referral level: Good- Malarla control prograrne: Antlnalarla actLvicles are carried out through PHC.- Malarla tralning centrea: Not avallable- Trained nanpolrers available- Speclal problens: Inported nalarla.
Fron recent lnfornation connunlcated to !|IIO/EMRO, data on the status of antlnalarla
actlvlt les ln Qatar durlng 1988 show the followlng:(populat lon: n ld-year est lnate ln 1000s) :
- Tota l populat lon: 301- Populatlon of orlgLnally ualarl 'ous arees: -- Populatlon of areaa clained to be freed froo nalarta: 301- Populatlon Protected by extensive houee spraylng coverage: -
- Populatlon Protected by other antl-vector Eeaaures: ?- Populatlon under eurvell lance: 301- No. lnpor ted ceaea: 130 ( In i t la , Paktetan, Sudan, wt th 3 cases of Qatar l nat lonals) '
I n @ , t h e r e a r e s 1 : i a d o t n 1 s t r a t 1 v e p r o v 1 n c e a a 6 1 1 1 u s t r a t e d 1 n F 1 g . 9 ,whtch afE6-6'f,6ffi[E areaa that reached the rnalntenance phaee and area that etlll remain
malarlous.$lth the maln vectore ehonn. l,[alarla control hae a long hlstory ln Saudl
Arabla. It connenced ln 1948 tn the Eastern provlnce as a Jolnt Project between the
Governnent of Saudl Arabla and the Arablan Anerlcan 011 Conpany (AMMCO) ae deecrlbed by
Daggy (1959). 'subeequent ly the Governnent took over the responelb l l t ty of oalar ia contro l
tn ihe Eaetern provlnce. it, 1952, a nalarla control demonstratlon proJect ltas establlshed
wlth the cooperatlon of WttO ln the pllgrlnnage area (Jedda-Makkah and adJacent valleys and
ltedtna). In 1955, the Natlonal Uallrla Control Servlce ltas establlehed and eeveral surveys
were carrled out to delftnlt the extent of oalarloua areee, and ldentlfy the reeponslble
vectors in each ar€a. l lalarla control stations whlch were already establlehed ln Jeddah,
Makkah and Medlna contlnued to functlon to protect the pllgrtnnag€ ar€a. New etatlons ltere
eetabllshed progresslvely to cover all nalarloua areaa of the country' In additlon to
trainlng of per-onnel abioad, a ualaria tralnlng centre wae establlshed ln Jeddah ln 1955,
and a depongtratlon and trainlng area of the nalaria pre-eradlcatlon Programme ltaa
v B c / 9 0 . 3MAL/ 90. 3Page 192
organized in the Eastern prov ince in 1966. Recent ly , a large nat lonal malar la t ra in lngcentre was establ ished in Gizan to serve the southern and other prov inces. The h is tory ofnalar la a1d the development of nalar ia contro l in the southern province have been rev iewedin PART I - uP to 1984. More recent in fornat ion on problens fac ing malar ia contro l in theSouthern provlnce comes f roo a repor t of a Malar ia Advisory Tean of the Heal th Secretar iatof the Arab States of the Gul f Area (Far id et a l . , 1985). The tean v is i ted two Ernarahs(wr i t ten a lso Anarah = subgovernorate) : A l -Khoba and A1-Salb which are considered theforefront of nalar ia lnpor ted f ron Yemen ln v iew of in termingl ing v i l lages and theextension of va l leys between the Yenenl and Saudi s ides. Malar ia contro l acc lv i t ies in thetwo Emarahs are undertaken by the nalar ia contro l s tat ion establ lshed in Al -Khoba. Thefo l lowing observat ions were made:
(a) The pr lnc ipal nethod of contro l ls larv ic id ing of breeding p laces wi th t ,erneplosonce weekly. The two Ernarahs was divlded into 96 oVeraSlonal unit, each cover 2.5 kn'.The to ta l su r face a rea t rea t .ed i n 1984 was 34 8 I l 666 n .
(b) When a f lare-up of oalarLa ls d lscovered in a focus, a l l housea are t reated wi thULV appl lcat ion us lng pyrethro ids (4 t lnes weekly) . In p laces of d l f f lcu l t accesslb l l t ty ,where larv lc id lng appl lcat lon ls d l f f icu l t , DDT house spraying ls carr led out , e .g. , theshores of the lake of GLzan dan, and enall vl l lages sltuated in valleys ln mountainousa reas .
(c) Satisfactory performance of larvlcldlng sguads ls checked by an operationalsupervlsor. Moreover, entonological scouts are sent to roake spot checks to detect breedlngplaees posl t lve for larvae of arabienels and to est lxnate the densl ty of l ts adul te rest lngin houses by PSC. The crlt lcal-E6Gilfof arablensLe above r.rhlch rnllaria transnlsston wil lbe resuned was set by the control authorit les as one fenale per dwell ing. To achleve sucha level , the larv ic id ing operat ions need to be per forned wl th the urnosi per fect lon.
(d) fne epldenio loglcal evaluat lon lnc ludes a b lood survey of schoolchl ldren (6-9year6 o ld) in March every year . I f the contro l operat lons were ef fect ive, a reduct ion of302 every year should be expected. Besldes which, the posi t iv i ty rates of c l in ica l lysuspected nalaria cases among those attending PHC centres are consldered. The paraslterates auong schoolchildren surveyed ln March of 1983, 1984 and 1985 were: 202, IOZ andL0.62, respect ive ly . Thle indicated that the nalar ia s i tuat lon d id not iuprove between1984 and 1985. The s l ide posi t iv i ty rates recorded among at tendants of PHC centres dur ingthe per lod Decerober-March of L983/L984 and 1984/1985 were 152 and 2 lZ, respect lve ly . Thlswas due to Ehe increase of lnported cases fron Yenen. Ot 29 787 persons reportlng to thePllC centres durlng November 1984-Aprtl 1985, 2OZ nere from Yemen. Thls ehowe that unleesmalarla ts controlled ln area6 of Yeroen borderlng Saudi Arabla, the oalarla situatlon lnAl-Khoba and Al-Salb Eroarahs w111 not loprove.
The members of Che l'lalarla Advlsory Tean further concluded and recorntnended:
(a) ttre lake of Glzan dan creates a oaJor problen when the water recedes creatlng vastareas sultable for vector breedlng in Ardah Enarah. Thls was due to deflciencles ln theorlginal plannlng of the dan frorn a health standpolnt, and should be avolded when new dansare conatructed. At present, the posstblJ.ity of applleation of teuephos to these vastbreeding area6 by aircraft used ln agrlculture every 15 days durlng the nalarlatransnlsslon Eeason, ehould be studled.
(b) The nany burrow-plts forued ln the courae of road and bulldlng constructlons,whlch becone favourable breedlng places for the vector durlng the ralny season, increasethe burden and coet of control operatlons. Contractore should be charged wlth the fl l l tngln of such plts before they dellver the work.
iffitoR BroNourcs rN THE EprDEMroLocyRECION & THE SOUTITERN WIIO EASTERN I.IEDITERMIIEANDocument VBC/85.3-MAP/85.3 - aee ANNEX 1.
AI{D CONTROL OF MALARIA IN TTTE I{ITO AFRICAT{RECION. SECTION III(T) SOUTHWESTERN ARABIA.
vBc/90. 3MAL/90 .3Page 193
(c) The creat lon of nany farns on the p lateau l r r igaEed f ron a ser l ,e1 of wel ls Ied to
the fornation of numerou6 breeding places around the wells and the adJolnlng cer0ent
reservolrs whlch would need the eoployoent of rnany labourere to cover then adequately wlth
tenephos. To overcome thls problem, it is recornmended that each farmer should be roade
responslb le for t reat ing such p laces by h is own farm labourers. The rnalarLa d l rectorate
snouta be ready to train those labourers and to provlde each farroer with the requiured
quant l t les of the larv lc lde and spraylng equlupnent '
(d) Many of the local conmunlcable and parasl.t ic diseases are caused by contanlnation
of the envlronnent. This can be overcome by {ntersectoral cooPeratlon involvlng the
serv lces of i r rLgat1on, agr lcu l ture, pubJ. lc works, municLpal l t les, educat lon, and heal th '
A canpalgn should be organized to seek the cooPeratLon of the publlc through vll lage
authoi l t iee, c lubs, sch6ols and develoPnent sectors for preserv lng the envi ronnent '
(e) In v lew of the widespread use of teroephos, DDT and pyrethro lds ln nalar la contro l '
n o n i t o r 1 n g ! h e s u s c e p t 1 b 1 1 1 t y 1 e v e 1 s o f @ t o t h e s e a n d o t h e r a 1 t e r n a t 1 v einsect lc ides shoul-d receive pr lor i ty anong the entomologlcal act iv i t les '
A recent report by a Jolnt Government/Il l tO Revlew Ml.sslon to Saudi Arabla (NaJera &
Far ld er a l . , 19-87 - unpubl lshed repor t to WIIO) deal t wt th the malar la sLtuat lon ln
dlfferent part8 of the "our,tty.
In an annex to thls rePortr a chronological account of the
developoenl of the malaria control prograone slnce lte lnceptlon durlng L948'L952 uP to the
pre6ent has been preeented. Briefly, ln the Eastern provlnce ualarla was endemic ln nost
of n-Qattf and li-ttasa oaaea. Aoong the enployees of ARA}|CO' malaria norbldlty rates ln
lg47 were 2700/10 o0o. proportLonal malarla nortallty ratea showed that oalarla accounted
for g.57 of a l l deaths rn aneuco bospl ta l ln 1947. In 1958, a severe oalar ta,epldenlc was
reported ln uneprayed rnountalnous valleys abou3 250 kn north of Jeddah-ltakkah- ' The
nflnfy nalarlous .r""" ln the southnestern part of the country were practlcally not
controlled by any meaaure untl l late ln the 1970-s. The nalarla control PrograDDe ln Saudt
Arabla followed the eoclo-econonlc developnent of the countryr startlng fron the,Eastern
provlnce near the oll f lelds. Durlng lts second stage, the progranDe,concentrated lte
efforts on onlaria control ln the ltoiy places and thelr route6. Lastly and ae a thlrd
6tage, the control scttvlt le8 were alrettea to tackle the most diff lcult nalarlous areae of
the southwest Part of the country.
The nalarla situation ln dlffere.nt provLnce8 of Saudl Arabia was deecrlbed as follows:
The Eaetern provlnce: Slnce 1972, ualarla Bransnleslon hae been lnterrupted' All ualarla
caaea detected r"F"r"""i ir"a ." hpo.t"d froo abroad or frol endenlc ereaa wlthln the
eountry rnalnly the eouthwestern part. In the Eastern provlnce, there are 12 hoepltals, 137
PHC centres covering a populatlon of one n1111on. These health establtehDents are well
dlstrlbuted and etaffed for curatlve servlces. The PIiC centres are the only health
establlshnente nlth a Preventlve role. Thelr Partlclpatlon I 'n dlagnoeis and treatnent of
nalarla ls l lnlted to their locallt ies, but th-y have no role 1n eurvell lance and vector
control actlvlt les. It 16 envleaged that they should be lnvolved gradually I 'n vector
surveys and control. The governnent effores ln constructlng the lrrlgatlon and dralnage
schene ln the aouthern parl of the Eastern provlnce have contributed nuch to the
ellnlnatlon of the Ealn vector, *PEEI, treedlng places (see under-3 below)' Thta
accelerated the interruptlor oi friff i-EransoLeelon and helped ln nalntalnlng the provlnce
free fron nalaria. The epldenlologlcal and entonologlcal actlvlt les of the malarla
statlon' in the Eastern provlnce .ip."t to have not been nalntalned' Thle rnay be due to
the lack of quallf ied prlfeaslonal personnel. Whlle the lncorporatlon of
sero-epldernlologtcal siudlee could t"t" "
good contrlbutlon to the epldeolologlcal
surveil lance and the study of suspected trinsulsslon focl., a slngle survey w111 add very
lltt1e to the epLdenlologicat lnfbrnatlon already avallab1e,on the Ealarla sltuatloD' It
ls therefore, reconmended to revlve the prevlousiy eetabllehed plan of thle technology ln
an approprlate reference laboratoryr for lts utl l lzatlon a8 an epldeolologlcal tool lf
requlred ln future.
the report deecrlbed the sltuatlon ln Awanlya
last focue of malarla ln the Eastern provl'nce as ltlocality, Qatlf sector whlch ltas the
had thiee lndlgenoue caeee ln 1972'
rc-d'ffi ln PART r, PP. 225-226.
vBc/90.3MAL/ 90. 3Page 194
The rev iew niss lon nenbers v ls i ted th ls local l ty which was being developed as a sroal lnodern town wlth a populatlon of 15 000 inhabltants. The town is surrounded by paln treeplantat lons. The sources of water are ar tes ian we11s f ron which the water ls punped into anet t rork of l r r lgat ion canals. Anophel ine larvae Ispecies not shown, probably s tephensl ]were recorded ln June 1986 and the canals were t reated wi th temephos. Al though the nalar iar isk appeara to be very 1ow, the presence of su i table breeding p laces together wl th theexistence of fore lgn agr lcu l tura l labourers f ron ma1ar lous countr ies, the possib i l i ty ofresumpt ion of roalar ia t ransmiss lon cannot be complete ly ru led out . I t would be advisable,in v lew of the econonic deveJ.oprnent , for the malar ia s tat lons to conslder the possib i l i tyof coordlnat lng local resources ln order to develop a comprehensive nosqui to contro l
PrograDme.
The neubers of the rev iew nlss ion a lso v is l ted the Epidenlo loglcal Serv ices Div is ionof AMMCO. Good cooperation exlsts between the dlvislon and the Malaria Control staclon inDarnnan. It was reported that no anopheline larvae or adults were observed durlng weeklychecking wlthln ARAI.{CO compound. Investlgatlons of posi.t lve malaria cases has so far beencarrled out satlsfactorl ly and ehowed that all cases proved to be lnported and are lncludedin the statlstlcs of Dannan Malarla Control statlon. ARAI'{C0 Health Dlvislon covers theenployees and thelr fanll les, a populatlon of about 195 000 representing about 202 of thetotal populatlon of the Eastern province, and the naJorlty reslde outslde ARAMCO cotopound.
The Central and North*_pglggg,: Malarla transnlssion has been lnterrupted in the twoprovlnces.
IThe Pl.lgrlunage area ln the Western province-: The pil lgrlnnage area and its route hasbeen f reed f ron malar la, and Ehe area around Jeddah hae been c leared f roro the ef f lc lentvector , arablenFls.
The Southejn proylnce.Glzan sector : Thls sector conslsts of 36 Enarahs wl th 0.5 n l l l lon lnhabl tants l lv lng in2391 local l t les. Thls reglon has the largest agr icu l tura l , area ln the country. I r r lgat lonls prov lded f ron wadls (val leys) , and ar tes lan wel ls have been lncreaslng on the coasta llowland strlp. Glzan reglon ls consldered the most rnalarious area ln the country.Inplenentatlon of nalarla control has been delayed due to cosounlcatlon dlff iculties untl l1982, when extra ef for ts were nade to establ ish e lght nalar ia contro l substat lons. TheDaln attack neasure now belng used ls larvlcldlng with Eenephoe supplenented by otherrneasures aa neceasary. The ualarla control prograrme ln Glzan has been fully inplenentedsince 1983. Table 19 shows the evolutlon of the nalaria situation in Glzan aector slnce1978. The data show a progresstve lncrease ln the number of slldes collected by PCD,lndlcatlng Lnproved collaboratlon of the infrastructure of the health eervices. It 16coneldered that the poslttvlty rates derlved fron PCD glve a better representatlon of theepldenlologlcal el.tuatlon as they reflect the overall denand for oedlcal care. The tablealeo shows that the hlgheat sl1de posltlvlty rate (SPR) nas attalned 1n 1981, when otherLndlcatorE'such ae the paraslte rate anong echool chlldren and school absenteeiso lndicatedthe exlstence of a aevere nalarl.a epldenic. It was ln that year that an extensLveconcentrated planning of a malarla control progranne was lnlt lated. Subsequently, the SPRshowed a decllnlng trend. Yet the free novernent of the populatlon along borders wlth Yenenand the lncreaee of farrnlng and agrlcultural actlvit lee constltute a constant threat.Coordlnatlon wl.th the l l lnistry of Agrlculture wll l prove effectlve for locatlng nelt farrosand welle, and for provldlng lnfornatlon on work pernlts glven to agrl.cultural labourers.This w111 aselet ln detectlng ln advance the poestble persletence of threatenlng oalariafocl and taklng the neceesary actlon for detectlon or preventlon of malarla epldenlcs. Onthe other hand, lnvest{gatlone of the routes followed by Yenenl.labourers, thel.rsettlementg and early dlagnosle and treatDent of posltlve persone, may reduce to a largeextent the danger of lnportatlon of ualarl.a fron Yemen.
It ls worth notl.ng that the nalarl.a control progranne Ln Gizan ls followlng a flexiblepLan accordlng to the epldentologlcal f lndlngs and changee Ln the oalarla sltuatlon. Theprogranme ls enJoylng the fuIl support of the Dlrectorate of l lealth Servlces in Glzan.Particlpatlon of perlpheral health eatabllshnenta, nalnly PHC centres, ln dlagnosls
I. See rnore detalls below.
v B c / 9 0 . 3MAL /90 .3Page 1 95
treatpent and repor t ing of nalar la cases ls progressing sat is factor l ly . I t was a lso noted
that the nalar la "ootro l
serv lce ln Glzan has an exper ienced core of specia l is ts ln Dalar la
and that the professional staff has acqulred the knowledge and experlence to gulde the work
on a sc ient l f lc epidenlo logical basis .
Tabte 19. Number of b lood sI ldes examlned and number of posl t ives
du r i ng f978 - f986 , GLzan sec to r '
Year PCDExan. +
Poe l t l v l t y ECSrate Exam. +
MBS Tota lExailI * Exam. +
P . f .
1978 14421979 8761980 2854t 9 8 r 1 0 1 2 41982 930871983 931871984 730561985 t23699r985 l t8 l49(Jan-June )
2779 I20517 36592 75
1 1 6 0 7 1 5 61929 l l9
64756 6326730 90
89835 1680
5560*r 3 9 33446
2t7319 5 0 1 6
t629179r956
2t3534
440r, 394*106 r02563 556
23098908 8727
10537 1025r7232 7030
12457 12313
l 7 r7 0
4882153878996566562
t0777338r
I 1 . 8 68 . 0
1 7 . l2r.39 . 4
1 0 . 49 , 08 . 72 . 9
497t2170
0
249580
Exau = ExanlMase Blood Survey
4 - posi t ive = Epldeniologlcal contact SurveYP. f . - P . f a l c l pa run *ACD ls lncLuded
l{ohsyel sector: Thls cector occurs 1n Asir regl.on and.has 11 Enarahs wlth a populatlon of
ff idd. In-this sector slx conaecutlve DDT house spraylng rounds had been appl' led uP to
the end of 1980, aud when the SPR reached 0.62, DDT was discontlnued. A serlous nalarla
epldenlc broke out ln 1982, and DDT spraylng nas rel.nstituted in one round per year ln-a
deflned area coverlng 55 OOO fntraUttants at the beglnnlng of the transnlsslon aeaaon during
1983 and 1984. Larvlctding operatlons uslng tenephos were lntroduced ln Aprll 1984 tn
aeven Lnportant valleys toi gg rounds. The avallable data show a reductlon ln SPR between
1978-1980 and f982-19b5. These perlods roughly colncide wlth the perlods of DDT spraylng.
Introductlon of Larvlcldlng has not yet shown an lmprovenent ln the ualarta sltuatlon.
Conparatlve data between the flret seneatera of 1985 and 1986 ehow an lncrease ln the SPR
trop 4. :Z to 6.32, respect lve ly . The oalar la contro l s tat ion of Mohayel at t r lbuted the
llCtle Lnproveroent on ih" malarla situatlon to the lack of manPower reaourcea and other
facll l t lee. The ento6ologlcal technlclans of Mohayel staCton are uatnly occupled ln
checklng the larvlctdtng operatlons. The ftndlnge show a reductlon ln arablensLs larval
d e u s 1 t y , b u t e u r p r i e 1 n g 1 y t h e d a t a e h o w n o r e d u c t l ' o n 1 n d - t h a 1 1 1 a r v a 1 f f i t u r sdeeerves a study stnce-ii te dlff icult to attrlbute ttre 6Tffid reductlon of arabiensis to
larvlcidlng.
Qunfudsh ltalarla Control Statlon: Ttre statlon was establlshed ln 1980. Part of lts
n e w t y e e t a b 1 1 s h e d o a 1 a r l a c o n t r o 1 8 t a ! l o n 8 a t T h r e l ' b a n ' a n dEl-Gouz ae fron 1985. Quntuaatr 6tatlon receives guldance frorn Jeddah ualaria control
atatlon. . l lowever, the number of supervlsory vlslta are qulte lfunited and are only paid ln
caae6 of recognlzed epldenlcs. Also, there ls no coordinatlon between Qunfudah roalaria
6tatlon and the nelghlourlng hospltal. The nain functlons of the statlon are larviciding
operatlone, nlcroscopical diagnosls of nalarla caaes and case lnvestlgatlolne. The last
actlvlty le carrled o.tt ." a ioutlne work every two weeks by ft l l lng ln a queetlonnalre for
each caie, collectlng blood slldes fron gollaterals and spraylng wlth vehLcle mounted ULV
equi.pnent when the h6usee of the positlve casea could be reached. l lalaria dlagnosls and
treat6ent are carried out by the PHC centres and the central hospital. The PIIC centres
collect blood slldes froro slspected nalaria cases and send thern to the nalarla statlon for
mleroecoplcal dlagnosis. The hospltal has a microscoplst and carrles out the dlagnosle and
treatroent of nalarla caaes wlthout even lnforning the nalaria statlon of the nunber of
s l ides col lected nor the posl t lves. DDT houee spraylng nae star ted ln 1981 wl th two
rounde. In 1982-1984 only one annual round was applled. Since 1984' DDT spraylng wae
dtscontlnued and larvlcidlng operatlons were lnlt lated. As explained by the chlef of the
v B c / 9 0 . 3MAL /90 .3Page 196
malar la s tat ion, the number of labourers ls only suf f ic ient Eo carry out larv ic ld lng
operat lons wl th reasonable coverage ln the dry season, but ln the ra lny t ransmiss lon season
and when the nunber of nalar ia cases r lses, the avai lable manPower of the stat ion cannot
cope wi th the increased nunber of breedlng p laces. MaLar ia epidenlcs were observed ln la te
1985 and 1986 in val leys in Qunfudah sector ; the SPR rose f ron 1.67" I r r 1985 to 10.72 dur ing
the per iod January-June 1986.
Of the conclus ions and recogmendat ions of the Joint Revlew Miss lon, reference is nade
t o :
The nalar ia s i tuat lon in the Kingdon
(a) Areas basical ly nalar ia- f ree: Thi6 inc ludes the whole Eastern ' Northern and
Centra l prov inces. Soclo-economlc developnent associated wl th ecologlcal changest
developnent of heal th serv ices, conbined wl th ef fect ive nalar la contro l measures have
considerably reduced the r lsk of malar la t ransmlseion. The exper ience of the last 10-15
years appears to conf i rn the stabl l i ty of th is s i tuat ion.
(b) Areas with lnportant malarla rlsk and lnadequate control: Thls lncludes the
southern part of the tfestern province (Qunfudah and Al-L1th sectors) and Parts of the
Southern province (Asi r sector) . I la lar ia shows low endeulc l ty wi th f requent epidenic
o u t b r e a k s . P . f a 1 c i p a r u a i s p r e d o m 1 n a n t a n d t h e r n a 1 n v e c t o r 1 " @ o c c u r r i n g a t t h ee c o 1 o g i c a 1 f m d 1 s t r 1 b u t 1 o n . M a 1 a r 1 a c o n t r o l h a s b e e n 1 n p 1 e n e n t e d f o r 1 0 y e a r swlth varled coverage of attack rneaeures.
(c) Areas wl th inpor tanf malar la r lsk and recent ly successfu l contro l : Thls ls
represented by Gizan sector of the Southern provlnce. Malar la though baeical ly hypo- to
nesoendenic, has a htgher level of endenicity than the eurroundlng arear and epldenlc
outbreaks have been more severe and extensive, wlth paraslte rates reachlng near 502.
L. falciparun ls highly predornlnant (9OZ) and g?Ilelrsls ls the roaln vector' whlch aPPears
6Te ffiT;aapred io ttr! tocal ecology. af tei:dlFE!!6Tntlng control measures that started
ln the ntd 1970's, an ln tenslve ln tegrated contro l caropalgn ln 1983-1984' brought about a
gustalned decllne in ualarioroetric lndices to a level never recorded before.
Several recomnendations were made for nalarla strategy ln Glzan sectorr the northern
part of the Southern provlnce and the eouthern Part of the lfestern provlnce.
Heal th systeD LnfrasEructure
(a) Process of development: The rapid developnent of the health eystem lnfraetructure
is noticeable, particularly !n the peripheral servlces (PHC centres) whlch have
progressively lncreaeed by 132 per year ln the last four years. As ln the Past, these
"et.rt""" has a predoninantly curatlve and general oedical- orlentatlon wlth weak
epldenlological services, eicept for a few speciflc dlsease control PrograDmes, and no-
connunlty based perlpheral ""r.rlc"".
They have also been excesslvely dependent on hLgh
econornLc lncentives ittractlve to forelgn professionals. It ls very encouraging to note
the new orlentation towards developlng the preventlve copPonent of PIIC'
(b) partlcipatlon ln nalarla control: The general health eervlces perforrn the
functl.ons of dlagnosls and treatroent of nalarLa casea. Most hospltals (Partlcularly ln
Ealarious areas) and sone PllC centres have capabll lt les for olcroscoplc dlagnosls of -nalarla. AII others collect blood glides fron suspected oalarla cases and send then for
dlagnosie at the nalarla 8tatlon8. A systel! of nonltorlng drug eensitlvlty of
P. falclparun ls belng organized. All PHC centrea and hoepltals ln Gizan provlde
lnformatlon on cllnlcitty-atagnosed caaea, and those mlcroscoplcally conflrned' Some
hospltals outslde Glzan do not provlde lnfornatlon on malarla cases to the nalarla
stallons. No infornation is generally provlded on cllnlcal forus of nalaria, severe cases
or even deaths.
Screenlns of fore ign labourers
It appears that this screenLng ls only done at the flrst arrlval of the labourers as a
condltlon for lssulng a work pemoli. The rlsk of lnported nalaria froro hlghly endenic
v B c / 9 0 . 3MAL /90 .3Page 197
countr les is equal ly ser ious on every re-entry and l lkewise for other faol ly neobers who,
are a l lowed to v is l t the l r countr les of or ig ln. As th ls procedure nay be too conplex and
the general epldenlo loglcal data do not show that lnpor ted nalar la f ron fore lgn countr les
"orr"i it,rt"s a hlgher risk than that of the Saudl natlonals travell lng withln the countryt
l t ls suggested ihat th" resources present ly ut l l lzed for ecreening of fore lgn labourers be
ut l l lzed for s t rengthening of d iagnosls and t reatment fac l l l t les. I t was observed that
Fansldar tablets a ie used- ln hospl ta ls and are aval lable on the local narket ' The Mln is t ry
of Heal th rnay wLsh to contro l the inpor tat ion and restr lc t the ut l l lzat lon of Fansldar to
cases that are not resPonding to chloroqulne. As Fansldar can produce ser ious s lde
ef fecte, l t ehould not be used as a f i rs t l lne t reatDent .
Malar la dur lnE the Haj season
It is understood that t.he l loly areas are free fron nalaria transnlselon. This status
ehould be nalntalned by further gtrengthenlng of the nalarla statlong in the l ioly places'
Treatmen! of nalarla, ihe slgns and synptorns of severe malarla, together wlth the treatBent
of severe malarla "."."
shouid be known to cllnlclans and other rnedlcal offlcers attendlng
patlents durlng Ehe HaJ aeason. Thls could best be done through a clear chart to be
dlstrlbuted to all phyilclans involved ln the treatoent of pllgrins'
The report of the l ialaria Control Service of Saudl Arabla (1984) gave sone detalls on
the nalarla Bltuatlon ln the l1estern provlnce. i lalarla transnlselon hae been lnterrupted
ln the coastal area lncludlng the tslantc l loly placee ln thls provlnce, where DDT spraylng
was d lscont tnued in 198I . However, a nunber of res ldual nalar la foc l s t l l l pers ls ts ln
rex0ote valleys of the HlJaz mountain range where sergenll l showed refractory resPonse to
DDT house spraylng. Slni,e 1982, weekly i.arvtclafiE'ffiTenephos in these focl has been
applled auring- the transnLselon eeasorr. The effect of thls Deaaure seeEs to be much roore
p.onounc"d than DDT house spraylng ln thls ?9tj9"tl l ares' An' ara-bleEql?: t l:^it:: -,^
ef f lc lent vector was complete ly absent ln 1984 1n the area l t prev lously occuPred ln Ene
foothil ls of the HlJaz Eountalns near the ltoly clty of Makkah.
In the unpubllshed docuroent of Farid (1987), the country nalarla profl le of Saudl
Arabla was aa follows:
- Populat ion: l2 n l l l lon Populatlon at rlsk: about 3 rnil l lon
1984 1985 198636T-59'8 4482 fiTTs4l l 091 16 242 12 975I 576 5 000 5 000
No. s l ldes examined:No . pos l t i ve e l l des :No. P. fa lc lDaruo cases:
- P. falclDanrn reslstance to chloroqulne: Many tests+- tE-to'ffialarla accordlng to vectorlal inPortance
res ls tance to lnsect lc ldes:An. arabiensls and An. sergentll: Southwest
ffi- ;.rsffiifana +iT.'@s :'r-crih';es tAn.-steptrensl : DDT/dle ldr ln : East
- l ialn vector control Eeaauress Tenephos larvicldlng, DDT houee spraying and ULV
appl lcat ion- Case detectlon: PCD and follow-up roass surveys- Development of PttC at perlpheral level: Well establlshed- Developroent of PtlC at referral level: Well establlshed- M a l a r t a c o n t r o l P r o g r a E m e : l s a v e r t i c a l d e c e n t r a l l z e d o n e .- Malaria trainlng
""it.."r one tralnlng centre exlsts ln Glzan
- Tralned manPolter: Avallable ln suffl 'clent numbera- Speclal p.oll"r": Inported nalarla frou abroad and froo wlthln the country'
Fron lnformatlon conmunlcated to mIO/EMRO, data on the status of antiEalarla
actrvit i ls in Saudl Arabia ln 1988 show the folJ.owlng (populatlon: mid-year e6tft0ate ln
1000s ) r
per forned, a l l . suscePttb le '- wlth lnfornatlon on vector
vBc /90 .3l,rAL/ 90 . 3Page 1 98
- Tota l populat lon: 12 600- Populat ion of or ig inal ly nalar lous areas z 4 200- Populat lon of areas c la lned to be f reed f roo malar ia: I 700- Populat lon protected by extenslve house spraying coverage: 266- Populat lon protected by other ant i -vector Deasures: 4000 ( larv ic id ing and ULV)- Populat ion under survei l lance: 500- No. lnpor ted cases: 665 f ron abroad and f ron wl th in the country
As summazrized in the report of the l l1d hlth sta!!9g:-gggrt._ concerning the oalarias 1 t u a t 1 o n 1 n 1 9 8 8 ( w H o ' l 9 9 0 ) , t h e n a 1 a r 1 f f i b i a i n l 9 8 8 i n p r o v e dconslderably as the nutnber of cases detected was l0 000 conpared wi th f8 000 in 1987. Thernost af fected areas, the footh l l ls and the lowlands of T ihana reglon (Southern province) ,
recorded a reduct lon f rom 1l 000 cases ln 1987 to 4 000 in 1988.
I . ! @ ( f o r r o e r 1 y Y e r n e n } e p u b 1 1 c ) , t h e a v a i 1 a b 1 e 1 n f o r n a t 1 o n o n t h e o a 1 a r i asltuatlon has beenTurunarlzed in PART I'. Newer lnfornatlon Is thus glven here. Delfint(19S6 - unpubllshed report to WHO) visited Yemen frorn 14 Septeober to 5 Novernber 1985 toassis t tn p lannlng the in tegrat lon of nalar ia act lv l t les ln to the PI IC systemr and to assessthe nalarla sLtuatl.on and lts control prograune.
(1) In tegrat lon of malar la act lv i t ies ln to the PI IC systern: By Min is ter ia l decreeNo. 713 oF-B' lugusr 19-85; i i na6 deCiaea that all naJor endenic dlseases prevall lng ln thecountry (nalar la , schls tosomiasls and tuberculos ls) are to be ln tegrated in to the PHCsy6ten. Thls partlcular organizatlonal set-up and the present developnent of the NatlonalMalar la Serv ice (NMS) favours a t imely ln tegrat lon of nalar la act lv i t les ln to thedeveloping PHC systen. The NMS, as l t s tands, has no ver t lca l per lpheral s t ructure.Techi lca l co!0petence, wi th re lated adroin ls t rat lve and logis t lc support , is concentrated lnthe headquarters ln l todeida and, on a reduced scale, at the malar la regional of f lce lnTalz. Two aspects of . i .n tegrat lon need to be consldered:
Mnin is t rat lve ln tegraEion: To at ta in th ls aspect , the present schene of heal th serv lcespersonnel needs to be revised so that personnel working ln vertical progrannes and generalheal th serv lces would fa l1 ln to wel l def lned categor ies comon to a l l . Thus, personnelworking at present ln the nalarla service would have career prospects sirollar to those ofany other heal th s taf f o f the heal th serv ices. Thls LB to nater la l lze accordlng to a vte1ldef ined p lan for etaf f t ra in lng and developnent . .
Funct lonal ln tegrat lon: Two step6 were def lned as fo l lows:Step I: The present penuanent staff of the NMS ls to become wlthln the organizatlonal
structure of the PIIC systen. Thus, the Dlrector and Deputy Dlrector of the NMS and theirlnternatlonal counterparts w111 be members of a technlcal advisory body on Dalarla ln thecountry. Thls oalarla ltadvisory bodyrr w111 be responslble for:
- gather lng epidenlo loglcal ln fornat lon on nalar ta (e.g. , analys ls of records andreports, organlzatlon of oalarlometrlc and entonological eurveys);
- preparing ln collaboratlon wlth the reeponslble PHC senlor offlcers plans forthe control of nalarla ln dlfferent eco-epldenlologlcal sltuatlons, tncludlng preventLon offlare-ups and the appllcatLon of renedlal oeasures 1n energency sltuatlons;
- advlelng and provldlng technlcal supervl.slon on antloalaria activlt les to belmplemented through the PHC systen and communlty lnvolvenent (e.9., caae detectlon andtreatDent, aource reductlon);
- organizlng hlghly speclalized antlnalarla actlvlt ies which would be beyond thetechnlcal conpetence and pract ica l real lzat lon of ex ls t ing PHC structures (e.9. ' epecl f icneaaurea against adult vector populattons);
- evaluatlng acttvlt les luplenented;- organlzl.ng tralnlng on nalarla;- carrylng out f leld reeearch;- preparlng annual rePorts.
i @ D . a u D e n t v B c / 8 5 . 3 - u A P / 8 5 . 3 ' s E c T I o N I I I ( F ) S o u t h w e s t e r n A r a b 1 a , p p . 2 3 4 - 2 3 6 .
vBc /90 . 3l , rALl90.3Page 1 99
Step 2: (inrnedlate) The raalarla personnel wll l contlnue to provlde tralning to PllC
staff, attd a tralnlng scheme of PIIC workers and supervlsors ae lrell as laboratory
technlc lans ln heal th centres and hospl ta ls was out l ined. Fur ther , 6teP 2 lnc ludes.
organlzing a study area where an integrated approach w111 constltute a feedback nechanlsm
for act lv l t ies per forrned by PI IC and conmuni ty par t lc ipat lon in ant lnalar ia act iv i t ieo ' In
consultatlon wltb the senlbr health authorlt lee, an area covered by ZaLdLya health centre
of about 1000 knz (60 kn north of l{odelda) with a populatton of 14 726 and an average
populat lon of 2103 per PHC unl . t was selected (7 eate l l l te PHC unl ts) ' Malar iometr lc
iongftutl lnal surveyl ln the area lndicated a hypoendenlc malarla sltuatlon, wlth a
po"ftUtttty of eplienlcs. The nalaria prevalence ratea of about 67 vas recorded In
,"p" . t "d observat lons f ron January 1985. The fo l lowing act lv l t ies were suggested to be
undertaken ln the studY area:- The 7 pIlC workers and the laboratory technl.cian of Zaldlya health centre will
recelve tralnlng (by the NMS) reepectlvely in caee detectlon and rnalaria mlcroscopy as well
ae general lnfornatlon on oalarla and lts control '- The other responeibll l t lee of the NMS include: aasesaDent of the roalaria situatLon
ln the etudy ..""; pio.rlelon of supplles for blood taklng and antlnalarlal drugs to PIIC
workere; technical aeelstance, eupeivlelon and evaluatlon of antlnalarla actlvlt ies ln the
area; provlelon of technlcai. and operatlonal support to PIiC norkera through the PIIC
tratneis/supervleors; and ln-servlce tralnlng of the PIIC tralners/supervlaora. The
antlmalar{a actlvlt lea to be carrled out through the PIIC systen and coEEunity lnvolvenent
were deflned as followe:- caae detectl.on, dlagnoeis (laboratory) and treatnent;- reductl.on of uan-vector contact through aource reduction ln whlch connunlty ls
to be involved. The poeslbtuty of alternatlve nethode of antl larval control I 'n peroanent
water bodlee that are not anenable to nechanlcal ellnlnatl.on or drainage, should be
explored.
Step 3 (eud of 1986): An evaluatl.on of achlevements and a cost-effectlveneas "o"ly"t"
of neasuies applled ln the etudy area ehould be carrled out at the end of 1986. The
poeltlve elenente of the study Uft U" lntegrated lnto the PIIC systeo ln other Parts of the
country.
Step 4 (as eoon ae practl.cable): A1l nalarla pereonnel should be orlented, through
approprlate tral.nlng progrannrea, to the atrategles, obJectlves and lntegrated health care
dellvery Dechanisms of the PIIC Eysten.
(11) Aeeessuent of the malarla eltuatlon: Paraeltologlcal and entomologieal data by the Nl{S- - . !
f r o n 1 9 8 3 t o r 9 a s @ p 1 d e n 1 o 1 o g l c a 1 l n f o r m a t 1 o n e x 1 s t l ' n g p r 1 o r t o 1 9 8 3wae revlened whenever 1t could be conel.dered reliable. Although the nalarla Project lDyeoen was eetabllehed ln 1978, lt wae only fron 1983 onwards that rellable parasltologlcal
data could be obtalned through proper retralnlng of the aalarla mlcro6coplsts. The country
ts dlvlded lnto four epldenlologlcal reglons
(a) The coastal platns (alao known as the Tlhana plaln or reglon) which extends fron
Bea level to 200 E altltude
(b) The foothll le and uiddle hetghte whlch extend frou 200 n to 2000 n altltude'
(c) Ttre central hlghland plateau whlch extende fron 2000n and above.
(d) The arld slopes whlch are an extenslon of the Arablan desert.
The followlng lnforrnatlon waa provlded for each reglon:
.(a) The coaetal plalne (Tlhaua plalns): Examinatlon of the avallable paraeltologlcal
data shotred thst the eaople alze wae often lnadequate. Aleo lnfornatlon waa lncoEPlete or
lack lng ae lu the caee of oeteorological condi t lons, Parasl te denel t les ' -P: fa lc lparun.
gametocyte ra!e, and age-groups of pereons exanlned. In vLew of these llnltatloner only a
iew facte could be eubstantlated whlle certaln assuoPtlona nere made which w111 need
ver l f icat lon.
v B c / 9 0 . 3MAL /90 .3Page 200
The fac t s a re :- t ra lar ia occurs at low endenlc i ty ln the coasta l . p la ins;- P. fa lc iparun ls the predonlnant specles, fo l lowed by P. v lvax and P. nalarlae-;- no ca6es of P. ovale have ever been encountered;- arabieners i.ff ie-pedomlnant anophellne specles collected by PSC and rnan-bait
capturel-F6Gds prinarily ln surface naters exlstlng In the beds of wadls, whichconst l tu te i ts largest breedlng habi tats . Besldes, l t breeds in l r r lgat lon canals andwaste water near wel ls . The lat ter const i tu tes the nain breedlng p lace where Ehe l ta tersur face in the wadls dr les up. I t b l tes both lndoors and ouEdoors f rom sunset to sunr lse;the peak b i t ing per iod being f roro 2200 to 0100 h. I t re6Es lndoors af ter tak lng abloodneal, both ln hunan and anirnal shelters, the latter being rare ln the coastal plalns.
The assunpt ions are:
- The dynanics of nalarta transmlssion in the coastal plalns lndlcate a sltuation of aprevalence of hyperendenlc, unstable and focal disease. The cooler months (Novenber toFebruary) are generally those during whlch relatlvely hlgher paraslte rates and densltlesof arablensis preval l . But , due to the focal l ty of the d lsease, c losely re lated to theavalla611lty of breedlng oources aE a given tlne and place, trend inconslstencies are boundto occur .
- No regular cllnatologlcal observatlons -have been collected ln the area. Soueanonymous reports lndicate that August and Septerober are the ralny nonths wlth an^averageannual ralnfaLl of 70 nm og less. The mean annual tenperature waa given as 30-32'C.Teuperaturee between 4O-45oC have been recorded durlng the hottest nonths (July-August).The average relatlve hunldity was glven aa 907 throughout the year.
- Surface naters as the naln arablensis breedlng places ln the wadls depend oore ont h e w a t e r f 1 o w 1 n g f r o n t h e r n o u n t a l @ h a n o n t h e 8 c a n t y r a l ' n e 1 n t h e c o a s t a 1 p l a l n s .Thls nay account for some of the varylng trends.
- The generally lower lndlces (parasltologi.cal and entomologlcal) observed durlng thehottest Eonths nay be explalned as betng due to a reduced vector activlty durlng hostl lecllnatological conditions as well as to a general reduction ln breeding places (when nostof the wadls dry up) .
- There seens to have been a decreaslng trend ln transolselon durlng the last fewyeare due to dr ler condi t lons ln the area.
- Passive caee detectlon ln urban areae of the Tlhana plalns (Hodelda) sholts fewerposltl.ve cases than ln rural ar€aao
- arablensl.s is assumed to be the vector ln vLew of lts closeet assoclatLon wlth uantn relaiTiEiffrflher denelties than any other anophellne epecies, and by analogy wlth a
slnllar siguation ln other countrles where arabiensls ls the proven vector. The onlyeporozoite-posltive speclnen was found Uy CIi6lEEI6i (guoted by Mount' 1953) ln the nlddle
heights region (Talz area).
Obvlously, much remaLns to be done to clarlfy the dynanlcs of nalarla transmlssLon in
the coasta l p la ln, for whlch Del f tn l ( loc.c l t . ) put forward the fo l lowlng baslc
requirenents:
- co l lect ion of re l lab le c l loato loglcal data;- hydrographical studLee of the area to deflne- the role of perLdomestlc breeding places lnwadls dry up;- collectlon of representatlve and elgnlflcantsanples;
annual varlable Patterne;nalaria transmieston, PartLcularly when
entornological and parasltological
- deta l led analysLe of data (e.9. , parasl te densl t les, vector Paroua ratea- malntalnlng contlnulty ln data collectlon.
e t c . ) ;
vBc/ 90 . 3MAL/90. 3Page 201
Lt ls acknowledged that, wlth the preaent facll l t les avallable to the NMS, not al-l the
necessary studies nentloned above can be undertaken. Therefore, prlorl ' t les w111 have to be
e stabl lshed.
(b) The foothll ls and rnlddle helghts reglon: Observatlons ln thls reglon started only
in 1985 and conelsted eole ly of longl tudlnal parasl to loglcal aurveys carr led out in three
lndicator v l l lages. The or lg inal target of 1000 b lood s l ides Per nonth per lnd lcator
dietrlct could not be adhered to. The only other actlvlty so far undertaken has been PCD.
pre-exls t ing ln fornat lon (Mount , 1953; Thur iaux, 1971 and KouzneEeov, 1976) lndlcates
that rnalaria ls oesoenderalc !n the foothll ls and ulddle helghte, wlth arablensLs as the
principal vectcr "nd .g35gggg!!, 931!, pharoeneiq and fluYtatl l le as Potential eecondary
vectorl. Both presenffi?5?erGffi iE an<i pr-Exlstlng-nfornatl.on are lneufficlent to
draw any concluslons on the characterletlcs of nalarla and lts transmisslon ln thls
reglon. However, there are aome lndlcatlons whlch muet be verlf ied: that the level of
transmlsslon in thle region ls somewhat hlgher than ln the coa8tal plaine; transroisslon nay
be perennial rrlth a hlgher level durlng the warner nonths (June to Septenber); andp_. ialclparun ie the only parasl.te apecles that has so far been ldentlf led by NMS.
(c) The central hlghland plateaux: Only one paraeltological survey was carrled out ln
March 1983 in the vtl lage of Amran. A11 slldee examlned ttere negatlve. Pre-exietlng
lnforroatlon showed.""oid" of two nalaria epl.denics, one ln 1946 and the other ln 1967'
An. eereentil. An. turkhudl and An. clnereus were recorded ln 1953-1954. Wlth th18
Erag6j-nts.ry lnfffiffi;-; conciffi-iFaeeumptlona can be nade on the Dalarla
sltuatlon ln thle reglon.
(d) The arld slopes: only one parael.tologlcal/entouologlcal eurvey wae carrled out by
the NUS ln October tgb5 fn thte reglon (Mareb area). A11 elldes exanlned (1145) were
negatlve and no anophellne noequltoe nere captured ln etther larval or adult surveya (only
cullclnes were coll icted). Pre-extatlng lnforuatlon lndlcated thst nalarla was hypoendenlc
wlth arablenele ard reg1l belng euepected vectora (Ahnad, f962). The eltuation remalns
to be etudled conpletely.
( r r r ) @ : T h e a n t l D a 1 a r 1 a a c t 1 v 1 t 1 e e c a r r t e d o u t b y t h e N l { Se 1 n c e t t s e m b e e n d 1 r e c t e d t o g a r d s t h e d e v e l o p n e n t o f p a s s 1 v e c a a edetectlon oechauleme and llnlted control raaures ae of 1981 onwardE'
(a) Caee detectlon and treatnent: The ualarla proJect hae alred at developlng a
network of ttnalarla detectlon postsrr by tralnlng and eecurlng the cooPeratlon of laboratory
technlclang posted tn varloue health lnscltutlons. Up to the end of 1985 aeven such poete
have been eetabllshed ln the Tlharna plalne, lncludlng two hospltale and the nalarla
headquarters. In the foothll le ana Uaate helghts (Talz area), three euch poete have been
op"r.t lng, tnclgdlng the Talz nalarla reglonal offlce. Data of paesive caee detectton tn
the Tthana plalire and the TaLz atea ehowed that laboratory-coofiroed nalarl'a poeltlve caaeg
appeared to be low and decreaelng frou 1983 to 1984, reflectlng the general trende of
peraslte ratea recorded fron fleld aurveya ln the coastal plalna. Populatlon coverage by
thlg actlvlty reDalne l lolted to areaa around the detectlon poste; nany rnore such
facll lt iee are needed ln the coultry. AtteDPtB to lDtegrate PCD actlvlt lee ln the
developlng PHC systen have ao far oet wlth l l4lted succeee. However, wlth the new
governDent pollcy that nalarla and other vertlcal PrograDDes nu9t,b: lntegrated nlth the
pBC systen, atep6 have already been taken towards thle end. A11 laboratory-conflroed
nalarla cssea reported to the detectlon postB recelve radlcal treatDent. Chloroqulne and
prioaqulne, at atandard doeages recomrendett by IfHO, are belng utl l lzed' The tendency of
sorne physlclans to prescrlbe Fansldar, wlthout Juetif lcatlon, should be dlscouraged'
(b) Vector contro l operat lons:,
- DqT houee spraylng: DDT spraylng applled at a dosage of 2gla' has been the uain
vector control Eesaure elnce l98l tn eore clrcunecrlbed areaa of the coagtal plaln' In
Iggl, IggZ and I9E3 epraylng was carrled out 1n Naheya (- local-lty) el Zuhra aod part of
vBc/90. 3MAL/90. 3Page 202
Naheya Luhaye cover lng 43 4f3,52 829 and 56 016 populat ions dur lng the three years,
resplct ive ly . In 1984, DDT spraylng was wl thdrawn f ron Ehe area and replaced by ant l larval
r".iur"" which only now are belng regularly applled after a long delay due to
adroLnist rat lve reaions. In 1984, f ive new Naheyas \ tere sprayed dur lng October-Novenber in
Abs and a long the wadis of A1-Tor, Surdud, Sihan and Zabeedr Protec l ing a populat lon of
78 8 l f . Dur lng Septerober-October 1985, a second round of DDT spraying was appl ied in the
sane areas and ln lone nelghbour lng v i l lages, protect lng a tota l populat ion of 89 451'
Spraylng operat lons p lanned in 1985 for l larad Naheya, border ing Saudi Arabla, to protect 19
260 lnhabl tants, "on1d
not be carr led out due to lack of funds. For a l l o ther areas '
spraying operat lons 1n 1985, for the f l rs t t ine, could be corupleted as p lanned; the
spraylng coverage reached 95.2-98.77". An. arablensls remalned susceptible to DDT. Fron
che avaLlable data, it appears that DOT hadJn general, an innedlate lnpact on g!4b1gne+
populat ions, and consequent ly on nalar la t ransolss lon. I lowever, s ln l lar t rends were found
to occur at t lnes tn the same period, in unsprayed areas. It should be borne ln nlnd that
the sprayed areas are snal l and, therefore, epldenio logtcal ly in f luenced by the unsprayed
surroundlngs. More coroplete and contlnuous epldeniologlcal observations are needed ln
order to elucldate better the lopact of epraylng on nalari.a transnisslon- Studies on the
v e c t o r 1 a 1 c a p a c 1 t y " f @ 1 n s p r a y e d a n d u n s p r a y e d a r e a s c o u 1 d h e l p t o w a r d s t h i send.
- Larvlcidlng: Tenephos 500 EC was lntroduced ln February 1985 in Yenen for the flrst
t lme ln Wadl Mor, Naheya Al-Zu$ra (prevlously under DDT spraylng). The larvlcide was
applled at a do6age of 10 mg/a' at weekly intervals fron the fourth week of February up
to the end of Uarctr 1985, coverlng a surface area of 42 000 n' and protecting about 5000
people. Ternephos larviclding was resuned on 28 October 1985 and contlnued to the end of
iLritr 1986, covering the most favourable perlod for roalarla transnlssion. There have been
no observatlons to as6ess the Lnpact of thle toeasure on the lntenslty of nalarla
transmisslon Ln the area protected. Treated waters renalned free of anophellne larvae.
- Coomunlty partlclpatlon: It was observed that ln a few vll lages, followlng the
advice of nalarl.a-personnel, conmunltles partlclPated ln source reductlon actlvtt les such
as dralnage, f l l l lng ln and oll lng of breedtng places. Coumunlty particlPatlon ln
antLrnalarla activlt ies wl11 be enhanced Ln the near future through the actlve involvenent
of PHC workers throughout the country.
- Aphanlus dlsoa,r larvivorous flsh: !94o1fng the collectlon of sPecimens of thls fish
froo l ladl Mor at -U'fiEa
Al-Zuhra, the utl ltz'atlon of biologlcal control with the
larvLvorous flsh ls under study.
(c) Tra intng
Slnce the incept lon of the roalar ia proJect i .n 1978, 59 heal th personnel of d l f ferent
categor les (aesls tant entonologlata, entomologlcal technlc lane, sanl tary inepectors,
ntcroecoplets and lnsect collectors) have been tral.ned wlth a vlew to retalning them in
the nalarla servlce. The turnover of thls personnel has been very hlgh and only a few
technlcal staff are Btl l. l servlng ln the malarla servlce. No entonologlcal technlcal staff
has renained; and thts constltutes a uaJor handl.cap ln the development of technical
self-rellance by the ualarla proJect. It is hoped that the expected changes wlthln the
scheoe of servlcee following the lntegratlon proceas may render health Preventlve work more
attractlve and tralned persinnel nay itrereby be retalned and utl l lzed for the job for which
tralnl.ng has been provlded.
(d) Research
Llnlted Danpowdr reaourcea have unfavourably l lnited the research activit ies.
Attenpte, however, have been made to study:
- dlfferences tn rnalarla endenLcity and relative vector populatlon densltles tn
conmunltles l lvlng close to the uountaln ranges, nldway between then and the eea, and at
the distal ends of wadLs flowing toltards the sea;
- d l f ferences in nalar ia endenic i ty and re lat lve vector populat ion densl ty
coromunltles close to and away fron the wadl'
Data so far co l lected have not 1ed to conclus ions and i t ls p lanned to
s t udy .
To conclude, Del f ln i out l lned the fo l lowlng:
(a) Strategy for oalar la contro l in Ye
T h e s t r a t e g y f o r o a l a r l a c o n t r o l i n Y e r n e n h a s t o b e b a s e d o n
- u t l l l z a t l o n o f l l n l t e d r e a o u r c e a t o a t t a l n b e s t r e t u r n s l- varylng epldernlologtcal sltuatlons and apparently wldeepread focallty of the
dLaeaee;- lntegration proceee of vertlcal prograrnrnee lnto the PIIC eystem'
The general prlnciples to be followed are:
- deflne the dynanlco of nalarla tranemleslon ln
whlch the country la divlded (see above);- determlne areaa where oalarla le hlgheet;- eelect prlorlty oPerational areag that can be
that exlst or can be nobll lzed for thte purpose;- carry out contro l .operat lons ln the fo l lowlng
(a) l leasures against the vector :
- ellolnatlon of perldoneetic breedlng places by the
the lnvolvenent of PHC workers;. u t l l l z a t l o n o f l a r v l v o r o u e f l e h l n p e r m a n e n t t ' a t e r- larvlcldlng wlth tenephos (eueceptlblltty tests on
perforrned) along wadls and other rtater collectlons where other- residual houee epraylng (DDT to be lneectlclde of
renaln suecept lb le to l t ) .
v B c / 9 0 . 3MAL /90 .3Page 203
beEween
cont inue the
the four epldenlologlcal strata lnto
real le t tca l ly covered by fact l i t les
order of Pr lor l tY
coununlty nobll lzed through
col lect lone;target anophellnes to beneasures cannot be aPPlled;
cholce lf target anoPhellnes
(b) l leasuree agalnst the parasl te:
- case flndlng and treatDent through the partlclPatlon of health facll l t lee ln
the operatlonal area' lncludlng PHC workersl- chloroquLne and prlnaquine to be the drugs of choicel- n o n 1 t o i t " g L - @ ' s e n s i ' t 1 v 1 t y t o c h 1 o r o q u 1 n e t o b e r o u t 1 n e 1 y c a r r 1 e d
ou t ;- laboratorl.es 1n health centrea ln the oPeratlonal area w111 examlne blood
elldes collected by PHC workere or take! fron patients rePortlng to the centree; forwardlng
of slidee to the raboratories and feed back procedures to be organlzed through conmunlty
support end PartlclPatlon.
Each-year, or whenever feaslbler a new oPeratlonal area can be eelected and added to
the prevlous one. Operatl.ona! areae w111 be under the dlrect supervlelon and technical
gutdance of oalarla epeciallzed personnel, partlcularly ln relatlon to planning and
lnpleoenting conplex atrtt-vector Deaaure8, epldenlological studlee and fleld research' In
the rest of the country, etopl-e dctl'vttlee for larval control and case detectlon and
treatment ehould be entrusted to the PHC Bysten and the comunltles concerned wlth
technlcal guldanee provlded by the nalarla epeclallste ln the country'
vBc/ 90 . 3I,rAL/ 90 . 3Page 2O4
In the unpubllshed docuroent of
- Popu la t i on : 10 .3 n i l l i on
- No. s l ides exarolned:- No . pos l t i ve s l i des :- No. P. fa lc i_Perge cases:
- - -- P . f a l c iPa rum res l sEance to- Vei iors of nalar la accordlng
resis tance to insect lc ides
Far ld (1987) the country nalar ia prof l le of Yemen was;
Populat ion at r18k: about 6 ro i l l lon1984 l 98 I 1986
3 1 9 1 7 4 3 9 6 5 5 5 9 8 rL 2 6 2 I 1 7 8 I 8 6 2I 153 I 145 I 846
chloroquine: Suspected but not checkedto vectorial funportance - slth lnformation on vector
An. arabiensls [recognized Al. f1yl19Ei11s l[suslectedan. sers6F *'ectoi"l F.-F" , _ |
vectors)An. cul ic l fac les adenensls I
- I ' 1 a i n v e c t o r c o n t r o 1 n e a 6 u r e s : o o t n o @ 1 a r v 1 c i d 1 n g .- Caee detect ion: 0n1y PCD aval lable ln h lghly roalar ious areaa.- Developrnent of PHC at perlpheral level: poor- Developnent of PHC at referral level: poor- l lalarla control progranme: is a vertlcal one, developlng and coverlng nalnly hlghly
endeolc areaa ln the Tiharna. I ln tegrat lon wi th PHC foreseen] .- Malarla tralnlng centres: Not available- Tralned Danponer: Not sufflclent and key personnel are lacklng.- Special problens: Llnited reaources and nanpower'
Fron lnformatlon comnunlcated to WHO/EMRO, data on the status of the antimalarla
act lv i t ies in yemen ln 1988 show the fo l lowlng (populat lon;n ld-year est lmate ln 1000s) :
- Tota l populat lon: l l0 I35- Populat lon of or lg lnal ly nalar ious areas: 4 588- Populatlon of areaa clained to be freed from malarla: -
- Populat lon Protected by extenslve house spraying coverage: 313- populat ion protected by other ant l -vector neasurea: 105 ( larvtc ld lng) .- PopuJ.atlon under surveil lance: -
As surnroarlzed ln the report of the Wld hlth statls. quar. concernLng the world malaria
s i t u a t l o n 1 n 1 9 8 8 ( w I t o ' 1 9 9 o J , t n " n u n b e f f i a c a a e s r e p o r t e d 1 n N o r t h e r nyemen through the malarla control programme dld not change nuch I 'n 1987 and 1988 (2600
cases), although the percentage of po;it ives among the blood slldes exanlned lncreaaed from
4.37 ln 1987 to 6.22 in 1988. However, incooplete stat ls t lcs f ron hospl ta le and heal th
centre6, not includlng prlvate laboratorles and cllnice, show 40 000 cases (lncludlng
c1ln lca l cases) recorded ln 1988.
In Southern yenen (fornerly Dernocratic Yeroen), the avll lable lnfornatlon on the
nalarla sltuatton-G!-Eo l9g3 has been dealt wlth in PART rr. rn an unpubllshed worklng
paper to lnlo, Afrfdi (1984) revlewed the nalarla eltuatlon and lts control ln Southern
yemen. Although the nalaria servlce renalned a6 a vertlcal progranne wlthin the general
heal th serv lces, i t was operat lonal ly decentra l lzed at governorate level s lnce 1980' The
gradual integration w111 starg at th; perlphery level as PHC centres are establlshed' The
followlng notes were roade:
- status of nal-arla and its control: ltalarla ls sti l l a serlous public health problen
in Southern yeoen. The disease Ls enderolc all over the country with varlous levels of
endeniclty. The geophyslcal and meteorologLcal features favour transmlsslon throughout the
year except ln arlas-"Lo.r" 2000 n altitude and in the de6ert' Due to lack of tralned
health manpower and flnancial resourcesr a countrywide control Progranne hae not yet
star ted. Present ly , contro l operat lons are rest r ic ted to areas wi th h igh endenic i ty and
economLcally inportant. Thus, only a sna1l segnent of the populatlon. (about one flfth) is
protected, to a cer ta ln extent , f ron nalar ia r isk. The progr iss has been s low s ince the
lnceptlon of the Progranme. Neverthelessr sone of the objectives of the plan have been
I. 9ART I: Documenr vBc/85.3-uAP/85.3, SECTION III(F) SOUTHIIESTERN ARABIAT pp' 237-240'
vBc /90 .3MAL /90 .3Page 205
achleved euch ae gradual reductlon ln the roalaria lncLdence, contalnment of na.larla
outbreaks, ellnlnatlon of nortallty due to nalarla, and brlnglng the oalarla PrograEloecloser to lntegratlon with the PHC systeD. The naln actlvit lee conducted were reeldual
house spraying, larv lc id lng, source reduct lon, case detect lon and t reatment . The
actlvlt les eo far carrled out, however, have been lnadeguate ln space and tl 'ne. Caee
detectlon i.s rnalnly carrled out through hospltals. The nunber of blood slldes collected
and of conf i rned cases s lnce 1979 up to 1983 was as fo l lows:
Year
t9791 9 8 0t 9 8 rI982l9 83
4482809 1 3l t 5433
3 3363 0204 0427 6099 294
9. r9 . 9
r 0 .915 .712.6
Total s l ldes Tota l poel t lve cases SPR
363036487 3
Epldenlo loglcal t rends lndlcate a steady lncrease ln oalar la lnc ldence. In 1982,
abnornal ralnfall and floode have further lncreaeed the ualarlogenlc Potentlal leadlng to a
sharp r lee in the El lde posl t lv l ty rate. The predonlnant parael te epeclee ls P. . fa lc lparuo(ovei 902) , and the reualn lng are P. v lvax and P. malar lae. P. . fa lc tpagun 1g st l1 l
sensltlve to chloroqulne (eee Uelow)l--To know the exact elze of the oalarla probleD ln
Southern Yeoe.n, nori epldenlologlcal data collectlon le needed. Slullarly' 1o the absence
of approprlate base-llne data, the lupact of the Present antlnalarla neesure6 on Dalaria
t r a n e D 1 s s 1 o n c a n n o t b e e v a 1 u a t e d e x a c t 1 ' y . T h e D a 1 n v e c t o r 1 s @ w 1 t h r e ! ' 1 1playlng a eecondary role. Entouologlcal lnfornatlon ls aleo lnadequate, and more 8tud1e8
are needed. A few eusceptlblllty teets were condueted ln Noveober 1983 showlng that
arablensle le etl l] eueceptlble to DDT. Aden town having 0.5 ull l lon populatlon le free
fo'ffi;1a; only 1n the suburbs sporadlc traneuleslon Day occur. The Aden nunlcipallty
carrles out effectlve larvlcldtng operatlone and aource reductlon. 0n the whole, the
prograpoe ls faclng natnly adnlnistrative and flnanclal constralnts and ehortage of tralned
health Darrpolr€!o
- Research act lv l t lee:
( a ) S t u d y o f t h e r e 8 P o n 8 e o f P @ l n f e c t l ' o n e t o c h 1 o r o q u l ' n e : T h 1 s e t u d y w a aconducred frou April to Dlcenber f96TTi-If,jiEiplacea: Chtldreu hoepttal, Al Maneora (Men
governorate), t l l Abbae hospltal (Lahej goveroorate) and NaJi hoepital (Abyan
io.r"tr,o..t. i . These hoepttale were choeEn becauae of thelr belng falrly rePresentatlve of
ih" hfghfy malarloua at"i" and also becauee of easy supervl.elon. In thle study' 153
parlenis iufferlng fror 3_:_.1gl@ lnfectlon were subJected to the standard l l l lO test to
ieternlne ln-vlvo ttre etffi?-Et?idard doeee of chloroqulne on the paraelte. A11 163
patlents Uffire-iigatlve by day 6 and renained eo durlng the entlre perl'od of obaervatlone '
whlch varled from a ulnlnun of 8 daye (24 pattents) to a oaxlnun of 28 daye (47 patiente)'
It can, therefore, be aeeured that chloroqulne at the usual dosee le etl l l effectlve
agalnei P. falctparun lnfectlone ln Southern Yenen and that no.resletance to the drug hae
eo far been obeerved.
(b) Ftefd trlal wlth 252 DDT enulslftable concentrate to aaseas the acceptabll lty of
thle fornulatioan by the lnhabitante: A enall f leld trlal wtth DDf euuletflable concentrate
wae conducted la lfr1a1 vil lage (Abtyan governorate) tn Novenber 1983, where the rate of
refugale by the lnhabltants to spray their housee wlth 752 DDT water dlepersable powder
(wdp) wag very hlgh. The refusala r"t. ualnly due to etalne left by the wdp on painted
walls of housee. The coverage of DDt/EC was qulte satlsfactory elnce people readlly
accepted the new fornulatlonl [No lnfonmtl.on was glven on the entonologlcal aeeesanent of
tt. Llologtcal effectiveness of the euulglonl
(c) Btologl.cal control wlth larvivoroue flgh: Aphanlue.919Par, an lndlgenous fleh' was
detected fn 1980; it 18 avaLlable ln large numbere l lnTf,e ttrfrd and flfth governorates'
Durlng a vlslt to ltrwar 1n connectlon wlth a oalarla outbreak ln the thtrd governorate' a
l a r g e n u o b e r o f A P @ ' w a e d e t e c t e d n e a r R o w a d v 1 1 1 a g e . S a u p 1 e e w e r e b r o u g h t t othe oalarla office and the flsh sere ralsed under laboratory condltl 'ons. It was obsenred
vBc/ 90. 3MAL/90. 3Page 205
that the reproductlon rate ltas very low and 1ts larvlvorouE capaclty !ta6 not very
pronounced. However, large numbers have been dlstributed fron the naEural breedlng sites
lnto other water sources 1.e. , wadls and l r r lgat ion channels. Proper evaluat lon of i ts
ef f lcacy has not been carr led out . Ef for te t t t t u" nade to carry out a f le ld t r la l wl th
th ls f lsh ln the near future.
In hle report on a visit to Southern Yemen i.ncluding Socotra lsland durlng
February-i larct fgii l- i i"u""ig.yan (f987 - unpubllshed rePort to lntg) reviewed the roalarla
situatlon and control actlvit ies ln the couniry. The followlng observatlons were made on
the nalarLa s l tuat lon and i ts contro l :
The nainland
(a) The rnalar la s l tuat lon: The est lnated populat lon of the country ts 2 '2 n i l l lon '
A11 rural areas are regarded ae oalarlous, although nalarla transulsslon depends on
ralnfa l l ; t ransmlss lon ls rest r lc ted dur ing dry years as I 'n the case of 1983/1984' There
ls stratif lcatlon of nalarla endenlclty ba-sed Ln nalarlo'etrlc 'urveya, but PCD and fever
surveys dur ing spraylng operatLons.have g lven s l ' ide posi t lv l ty ratea of 10-152' Accordlng
to 6one prevlous rePorts, r0alarta ts negltgtble ln towns ana vtttages along the coast lsee
also PARI I , p . 2391. As nent loned aboie, Aden c i ty wi th a populat lon of about 0 '5 nt l l ion
remalns rnalarla-free. The submountaln tracte and the wadls are the noet affected'
senl-desert platns roay also be free fron nalaria due to lack of water' However' ln all
these areaa, exceptlonal ralnfall nay cauae sporadlc epldenlcs' on -t!re wholet the country
is consldered hypoendemlc. On the oih"t hand, Socotra lsland le hlghly malarlous (see
below)
(b) organlzatLon of the l. lalarla control Progranne: The country 18 adnlnlstratlvely
dlvlded lnto slx governoratee: Aden (lncludlng sicotra), LaheJ, Ablyan, shabwah, l ladraroaut
and A1 Mahrah. l lalarla control has been decentrallzed and ls now under the responslbll i ty
of the health eervlce of each governorate. At the central level 1n Adenr there ls a
dlrector ln charge of the progranDe and le aeslsted ln the planning' technical guldance and
evaluatlon of the work by paristtology and entonology supervlsore-and an adnlnlstratlve
officer. At the Present t lne, nalati. "o.tttol
actlvlt lea are conflned to three
governorates: LaheJ, Ablyan and lladraroaut. The total staff asstgned to the programme ls
IUo,rt 200, incluttlng the headquarters staff at the governorates, vlz: technlclans'
nlcroscoplsta, spraymen and others. Twenty tno rlore staff lncluding two 8upervleore, four
entonology technlcLans and 16 nlcroscoptsts were belng recrulted and tralned durlng the
f l rs t aemester of 1987.
(c) Contro l act lv l t les:
- Resldual houae spraying: Although no flgures are avallable, house spraylng now
covers aPProxlnately fOO 000 people. ioth 752 DDT wdp and 257' DDTIEC are belng used at the
usual dosage "r.
i- i i^z. so*'"rl"" are sprayed once and others twice a year' Th:
refusal rates 6eem to be rather hlgh, ." rtr"i as 302 or Eore, and coverage, thereforer MY
be only about 502. Thls added to itt" habtt of people sleeping outdoors durlng rhe hot
seaaon nay draetlcally reduce the value of house epraylng'
- Larvlcidlng: Teuephos 500 EC ls belng applled durlng the dry season ln seepages of
the nadls. The s}oe "pr.yr"o
who carry out house epraylng are ueed for larvlctding durlng
the off seaaon whlch le a- loglcal arrangenent. The same larvlcldlng teans also carry out
sorne nanipulatlon ln the streaDs to lead thero along deflnlte paths to naintaln a steady
flow, besldes whlch pools are also dried to reduce the anount of larviclding'
- use of larvlvorous fLsh: Aphanlus dlspar has been introduced ln the wadls' The flsh
lrere seen thrlving 1n the wadle vfEEEE-taheJ and Ablyan governorates' Due to the
shallownees at the edges and heavy growth of algae and other vegetatlon ln such places
where larvae abound, flsh alone nay be lnadequate and have to be supplenented with
larvlcldlng.
(d) Flelal entonologlcal observations: An entonology tean carrles out checklng of
larvae after larvlcldlng operations once every tortni 'git ' Wlthout ldentif ication of the
anophel lne epecles, the data gathered at such exPense is of l i t t le va lue ' At presenEt
there is no identl.f ication carrled out elther at the governorate or the headquarters level'
vBc /90 .3MAL/90. 3Page 2O7
The entoroology technlclans have been tralned 1ocal1y as well as abroad and should betnstructed to ldent l fy co l lect lons. I f they are st i l l unable to do so ' they should be
retra lned. Dur lng the v ls i t , a few larvae of a_rablensls were col lected f ron Adlrgag 1nAblyan governorate but no adults of thie specleE could be found. In Asrdah in LaheJgovernorate, no adult anopheline could be collected by PSC ln houses and larval surveys lnthe wadl were negat lve, beLng'under teroephos larv lc ld lng. In Mureabr LaheJ governorater atota l o f 47 sergent l l and 29 arablensls females were col lected by hand capture f rom twoanloal sheltFtTthese, 43-ffi8;-of the two vectora nere exposed to 42 DDT for onehour, and conplete k l1 l wae obta lned wi th no nor ta l l ty ln the contro l o f . 26 nosqui tos.Thls lndlcated that the two vectora were stl l l susceptlble to DDT. The area has been under
DDT spraylng s lnce 1976 and nas last sprayed ln October 1986.
Socotra lsland: Thls ls an lsland about 140 kn x 40 kn sltusted ln the Arablan sea atabour-TdT0TdTi6E-Men. The populatlon ls estlnated at 50 000 of whon 202 are nonads.The nalo town Ls ltadlbo whlch ls l lnked wlth the nalnland by a weekly fl lght during 8-9nonths of the year; the fl lghts are suapended during storny nonths (about June-Septenber).There are 6one boats plylng between the lsland and the Gulf area whlch are also suspendeddurlng stor6y months, The leland terraln le eandy and rocky interspersed with undulatingrocky hll le, unsuitable for'any vegetatlon except for date palns and soloe hardy desertplants. Conditlons of l l fe bre extrenely dlff lcult and rooet of the populatlon l lve alongthe coaetal areas where there ls a good fiehlng yleld wlth l ltt le chance for exportlng thesurplue except as drled flgh. Becauee of the lsolatlon of the leland and lte dlff lcultcondltione, the leland populatton lage far behlnd that of the natnland. The Governnent israther concerned about thls and la anxlous to lnprove the ltvlng condi.t lons of the lsland.Malarla le the noet lnportant publlc health problen, hence nalarl.a control would be aprerequlslte for any klnd of developnent. 0n the nalaria eltuatlon ln the leland, thefollowlng observatlons ttere nade:
- Health services and current antlnalarla actlvlt lea: There ls a health dlrector forthe leland statloned ln the capltal Hadlbo. I le ls ln charge of all health actlvlt leslncludlng nalarla. A hoepltal wtth 20 beds eerves the populatlon of ltadlbo' headed by anedlcal officer who Le sent from Aden on a rotatlon basle every five oonthE. The hospltalhas a rnalarla PCD post wlth two nlcroscoplsts charged stth the exanlnatlon of blood slldeecollected by the outpaclent departnent. The slldes are exanlned lnnedlately and treatmentle glven to all poeltlve caae6. There Le a nalarla offlce ln l ladlbo conprlslng oneeupervlsor, four sprayoen and one lnsect collector. They have one vehicle. whlch lscontro l led by the heal th d l rector who-also provldes thenwl th t ransPortat lon when l t 18avallable. Thte tean hae been eupplled wlth 752 /DDT wdp and tenephos 500 EC' and due tothe preesure of work fron varloue sourcee, they carry out resldual houee spraylng and gome
larvicldlng on an ad hoc basle. The tean hae not been adequately tral.ned, and has nodeflnlte planned p@-rrne of work.
- The nalarla el.tuatl.on: Examlnatlon of the reeults of PCD post ln l ladlbo hospltal for1985 ehowed that the hlghest sllde posttlvlty rates (70-9OZ) were recorded durlngllarch-May. On the other hand, oaee blood surveys carrled out during the author-s vleit(27-28 February 1987) gave an overall parasl.te rate of about 292. Durtng a perlod of fourdays, blood ell.dee fron all pereon6 attendlng the hospltal ae outpatlents (87 Persong)ehowed that 27 were poeltlve for ualarla, glvlng a posltlvlty rate of. 3LZ. Fron all bloode x a n l . n a t l o n 8 f r o n t h e l e 1 a n d ' o v e r 9 5 7 o f ' a l 1 p o e 1 t i v e s h a r b o u r . d 3 @lnfectlone. It 18, therefore, evl.dent that Dalarla prevalence ls very hlgh ln and aroundltadlbo a6 aeeu ln the hoepl.tal-s PCD post as well ae in the vll lages of Maanafta and Altawhlch are sltuated Just outslde the totrn area. Qualaneia which ls about 50 kn fron l ladlbo
towarde the east had an SPR of 247 afi, Pavl.a whlch le about 25 kn to the west had 122.These two locallt ies were ac dry ae the forrer locallt lee but wlth far fewer breedlngsltes. AccordLng to the PCD poet of the hoepttal, March, Aprll and ltay are the nonths ofthe higheet nalarla transmleelon whlch also colncldee wlth the raluy 6€a6on.
- Reeults of entoroologlcal lnveetlgatlone ln the lsland: Thevasagayan (loc.clt. )recorded An. cullclfacles adenenel.e and, for the firet t ioe, he recorded Air. arablenqle ae1 a r v a e a n e r , s u b s e q u e n t a u r v e y a ( F a r 1 d , l 9 8 8 ) c o u l d n o t c o n f 1 r nthe preeence of arablenslg 1u thle leland and, therefore, An. cullclfaciee adenensis renains
vBc/ 90 . 3MAL /90 .3Page 208
the pr lnc lpal nalar la vector ln Socotra [For deta l ls see SubsectLon ( i ) under 5 above] . Inhis concluslons, Thevasagayao rernrrked that although Socotra ls a snall isolated leland,one should not be carrted away by an funpression that malarla control would be a falrlys inple operatLon. The very fact of Lt .s iso latLon and sparse populat lon nagnLf les theproblen fac ing malar la contro l several fo ld. On the other hand, there ls hard ly a heal thLnfrastructure on which an antlnalaria programme could be butlt. Staff and loglstlcs wouldbe oaJor obstacles, even if funds and materials could be nade available fron the Governmentor outs ide reaourceo. One, therefore, has to s tar t wi th what ls avai lable, galn soneexperlence, build on lt, and expand a6 nork goes along. The lsland could be consldered,therefore, aa two areas:
Area A: Hadibo and its surroundlngsr a rather conpact area wlth a populatlon ofr0 000.Area B: the rest of the is land.
The proposal would be to 6tart the nalarla control prograurc Ln Area A wlth the staffand transpost now avallable and to extend the work to Area B when staff, logistlcs andsupply situatlons inprove.
Area A has a populatlon of 10 000 ltvlng ln 1800 houses. It ls about 3 kn fron thecentre of ltadlbo town and easily accesslble by a road. Wells are the Dost f i lportantbreedlng places wlth one or tno wadls which retaln water durlng the dry a€aaoo. Acceptanceof reeldual house epraying by the lnhabitants may decrease after the lnlt lal enthusiaemwhich ig sald to be good at the present t lne, but no fLgures were provl.ded to eubstantlatethts. On the other hand, houee epraylng w111 be eubetantlally nore expenelve conpared wlthant.i larval meaaures due to the l inlted ldentlf lable breedlng sourcee. Therefore, the malnantl-vector Eeasures for Area A ehouLd be anti larval nethods ag defined ln the followlng:
Introductlon of larvl.vorous flsh: If a suitable larvlvorous flsh could be found on thels land l t should be tested ln a t r la l . I f a local ls land f lsh te not ava{ . lab le, then thenalnland flsh Aphglr:lgejlspar could be brought f rorn the rnalnland and eetabllshed in aspecially built tank or a well close to the rnalarLa office. After the flsh culture leestabllshed, they could be lntroduced gradually lnto wel1s and also the wadls ln thelsland. A regular check of the wells would ehow if they survlve and are able to controllarvae.
Uee of fZ t"n3g$lg*glg: As 1t carinot be certaln whether the larvivoroue fleh wl1lsurvlve and becone effectlve ln wells and even if they do, lt nay take a year or Dorebefore they can get establlehed, lt 18 suggested that welle to be treated nlth lZ teoephosgranules, a formtrlatlon whlch ls effective and very safe to use ln drlnklng rtater. As afirst Deasure, a proper cenaus of all wells should be nade whlch can be done easlly by theexlstlng nalarla staff ln about 2-4 weeks. As a well has a dl.aneter of about I n, 20 g oflZ ternephos granules nould glve good control for at least two weeks if not four. At 20 gper well fot 24 treatnente per year, 100 wells would need approxirnately 50 kg of granuleeper year. Taking the hlgher estinate of the total nunber of wells belng about 2000' thequantlty of granules would be 1000 kg per year. If after checklng, lt 18 found that thedoeage is effectlve, the frequency of appllcatlon can be adJusted to -week lntervalslnstead of two, hence the anount of granulee needed would be only half. It is noted wlthnuch Lntereet that a proposal has been nade to conpletely seal all the welle by lnstall lnghand punps of whlch 100 have already been provided through UN assistance. Thle ls anexcellent ldea whlch w111 help the people and prevent vector breedlng ln wells.
Uee of tenephos 500 EC: Larvlciding wlth this fornulatlon ln wadls should contlnue atfortnightly lntervals as carrled out at present.
Residual ho."g.ryg!3g: In the outeklrts of area A where there are no ldentlf tableureea@lages rnay be sprayed wlth DDT.
Avallabil l l ty of antlnalarla drugs: There ls a plan to extend PIIC system to the wholec o u n t r y G u i 1 e s o f t h e P I t C s h o u 1 d b e p o s t e d a t t h e e a r 1 i e s topportunlty. It would then be the responslbLllty of the malaria control Progranme to seethat theee guldes are tralned ln the treatoent of nalaria suspected cases and provlde then
wlth eufflclent antfuoalarlal drugs. Thlswel l as to reduce nalar la Eransnlss lon to
For area B, in v lew of 1ts d is tancelarvlcldlng rneasures because of the needfolJ.owlng suggestion6 were nade:
vBc/90.3I'{ALl 90 . 3Page 209
would be the flrst steP ln reduclng norbldlgy assome extent .
f rorn Hadlbo, l t w111 not be pract lca l to inst l tu tefor for tn lght ly t reatroent . A l ternat lve ly , the
PHC: As an urgent prlorlty, PHC health guldee should be aesLgned to Area B eo thatthey i l i s tar t t reat lng fever cases.
Resldual horspl$g: A proper census should be carrled out to estlnate manPower's u p p t @ s P o r t n e e d e d f o r 1 o p 1 e n e n t a t l o n o f t w o r o u n d s o f s p r a y 1 n g P e ryear. One spray tean should be statloned ln Qalansla, and another tn Nugid or any othersuitable place. [Full geographlcal reconnalsance should have been recornroendedr and ltwould be more convenlent lf spraynen are eoployed froo local lnhabltante and be glven
adequate t ra ln lngl .
Antllarval Deaaures: Ueasures slnllar to those euggested for Area A could bec o n a 1 m r e a g g 1 o n e r a t l . o n 8 o f h o u e e e e x 1 e t . I f 1 a r v 1 v o r o u s f 1 s h p r o v eeucceseful, then the lntroductl.on of f ieh Ln wells nay be extended nherever poeslble.
Farld (!9S8 - unpubl.lshed report to l l l tO), Jolntly with a natlonal tean vislted Socotra
leland for two weeks fron 21 March to 4 Aprl1 1988 wtth the followlng alue:
- to lnvestlgate the degree of nalarla endenlclty ln dlfferent Parts of the lsland,and to deternl.ne the roagnltude of the nalarla problen in each area.
- collect baelc lnfornatlon on health faclltt lee exletlng ln the lelaod, thelrd let r ibut lon and E€aoulc€Ee
- draw a feaslble plan of actLon for nalarla control lncludlng evaluatlon rethod8.- e8tlEate reaourcea requlred for the lnplenentatlon of the recoooended p1an.
A good descrlptlon of the leland was made whlch would be ueeful to eu@arLze hereelnce the knowledge of the leland frou prevlous reporte 18 very l lnited. Nearly the saDedeecriptlon of the geographlcal sltuatlon of the laland ln relatlon to the nalnland' lte
eurface area and populatlon was glven as shown ln the abve rePort. The leland 1e
donlnated by nountal.ne of the Itaygter range whlch rlse Just over 1500 n above sea level ln
the eaetern central reglon. The lel-and could be claeelfled lnto flve zonee conprlelngnorth coaatal area, eoutherg coaetal area, eaatern plateau, central plateau and western
plateau es shosn ln !1g. 2lr. The cllnate ls a hot Darlt lne tyPe wlth a nean dallyLenperature of 28-39oCi Ralnfall occura durlng the northeast Eonsoon, generally durlng
October-Deceober and agaln durlng the sunmr nonaoon, moat frequently betlteen March and
June. Both the wtnd eteed and directlon vary conslderably, wlth speed generally below 36
ko/hour, except during June-August when the epeed reachee uP to 215 kn/hour. Frou the
avallable lufornatlon, ralnfall le about I70 nn/year for the whole leland. There are no
aephalted roade; a eerl.es of bulldozed tracke have been constructed to facll l tate
traneportatlon between lladlbo, the capital, and large BettleDente locludlng Nugld Iu the
south; Qalanel.a ln the weot and Honl ln the east. Theee tracke are l lable to be waehed
aray initog heavy ralns and becooe lopaaeable when wadle are flooded. The total populatlon
of the leland le not known exact,ly, but ln 1975 tt was eatimated at 55 000. A new cenaus
iraa atarred 1n ltarch 1988. The naln occupatlon of the people of the leland le ftehing ln
the coaetal areaer Broall farulng (paln trees along the valleye) and cattle ralelng 1n
mountal.noua ar€a8. A nixture of racee exl8ts ln the north coest nalnly ln l ladlbo: Arabst
Mrlcane and Indiane, whlle ln the nountalnoue areas and eouth coast Arabe predonlnate.
The elopes of the nountains are 6teep tosards the north leavlng a eoall coastal strlp. In
the eou-th, the Dountalns aloost end wtttr a vertlcal cllff followed by a eandy coastal etrip
of f lat land about 8 kn wlde. The populatlon Le scattered all over the leland wlth htgh
densltles ln Eadlbo and Qalansla and thelr eurroundlngs on the north coaet where Dore than
502 of the populatlon l lve. The rest of the populatlon l lve ln eoall scattered vll lagee or
f-IeproAucea-by perniselon of llItO/EuRO.
vBc/ 90. 3MAL/90.3Page 210
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are nomads, par t lcu lar ly ln the Dounta lnous areas. The houslng condi t lons are poor l houses
are nalnly bullt of stones and have roofs roade of paln leaves. In sone areas of the southt
the houses are complete ly eonstructed wl th paln leaves. Caves are used by the nomadlcpopulat lon as a shel ter dur ing adverse c l lnat ic condi t lons." In l {adibo and Qalansia, houses
are wel l constructed. A typ lcal house measures about 150 n- and conslsts of one or two
rooma and a yard ln whtch a wbll ls almost always found. Cooklng is perforned In the yard
where so6e emal l anioals are kept . The fo l lowlng notes were made on heal th in f rast ructure,
and health problens, edubatlon and the oalarla sltuatlon ln the island:
I l e a 1 t h 1 ' f . " " @ : T h e r e a r e n o h o s p i t a 1 s o r r n e d 1 c a 1 o f f 1 c e r s w o r k 1 n gp e r n a h e a 1 t h c e n t r e 1 n H a d i b o [ T h i s w a s c o n s 1 d e r e d as6al l hospl ta l wl th 20 beds by Thevasagayan, 1987 - see abovel and s ix per ipheral heal thunl ts , From an adnln ls t rat lve standpolnt , the heal th s taf f o f the ls land are under theAden Dlrectorate of l tea l th Serv lces. The tota l t ra lned heal th s taf f o f a l l categor ies ls
68. The rnalar ia s taf f are stat loned ln Hadlbo and conslst of one assis tant heal thlnspector who le the chlef of the teaE, tno malaria oicroscoplstsr one entoDologytechniclan and four spraynen who are all poorly tralned. Moreover, there ls a teatr of twofeuale French nureea worklng lndependently as volunteers for lmnunlzation coverlng nainlythe north coast. They have.thelr onn transportatlon, supplles and equlpnent and they are
dotng ueeful work trytng hard to cover the accesslble populatlon. MaJor health problens
other than oalarla are: Tuberculoels, resplratory dleeaees other than TB, nalnutrit lon andechlatoeonl .aels .
Educatl.on: Schools up to Sth grade (united school systen) exist only ln l ladibo,qatanEffionle nil l tgry bedouln school. other schoole are soaller and consist of onet.o four claeses coverlng snaller gradee. The total nunber of schools in the lsland ts 14and the tota l nunber of enro l led chl ldren ls 3159.
The nalar la s l tuat lon: FroD the stat is t lce aval lable ln l lad lbo heal th centre and othert r e . t t @ e t o b e t r a n s o 1 t t e d a 1 1 y e a r r o u n d . T h e n a 1 a r l ' a s 1 t u a t 1 o n w a sdescribed 1n flve geographlcal zones as follows: -
(a) Central nountalnous area: Thle area conslsts of the central plateau where peoplea r e n o n a d f f i a r e f o u n d a 1 1 y e a r r o u n d a 1 1 o w l n g n a 1 a r 1 a t r a n s m i s s i o n t ocontlnue throughout the year. The area le extensive and lnaccesslble by road except alongthe track that conn€cts Hadlbo and Nugld Ln the south. The area Ls consldered eltherhyperendenlc or of hlgh oesoendenlclty wlth a spleen rate of 5lZ. The fact that theGovernnent provldes nlJ-ltary boarding schoole (at l lort and Monl) to the children of nonadlcpopulatlons eltuated tn relatlvely nalarla-free areaa on the north coaat, explalns the lowparaeLte rate aoong schoolchlldren (at the tlue of the vielt, the chtldren were boardlng ln
echools for oore than elx nonths). The average enlarged spleen wae found to be 0.57 anongthe rnll l tary echoolchlldren reflectlng their prevloue exposure to nalaria ln other areas.The overal.l paraslte rate of the populatlon exanlned ln the mountainous area along the roadwae l4Z and the average adult,vector denslty wae 6.5/roon [49:_9!4!Sl!lclee adenensis 1ec o n e 1 d e r e d t h e s o 1 e p i 1 n c 1 p a 1 v e c t o r o f n a 1 a r l a 1 n t h e r e t a f f i
(b) Hadibo and lts eurroundlnge: Hadlbo le the capltal surrounded by several vll lagesa l o n g t t r e r e e d 1 n g s 1 t e e a r e d o m e s t 1 c w e 1 1 s a n d t h e e d g e s o f t h estreams ln the valley. The denslty of the hunan populatlon ls the hlghest ln the leland(about 2OZ of. the populatlon), The area ls mesoendenl.c wtth a spleen rate of 32.62 and an
average enlarged spleen of 0.5. fhe parasite rate Le 9.97. Although the houses are wellconstructed, outdoor sleeplng ls coromon. As the vector reats lndoors, the area could be
coneldered eultable for house spraylng operations. The denslty of the vector was 2.5/roondue to the fact that DDT house epraylng wae completed in February 1988 wlth 872 coverage.Ilowever, the epraylng rras partlal accordlng to the wlsh of house oltners.
fc) South coastal area (Nugld): The area le rather dry as the mountalns provldep r o t e c t 1 o @ a t a f f e c t t h e n o r t h e m c o a a t a n d a 1 s o P r e v e n t s o m e r a 1 nclouds froo reaching the south coast. The populatton ls scanty and scattered. The area Ls
coneldered mesoendemLc wlth a epleen rate of 257 and an average enlarged spleen of 0.2.The parasl te rate recorded was 8.72 and the vector densl ty was 1.7/ roon. The houslng
condltion ls poor and does not call for any type of effectlve house spraylng operatlons.
vBc /90 .3MAL/90.3Page 212
(d) Northeastern area: The area represents the eastern pfateau wl th a very narrownorthern coiEta l s t r fp . The populaElon is scat tered wl th very l l t t le nater ' na in ly f ronwel ls . The area is consldered to be hypoenderoic wi th a spleen rate of 2.52 and an averageenlarged spleen of 0.05. The parasi te rate na6 5.2%. and the vector densl ty was 0.4/ toom.Houses are modest and the people are seml-nomadic.
(e) Qalansia j r rea: The area conslsts of the western p lateau and l ts coasta l s t r ip .Although p. t. lSlpefCA was recorded ln all above areas constltuting 76-80% of allinfectionFlTEJ-ieroatning lnfectlons were P. vivax with a snall ProPortlon of P. nalariae),no P. falciparun was found in Qalansia, anE-6i$-P. vlvax with a
"tttt proporti6liF
P. nalar lae iecorded ln th is area whlch is consldered hypoenderolc . The spleen rate ln
Gtllf iTil-rea was lZ with an average enlarged spleen of 0.31 and vector denslty of 9/roon.
In the conclus lons, Far id ( loc.c i t . ) and the nat ional tearo under l ined the fo l lowingp o i n t s :
- Socotra ls an lso lated ls land, less developed than the rest of the country. TheGovernment is giving hlgh priorlEy for developnent progranmes Ln the island.
- There is an acute shortage of trained manponer. Due to hardshlps of l lvlngeondi t lons, the harsh c l lmate and poor houslng condi t lons, l t ls unl lke ly that nedicalof f lcers and other profeeslonal s taf f could be at t racted to 6erve In the ls land except forshor t per lods or on a rotat lonal basis .
- itthougtr nalaria ls the most inportant health probleo, other health problens add toEhe suf fer lng of the people.
- Under these clrcuustances, the only hope ls to lnplenent a systeo of health guldes
of PHC fron che lslanders thenselves simllar to that in the rnainland.
- Sirnllar roiselons ehould vlslt the lsland to carry out cooprehensive surveys toevaluate the s iEuat lon of other d iseases and thei r re laEed heal th problens, and to or ient
the tratning of health guldes and other auxll lary health staff ln the lsland to deal wlththese problens.
- Malarla deserves speclal attentlon. The roere presence of chloroqulne tablets on the
narket ln ltadibo indicates the prlority denand of the populatlon to treat oalarla; two
tablets of ch loroqutne cost US dol lars 0.8.
- For control of nalaria, one should not be anbltlous and aPPly resldual house
spraylng or lnterfere nuch wlth the acqulred ftnnunlty of the populatlon. The only areas
chat could be covered by vector control measures are Hadlbo and Qalansla. Other areaa
cannot be sprayed because of poor houslng conditlons and nomadlsn.
- It 16 noted that nalarla control ls haphazardly applted wlthout guldance fron HQ in
Aden. As an exanple, DDT spraylng tn ltadlbo was carrled out ln February 1988 durlng the
dry season wl thout any Just l f lcat ion.
- It ls noted with regret that whlle malaria ls the most lmportant kl1ling disease'
and wlth the great prevalence, moat nedical staff are curatlvely orlented. As far as
roalarla ls concerned, Lt ls suggested that all oedLcal staff ln the lsland be tralned on
nalarla transmLsslon cycle, treatnent and control. Courses ehould orlent the staff towards
preventlve measures lncluding health educatl.on.
- It was also observed that radical treatment for nalaria ls glven to microscoptcally
conflrroed cases which constltute a mlnor portlon of the paraslte ca.rrlers ln the
populatlon. Mlcroecoplcal dlagnosls ls only avallable ln trladibo.
- In an lsolated lsland llke Socotra, one rnay be tenpted to think about eradlcatlon of
malarla. l lowever, due to the dlff iculties and linltations encountered, the reduction ln
oorbldlty and mortallty -fron oalarla would be a more reallstlc goal at thie etage.
vBc/90.3MAL/90.3Page 2I3
A plan of actlon was prepared, and a sertes of reco@endaElons nas lqade of which
reference ls nade to the followlng:
(a) There ls an lnrnedlate need for the eetabllshnent of a systen of health guldes withspecla l at tent lon to nonadlc and seml-nonadlc populat lons.
(b) In a l l heal th centres and uni ts , c l ln tcal t reatoent ahouLd be pract lced. There lsno just l f lcat lon for radical t reatment to be adnln letered whl le LLZ of the schoolchl ldrenare harbourLng nalarla parasites wlthout any synptons.
(c) As the roaln source of vector breeding le wel le , larvtc ld lng these wl th tenephos
every two weeks to reduce vector denslty ln l ladlbo and Qalansla should be the traln vectorcontrol meaaure. Larvlcidlng with tenephos should also be applled along the edgee of nater
collectlons ln the valleys crosslng l ladlbo and Qalanela.
(d) DDT houee spraylng is not reconrnended.
(e) Tralnlng: a tralnlng progranne for nedical aeelstante ln Hadlbo wae suggested.Aleo, Balarl.a staff ehould be retral.ned to be nultl-purPoae workere.
(f) A trlal wlth larvivoroua flsh was started ln the valley near l ladlbo by lntroduclngAphanlue dlspar brought fron the nalnland. The trlal ehould be encouraged and extended to
cover dooeetic wellg.
(g) Covertng donestlc wells and lnstall lng hand puutPs le an ldeal solution to Preventbreedlng 1n wel ls .
(h) Uw appllcatlon Day be used ln the followlng condltlone ln l ladlbo:- lf the nunber of ol.croscoplcally conflrned caaes exceeds 100 over a perlod of
trto consecutlve weeks- lf vect,or denalty reaches l0/roorn
(1) Itealth educatlon for nalaria control should be the reeponelbllt l ty of all health
workers. This should lnclude the acceptance of tenephos larvlcldlng and fleh dletrlbutlon
ln we]ls, reportlng lnnedlately for treatoent ln caee of fever, and aesletlng nalar{a etaff
ln thel r act lv l t leg.
(J) In-vlvo te8t6 for P. falciparun response to chloroqulne ehould be carrled out by
the lntercountry malarla teaE.
In the unpubllshed docunent of Farid (1987), the country oalarla profl le of Southern
Yemen lncludlng Socotra leland wae ehown as followe: (wlth eone addltlons by the nrlter)
- Populat lonr 2.2 n l l l lon Populat lon at r isk: 1.5 u l l l lon
No. elldee exaulned:No. poel t lve e l ldes:No. 3-:_-!@ caaea:
3. fa lc tparun res letance toVectors of nalarla accordlng
1984 19854E-3'e 4frio3 615 3 0 r33 043 3 013
chloroquine: Suspectedr but notto vectorlal funPortance - wlth
19864 0 l l l
3 2973 297
checked.Lnfonnatlon on vector
adenensls
res ls tance to lnsect lc ldes:Hal.nland: l. AD. arablensls 2. An. sergeqtil
3. E.-au1-fcffaCtes 4. An. cullcllacies
reductl.on- Caee detectlon: PCD and ACD Poor- D€velopoent of PHC at peripheral level: Poor- Development of PIiC at referral level: Poor- Malarla control progra e: Ls a locallzed verttcal one- l lalarla tralnlng centres: uon exlstant- Tralned manporter: lneuffl.clent- Speclal problene: l lulted reEourcea and manpower.
Socot ra :An. - f f i - iesadenens lEGl - f rab lens : l .B- Maln .,""ffirro1mrnEiTiffiffiE
i6.Grrrnea)and sooe Source
vBc/90.3MAL/90.3Page 2I4
Frorn lnforroatlon comnunlcated to IIHO/EMRO, daEa on the statue of antinalarla
act iv i t ies ln Southern Yemen ln 1988 show the fo l lowlng:
(populat lon: ro ld-year est imate in 1000s)
- Total PoPulation z 2 200- Populat ion of or lg lnaL1y nalar ious areas z 2 20O [This f lgure should be correc led
aceording to Ehe abovel .- PoPulation of areas
populatlon ls clalned Eo be- Populat ion Protected- PoPulat lon Protected
cla lned to be f reed f rom malar la: [Aden c l ty wi th 0 '5 rn i l l ion
f ree f ron roalar ia l .by extenslve house spraying coverage: 39
by other ant l -vector measures ( larv lc id ing and some source
reduc t i on ) : 100- PoPulation under survel l lance: [L in l ted PCD act iv i t ies by PHC and hosPtta ls ] '
The repor t of the w19 h l th s tat is t . .quar t . . ( *0, 1990) sunnatLzed the wor ld malar ia
sltuation ln lggg. ForJourhern yeddi- ? shown that. Aden clty and the high
nountalnous and desert area are oalaria-free' Socotra island is highly enderolc with
malarla prevalence ra!e6 reachlng about 402. The lncidence of nalarla varies ln other
areaa and 1e htgher around sadls. Antlnalarla activit ies are carrled out as part of the
PIIC systen.
In Onan, several nlssions vlalted the country ln recent years to a68ess the nalarla
sltuatLon and advise on control Deasures. Reference ls lDade to the lnlt lal country-tride
ualaria survey carried out by Farld, Nasir & Bentheln (Lg73 - unpubllehed report to WIIO)'
The entomologtcal f lndtngs have been shown !n Subsectton (1) under 4'2 and 4'5 above' On
the nalarla sltuatlon prevalltng at the tlne of the survey (Aprll-June 1973), the authors
drew the followlng concluslons:
(a) Malarla represente a naJor health problen ln Onan; I ' ts levels of endenlclty vary
between hyper- and hypoendenlclty. It ls partlcularly eerl 'ous ln the Batlnah reglon whlch
has the hfghest prlorlty ln soclo-economlc developnent'
(b) The adverse effects of ualarla on soclo-economic development are reflected by the
hlgh rates of school absenteelsn, and repeated cllnlcal attacks of nalarla experlenced by
the labour force. A hlgh nalarla Prevalence rate among Oroani school teachers wbs noted
fron the questlonnalre cl 'rculated to then'
(c) The acgulred lnnunlty agalnst malarLa ln the adult populatlon ls not a solid one'
ae Lt wa8 noted that at least 302 of the adults suffer from one or Dore attacks of malarla
every year .
(al) The absence of nlcroscoplc diagnostic facll l t ies for conflrnatlon of oalaria has
Led to very hlgh figuree of cllnlcal cales. l lrong dlagnosls of rnalarla ls partlcularly
serlous ln the case of tnfants and toddlers, a8 the dlsease may Prove fatal '
(e) No vltal health statlstl.cs exlst, but the funpreselon galned froro rnothers regarding
the nunber of pregnancles they had had, and the number of survlving chlldren lndicated a
hlgh nortallty raie occurrlng ln the young age-grouP6, for which nalarla nust be consldered
one of the contributlng factors.
(f) There are no guldeltnes regarding the tyPes and dosages of antlnalarlal drugs
adnlnlstered by health establtshnenia, or out6fal-fn the few pharmacles of the matn towns'
The retail prlces of these drugs ln the roarket are exorbltant'
(g) Clinatlc condltlons peruit nalarla transnisslon all year round' though at a much
reduced scale durlng the hot, dry nonths of Aprtl and May. The I'ntensity of rnalarla
transmlsslon varles from one season to anothei, dependlni on the levels of vector denslty,
whlch ln turn are dependent on the availabll lty of breeding places for the maln vectors'
In th18 respect, ralnfall seeDa to be the declslve factorr-"ttd itformatlon on the amount of
raln ls lmportant Ln understandlng the epldenlology of rnalaria ln the country'
vBc/90.3MAL/90.3Page 215
(h) The adaptabl l l ty of the two main vectors: cu l lc l fac lee and stephensl to the 'p h y s 1 o - b 1 o l o g 1 c a 1 e n v i r o n n e n t , a e w e 1 1 a s t o t t r e e c 6 I f f i ? p e o p r i i I i l G G a e 1 t p o s s 1 b 1 efor theee vectors to survlve through adverse clluatlc condlcione prevall lng durlng the hottdry season. As th ls season repreaents the Dost crLt lca l per lod in the l l fe of thesevectors, fu1l advantage can be taken of lt Ln tLrolng the attack meaaures.
(t) The Government is keen to reduce the ravages of nalarl.a, and to inlt late organizednalarl.a control. Ae the Danpolrer and fLnancial reeourcea are Lfuolted, the approach tocontrol. the dlseaee should be based on well-concelved pilot etudles to avold wastage ofthese reaourcea, and aeeure effectlveness of the nethods that vll l1 be applled.
(J) The responee of the people to health prograomes, partlcularly those related tochlldren and roothers, is exenplary. Full advantage can be taken of this in generatlng aeelf-help progranne for nalaria control '
(k) There Le no antl.nalaria leglelatlon regardlng the preventlon of nosqulto breedlng,or the cooperatlon of the lnhabltants ln antloalaria canpalgne. Sinllarly, no legielationexl.sts a8 to the control of ftnportatl.on and ueage of lneectLcldee ln agrlculture. ULVspraytng wlth rnalathlon hae.been ueed recently to control certain pests of date palntrees. IndlEcrlnlnste applicatlon of peeticldee ln agrlculture tlay preclpltate realstanceof local vectora to eone of the nost effectlve and cheap Lneectlcidea uaed ln publlcheal th.
Since the 1970-s, Onan hae undergone vaet developnent ln all aspects lncludlng thehealth Bector. Startlng fron 1976, eeveral fteld trl.ale have been conducted to select thenoet sultable and cost-effectlve nethode of nalaria control. Zahar, Delflnl & Ruebush(f982 - unpubllehed report to I{HO) vlstted Ouan during December 1981, as an lndependentas6easDent teaD to exaulne the reeulte of f leld trlale as well ae ongoing routl.ne nalarlacontrol actlvl.ttes, and to advlee on the necessary uodlflcatlone of the exlstlng plane forexpanding nalaria control ln the country. Data were provlded by the central HalarlaCoutrol Sectlon (UCS). For locatlon of places, the nap of Flg. l l should be coneulted-.Although Dany areaa renalned untreated, only one untreated locallty, Barka, could be putunder regular observatlone entouologlcally slnce June 1977 and paraeltologlcally sinceJanuary 1978 (eee Fig. 12 and the acconpanying explanatlon). Thle locallty could onlyaerve as a conpar leon for t reated areae ln the Bat lnah coasta l area, L.e. , Seeb undertenephos larvlcldlngr end Shlnae under DDT house epraylng. Treated areaa ln the lnteriorand other reglone renained without conparlson. Regular entouologl.cal observatlons couldnot be malntal.ned beyond 1977-1978 Ln some areas under antllarval meaaures (Sanayel andBahla). Therefore, the present asseaameot of operatlooe Ln theee areaa was eolely baeed onparaettological data.
Paraaltologlcal aaseaament euffered fron varlatlons ln saropllng procedures. Exanples8 re :
- In Barka, the uaJorlty of the eanple taken ln December 1980 was fron echoolchildrenwhereas previous sanpllng was by uaes blood aurveya.
- In Seeb, the oaJorlty of the eaople of March/Aprll wae taken fron echoolchlldrenwhereae the oage blood survey proceduree wae adopted previouely.
- In lludarlb, eanpllng of echoolchlldren was carrled out ln one lnstance and spotchecks were applled ln another.
Entonologlcal aaaeasnent aleo euffered froo naJor setbacks, for example:
- There na8 uo contl.nulty ln the sanpllng techniques adopted. The baee-llne of vectorroom density lD Shlnas, Dank and partly ln Seeb wae obtalned by hand capture whereae PSCwae lntroduced after appllcatlon of control Deaoures. Although hand capture was alsooalntal.oed, it wae reeerved for premlees not sultable for PSC and the frequency ofobeervatl.ona was often not ral.ntalned at the deslgned nonthly interval. Man-balt capturewae lntrodueed after the appllcatlon of control Deaaurea at 3-Eonthly lntervale,
vBc/90.3r{Allg0.3Page 216
understandably due to the conpel l lng c i rcumstances of s taf f shor tages. For these reasonst
the presen! assessEent was based on the nost s table technlque Performed, 1.e. ' PSC whlch
has been roalnEained reasonably at rnonthly lntervals'
- Sone of the searches were made in unsprayed or a l tered premises ' The densl ty
indi .ces of these should have been t reated ""p. . . t " ty ,
81nce they represent the condl t lon of
tnadequate spraylng coverage. Pooling data of theee with those obtalned frorn sprayed rooms
is misleadlng ln that the overall lndices may incorrectly be taken to lndlcate that the
lnsect lc ide is wear ing of f or pers ls tence of the vector is d in ln lsh ing due to lnsect ic lde
res l s tance .
Due to at l the above reservat ionsr no at tenPt was made to draw precise ln ferences f rom
the avat lable data. only the overal l t rends were consldered ln the broadest aense' In the
same way lt was attenpted to Project graphlcally the degree of reductlon ln the avallable
parasl te rates, us lng ' the roet-hod-of t t re ia te of fa1l (consider ing the nearest base- I lne
parasi te rate as 1007), but wiEhout any conslderat lon of the to lerable levels ldeal ly set
as the crlteris for neasuring the degrle of success of control Deaaures versus tlme
(tlacdonald & G6ckel, 1964). Entoroologically, lndlcee of only the roaJor vector'
cullcifacie6 were giaphlcally presentld, slnce the nunbers of other poselble vectorg
ElGEtffion treated and untreated areas ltere extrenely snall'
The followlng are the results of assessrnent of varioue fteld trials and routlne
rnalar la contro l act iv l t les :
,",.,l i) ', ' i}}il i"::}i"i"::':::::: ':Hii' iEofDDThouse spraylng r""
"orrd,rcted ln the coastal area of Shinas, Batlnah rgglon' Init lally' the
epraying ln 1976 covered a populatlon of 1538 lnhabltants l lvlng ln 678 houses' The trlal
was gradually expanded to "Lrr",
8204 inhabltants ln l98l' Dank, ln the h11ly area of the
Dhahira region ltas Put under DDT epraylng startl 'ng fron 1978 with 3585 lnhabLtants
protected lncreaslng to 6016 fn 198I.- Two spt"y rounds were carrled out ln each of the two
areas up to 1980. Accordlng to the la6t Ealaria control plan only one annual sPray round
was applied In each of the two areas ln 1981, and this strategy has to be followed ln
subsequent years wlth the aval' lable reaources'
(a ) T r l a l - o f sh inas , B? t l nah - reg lon (FLg , .22 a & b )1 : D l s rega rd lng the absence o f
e n t o n o 1 o g 1 c a t o u s f f i a n d - 1 n 1 9 8 0 , 1 n g e n e r a l t e r r 0 6 i t c a n b e s e e n(Fig. 22a) that the lndoor resting density of cullcl iactei under DDT spraylng was kept
under one per 1006' a level arbltrarl ly "Lt
foi?aE?iGry control ' - l lowever' there is an
lndlcatlon of a bulld-up of vector denslty durlng May-July rgat, though the denelty 6t111
remained below one per .oor. Thls build-uP correaponds to that observed about the salle
tine in the untreated area of Barka (see Fig. 12). However' the apparently satlsfactory
vector denstty trend dld not have any suppoiting parasltologlcal evldence' excePt perhaps
af ter the f l rs t , eprayLng round of Septemier 1976, wl th resPect to P ' . fa lc iparum lnfect lon
w h 1 c h t e n d e d t o d e c 1 1 n e 1 n D e c e m b e t L 9 7 6 ' t w o m o n t t ' " - " r l . i ' s p r a y t n @ z u ) . W h i l e
lnvestLgated and its causes rerDal.n unexplal'ned. Subsequently, the trend of both infectlons
waa mo6t erratlc, culninatlng ft "toiher
ept'soae of P' vivax ln Deceuber 1979' At the sane
tlme, conslderable Lncreaee i" ag,i@ lnfectl in-was recorded, exceedlng twlce the
ortglnal level. Thls flare-up wasJi@Eed by the nalaria staff i 'n Shlnae ar€a' Fron
t,heir report and discusslons, it was clearly ehown that aLl poeltive caaes were local
lnhabltantE, thus excludlng the posslbil l ty 'of I#ax lnfettlon belng fioported by Aslan
labourers. Moreover, blood sanpllng rtas repeated lnli inuary 1980, -the results of whlch
confirrned the findlnge of Decenber \gtg. Tire lnvestigatlon covered 29 cases' all of whom
were children below il.r" y".t" of age, wlth the followlng results:
such reductlon in p.-i"f"fo.t"t lnfectlon was observed, the proportlon of @
simultaueously lncfi iff ibEember 1976 to a high level' Thls eplsode ltas not- r ^ C L ^ i l r {
@ & b , 2 3 a & b r e p r o d u c e d b y p e r n 1 s e 1 o n o f w H o / E M R o .
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I Fig.zzu..WSLOPE OF FALL OF THE PARASITE RATE( f rom rts or iginol lcvof tolcn os ,OO% ) UNDER
ODT SPRAY'NG SINCE SEPTEMBER ' 97 6
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15 caees of P. falglpg5ggi10 caeea of P. v lvax, c lass l f led ae lndlgenous;
ae luported frorn the unProtected area2 cases of P. fa lc lparun, c lasel f ledShinas Welayat durlng the summer of t979;
I case of P. v lvax (aged 2 years) , c lasel f ied ae re lapse s lnce Lt was f i rs trecorded lu 1978.
Entornologlcal lnveatlgatlone durlng March 1980 shorted absence of the vector ln houeestwhl le larvae were col lected f rorn breedlng p laces ln the v lc ln l ty of the posl t lve cases. Bynan-balt capture only one cullclfacles was caught at each of the lndoor and outdoor sltes.Larval suecept lb l l l ty tests lndlcated the preeence of DDT res ls tance ln cul lc l fac lee. Theconcluslon drawn f ron thls lnvestlgatlon attrlbuted the cauaea of thls eii r-i i l i i-6Teveralfactors as fo l lows:
- lnhabltants sleeplng outdoors durlng the sumer or ln tenporary hut8 soae of whlchwere newly const;ucted and renalned unsprayed;
- the enall slze of the sprayed area, and movenent of the people to unprotected areae;
- Lnadeguate treatment.of posltlve caaes due to handtng over of the antlmalarlal drugsto the patlent or hle relatlvee.
- the epraylng coverage ln thle locallty at the end of October 1979 was about 802.Undoubtedly thls coverage was lowered with the new houee constructlone, whlch were greatlylncreaslng wlth the rapld econouic developuent of the Batlnah reglon.
Later, the preeence of DDT reelEtance in cullcifacies was confLrned by tests conducted Lnadults raieed fron larvae collectea at strFsl@ the situatlon ln Shlnae DDT epraylngtrlal rernalned conplex but deflnltely tranemlselon peretated. ln sddltlon to the factorgehonn above, there was the problen of vector reslstanCe. Wlth the avallable lnfornatlon,lt ls extrenely dlfftcult to deternlne to what extent thle reeletance, aDong other factore,contrlbuted to the pereletence of nalaria traneniaelon. Soue epeclflc and well euperviaedfield obeervatl.one ehould be inpleuented lnnedlately to eolve thle problen, enabllng adecielon to be taken nhether to contlnue DDT apraylng or to replace lt by an alternatlvelneect lc lde.
(b) Dank, Dhahlra reglon (Flg. 23 a & b): The entouologlcal baee-ltne.le fragneltaly( r r g . 2 3 a m e t t o l o g l c a 1 b a e e - 1 1 n e l s t h a t o t t t r e p a r a s 1 t e . r a t e o f 2 7 . 9 z(wlth P. falclparuu constltutlng 27.47) recorded fron a naee blood survey ln January 1978.EDtonologlcally, cullctfacles roon density nas kept below one under the spraytng rounde off978-198f except for certaln peaks ae followe:
- Auguat/Septenber 1978 and Novenber 1979, tor whlch the condltlon of the roonesurveyed was not lndlcated;
of
- Sone rlelng trend, though rnoetly below one per roon, wa8 obEervedl98l and Novenber 1981, but thl.s nas found to result fron incorporatlng
lu Hay 1980, Junethe nrrmbers of
cullclfaclee collected fron unaprayed or altered roons.
Paraeltologtcally (Ftg. 23a), there waa a pronounced reductlon ln the overall paraslterate recorded fron a naaa blood survey carrl.ed out about six oonths after the flrst sPrayround of 1978. Bowever, thle reducti.on waa not euetalned stnce the eubsequent 8ix nonthlyparaalte rate lncreased at the end of 1978. Further decllne wae obgerved ln the paraeiterate recorded ln July 1979, thereafter the paraslte rate levell.ed off ln 1980 and early1981. Ilhen only the predooinant Lnfectlon, !!g}g;!gg, trae considered on the basls ofanhual uaas blood aurveys (Flg. 23b), 1t becane clear that conslderable reductlon occurredln P. falclparuu infectlon rate reachlng 402 of lte orlgl.nal level. after the flret year ofeprayl,ng, eubeeguently levell lng off with 8ltght reductlon at the beginning of 198'1.Coneiderlng the probleme of coverage, the l lolted el.ze of the trlal area, the movenent ofthe populatton to and fron unprotected areas, Lt would eppear that the levell lng off of thenalarla prevalence rras the net outcone of the lnteractlon of DDT epraylng and theee
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vBc/90.3MAL/90.3Page 222
factors. To accelerate fur ther reduct lon, other measures ehoir ld be sought , pr lnc ipal ly
envlronmental oanagernent by englneerlng nethods to control the extenslve fornatlon of
srranps ln the "o,r.i"
of the adjacent .r"tt"y. No susceptlbil l ty tests have been done ln
thls area and thls should be a priorlty beiore the expanslon of the spraying oPerations
wi th DDT.
(2>IJ : ia ls of ant l larvaL neasqree:
coasrar ".:ii ;"ti!l"ll"i '"
test the ef fect of tenephos larv lc td lng on vector breeding ln cenent baslns used for nater
storage euch as those found ln the gatinatr reglon along the coast. The operation started
ln January fszz co.,eiing breeding places tn ttre v' l lagi of Seeb ltself. It wae extended to
cover slx vilrages in lt iscat and-Al Khwelr area in Aulust 1977, L9 vil lages and 2l vll lages
Ln other surroundlng " . " " "
ln 1979 and 1981, respect lve ly . Belng accesslbre to the
capltal, ltuacst, the operatlons ln these areaa recelved maxlnuu eupervislon from the senior
Btaff of MCS and ll l to Technical Offlcers. The dosage of tenephoa Itas deslgned to be 10
rg, la t at weekly ln tervals .
T h e r e i s n o e n t o n o l o g l c a l b a s e - l l n e l n s e e b ; t h e o n l y p a r a s i t o l o g l c a l b a s e - l l n e c o o e sfron a oass blood survey iarrled out ln November 1976, Just before conmenci'ng the
larvlcldlng oPeratlon. Thls is taken a8 the orlginal level of the overall paraslte ratel ^ ! - ^ f i l r a
(rg.gz wlrh the P. falclparun rate being L6.42). As shown ln Fig' 24a, d'ata of the
Po6t-oPerat1ona1'ffioi-"o:.r"ri'"r?"::T:T:::1":::?1:.:-1".l31':.'i::i ' i:};POEiL-OPelALrvuor t
r e c o r d s e h o w e d a n 1 n c r e a s e 1 n r o o n a . " f f i J u 1 y l 9 7 7 . D u r 1 n g t h e s a m e p e r 1 o d , 4 . 2 5bt tes/oan/n ight for cu l lc l fac leq r" t " . " "L.ded outdoors, whl le no vectora were caught
1 n d o o r e . S 1 n u 1 t a " " o f f i - " " s 1 t y o f s t e p h e n s 1 r e s t t n g 1 n h o u s e s a n d b 1 t 1 n g D a n w a srecorded. Subsequently, the denelty'of c;if i : iE;ies undei the larvlciding scherne was kept
under one per roon except ln NoveoUer t979-ii?-nber 1981' 0n the other hand'
stephensl was only found occaelonally. Compared-*tttt ttt" untreated area' Barka (Flg' 12)
these flndlnge represented a consl.deiabte reductlon ln cu119lf?9tes denslty' The
inconplere room lnd1ces of 1977 did nor allow conparlsoil i i frTfflarasltologlcal trend'
The paraslte rate steadlly decllned, reachlng a narkedly low level ln August 1977' about
nlne nonths after the start of the larvlcldlng oPeratlons. subeequently, the Paraslte rate
started to rlee early ln 1978' contlnulng to ao lo ln 1979 and onwards, wlth the exceptlon
of rwo reductlons: one Ln Septenber 1979 and the other ln December 1980 (Flg' 24a)' Th"
overall paraElte rate lncludtng the P:.f?lc-lparun rate contlnued to lncreaee and in the
lasr observarlon r"a. i" U.rcUTeprff-Tg[T@rate waa aE 7LZ of lts orlglnal level
(Fig. 24b), It 18 extreoely dlf i lcutt to explal-n why the larvlcldlng operatlone in the
flrst year of appllcatlon had a Pronounced lopact as evldenced by the favourable
paraeltologlcal trend, and that such responee could not be sustained as the larvlcldlng
prograDDe progreeeed. Factore related to ttre enall slze of the area and roOvenent of the
populatlon tO adJacent unProtected areas have possibly rernained constant' It I 's also
assuaed that cloEe eupervislon by the central MCS staif has been nalntalned througtrout'
Aoong factore that ehould be lnveEtl 'gaEed are tho6e of an operatLonaL nature such as
changes ln larvtclders,gtrgnges ln the flret echelon supervliors, and changee in nozzle tlps
wlthout proper retrainlng of larvlcldere, all of whlch would affect the appllcation of the
optlnun dosage and coverige. Added to thls, sone selective sanpllng occurred durlng the
blood surveys that were carried out at the later stages of.the trial- ' Regardlng the
posslble technlcal factore, susceptlbll l ty of the vector(s) to tenePhos should have been
conf i rned [eee Subeect lon ( t ) , under 4.L2-z Shldrawl , 197e i p" t "ot t t1 communlcat lon 1990] '
(b) l luCairlb, S.hafqutyq reglon, undeT envlTonoeqtal manaFement/teneqhos 1?TY1919lng:In the paatr Mudalrlb locallty repre
nonic
developnent. As wltneeeed by Zahar (unpublishel observatlons, L977), the problem was
created by the excessl.ve watlr supply, ihe natn 6ource of whlch was a eerlls of "Faladges'l
(eee deecrlptlon below) elluated far-iron the locallty, and the water reachee the locallty
ln underground tunnels by gravlty.- Four naln open canals peneErated the locallty'
dlstrlbutlng the nater aDongst houees for donestic use and lrrlgatlon of paln and cltrus
groves. The locallty ltee at a lower level than the eurroundlng terrain' and wlth the
contlnuous flow of itater and lack of dralnage, the land becarne boggy and paln and-clErus
groveg nere threatened wlth excesel've water. Furthernore, people nere sufferlng fron
vBc/90.3MAL/90.3Page 223
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FI6 .ZAUSEEB
sLoPE OF FALL OF THE PARASTTE RATE OF PtotciPorun
tok rn o t IOO % ) UNDER
S ' N C E J A N U A R Y 1 9 7 7
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Page 225
nalarla; the paraslte rate recorded Ln L977 !ra6 about 202 wlth P. falclParuo predonlnant.
The Vector Control Unit of the Preventlve Medlclne Directorate carrled out aone larvicldlngand foggtng'agalnst ruosqultos whlch gave only tenporary rellef. Stlnulated by thelrwell-lnforned Judge, the inhabltants attempted to drain the excessive water lnto theadjacent dry desert, b,rt -gggg!gg.1 was found breedlng there ln the newly foroed seranPswlthin Ehe fl lght range of the vector fron the locallty. As a good exanple ofln tersectora l cooperat lon, the Min ls t ry of Agr icu l ture waa approached to Provlde technlcalexpertise and funde to draLn the excesslve water lnto a nearby dry valley. Accordlng to aprevious report (Bahar, L979 - unpubJ.lshed report to !fHO), the Department of Irrlgation wasaware of the sltuation ln ltudalrlb; a proJect for controll lng the surplus itater was 1nprogress and about 9OZ of. the work nas accourpllshed by Aprll 1979. The assessoent teauvislted the area in Decenber 1981, and was fuopreesed to 6ee the great fuoprovement ln theecological condltlons ln the locallty. The flelds where paln and cltrue tree groves havedrled up, though covered wlth salt cruets, a situatlon whlch needs further attentlon froDthe agriculturel authorlt les. At the entrance to the locallty, the water lras controlled bythe con8tructlon of Cwo gates: one to allow the optlnun aDount of ltater to go through thelocallty, and the other to dlvert the excees to the nearby valley. A further control eraarnade at the rear end of the vll lage. Due to the scarclty of ralnfall ln recent yearatthere has been lltt le exceaa of water to be dlverted aB the amount of ltater coning fron Lte
aource was eufflcient to meet the need of the locallty. Undoubtedly theee droughtcondltione have also helped, hence the locallty should be watched carefully when wetcondl.t lons agaln prevall. The baee-llne paraelte rate in l ludalri.b as recorded ln January1978 was 19.32. In Septenber 1981, l t fe l l to l5Z of l te or lg lnal level . A l though uaesdrug adnlnletratlon and envlronnental ltanagenent oeasures were applled slnultaneouely untLlthe nalarla prevalence naa reduced, there have been no adveree effects when it wasdiecontlnued. The perrmnent control ach{eved was supplemented by tenephos larvicldlng. An
lnportant source of vector breeding whlch renalned were 162 welle; several of theee wereunueed. The problen of dlsueed wells exl.ste ln roany areaa of Onan; the lnhabttanta refuseto f111 then ln, because euch welle repre8ent a aource of water supply Ln case of drought.During the vislt of the aasessoent team, these wells, together wlth a few eeepages, wereunder temephos larvlcldlng. To save the coet of larvlcldtng the dlsused wells, lt wae
suggested that they nay be covered wlth locally avallable cheap naterial such aa paln wood
and leaves, through connunlty partlclpatlon. An exanple waa seen ln the welle ln Barka
local l ty .
(c) Trlal of larvlvoroue flsh ln Sauayel, Interlof.reglgr: The valley of Saoayel ls
about lO cted to aaseaa the ef fect of
conbined lDeaaureal i.€., blologtcal and environrenal control. The larvlvoroue flah
Aphanlus dlepar whlch nas orlginally dlecovered naturally breedlng ln snall pools ln the
;Auree of@el valley was utl. l lzed. In November L976, the fleh were seeded ln welle ln
whlch cullcifacie3 bred, at the rate of l0 flsh per well. Lsrvae were not checked Prlor to
nor aftfi-fiffiTioductlon of the fish. It nas observed, horever, that the fi'sh were
thrlvlng ln the welle throughout the trial perlod. In the courae of the Sanayel valley
where siephenet, f luvlatl l le, g9rge,!g11 and d-thall were breedlng durlng the favourable
eeaeon;:ili;E;h Ere-ac-G onTEffiivae li-Tf,e-larger poola, but could not penetrate ln
the enaller and nore ehallow pools, ao Doaqulto breedlng contlnued ln euch eltee. Ae a
supportlng Deaeure, aource reductlon lnvolvl.ng clearlng of the rtFalaJrr (water drarm fron
dlstant epr1nge ln the roountalns for lrrigatlon and domestlc uee) through the valley, was
carrled out Uy the lnhabltants and the nunlclpallty. Accordlng to the MCS staff '
larvlcldtng wlth teoephoe had to be lntroduced 1n Novenber 1977, when the flsh and eource
reductlon had a ltnlted lnpact on vector populatlons; the area covered by larvicldlng wag
about 15 000 nz. Chenoprophylaxle for schoolchlldren contlnued uP to the end of 1981.
The baee- l lne paraei te ia te recorded ln May 1976 Juat before contro l s tar ted waa 17.82 ' I t
was slightly rlduced ln subeequent yeers but rose agaln ln May 1980 (1.e., three years
after the lnpleoentatlon of control meaeuree) reachlng 7O7 of. lte original level.
(d) Trtal of larvlvorous fl.sh 1l l ty : In 1979' a I I I IO
consultant (Dr R. Haae) vislted Onan and reconoended that APhanlus d18 i be trled ln
cenent water basl.ns, and further suggested that a Portlon of ttre floor of the basin be
excavated to provtde shelter for the fleh when nater is enptleil for lrrlgatlon. The MCS
etaff and the l l l tO Techntcal Offlcers conducted a prellnlnary trlal durlng June-Septenber
vBc/90.3HAL/90.3Page 226
1980 ln selected cqnent basins ln a sect lon of Barka local l ty ' As expla ined ln an
unpubl lshea t "por i l -by Mr S.E. Mat ta on th is t r la l ' 1400 wi ld caught f ish were col lected
fron l {adi Nakhl , the nearest natura l source of the f ish !o the t r la l .area ' These were
seeded in 34 selected nater baslns at a rate of 5 f lsh/nz ' No larval inspect lon was
d o n e r n e l t h e r b e f o r e n o r a f t e r s e e d i n g t h e f l s h ; t h e . a l n l t a s E o o b s e r v e w h e t h e r t h e f i s hwould per ' is t de 'p l te the per lodf" t " i " . " " o f wacer f ron the baslns for i r r igaElon ' There
was complete loss of f lsh t ron 19 baslns (56%) one week af ter seedlng ' More losses were
observed in subsequent weeks untl l the 13th week when only 10 basins- (29%) etiLl had flsh'
two of whlch had spaun but these were then cleaned and dried uP by the tnhabitants' Four
srnal1 baslns \rere seen by the assessment tean to harbour the flsh slnce seedlng 1n June
1980. The explanaElon of fered was that the f ish could shel ter in an underground p ipe
connecting the eDatl baslns wlth the larger baslns' The concluslon drawn was thatt as
vector breedlng in BaElnah coa8t occurrlng in cernent water baslns whlch were estLrnated to
beabou t450001nas t r1p300kn ro , ' g , t i l euseo f - s r yw11 rabecos t1yandiropracticable uecause rhe fish would t"*r" to Ue cotff i i l i lTEan'Ported frorn distant high
val.leys where they breed [see under (4) belowl' However, the assessEent tean thought that
more trlals shoul.d be conducted before rullng out the use of f lsh tn thls type of breedlng
place; rhe natLonat ana I{Ho staff .;;"";:--i i "t"
also agreed that atteDPts should be uade
to establish ftsh nurserles at v11lige level as previou"iy "ttgg""ted
by ttaas (1979) so- that
the effort and co6t of collecttng anl transportlng wild caught fish can be reduced' More
careful studlee rrere suggested to deternlne the frequency oi ernptying baslne for lrrlgatlon
durlng dlfferent a€aaona. Moreover, larval lnspection eirould be lncorporated ln future
t r la ls . Perhaps cer ta ln baeins wt th fat r ly f requent re leaees of water may not be sul table
for larval breedlng and may not need to ht.r" f leh or larvlcldee' The idea of excavations
ln the botton of baslns to shelter the flsh has lnportant drawbacks, as lndlcated by the
proJect s taf f . F l rs t ly , l t le qul te l lke ly that the lnhabl tante l t i l l ob ject ; secondly '
theie holes nay becooe-. "o, r r " .
o t - t .o f f f f - " . r " " to, breeding t f the f ish do not pers ls t ' Dr
A. paltrlnier1, forner WII9 ."p."""r,t.t lve ln ooan, thought a trdry dayil once a week nlght
eolve the problen cheaply and permanently 1f connunlty larticipatlOn ls stinulated through
ef fect lve heal th educat lon '
(3) Assessnent of routine oalar
(a) I'{al'arla contro+ actlvttle9 thfough,-tlig+tr-!elY1!=t-1"--lldttlon to services
provlded by the Ug@atpent of nalarillflEits as well as drug
prophylaxla are """i l"d
6ut Uy health establlshroentsr vl 'z: hospltals' health centres'
dlspenearles, publlc health conpounds and unlts' Uost cases oi ualarla are dlagnosed
cltnlcally, based on the patlent-e htetory and cllnlcal exaulnatl 'on' uslng such crlcerla'
sbout 200 000-350 000 c."L" have been replrted annually durlng the past 6 years'
Facil it lee for mlcroscoplcal dlagnosis aie avatlable fn hosplials, health centrea and four
of the flve publlc health conpounde. Dlepensarlee and publlc health-unlts do noE have
laboratorlee. In publlc health cornpounds, thlck blood it""." stalned wlth Glernsa are ueed'
whlle nearly all hospltals and treafitr ""rrir."
uee thln blood fl lns stalned with Leishman-e
staln. The latter nethod is not satisfactory for nalarla dlagnosls and perhape for thls
rea6on the physlcl.ans worklng ln the 14 hospitals and l0 health centres rarely rely on
blood Bmeara for dlagnosle. Brood snears are apparently taken ln only about 102 of the
suspected casea, f.el, Ehoee for whlch the phyeitlan le not sure of hls cllnlcal
dlagnoste. Blood "r".""
examlned Ui-trospftale and-health centres are rarely sent to the
UCS laboratory for checklng. In thlse tirat were checked' errore were qulte frequent
partlcularly 1n sPecies dlagnosis'
Three-day treatment wlth chloroqulne ls adninlstered to all Patlents suspected of
havlng r'ararla. Because of the srnali number of cases dlagnoeed mlcroecoplcally and errors
of blood examlnatlon, very few patients tt lth P' virvax lnftctione receive prlnaquine
treatment. Maternal.and child l lealth unlts aEiff ir weekly antlnalarlal prophylaxls wlth
chloroqulne to Pregnant ltomen and to pre-school chlldren attendlng thelr clinlcs' This
progranme appear' gulte effectl.ve arrti"g Pregnancy but the Percentage of wonen and chlldren
l. S.E. l.[atta: Noteo on prellulnary observatlonE on Aptranlus dls-pgr fleh behaviour ln
ceDent lrrlgatlon cl.eterns at Barka, Batlnah coa6t, sultanate ot uman'
vBc /90 .3l.{ALl90.3Page 227
at tendlng af ter del lvery fa l ls rapid ly . Weekly prophylax ls wl th chloroqulne ls a lso^
adnlnlstered to schoolchlldren outside the capltal area of Muscat. The coverage achleved
by thls progranne aeems to vary conelderabJ.y fron school to school. It works best when a
health visltor froro the loca1 publlc health unlt or coupound visits the schoola on a
regular basle and personally eupervlses the adnlnlstratlon of the drug'
(b) Rout lne appl lcat lon gf tgnephos laTvtq l { {ng: In 1976, temephoe larv ic ld ing was
s t a r t e d l n s o m e u 9 t r e g 1 o n s , a n d w a s e x t e n d e d d u r 1 n gLg77-Lg79. The target doeage of tenephos ltas l0 ug/n' at weekly intervals'
Entonologlcal checklng was elther lacklng or inconpleter thus the present assessmenE was
based on the availabl! parasltologlcal data. For exarnple' a'sessment_ of these operatlons
in Bahla localtty of thi Interlor reglon showed a steady decllne ln the paraeite rate fron
lts pre-operatlonal leve1 of 19 .97. L; Aprll 1976 to 267. of. lts orlglnal leveL durlng July
L97g. Ilowever, thle level waa not sustalned as the paraslte rate ln Apr11/May 1980 rose to
457 of. its orlglual level. Anong the posslble factore ttere sone laxlty in supervislon (and
thl.s also appllee to all areaa where larvicldlng !s carrled out by the publlc health
compouods and unlts, ae well as changes ln nozzle tlpe and larviclders' without proper
trainl.ng a6 mentl.oned above.
(4) Coet of contro l t r ib ls : Having aesessed the degree of ef fect lvene8s of d l f ferent
nethods ut-iTiEiT tt is nece6sary to constder the cost lnvolved. Frorn a ProJect worklng
paper (S.8. Uatta, IIHO Technl.cal Offlcer, unpubllshed report to WIl0, l98l) and other
lniornatloo provlied by HCS, the cost of vector control oPeratlons, lncludlng the cost of
insectlclde twhere appitcaUie), traneport, salariee/wages and allowances was calculated as
fo l lowe:
DDT res ldual house sprayi -ng (as appl led ln Shlnas) :3.8 US dol lars per capi ta 'p 1 1 e d r n s e e u ) : a b o u t l 5 0 0 w a t e r b a e l n e i n a n a r e a l 0 k n
-@ 1 t h a p o p u 1 a t 1 o n o f 4 0 0 0 : 1 2 U S d o 1 1 a r e p e r c a p l t a .Aphln lus d iepar col lect lon-and dtet r lbut ion ln water baslns ( ln Barka) : l l .6 US
dbl lars per basl .n or 3.6 per capl ta
The hlgh co6t of house spraylng and larvlctding was attrlbuted to the htgh cost of
lnsect lc ldee. In re lat lon to larv lc tdtng, there was a leo an addl t lonal factor whlch wae
the low populatl.on denslty compared nlth the large surface area of the water baelns to be
treated. The use of larvivoroug flsh rrag costly becauee of labour and cosE of transPort
involved Ln collectl.on and dlstrlbutlon of f lsh. As shonn above lunder (3)d] reductlon ln
cost Eay be achleved lf local f lsh nureeriee are establlehed at vll lage level'
Flnally, the asgesement teao propoeed a readJustnent of exletlng plans for expanslon
of nalarla control ln the country. Further, eeveraL reconmendatlona were presented:
(a) To ensure intersectoral cooperation, a Ualarla Control Coordlnatlon Board should
be eatabllehed and be forned of repreeentatlveg of nlnlstrlee, departnenta and agenclea
concerned.
(b) Approval of the annual budget for etrengthening the central- MCS and stafflng the
perlpheral-ltalarta Control Statlone should be expedlted' othentlee the expanslon of
activlt les w111 be hanpered or elowed down.
(c) Stnce restdual house spraylng Ls not the oeaeure of cholce for long-tern nalarla
control, i.t le recoooended that efforie be oade to develop non-cheolcal measures to be
applled on an operatlonal scale 1n order to eventually reduce or discontlnue house
epraylng.
(d) In vlew of the problen of DDT reeistance appearing ln the naln vectore'
culicifactea and etephensi, lt !.s recommended that early aclion be taken to i leterolne the
;Fg;[;ffi'e proEFn-lid-lts opeiatlonal lnpllcatlone ln areaa currently under house
apraylng.
(e) Ae the entopologlcal work ls lncreasLng due to the appearance of technlcal
problens and to the evaluatloo regulreDeota of dlversif led vector control meaaurear lt ls
vBc/90 .3MAL/90.3Page 228
recommended that b i la tera l ass ls tance be sought for establ lsh lng a PosE for an
lnternat lonal ly recru l ted entonologist for the next f ive years.
(f) It ts of prfune lmportance that the recruitment of onanl natLonals be sought fron
nolf on, so that they can be properly trained and be ready to assume their reeponslbil i t ies
in the MCS. Such key personnel conpr lse:
- I Medical Of f icer to be awarded a fe l lowshlp for Postgraduate studies leadlng
to a Master Degree in publ ic heal th (wl th najor ln nalar ia) , to be appolnted as a Dlrector
of the MCS wl th in the Min is t ry of Publ lc Heal th '- I Graduate of Science or Agr lcu l tura l Science (wl th najor tn Entomology) ' to be
awarded a fellowshlp for postgraduate itudies leading to a Master degree in Medlcal
Entornology, to be appotnted Deputy Director in the MCS'- I Chlef of operations to be eelected froro among the present nalarla natlonal
staf f or wi th a eecondary school leavlng cer t i f lcate, to be awarded a fe l lowshlp to obta ln
a Diplona of Sanltarlan frorn a school of publlc health and further to attend a oalarLa and
vector control course.
(g) In order to lncrease the capabll it les of the exlstlng and newly recrulted
non-professlonal staff, a tralnlrrg progt"tt" should be establlshed for all categofies' The
tralnlng should also be glven to st;ff of publle health unlts, hospitals and other health
establlshnents. It is recornrnended that the,original oalarla tralnlng centre in Muscat (now
used for tralnl.ng nursee) should be restored for malarla.
. (h) Per lodical assessment of roalar la contro l should be a bul l t - ln act lv l ty to detect
deflclencles and lnplenent lmrDedlate remedial actlon. Mld-tern aasessment (every 2-3
years) and overall assessnent at the end of the 5-year plan are of prine funportance for
deternining the degree of progress made and lntroduclng further readJustnent for the
expanslon of the Plan.
prograEne asseasment wlth UAE should continue and coordlnatlon of nalarla
ln the tno countrles be strengthened wlth a vlew to achievelng eet
8 t € 8 5 o
(1 ) Pe r l od i ccontro l act iv l t lestargets ln border
(J ) Specta l lnvest lgat lons are requl red ln Dhofar , Southern reglon, for a deta l l led
assesament of the nalarla situatl.on roi for plannlng approprlate measurea alred at
ellnlnatlon of any focal Dalarla transnlsslon'
(k) Health educatlon should support aLl actlvlt les of the nalarla control PrograllDe'
It ehould be lntensified at all leveis lncluding vll lages' schools and other establ' ishnents
uslng the loost effectlve rnedia and nethode'
As oent toned ln Subsect lon ( t ) under 4. I l and 4.12 abbve, sh ldrawl (1982 - unpubl lshed
reporr ro I{IIO) found that the level of DDT resl.stance 1" Sg999"91"". ln shlnas area'
Batlnah region under DDT spraylng has greatly lncreased' -torozolEe-poeLtive sPecloene
w e r e d e t e c t e d l n b o t h 9 @ " " a " " . e n [ $ ' . t h e 1 a E t e r s p e c l e s ! ' a s a 1 8 o f o u n d t o b ehighly reslsrant to oot-G$T operEE-onal d.fects due to low coverage occurred' lt was
diff lcult to determlne the role of DbT reslstance ln perslstence of roalarla transnisslon Ln
thle sprayed area. Shldrawl, therefore, also oade suggestlons for achleving high 6Pray
coverage, so that the lnpllcations of Oi'1 reslstance .tot" can be determlned on the basls
of whlch the u6e of a sultable alternatlve lnsectlclde can be sought'
F a r i d & } 1 u l r ( 1 9 8 5 - u n p u b l l s h e d r e p o r t t o l l l t O ) v l e l t e d o n a n f r o n 2 3 M a r c h t o 5 A p r l l1985 to aaseas the nalarla situatloi, t""f.t the achlevements of the malarla control
progranne, revlesr the Plan of Actlon of 1985 wlth dlscusslons on the future plannlng of the
antimalarla PrograDme, and assess the neede of oanpower reaources and tralnLng' The
developmenr of rhe antlnalari. progi*r"-iotf"g f9i6-1980 and 198l-1985 wae revlewed' A
,rmr".y of the flndings of the latter perlod ts glven here'
vBc/90.3UAL/90.3
. Page 229
(a) Organlzat lonal aePects and budget :
- Establ lshrnent of nalar la unl te ( - s tat lone) : The Mln is t ry of Heal th sanct ioned
a budget adequate to establ lsh f lve rnalar la uni ts and assign the necessary staf f to each.
The naln functlons of theee unlts nere to carry out geographlcal reconnaiesance of the
breedlng places ln thelr respectlve governorates and lnplenent and eupervlee anEllarval
operati;ns. Tr.ro of these unl-ts were vislted by the teao (Mudhaibl and Ruetaq). It was
found Ehat the assigned number or orderllee origlnally approved for each unlt could not
cope wlth treatlng all the breedtng places wlth ternephos, and a number of Onanl workers
paid dally were assLgned to all nalarla unlts whlch becaroe able to extend thelr activlt les
io netghbourlng govertorat"". There ls a need to strengthen these unlts and deflne thelr
functlons nore clearly so as to oake thern conErlbute nore effectlvely ln both oPeratlonal
and epidenio loglcal act lv l t les.
- Budger: The Mlnlstry of l leaLth budgetary allocatlon to the MCS and lts f ive
nalaria unlte greatly increased durlng 1984 reachlng the equl'valent of US dollars
| 896 7g4. In addltlon, rhe Malarla Voluntary Fund of the Gulf Arab States, whlch was
establiehed 1n 1980, lnlttally provtded about I oll l lon US dollare to Procure the neceesary
transport, lneectlcldee, eprayLng equtpnent, aud to Pay rtages of tenporary workers.
Thereafter, the Fund contLnued lts f lnancl.al eupport to the Progranme ln an aEount ranglng
fron 0.5 to 0.75 n l l l lon US dol lare annual ly .
(b) Expanelon of antloalarla agglvlt lee: The MCS, as816ted by the concurrent
d e v e 1 o p u e o r a t e a , b e g a n t o c o n t ' r t b u t e t o t h e c o n t r o 1 o foalaria through larvicldlng, partlcularly ln the governorates where the nalarl 'a unlte had
been establlshed. The very tlUtea number of ualarla sCaff attached to the publlc health
conpounde and unlte could only larvlctde a llnited area near the town where they were
asslgned, leavlng the remote vll lages without protectlon. The MCS belng keen to Protect aB
rnany lnhabltants ae poasible, relled on DDT house spraylng carrled out by lte own teans' to
"oolr all vtl lages |n 15 governoratea. Thus, the DDT spraying canpalgn expanded fron four
governorates Ln l98I to f5 fn tgA+. The tlning of the annual DDT spraylng ltaa March/Aprll
in the foothll l areas, and Septenber/0ctober ln the Batlnah reglon. The larvlcidlng
operatlons were well organlzea ln the governorates where the five roalarla unlts exlst, but
ln other areaa, the l lnlted nunber of nalarla personnel and lack of eupervlelon have
reetrlcted the work to the capltal of the governorate and a few acceeelble vtl lages wlthln
a radlus of 10-20 ko. There have been cerialn problens encountered ln applylng the above
chenlcal reaaures, ln partlcular, house spraylng due to refusals by lnhabltants, locked
houses or peruiseiot to spray only certaln rooos. Thts has been the reason for the
defective coverage of DDT epraylng whlch reached in eooe governorstee ebout 702 of the
houses (not to rentton the sprayable surfaces mlssed or refused). In larvlcldlng
operatlone, garden doore were seldon locked. However, occaslonal overdoelng kt' l led en811
flsh. Cre61i goes to the ltCS for conductlng geographical reconnal'esance' partlcularly ln
all vl l lages tn the governoratea eubJected io-t"itdoal apraylng. The MCS sas, therefore,
- able to provide, for the flrst t lne, eoue factual data on the ceneue of the populatlon and
the nunber of vll lagee and houeeg ln varloue governorates. The field oalarla unlte also
surveyed and nunberid all permanent breedlng pl.aces of the flve goverrrorateE where they are
locatla, and have been extendlng thelr actlvlt lee to nelghbourlng governoratea aa r0entloned
above.
(c) Uethodolo :.The nethodology adopted ae shown I'n the
l 9 8 5 P 1 a n o t l c t r 1 9 8 l . l 9 8 4 , 1 s b a e e d o n t h e f o 1 1 o w 1 n g :
- Selection of a nuober of lndlcator vll lages ln selected governorates and
conductlng mass blood surveys ln l0Z of the populatlon (aLl agee) durlng ltarch/APrll ln the
go.r""r,or.ies of the coastal area, and durlng Septenber/October ln the foothll le'
- Paselve case detectlon by health eetabll.ehnente, glvlng the nunber of
outpatlents, number of nalarla caaes dlagnosed cllnlcally, number of ceaes exanlned
rnlcroscoilcally and number fouud Poeltlve.
- Entooologlcal uonltorl.ng of breedlng places under larvlctding eupplerented by
adult eanpllng (hand capture and pSC) fron a fen selected indicator vll lages, where
nan-balt cspture le alao carrled out regularly.
vBc/ 90. 3MAL/ 90. 3Page 230
The MCS cont lnued the above act iv l t ies year af ter year and presented the respecEive
data in annual repor ts wl thout cornment lng on whelher the programme was progressing or not '
Local epidenics kept on flaring up and "ot" ""t"
to be known only accidentally' The nunber
of c l in ica l ly d iagnosed cases d id not substanl la l ly decrease, and even the nunber of
rn lcroscopical ty conf l r rned cases la te ly showed an upward t rend despi te successive years of
re lat ive drought . The tean found i t d i f f icu l t to evaluate the inpact of the ant inalar ia
rnea6urea frorn the available datar as the rnethodology of evaluation left much to be
desi red. The connents of the tean on th is nethodology were:
- The pract ice of tak ing b lood saoPles f rorn I0% of the populat ion of each indicator
v i l lage le f t the nay oPen for the b lood col lector to choose h is sarople f roru accesslb le
adul t age-groups, o, t to t schoolchl ldren of d i f ferent ages ' When the tearn requested
resul ts of the vulnerable age-grouP (6-9 years) , i t was found that these were sampled
i r regular ly dur lng f982-1984. I t was aLst noted that f roro the resulgs of bLood exaoinat ion
of the 6-9 year-o ia " t i tar"n,
out of 25 v i l lages surveyed in 1982 in 12 governorates ' only
three v l l lages were examlned ln 1983, and one ln 1984. Two v i l lages in Bid Bid governorate
rrere Eurveyed in l larch 1982 when a parasl te rate^of 3.82 was recorded' one of the two
vi l lages na6 agaln surveyed ln 0cto ler 1983, g lv ing a Parasl te rate of 27 'L7" ' A11 these
vil lages ln this governorate Itere sprayed ,it[ pOt ln ]larch 1982 and in March 1983'
Despite thls spraylng, the paraslte ,.t" .o". ln October 1983 by more than 7 tiroes' The
blood surveys coniuc ied ln ind lcator v i l lages f roro eelected governorates (wl th assor ted
age-groups) were etar ted only ln 1983 and . "p"" t "d ln 1984. The resul ts of these surveys
cannot be relied upon as they lncluded unknown numbers of adults whose ages r Dovenents, and
even natlonallty were not ascertained. The only slgnlflcant decrease could be observed in
the Bat lnah reglon, the SPR fa l l ing f rom 6 '77" to 2 '22 '
- The nalaria statistlcs obtalned fron health establlshments roay be regarded as
representing the overall nalarla situation, but cannot be relied upon for evaluatlng the
inpact of the antiroalarLa toeaaures in each governoratet as the catchment areas of the
hospltals and sone dlspensaries go beyond tie boundarles of the governorates ln which they
are located.
. T h e e n t o m o l o g i c a l a s s e s s m e n t c o E P r l s e d f o u r b a s l c t y P e s :
* r,Conprehensiverr surveys: These are carried out ln parallel with the parasitological
'urvey once a year in a l l ind lcator v l l lages. The entonological aurveys consist of larval
surv"ys, lndoor-restlng collections (hand caPture and PSC) and oan-balt caPture'
* nper iodlcr , Burveys: These are regular act iv i t les carr ied out ln selected lndlcator
vll lages every three months. The saropling oethods are siollar to those applled inttcomprehenslve" 6urveYs.
* r,Spot checksrt: These are addltlonal activit ies using the same sanpLlng nethods shown
above. They are intended to provlde an addltlonal aesessment of the l-npact of conErol
meaaure6r and are made accordlng to a schedule declded upon at the beginnlng of the year'
* ,rpre-controlt, aurveys: These are baee-llne surveys lntended to provlde data for
comparlson \sith those collected from areas to be covered later by antirnalaria operatlons'
The sane sanpllng nethods nentl.oned above are enployed in these surveys'
* Suscept lb l l l tylarvae and adults.
te6ts: These are sarrled out uslng the $to standard methods, both for
The aboveaentioned entonologlcal actlvit ies are carrled out by two noblle teaDs fron the
MCS. l.[aterlal colle'cted fron the 6urveys are ldentlf ied at the MCS laboratory by an
entonology technician.
(d) The present nalar ia s t tu?t lon: The nethodology so far adopted (shown above) ln
a s s e s s 1 n g t h e 1 r n p a f f i a s u r e s c a n n o t g i ' . . t r u e P 1 c t u r e o f t h e n a 1 a r 1 asl tuat lon. The teao consldered the data col lected by the heal th establ lshnents s ince 1981
v B c / 9 0 . 3MAL /90 .3Page 231
as the only source from which an lndlcatlon of the nalaria trend over the years can be'
obta lned. In th ls respect , l t was assuned that the errors PerPetuated by the c l in lc lans in
c l in lca l d lagnosls of nalar la , as wel l as by the laboratory technic ians ln n icroscopic
examlnat lon of b lood f l lns as pract lsed ln near ly a lL hospi ta ls , thus Ehese errors reoalned
the same over the years, hence a conparLson can be nade to show the nalar ia t rend.
Exanlnat lon of data of heal th-establ lshroents showed that g lobal Presentat j .on of caees by
reglon conceals local f lare-ups occurr lng ln cer ta in areas of these regions. However, the
In ie r l o r r eg lon wh lch showed a SPR o f 19 .22 ,2L .97 " ,25 .5% a r rd 13 .92 i n 1981 ' 1982 , 1983 and
1984, respect lve ly , does lndicate the ex is tence of such epldenics that ra lsed the SPR in
th ls reglon. Moreover, the records of HaJar Gharbl showlng SPR of 532 and 60.4"A in 1982
and f983, respect lve ly , do lndeed lndicate that a very ser lous Dalar la eptdenlc s t ruck th ls
region during the two consecutlve years, xrost probabl.y due to optloal rainfall. Such
happenlngs could occur ln most footh l l l areas, once noroal ra lnfa l l ls resumed af ter the
last two consecutlve year6 of drought 1n the naJorlty of governorates. The average annual
nunber of c l ln lca l ly d lagnosed cases recorded by heal th establ lshnents ln 1981-1984 can be
taken as representlng the annual malarla load ln these establlshnenta. The average nunber
of these ca6es was estlmated as f58 848 ln Ooan as a whole. From nonthly data ln the
senl-annual report of 1983, the monthly average of L-fg.Lg!.ry lnfectlon was 93.32 of aJ-1^
lnfect lons, Lndicat ing the great heal th hazard that th ls of ten fata l ln fect lon imposes on
the lnhabltants. The ualarla records of Buralnl hospltalr sltuated ln a nalarla-free area
of UAE, and whlch draws at least three quartera of lts nalarLa caaes frorn the Sultanate of
Onan, are qulte elgnlflcant, a6 they can reflect the nalarta sltuatlon ln the two adJotnlng
reglons of the Sultanate (nanely Dhahln and the Interlor) fron which nost of the inported
casea to Al-Aln con€. These recorde ehowed that up to 1982, the nalaria eltuatlon wasqulte statLc, but lt was lnportant to note that the percentage of P. falciparuro has been
increaelng slnce 1979. Thls phenonenon was algo observed ln nany blood surveys conducted
1n the Sultanate. In a blood survey conducted 1n Uay 1973 anong school.chlldren of Btd Bld'
P. v ivax represented 38.92 of a l l posl t lve caaes, but ln a survey ln October 1983' there
were2CposltLve caaes out of 96 puplls examined, and all these posltive ca8es wereP. falclparuro. Thls very marked change ln the paraslte fornula over 10 years should be
6'orouE[1y-Gve6tlgated ae lt Day be a harblnger of the exlstence of chloroqulne-resle-tantstraln of P. falclg-:Ig ln Oman, which hae not yet reached a detectable threshold. Durlng
1983,95 plEGliff i-cases were tested for chloroqulne eensltlvlty and three were found
reslstantEGgffiiE conlng f ron Tanzania and ZanzLbar (Tanga and Slnglda). one of the
chloroqulne-resletant cases was also reslstant to Fansldar and had to be treated wlthquinlne and tetracycllne. About 50 passengers (a11 Onanls) cane froo Zanztbar and the
nalnland of Tanzanla every week by plane, mostly buslness people and a dlnlnlshlng nurnber
caDe to settle ln Wadl Adel ln the greater capltal area. Durlng 1984, sorne sensitlvltyteeta were nade on tno patlents l lvlng ln thls valley, and Ewo were found reslstant to
chloroqulne, but were cured wlth Fansldar. The MCS developed a Dechanlero to glve all
arrlvale fron East Afrlca, except pregnant woroen and chlldren, two tablets of Faneidar but
wl.thout prlnaqulne. [Chloroqulne-reeLstant L. falclparun stralne were recorded ln twolocal chlldren ln Decenber rgag - aee paragrilE-frffiJf
(e) Anophel lne suecept lb l l i ty tests: Fol lowlng the teats carr ied out dur ing f975-198f
w h 1 c h w e r P e o d e n t a 6 a e s a n e n t t e a n ( Z a h a r , D e 1 f 1 n 1 & R u e b u s h 'f982 - see above), few tests were nade af ter 1981, theee belng three larval tests ln 1983
and two adul t te6t6 ln 1984. Reslstance of cu l lc l fac les to DDT appeared to ex is t ' lnvarylng degreee, ln all localLtles where thl;m?iEil ie was tested. Many of the
locallt lei affected appeared to have had no prevlous treatoent wlth DDT by public health
author l t lee, therefore, l t ls l lke ly that gene f low occurred f rorn nelghbour ing areasr or
local use of lnsectlcldes Ln agrlculture rras reaponelble. The independent asaesanent team(Zahar, Delflnl & Ruebueh, 1982) was anare of the problen of DDT reslstance whlch was
developlng at that t lne and reconmended early action to deternine the extent of the6ltuatlon and the operatlonal lnpllcatlons of DDT res{stance ln areas under DDT house
spraylng. I t does not seen that act lon has been taken to th ls ef fect ; however, the fact
that the WttO Reglonal Entonologlst (Shldrawt, L982 - see above) found sporozolte-posltivespeclmens ln both cul lc l fac lee and stephensl . ln the sprayed area of Shlnas, Bat lnah reglont
is suggesrlve. Ir=-I;;68;t ro iiTE-IEIT the oltuatlon ln Yankul, where cullclfaclesappears to show signs of nultl-reslstance (to OOt, roalathlon and propoxur), shouJ'd beci ie fu l ly nonl tored. IFor deta l ls of cu] . l .c l fac les suscept lb l l l ty s tatus to Lnsect ic ldes
other than DDT, see Subsectlon (1) unaffi6-ovel.
vBc/ 90 . 3MAL/90 .3Page 232
Based on the above f ind lngs, Far id & Muir ( loc.c l t . ) rev iewed the p lan of act lon for
1985 and the future plannlng oi th" antfunalaria Programrne ln Onan' To conclude' they
P r e s e n t e d s e v e r a l r e c o m m e n d a E i o n s o f w h i c h r e f e r e n c e l s m a d e t o :
(a) Future st rategy of xoalar ia contro l !
- Residual house spraying ls to be l in i ted to areas adjacent to val leys where the
suscept ib i l l ty s tatu" " r ra
epldenlo loglcal data warrant such a measure ' The t in lng of the
spraying should preferably be f ron 15 Novenber to 15 December, unless specia l
meleorological condi t ions occur to warrant advancing the epraylng to septenber/october or
delay ing i t unt i l February/March. No house spraying is needed ln the Bat lnah reglon where
the breeding p laces " r "
t l "Et lc ted a l l year round to wel1s and baslns ' Larv ic ld lng wl th
ternephos should be regarded as the main attack measure for the whole countryt provided that
vector susceptibil i ty to ternephos is naintalned. The total coverage of the governorates by
larv ic id lng, and the need for ef fect ive superv is lon necessi tate lncreasing the number of
larv ic lders, labourers and sani tary assis tants in a l l governorates ' For th ls a deta l led
l is t o f s taf f was Presented.
- A t t h e s a m e t l m e , a l l a n t l n a l a r l a s t a f f s h o u l d b e p l a c e d u n d e r t h e d i r e c t
adninistratlve resPonsfUlttty of the MCS, whlch can deploy then to aPPly the approprlate
measurea fr, "r.tg.lcy
sftuations (using house sprayingt sPace spraying' mass drug
Fdoinistration, and tertaln envlronmenfal neasuies). space spraylng and rnass drug
adninistration of a single-dose treatment should be l inited to remote and sparsely
populated hanlets where locallzed epldenlcs usuaLly occurt and ln epldenlc areas whlch have
not yet been covered by the progranrne. Such space spraylng has to be done early in the
norning on three consecutlve days'
- On the other hand, no control measures are to be conducted without baee-llne data
obtalned fron an adequate blood sarnple of the vulnerable Z-9-yeat age grouP or from
6-9-year old school"hlldr"rr ln selected lndlcaEor vll lages ln each governorate (once iu
Septernber,/October before the ralnsr-"ta a".f"g March/Apift "t
the peak of the nalarla
t ransro lss ion season). At the same t ime, entouological - lnd lces ( lnc ludlng larval -and adul t
saopling) should be estfunated nonthly fion a nunber of lndicator vll lages whlch have a
maxlnum vector breedlng potentlal '
(b) Epldenlo loglcal evaluat lon:
- The epldeniological target should be a reductlon of rnalarla prevalence recorded ln
lndlcator vrrrages by-at least 302 of the level of the prevlous year' as ueaeured ln
March/April. Tbe nonthly entooological indlces -should show narked reductlon in adult and
larval vector densitLes, whlch stroita not exceed IZ of base-llne values as oeaaured ln the
Lndicator vll lages under optlnal breeding condltlons' l ' tonthly absenteeism from schools ln
lndlcator vll lages has to be rnonltored ninthly' Any rlse above 5Z should be lnvestlgated'
- The resul ts of PCD f ron heal th establ lshments, co l lected separate ly f ron each -
governorate, would be qulte ueeful lf folLowea up nonttrty' The data should lnclude the
total number of outpatients, the nunber of cllnlcally dlagnosed cases' the number of blood
aureara taken, and tire number of posltive cases by species'
(c) Other epidenlo loglcal act lv i t les:
- susceptlbtl lty tests should be performed in a nurober of selected vll lages in the
governorates under l lrvlcldlng or residual houee spraying' At-least one test should be
carrled out annually ln each goverrror"t" agalnst ttre insectlcide in use or a possible
6ubs t i t u te .
- Man-bait capture 1s to be dropped as a regular nonitorlng activity' and to be
resEricted to conprehensive epi'oenroioglcal lnvestigatlons of a Dalarla flare-up ln areas
where very low or negative vector adull or Larval densltles have been recorded'
vBc /90 .3MAL/90 .3Page 233
- The senst t lv l ry of P. fa lc lparun to chloroquine should be check"g !y both 1{r . v lvo
and ln virro tests t.,- a t"i- iEi' iEG-n a number of nalaria pat,ients adnitted to these
trospIfifff iarticularly among Tanzanlans. This w111 lnvolve lntenslve epidenlological
invest lgat lon Ln the lbcal i t ies where a chloroquine-res ls tant s t ra ln aPpears, ln order to
declde about prevent lve neasures to be Eaken. Pr tor i ty to be g iven to areas where
agglonerat lons of Omanls f rom Tanzanla nain land and Zanztbar cooe to set t ler e.8. r Wadl
Adei and Wadl Hat ta- t . There ls a need for a consul tant technologlst for one nonth ( la te
in f985) to carry out such tests and to t ra ln local technic lans.
- The pract lce of g iv ing Fansidar a lone to Pa6sengers coming f ron Eaet Afr ica to
prevent the in t roduct lon of a chloroqulne-res ls tant s t ratn ls not in l lne wi th the
tb3ect tve of c lear ing the P. fa lc tparuro ganetocytes f roo the Pat lent . A reglnen of
3 lablets of Fansldai + AS-G[lff iaqurne should be glven (other doses for younger
age-groups were l is ted) . This reginen, however, ls not for Pregnant women for fear of
t - ra iogentc s ide-ef fecta. The fear of pr lnaquLne haenolyElc cr lses in cer ta ln Pat ients has
to be d ispel led, ae such drugs are g iven ln h lgher doses ln Eaet Afr lca for t reatnent of
chloroqulne-res ls tant caaes wl thout untoward ef fects. such doses should be consldered ae
qul te safe, and are essent la l ln k l l l lng a l l ganetocyEes of the res is tant s t ra ln.
(d) Laboratory serv lcee:
- The practlce of oaklng thln blood fl lns and use of Lelshnan staln hae to be replaced
by the standard exaolnatlon of thlck ft lns and stalnlng wlth Glenea. The very htgh rate of
dlscrepancy betseen cllnlcally dlagnosed nalaria caaes and the results of bl 'ood ellde
exanlnattoi Uy treatth establlshnents does not glve credlblltty to the data obtalned by PCD
for evaluatlng the antlgalarla Eeasurea, nor for provldlng the treatlng physlclane wlth an
ef fect lve d lagnost tc tool to expla ln the h igh lnc ldence of fevere. Refreeher t ra ln lng
couraes for laboratory technl.clans ln health establlehnents, lastlng for at lea6t one week,
should be organlzed. ThLe recogmendatlon had been repeated prevlousl'y by all consultants
who vlslted the country.
- A1l laboratory technicians collectlng blood elldes fron outpatlents, or fron
surveys, EusE record the full name, age, o.i lonallty and vll lage of each Patlent' They
should also record the species, the slage of developtettt and paraslte denslty (ln syobole)'
and whether gaDetocytes are Preeent or not.
- Cerebral or other serlous compllcatlona of acute P. falclparun lnfectlons adDltted
to hoepltals should have the paraslte count ln thelr blood oonltored to see nhether
.""poo-"" to oral or parenteral therapy ls effectlve. A one-week seminar on the pathologyt
sy6ptoDatol.ogy and couplicatlons of .tot. P. falclparuP lnfectlons hae to be arranged for
the benefir of treatlng physiclane. fnyefGlG-n-ttre amed forcee should aleo attend'
- Apart frorn laboratory servlcee ln hospttale, at leaat one malarla nlCroscoplst
should be aeaigned to Publtc l lealth Conpoundl and some strateglcally placed Public Health
Unlts. These ehould be occupled full-t lne ln nonl.torlng the lncldence of the dlsease anong
outpatlenta in MCE unl.te as I 'el. l as to exauine all the elldes collected by blood suryeyl
for evaluatlon purposes. The practlce of naklng oalarla blood fl lus from cltrated blood
obtalned fron patl lnts for other haeroatological tests should be dlscontlnued' as Dalaria
blood flhue need to be taken fron flnge. pit"k" ao a8 to allow their f ixatlon on the el1de
by the ettcklnese of the 6eruD, and hence prevent washing out of the fl ln durlng the
sta ln lng proce8e.
Other reconnendatlons were made lnvolving the etafflng needs, tralnlng, health
educatlon, coordinatlon, research and Eonthly reportlng of the results'
Delflnl ( 1987b - unpubliehed report to WltO) vlslted Onan durlng l larch-June 1987 nalnly
to evaluate the adequacy and effectlveneae of the antlnalarla measurea applled t and to
prepare a request for a 5-year asslstance to the Progranne to be submltted by the
Government to the Malarla voluntary Fund of the Aiab-Gulf States. After revlewlng the
nalaria sltuatlon, lt was concluded that antl-vector Deasures cooblned wlth other factors
such as l t t t le ra lnfa l l ln the past fen years, bet ter s tandard of l lv lng condl t lons ' bet ter
understandlng of the roalaria problen Uy itre popuLatlon, better servtcee provlded by the
vBc/90.3MAL/90 .3Page 234
fast growlng network of heal th fac l l l t ies, have reduced lntensi ty of nalar la t ransniss ion
to the polnt at which concentrated ef for ts of a l l concerned, malar la could become a u lnor
heal th hazard wl th in a 1 lDl ted nunber of years. conversely, a lax i ty in the ant inalar ia
operatlons and the non-compllance with the need to apply varying oethods of control to
varying epiderolologlcal sltuations nay lead to uPsurges of malarla wlth grave consequences
for the af fected PoPulat lons '
Del f tn l ( Ioc.c l t . ) prepared a 5-year Plan of Act lon based on the fo l lowlng pr inc ip les:
- A s a p r e r e q u l s l t e t o a r a E l o n a l a p p r o a c h t o t h e m a l a r i a p r o b l e n a n d t h e b e s t
ut i l izat lon of avai lable resources, the "ont t t .y
has been st rat l f ied, according to the
aval lable ln fornaElon to f lve epldeolo loglcal s t rata:
(a) The coasta l area(b) The footh l l ls(c) The oaaes(d) The Dhofar reglon(e) The ls lands
B r i e f l y ' t h e p l a n w a s b a e e d o n t h e p r l n c l p l e t h a t l a r v a l c o n t r o l r e r o a i n s f o r a l l a r e a aa s t h e o a l n o e t h o d f o r r o a l a r i a c o n t r o l . . s o u r c e r e d u c t l o n w t l l b e p u r s u e d a s t h e m a i nmeasure to be gradually applled ln coastal plalns (one dry day a week for all irrlgatlon
basins whlch are the nain 'ourcee of vector breedtng), while larvlciding wlth tenephos wl11
be the main measure ln other areas. Resldual house spraylng_wlth-DDT will be a
complementary meaaure applled in energency sltuatlott", "oa
wh"re larval control alone 1s
not sufficlent to produce slgniflcant lnpact on the tiansnisslon of nalarla' Foothll ls and
oaaea wll l requlre a greater share of residual house spraylng. Cornrnunlty particlpationt
intersectorar coordlnatlon and gradual i lecentralizatlon oi ..tttt"laria actlvit les through
the developlng PHC systeD ln the "orrrrtty
would cornplete the strategy of oalaria control in
the conlng years in Onan. Regardlng thl toplenentatlon of activitLes, these were planned
to gradually extend the operatlons ihrougtr itre 5-year perlod so that full coverage of the
populatlon at nalarla rlsk nay be achieved by the year 1992' I lowever' the plan wll ' l retaln
a character of f lexlbll l ty and annual adJustoents need to be made accordlng to:
(a) whether or not addltlonal reaourcea and partlcularly ln relatlon to heilth
Danponer are oade avallable according to the stated needs;
(b) the aaaesarent of the lnpact of applled Deasures on the dynamlcs of malarla
transmlgsion.
Iuprovement of the work quallty and outPut are also foreseen at the central '
intemediate and perlpheral levels Lf tt" PrograEDe. Evaluatlon proceduree have been laid
down in detall 8o that a statlstlcal valld analysls of the Progress of the Prograrnae durlng
the 5-year plan can be made. Budgetary lnpltcatlons call for the equivalent of us dollare
5 658 000 ln supplles, equlpnent ana transport for the flve year perlod' Personnel to be
partlclpatfng fn'iaf.it" 'rort (preferably nultlpurpose health workers) should exceed the
present strength of 400 to reach about tboo to achleve the ful1 coverage of the population
ln 1992 .
Muir (1987 - unpubllshed report to wtlo) vlslted ooan durlng 23 Novenber-I8 Decenber
1986 to aaaeaa the entomol.ogical activlt les and advlse on the oethodology' plannlng and
lmplenentatlon of nalarla control actlvit ies'
The nalarla situatlon: At the present t lne, oalarla renains a serious health problen
ln varLous par t tof the country. In cer ta ln d ls t r lc ts , l t appears that larv ic ld lng
operators are unable to coPe ,tth th" workload, hence coverage ls partlal ' For example' ln
Saham, the Publlc l lealth Uolt can only cover part of lts area, hence donestic sources and
many garden area6 reDaln untreated; These untreated localit ies were lnevltably posltlve
for anopheline larvae when checked. sinllar sltuatlons ltere seen ln other areas vislted
where non-treatnent of water baslns resulted ln anopheli.ne production and hlgh 1'ocal
malarla Lncldence (e.g., Tanau and Yankul). There "pp""t"
to be no doubt that in
vBc/90. 3MAL/90 .3Page 235
developlng agr icuJ- tura l areas especLal ly , pro l l ferat lon of l ta ter s torage basins ls now
overwhefuolng the capaclty of the health services to coPe wlth the situatlon under thepresent operat lonal approach. Wtr11e wadis a lso forro an lnpor tant nosqui to breeding sourcetthel . r lnpact ls more loca1 and f luctuat lng accordlng to ra lnfa l l . Cenent basins, however,
are forrnlng an expandlng stable source of nosgulto productlon. Thls ls bound to adverselyaf fect the eco-epldenlo logy of nalar la i f le f t unchecked.
Pqsslb le solu l lons: Mulr ( loc.c l t . ) suggested some source reductLon Deasures asfo l lows:
(a) A ttdry daytt once a week should be rnandatory for all water baslns withln adel lDl ted heal th area.
(b) Two basins nay be used alternatlvely on a weekly basls. Inspectlon should becarrled out to ensure conpllance.
(c) Whlle a basln ls ln uee lt should be ft l led frou the bottoro and allowed tooverflow 60 aa to wash away.Dosqulto egge and larvae ae well as algal growth.
(d) A sultable standard deslgn for new nater baslns lncorporatlng the above featuresof conplete dralnage, f i l l lng fron the bottou and overflott Day be worked out lnconsultatlon wlth the Mlnletry of Agrlculture, and wlth the cooperatlon of the connunltiesuslng the baelne.
(e) Conslderatlon ehould aleo be glven to standard deslgne for new wells. Theses h o u 1 d b e e 1 t h e r c o v e r e d o r b e t r e a t e d w 1 t h n o n o 1 a y e r 8 o r @(8 . t . ) l t - 14 on a regu la r bas l s .
(f) Wlth regard to wadls, nuch could be done to ellnlnate pools forned ln sooe ar€aa.Most rounlctpallt les posseas earth novlng and gradlog equlpnent. Instances were seen (e.g.
at Al Asab and lladl Dhank) where such equipDent was actually belng used ln the wadls. -
Local health lnspectors, together wlth the entonologlcal teams, nay lndlcate breedlngsources suitable for such source reductl.on. Thls would ellnlnate much use (and nlsuee) oftenephoe, and uake larvlcldlng more effectLve. For enaller teuporary ltater collectlons lnthe wadle, elther the larvl.clders nay ft l l theo ln, or the cooperatlon of the localconnunlty nay. be eought for thelr ell idnatlon.
Mulr further exanlned the entonologlcal activit les aB outl lned ln the 1986 Plan ofActlon. Theee actlvlt iee consl.sted of nonthly surveyn, quarterly aurveys and epot checks,together wlth adult and larval eusceptlbll l ty testlng. There ls heavy emphasis onoperatlonal nonltoring. The three entonologlcal teane whlch oPerate fron the MCS centralofflce Ln l luscat are eomewhat thlnly spread over 56 governorates for undertaklng 4L4surveys Ln one year. In some casea, particularly where locallt les far fron Muecet arelnvolved, euch vlElta are of necessity rather euperflclal and non-productlve ln glvlng aproper aasessnent of the actual local operatlonal and epldenlologtcal sltuatlons. Out of16 establlehed entomologlcal posts, there are presentLy only l0 staff. The MCS as a wholeappears to be operatl.ng at about 502 stafflng strength accordlng to the 1986 PIan ofActlon. l lulr, therefore, suggested that, under the present organizatlonal ci.rcurnatance6,the nuober of surveys ehould be reduced ao as to lnprove sanpllng, and hence rellabll l ty ofdata. Regarding saopllng technlques ln nonltorlng eurveys, man-bait caPture proved verydlff lcult, l f not loposslble, to lnplenent. Sl.nce aone meaaure of anophellne presence anddensity would, however, be a ueeful check on larviclding or aource reductlon effectlvenesstbesllee belng a ueeful epldenlological lndicator, sone other sanpllng uethods should betrled. l lulr, therefore, suggested that g ttMagoontt type trap usl.ng anlnal bait ehould betested for eeneltlvity ln areae where Doequlto productlon ie taklng place.
Later, Mulr (1989 - unpublls\ed report to WHO) vlslted Onan fron 20 Novenber 1988 to2l Decenber 1988 and renarked:
(a) The nalarla sltuatlon and ualarlogenlc eources: Although roalaria lncldence ln thecouDtry a d over the four years 1983-1986, an
vBc/ 90 . 3MAL/ 90 . 3Page 236
upward t rend was observed f ron 1987 which cont inued dur lng 1988, both ln areas covered byPub1lc l {eal th Unl ts (such as Tanaro) and areas covered by Malar la Contro l Unl ts (such asSlnaw). I t appears that the current malar ia contro l act iv i t ies have been overextended lnsuch areas and the parasl te reservoi r has increased rnarkedly, p lac ing a heavy burden onheal th care fac i l i t ies such as centra l hospl ta ls and heal th centres. Thls fact , togetherwi th the steady expanslon in i r r lgat ion resul t ing f rorn the current enphasls on agr icu l tura ldevelopment in the Sul tanate, ind lcates the probabi l i ty of a s teadi ly worsening s i tuat ionwhlch, unless checked, could lead to ser ious episodes ln 1989 or 1990. Increasedproduct lon of nain ly cul lc l fac les resul t lng f ron the pro l l ferat ion of wel ls and I ta terstorage baslns, is to be expected over th ls per iod. The roain sources of vector populat ionscont lnue to be wel1s and cement water s torage basins. The four t radl t ional vectors belngcul lc i fac ies, s tephensi , sergent i l and f luv iat l l is . The exact taxononic s tatus of sone ofr -hesEls-not c lear . for exalople, the par t icu lar nember or members of the An. cu l lc l fac lesconplex which is presenE ln the counEry is not known. A new species Lt. piff i]fEi-recent ly been descr ibed Isee Subsect ion ( i ) under 4.5 above] . Thls species, whlch breeds1n shallow lrater among stones ln wadis was found associated It ith sone focal malariat ransmlss ion dur lng the present v161t .
I t is lnpor tant to note that a year of agr lcu l tura l expanslon l tas declared 1n 1988,and th ls has been such a success that expanslon ef for ts wl l l conlLnue lnto 1989. This w111enta l l fur ther expansion of i r r igat lon and cont lnued pro l l ferat lon of nater aourcese 1.€.1wel ls and storage baslns, wl th the consequence of lncreasing vector product lon.
(b) Malar ia contro l : Thls ls naln ly based on vector contro l by larv lc ld lng wadls,wel ls and water s torage baslns. Heal th centres and hospi ta ls cont inue to prov ldechernotheraput ic fac l l l t les. In the hospi ta ls v is i ted, c la ims were made of the presence ofchloroqutne-res ls tant E:_ l " l " fp* , but those have not so far been substant ia ted. Somechenoprophylax ls is occasLonal ly carr ied out in schools.
Occasional ly DDT ls used as an lnagocide ln v i l lages af fected by lncreases in malar laincidence. However, the efflcacy of thls roay be narglnal due to the presence of DDTresls tance ln the maln vectors tested. Despl te the recogni t lon of DDT as the res iduallnsectlclde of cholce due to lts good safety record and low manmallan toslclty, lt would beadvLsable to select a replacement at th ls s tage and denonstrate l ts ef fect lvenese ln thefleld. Malathlon would nornally be the next choLce, however, there would be pooracceptabi l l ty on the par t of the lnhabl tants due to the re lat ive ly h lgh standard ofhouslng. l la lath lon a lso has a narkedly shor t res idual l l fe on cenent sur faces. Test lng awLder spectrum of lnsect lc ldes agalnst the naln vectors over a greater geographical rangels therefore lndlcated.
Larvicidlng operatlons non appear to be overextended and are not naintalnlng therequired coverage. Thls has resul ted ln an lncrease ln malar la inc ldence ln cer ta inareaa. Due to the steady increase ln vector aources, a new st rategy of vector contro l lslndicated, both for shor t and long- tern appl lcat lons. Short - tern pal l la t ive aPProachescould inc lude use of s low-re lease larv lc ldal fornulat lons, par t lcu lar ly for we1ls andstorage basins, in order to reduce operat ional pressures caused by weekly t reatnent of eachsource at present. Pyrethrold-lnpregnated curtains could be used in houses ln an attenPtto reduce mosquito-man contact. In the longer term, envlronmental managenent approachesare requi red Eo n ln lmize nosqul to product ion.
(c) Entouologlcal act lv l t les: Mulr ( loc.c l t . ) noted that the dut les of thee n t o r n o 1 o g f f i 1 a n o f A c t 1 o n , a r e 1 d e a 1 a n d c o v e r a 1 1 r e q u 1 r e d a s p e c t s o fthe work, but, as ln the prevlous vlslt, he found that the number of staff avallable ls
l imi ted, belng 13 ln a l l , and th ls severely rest r ic ts act lv i t les. In practLcer most ef for tls spent on operatLonal monl tor lng in s l tes selected ln f lve st rata and ln ad hoc v ls l tE toproblen areas. Other act lv i t ies, lnc ludlng insect ic lde suscept lb l l l ty test ing aPPear to
have suf fered in consequence. An exper ienced expatr la te nedlcal entooologlst has just been
appolnted to head the entomol.ogy unit, and he should provlde approprlate guldance once he
eet t les in . In v iew of the l funl tat lons ln personnel ( there are no lnsect co l lectors or
f ie ld assis tants) entonologlcal act iv i t ies should be deployed so as to ref lect theprograrnne requlrements ln a balanced and effectlve way. Muir again suggested that
vBc/90. 3MAL/90.3Page 237
activit les such as oan-balt capture should be enployed only where sone epldenlologicalconcluslon .Ls requl.red. Thle technlque should be replaced by sone other sanpllng nethod tfat a l l posslb le. Entornological act lv i t les should a leo evolve a long wl th changes Ln theoperatLonal s t rategy of the Progranne.
Baaed on h ls observat lons dur lng thte v ls i t , Mulr recomnended the fo l lowing:
(a) As an lnterlm measure alned at reducing the nalarlogenlc effect of expandlngagr lcu l ture, and easlng the burden on larv lc ld lng operat lons, t r la le should be carr led outw l th :
- s low re lease fornulat lons for l r r lgat lon baslns and wel ls (par t lcu lar ly d lsusedwel ls) uelng tenephos or B. t . I t -14.
- uae of pyreth!6fd-lnpregnated curtalns ln houses to reduce vector-man contact.
(b) The Sultan Qaboos Unlverslty ehould partlcipate in connunlty health approaches tonalarla control ln f leld applled research lncludlng envlronmental nanagenentr PartlcularlyBtandard deslgn and node of uee of lrrlgatlon baelne.
(c) A replacenent lnsecticlde for DDT ehould be ldenttf led and tested ln caee of need.
(d) Ineectlcide eueceptlbll l ty levele of the varloug anophellne vector specl.ee ehouldbe ruonltored nore closely.
( e ) } l o n 1 t o r 1 n g t h e e e n e 1 t l v 1 t y o f 3 @ t o c h 1 o r o q u 1 n e e h o u 1 d a 1 e o b etntenElfled, lneludlng response nonttorlng by hoepltals.
(f) Deploynent of entonologlcal personnel should be nodlfled to reflect any changes lnoperatlonal approaches ln the near future to provlde clearer baee-llne data on anophellneldent i ty , d is t r tbut lon, b lonoDlcs and vector la l lonportance, for f le ld appl led reeearch.
(g) The Senlor Sanltary Supervleor, Entomology Unit, UCS would greatly benefit frou a
refresher courae on baslc nalarLa contro l .
(h) Durtng hls hone leave, the expatrl.ate entonologlst ehould acqulre some knowledgeof the newer entonologlcal techniguee, euch as ELISA detectlon of sporozoltee at theMalarLa Research Centre, Delhl, India. LLalson wlth the nedlcal entonologiste of theDepartneot of Blology, Sultan Qabooe Unlverslty would a18o greatly beneflt the UCS.
(1) Occaslonal checklng of lnternatlonal f l lghts arrlvlng at Seeb and Salalah airPorts
for lnported lneects would be a useful nonltorlng actlvlty ln general, and ln partlcular
wlth regard to poeslble lntroductlon of An. arablenela fron nelghbourlng countrlee Iofaouthnestern Arablal or fron troplcal Afrlca.
(J ) An ln-depth Lndependent revlew of the technical and adninlstratlve functlone of
the ltCS and the Publlc l lealth Unltg nay be of beneflt ln re-allgnlng the approach to
malarla control of eventual comunlty health actlvlt les and lnpleoentation of envlronmentalntnager0ent.
As shown ln Subsect ton ( t ) , under 4.5 above, Del f ln l (1987a - unpubl lshed repor t to
HI0) carrled out an entoDological survey ln certalu areao of the Southern reglon (Dhofar
reglon) of gnan durlng October-Novenber 1987. Concerntng the epldentologlcal eltuatlon'
reference Ls nade to:
(a) Ualarta tranemisslon: No evldence of rnalaria tranemlsslon could be found at the
t 1 n e o f t @ e e t 1 g a t 1 o n o f t h r e e p o s 1 t 1 v e o a 1 a r 1 a c a a e a d e t e c t e d 1 n l 9 8 7 b ythe publlc health sectlon of the Qabooe hoepltal aroongst the local Onanl populatlon ehotted
that all three patlents had travelled co other parts of onan prlor to the detectlon of the
lnfectlon. The poeslbll l ty that they had contracted the lnfectlon outslde Dhofar reglon
cannot, therefore, be excluded. Parasl.tological and entomologlcal data collected durlng
the preeent study gave no lndicatlon of oalarla tranenl.sslon in any of the ecologlcal
vBc/ 90 . 3MAL/ 90 . 3Page 238
strata of the reglon. Parasl to logical surveys carr led out dur lng 1983-1986 a leo fa l led to
dlscover lndlgenous malar ia, wl th the except lon of one poslEive unclassl f ied case ln 1985
that n ight have been indlgenous. Nevertheless, accordlng to the hospi ta l records,lndigenous nalar la casea d id occur in prev lous years, though sporadlcal ly , in aLl three
naln ecological s t rata of the region: the coasta l p latn (A1-Sahl l ) , the southern s lope of
the Dhofar range (A1-Jebel) and the deser ! and senl -deser t areas of centra l and nor tbernDhofar (Al-Badyan).
(b) Malar iogenic potent ia l : I t cannot be denied that a degree of recept iv i ty and
v u 1 n e r a b 1 @ s t i n D h o f a r r e g i o n . A s r e g a r d s r e c e p t i v 1 t Y ' . @ " l 'sergglrtl l aod jL3El!, at least the first two potential vectors' were found as larvae
ildffi! 'read GTFreglon. Cllnatlc and envlronmental factore do not aeen !o favour the
existence of cullcifacies, of which only one larva was found in 1984. Man-nade ltater
collectlons affiff iE-ln the central coa6tal plaln around Salalah. BasLns and wells
used for l r r i .gat lon const i tu te good potent ia l breeding p laces for anophel lnes. In
untreated area8, .stephqnsi was found ln these rtater collections. Adult epecimensr however,
were rarely "aptuEll-ff,?
"Khor6" (lagoon-Iike coastal lake) l lke the one surveyed atRakjut , ln sp i te of belng forned of bracklsh water , aeen to const l tu te anoEher Potent la laource of breedlng, where sergentll larvae were collected. In Al-Jebel, water collectlons
!n barrels aeen to be sultablEToi anophellne breedlng fron whlch sergentll larvae were
collected. The sltuatlon ln Al-Badyan nas not studied wlth the excePtlon of one surveycarrled out Ln Dhofar northern slope where d-thalt larvae nere encountered. The nunerouatradltlonal bedouln lrater holes at the edge of the deeert sand, where all the undergroundwadls flow lnto Um Al-Hayst wadl remain to be lnvestlgated.
Wlth regard to vulnerabll lty, nalarl.a carrlers do corne to the reglon. As much as aquarter of the populatlon are of non-Onanl origln, conlng nostly from Asia, where nalarlals et111 endemlc (Pakistan, Indla, Bangladesh, Srl Lanka and Phil lpplnes). Although thehtgheet concentratlon of thls forelgn populatlon ls found ln the naln city of Salalah, some4000 forelgnera are found over the rest of the reglon. The local Onanl populatlon doestravel not only wlthln the reglon, but also to other part6 of the country where nal.aria lsstl l l endenlc and occaslonally to nalarl.oua areas abroad. In factr one Day wonder how ltis posslble that l l tt le nalarla aeems to extst in Dhofar regl.on. It nay be that the nuroberof potentLal vectora and nalarla ganetocyte load nithin the reglon do not reach theconblned crlt lcal level that can support, at a given tlne and place, the continulty ofoalaria transoLsslon. l lore knowledge ls needed' about the anophellne epecles detected lnthe area, euch as their restlng and bltlng hablts, host feedlng patterns and longevlty.The fact remains, nevertheless, that adult specloens are rarely found ln houses. In theJ.arger urban aggloneratlons, J.1ke Salalah, Mlrbat, Sadha, Qelron Heirlci, alr condltlonlngof sleeplng quarters le a wldely spread comodlty. Insectlclde aerosols are comnonly usedby the lnhabltante. Typlcal rural houees have large rooms for eleeplng and cooklng.Burnlng of perfuued reslns ls comnon. This nay have a repellent effect on nosquitos.Indoor feeding nay also be tnhibited by oany donestic anLnals whlch llve around humandwelllngs, thus constitutlng accesslble alternatlve hosts. Zoophtll.c and exophll l.cbehavlour may exlet, but thls muet be verif ied. The cllnattc factors nay becomeunfavourable for the survival of adult anophellnee durlng several nonths. The drynese ofnorthern Dhofar throughout the year ls certalnly an unfavourable factor for the developnentof anophellne populatlons. The nlne nonths of dryness ln the coastal plaln, precedlng andfollowtng the three months of nonsoon (nid-June/nld-Septenber), together wlth very hlghtemperatures, particularly prlor to the monaoon ls certalnly a negatlve factor foranophellne eurvlval.. The dry land wind fron October to Aprll, very cold at nlght and veryhot ln daytfine wlth lts deslccatlng effect oay play an Lnportant role both directly onanopheline populatlons and lndlrecEly by deslccatlng the protectlve vegetatlon. Theconstant high wlnd epeed (about 40 kn/h) durlng the Donsoon may have a dispersing effect onuosqulto denelties. Thus, various comblnatlons of the above factors oay reduce the level
of receptlvlty to very low values.
Further thoughts were glven on the subJect of vulnerabll lty. To explaln why so fewoalaria caaea aEe belng discovered aroong the nearly 30 000 non-OmanL population in Dhofarreglon, oost of whon come fron endernlc nalarlous countries, the following reasona ltereof fered:
v B c / 9 0 . 3MAL /90 .3Page 239
- The awareneaa of nelrco6era to nalarla and easy access to antl.malaria drugs on the
local narket. Also, malarla treatnent roay have been glven prlor to departlng for Oman'- Treatnent preecribed without laboratory confirnatlon in various health
establlehnents Ln the reglon.- The long stay of the non-Omanl ln the region wlthout returning home, thus avolding
the r lsk of contract lng the ln fect lon there.
In the present surveyr 2T non-Onanl res ldenta \ tere exanlned for nalar la parasl tes, and a l l
were found negative.
Frorn the abover lt can be concluded that under nornal conditlons, the roalariogenlc
potential 1n Dhofar reglon ls low with decreaslng valuee as one goes from the coastal
pt . tn , through the Dhofar range, to the deser t lc and seml-deser t lc areas of the nor thern
iftof.i. Although data are requlred for the AliBadyan area' one rlay exPect a very low
nalarlogenic potentlal ln a very hot and dry land with scattered nomadic populations. It
was concluded that under prevall lng condltlons, malarla transnlselon can occur only
sporadlcally tn the Dhofar reglon.
(c) Cont_ro l neasures re$ul red: Del f ln l ( loc.c l t . ) f lna l ly €uggested that contro l
m e a a u r e 8 @ n 1 n c r e a s e 1 n t h e n a 1 a r 1 o g e n 1 c P o t e n t 1 a 1 w h 1 c h m a y o c c u runder partlcular cllnatlc condltlone ln conJunctlon wlth an lncreased lnflux of garoetocyte
carrlers. I{lth regard to receptlvltyr-the preeent larvlcldlng wlth temephos ehould be
extended to the other lrrlgated areaa of the Salalah plaln, prfunarlly Dahareez where
anophellnea are breedlng ln lrrlgatl.on wells and baslna. Other poselble Potentlal breeding
platee ln the coasta l p ia ln, the ' rKhors" ( lagoon- l lke coaeta l lakes) ehould be lnc luded ln
entonologlcal vigllancl but larvlcldlng should be applled only where anophelLne breedlng ls
detected. In A}-Jebel and Al-Badyan, control of anophellne breedlng should not be
dlff lcult sl.nce potentlal breedlng placee are generally clrcunscribed and llnlted ln
number.
The preaent netnork of health facll l t iee and preventive servlcee ln Dhofar reglon'
wlth sone re-orlentatlon of the exleting personnel and a few addltlonal etaff, partlcularly
ln the supervieory category, should be able to cope wlth the work. Entonologlcal vlgilance
should rely prlnarl. ly on larval surveys ln vl.ew of the meagre yleld exPected frorn adult
captures. I lowever, eone additlonal entonologlcal technlquee euch aa Ean- and animal-baited
nete and ltght trap8 should be trled ln the fleld to a88e88 thelr practlcal value.
Concerntng rnrl.nerabll lty, health facllttteE ln the area whlch lnclude noblle servlces
by road and alr, are adequate to aecure paraeltologlcal 6urvell lance. Inprovements are
only required for laboratory dlagnostlc facll i t lee and ln epldernlological inveetlgatlons of
poel t lve caae6.
Under the prevall lng eltuatl.on, the routlne annual collectlone of thoueands.of blood
66eara fron eelected schoole nay prove an lnsensltive tool. In a populatlon where no
lnnunlty to nalarla appears, any caee which Day occur w111 certatnly be lnnedlatelyreported or referred to a treatment centre ln view of the expected eeverity of the
Lnfectlon. Coneequently, lt oay bi more valuable and leee tlne conauning to carry out
thorough epldenloioglcal lnvestlgatlons of all detected poeltlve cases which would lnclude
blood icreenlng of an adequate sanple of the populat,lon ln the area where the case ls
suepected to have orlglnated. Routine Burveys of newconers to the region froo malarlous
areaa should be perforrned by all networks of health facll l t ies.
In the unpubllehed document of Farld (1987), the country nalarta profl le of Oman was
ehortn as follorts:
- Populat lon: 1.5 n l l l lon
- No. slldes examlned- No. posi t ive e l ldes- No. P. falclpgrun caeea
Populat lon at r lek: 0.9 o l l l lon
1984 1985 1986L7T669 27o 043 not available16 590 L6 445 ' l
L4 422 12 216 rl
vBc/ 90 . 3r4AL/ 90. 4Page 24O
- P. fa lc iparun res lsEance to chloroquLne: Suspected but 'hot checked- Vectors of ualar ia according to vector la l lnpor tance - wl th ln fornat lon on vector
res l s tance to l nsec t i c i des :An. cu l ic i fac ies DDD/die ldr inG],'..@ DDT/dleldrln
- l . t , a i n v e c 6 ? - f f i e a s u r e s : D D T h o u s e s p r a y 1 n g a n d t e n e p h o s 1 a r v 1 c 1 d i n g .- Case detect ion: Maln ly through PCD- Developnent of PHC at perlpheral level: Acceptable- Developrnent of PHC at referral level: Acceptable- Malar ia conErol progranme: is a new ver t lca l one- Malar ia t ra in lng centres: A nucleus ex is ts- Trained nanponer: lnsufficient- Specla l problens: lnsuf f lc ient uanpower.
From lnformatLon conmunlcated to !IHo/EURO, data on the status of antinalariaacciv l t les in Oman ln 1988 show the fo l lowing (populat lon: mld-year est lmate ln 1000s) :
- Tota l populat ion : I 500- Populat lon of or ig lnal ly nalar lous areas: I 500- Population of area6 clalned to be freed fron malaria : -- Populatlon protected by extenslve house spraying coverage: 30
Population protected by other antl-vector Eeaaurea: 700 (larvicldlng and fleh)- Populatlon under surveil lance: ? [No flgures given but fron the above revlew allpopulat ion ls under PCDI.
As sunnarlzed in the report of the l{ld hlth 6tat$.!-@. (WHO, 1990) concernlng thew o r 1 d m a l a r l . a s 1 t u a t 1 o n r n t g a a , t h e n u n f f i n a n , d e c 1 1 n e d b e t w e e n l 9 8 3(33 000 cases) and 1987 (16 000 cases) but lncreased to 25 000 1n 1988. The r iEe ln there lat lve prevalence of P. fa lc iparun observed tn 1987 and at t r ibuted to Lncreasedtransnlssion due to heavy ralns in areas not covered by antlnalarla measurea, contlnued lni988. Surveys carr ied out in protected areas showed prevalence rates of l . IZ ln thecoas ta l a reas , L .4Z i n t he f oo th l l l s , and 0 .72 l n t he oaaes .
Dr M.A. Farid, former WIIO Malarlologlst and Coneultant to the Governrnent of Sultanateof Onan, vlstted the country durlng January 1990. Il ls assessnent of the antLnalarlaact iv l t les and the malar la s i tuat lon were aB fo l lows (Personal conmunLcat lon, l99 l ) :
- No coordlnatlon exlsts anong entonologlcal, parasltologlcal and operatlonalac t l v l t i es .
- DDT ls sti l l sprayed desplte a hlgh level of DDT resietance ln eome ar€aa.- Assessment of the nalaria lncldence based on nlcroscoplcal dlagnosis of nalarla
cases ln 1989 showed 25 000 cases, whlch does not ref lect the actual nalar la s l tuat lon. Amore reallstlc estloate of the nunber of casee ln 1989 ls about 0.2 rnil l ion caaea, whlchls based on cllnlcal dlagnosis by health establlshments and chloroqulne consunptlon.
On the posltlve slde, there ltere:
- Deternlnatlon of the Goverament Lo relnforce nalarla control activlt ies.- High potentlallt ies for coromunlty Lnvolvement.- Avallabll lty of excellent roads.
0n the strategy of nalaria control, Dr Farld suggested the followlng:
- Intenslfylng tenoephos Larvlcidlng during the dry season.- Replacenent of DDT with an alternatlve insectlcide.- LiDltlng house spraylng to areas not anenabl'e for larvlclding.
In UAE, (see Flg. l0) the report of the Malarla Advlsory Tean of the IIeaIthSecretar IEE of the Arab States of the Gul f (Far ld et a l . 1985 - tn Arablc) rev iewed theorganlzation of the nalarla control progranne and assessed the malaria situatlon in thecountry. The nalarla coi'rtrol prograrlrne in UAE ls an ldeal ProJect for the control of
rnalaria transmltted by cullclfqc:lee and g!.g@1. This progranne had developed favourably
vBc/90. 3MAL/90.3Page 241
slnce 1979 af ter acquir lng epldeulo loglcal knowledge on the d lsease ln populated areas: Ras
AI Khafuna ln the e*ir"re north, the western coast couprlslng the Enlratee of On-A1-Quewelnt
Agman, Dubal and Abu Dhabi, and the eastern coast extendlng frorn the Gulf of Ouan to the
centra l p lateau and Al Ain area. These areas vary ln topography and sourcee of water that
breed vector specles. The c l inate ls hot and dry ln Ehe ournrner season (June-SePtenber)
during whlch the mean Eonthly temperatures reach nore than 32oC, a condltion that does
not favour malar ia t ransml-ss lon. In contrast , lhe autunnr wlnter and spr lng seaaons
represent the favourable per lods for malar la t ransmlselon, Par t lcu lar ly ln ra lny years.
The ef for ts made s lnce 1980 for the contro l o f nalar la enabled the country to contro l the
dlsease to a point near eradlcat lon except for areae adJacent to Oman where Eovement of the
populat lon across borders occurs, as wel l as the need for a labour force f ron Aslat lc
nalarlous countrles. Of the factors that heLped ln reducing the nalarla lncldence are the
socioeconornic developnent , the ef for ts of nunlc ipal l t les ln protect ing the envl ronmentr the
extension of educat lLn, and the avai labi l l ty of hospl ta ls and heal th establ lshoents (28
hospl ta le wl th an average of one bed for every 200 lnhabl tants aB l te11 as 100 PHC unl ts) .
These favourable factors asslsted ln reduclng nalarla prevalence excePt for some llnlted
focl. It can be concluded that the country has nearly reached the roalntenance phaee and
has 6et a target of API to reach less than O.l,/I000 durlng the next 5-year Plan (the
populat lon of UAE was est lnated ln 1984 pt 1.26 u l l l lon) '
OrganLzatlonal structure and nanpower: The total pereonnel avallable ls 269 conprlslng
tne a e, the technical d i rector ' ch lef of the
epidenlo logy eect lon, 5 chlefe of nalar la unl ts , 53 technlcal ass ls tantsr 4 draf tsrnen, 45
cierks, 34-irlvers and 127 labourers. Sharjah tonn nas selected to accomnodate the central
malar ia 6ect lon ( l tCS). Besidea, there are nalar la unl ts ln SharJah 1tee1f , Ras Al Khairoa '
Khor Fakan and A1 Zetd. Each unlt ie headed by a senlor technlcel asslstant assleted by a
nalar la n lcroecopl6t , a technlcal ass ls tant for eptdenlo loglcal lnvest igat lon and another
for entomological euiveys. At tached to each uni t le a f le ld oalar la centre staf fed by a
technlcal ass ls tant and sone labourers. In Dubat , the mrnlc lpal l ty has an lneect contro l
section for the control of lneects of nedlcal lnportance. Slullarly ln Abu Dhabl' the
nunlclpallty undertakee the task of controll lng vectors of nalarla and other dleeaaee' In
Al Aln, there ls a nalaria unlt attached to the Preventlve Medlclne departrnent of,thls
area. Thie unit together wtth Abu Dhabl nuniclpallty undertakes the Preventlon of
lnfl l tratlon of r '""ior populatlona acroas the border wlth Ooan. For entonologlcal
checklng, the central UCS- tn SharJah hae a team to aurvey areaa whlch have no [alarla
unlts. For paraeltologlcal checklng, the blood slldee exarolned by the nalarla unlts,
hospltals and health eitabllshnenta-are checked by the central laboratory of the MCS ln
Shar1atr, except thoee eltuated tn Dubal. Regardlng the nalarla budget, the anount
a l located ln 1984 was equlvalent to 3.1 US aol tare, g lv lng a Per capl ta expendl ture of 2 ' l
US do l l a r s .
I ' talarla control actlvlt lee:
( ' ) @ : r h e M C S 1 e r e e p o n s l b 1 e f o r t h e c o n t r o 1 o f n a 1 a r 1 a v e c t o r ein all areas e*cepffi i !ff iG the Jurledtctlon of the nunlclpallt les of large towna shlch
carry out control actlvlt les through the uee of lnsectlcldes and eource reductlon'
coordtnatlon ls establlshed between the Mcs and Duntclpallt lee wlth regard to unlfornlty of
lnsect lc ldes and dosages. For larv lc ld lng, teuqphos ts appl led at a dosage of 40 cc-of the
dl lu ted eoule l f lab le loncentrate (1:1000) per rz . Pyrethro ld conpounds are appl led for
house epraylng in reDote mountalnoua areaa ln northern UAE. In addltlon, pyrethrolde are
enployed fLr -pace spraytng ae ULV or fogglng. Blologlcal control_ue-1n9 o"hi?1Yi-++:Bi:has been ext,ended, ri th" nalari.a units started to dietrlbute the fleh to EunlclParlt leg
and farne ln dlfferent Parts of the country as an addttlonal control tool'
( u ) : . C a e e d e t e c t 1 o n 1 e n a 1 n 1 y c a r r 1 e d o u t b y h o s p 1 t a 1 ea n d h e a 1 t h c e n t r e @ a 1 e x a o l n a t l o n o f e u s p e c t e d u a 1 a r i a c a s e g 1 gundertaken. The MCS co11ect8 data fron these eetabllshrents neekly. The ucs aleo examlnee
the blood of young schoolchildren as ln Ras A1 Khasna and labourere ln large callPe as ln
A1 Aln, as well as collaterels durl.ng epldenlologlcal lnvestlgatlons of nalarla Posltlve
caaes. The fo l lowing are data of n lcroscoplcal d lagnosls of oalar ia col lected dur l18 1982
- October 1985, and ihe resul ts of epidenlo loglcal lnvest lgat lons of posl t lve caaea !
i-e:;;a-"-:a--Uy pernleslon of Dr l.t.A. Farld, Former llllO Malarlologlet, and foroer
consultant to the l{ealth secretarlat of the Gulf Arab statee.
vBc/90.3MAL/ 90. 3Page 242
Abu DhablAI Alnllestern CoastRas A1 KhalnaEaBtern GoastCentral Plateau
Year
19821983r9 841985 ( ln par t )
Exanlned Z posi t lve
6 . 95 . 03 . 63 . 5
of posi t ive
909 79 760
0 5 102L942579
No. posl t iveArea caaes
No. casesinveet lgated
r058851 9 l93
1 8 5267
No. indigenouscaaes
cases are as fo lLows:
No. inporEedcases
( P . f . / P . v : )
e3 (21 /72>873 (4s5/4r8)r4L (22/LLg>60 ( 15/4s)e4 (26168>4s (16 /2e )
Other cases
L 2T 2432 LL 77 L
The results of eptdenlological lnvestlgatlons
226l0 t51022L29594370
00
7 P . v .12 F;il74 C6-P.v.)
l 5 t ( 1 2 7 8 . )
P . f .P . v . - P. vlvax
These data Bholt that:
- The hlgheet number of lndlgenousadJacent Eastern Coast .
cases occurred 1n the Central Plateau and the
- No lndtgenoua caaes were found ln A1 Ain and Abu Dhabl; the naJorlty of caaes being
lopor ted.- Addltlonally, luported caees forned 747 of. the cases lnvestlgated ln
Coaet, 652 ln Rae A1 Khalma, 502 ln the Eastern Coast and L7Z ln the Central- The naJorlty of lnported cases came from Aslatlc countrlee (lncludlng
Indla), and partly fron Oman and sone Afrlcan countrles.- P. falciparun constltuted 422 of all lnported cases and 827 of the cases
fron Oman.lnported
In 1984, caaes lnported fron Ooan alone constltuted 592 of all lnported cas€s. Thls
sltuation led to the establl.ehnent of a local coordlnatlen cqrnil l ttee ln Al Aln and Buralma
for exchanglng nonthly data of epldernlologlcal eurvell lance and for organlzing vectorcontrol activlt les ln the border area betrreen UAE and Oman. However, Dost cases lnported
fron Onan do not cooe fron the border area, but orLglnate fron the lnternal Parts of the
Sultanate. Thus, the achlevement of nalarla eradlcatlon ln UAE depends on the progress of
oalaria control ln Ooan, as well aE the contlnuous eptdenlologlcal survell lance of caaes
lnported froo Aelatlc and Afrlcan countriea.
( " ) @ : T h e s e c o n t i n u e 1 n a 1 1 u a 1 a r 1 a u n 1 t s e 1 t h e r a s r o u t 1 n eo b s e r v a t 1 f f i 1 l 1 a g e e ' o r i n d 1 f f e r e n t a r e a s w h e n r a 1 n f a 1 1 c r e a t e s p o o 1 sof etagnant water, or durlng the epidenlologtcal lnvestigatlon of caaea suspected of belng
locally contracted. The entomologlcal unlt of the ltCS cooperates wlth the vector control
sect,lon ln Dubal and the nalaria unit tn Al Aln tn ldentifying the anophellne species
collected fron surveys as well as oonltorlng the susceptibll i ty levele of larvae to
lneecticldes partlcrrlarly tenephos. Adult vectora have become ao scarce that sufflcient
numbers for dleeectlon could not be found.
On the basls of the above findlngs, the team recommended the following:
(a) Epideolologlcal surveil lance
- A large number of P. falclparun caaes cooe from Tanzanla, Kenya and Sudan. Since
chloroqulne-reel.stant P. ff iT;ff i-Elralns nere present ln these countrles, sensltivity
the WesternPlateau.Paklstan and
vBc l 90 . 3MAL /90 .3Page 243
tests should be conducted at the centra l l {CS laboratory ' in SharJah. To t ra ln the chlef
technlc lan of th ls laboratory, the Technlcal Of f lcer ln charge of the sensl t lv l ty test6 ln
WIIO, Geneva should be assigned for a perlod of 15 days.
- For pronoting the cltnlcal diagnosl.s of malarla partlcularfy IgfS]tg:"t infectlon' a
specia l course should be orgahized to t ra in physlc ians work lng ln A1 Ain to learn the
slgns, synptoms, corapl lcat lons and t reatment of th ls ln fect lon '
- The current nedlcal registratl.on system does not encourage forelgn labourere to
report to hospi ta ls and heal th establ lshnents for t reatment . Instead, they buy
antinalarial drugs fron the local narket. As this treatnent nay often be lncomplete, the
nunber of affected forelgn labourers uay lncrease, thus enhanclng chances of resunoption of
nalar la t ransnlss lon ln areaa wl th h igh vector densl t les, e.g. r the Eastern Coast , Ras A1
Khalna and the Central Plateau. The MCS, anari of thls fact, opened a speclal cllnic for
diagnoels and treat6ent of oalarl.a. The dlagnosls ls based on mlcroscoplcal exaroinatlon of
a b lood s l lde whlch takes L/2 an hour. Subsequent ly , the appropr late t reatment 1s g lven
free of charge and wlthout nedlcal reglstratlon. It 16 hoped that after the success of
thls experlnint, more such unlts w111 be eetabllshed 1n A1 Aln, Khor Fakan and the Central
Plateau.
- The d lagnosls of L7 caae8 of o ixed lnfect lons (U+ P. f . ) in the Western Coast and
nore in Dubal, as well ae the reportlng of 160 unldentlf ied casee ln 1984' Polnts to the
abeence of sufflclent checkl.ng on the results of blood exanlnation tn Dubal Eulrate. It
was aleo revealed durlng epldenlologlcal. lnveatigatlons that casea dlagnoeed by Dubal
laboratorlea nere lncorrect: elldes dtagnosed poeitlve by health establlehnents of Dubal
are not aent to the central UCS laboratory ln SharJah for checklng ae mentloned above.
Thue, the level of perfornance of nlcroacoplc dlagnosle needa to be lnproved ln the Dubal
laborator l .ee.
(b) Entonologlcal actlvlt les
- The hlgh level of nalarla control achleved ln UAE rnade lt dlff lcult to flnd vectorposltlve breedlng placee or adult vectors resting lndoore. Therefore, routlne surveys for
e6tlnatlon of vector larval or adult densltlee cannot be Justif led. Inetead' effortsshould be concentrated on areaa where roalarla caaea are rePorted, or where Perranentbreedlng places are avallable.
- Foggtng wlth pyrethrolde ln any vll lage where an lndlgenous nalarla ceae is found,
or |n areas where a poei t lve breedlng p lace 1g found ls not ec lent l f ica l ly Just l f led. I t
Dust be based on evidence drawn fron a thorough entonologlcal lnvestlgatlon.
- Prlorlty ehould be glven to contlnuoue monltorlng of the eusceptlbll l ty of vector
larvae to teoephos uslng the dlagnoetic concentratlon of. 0.25 ppn tenephos-
- Pyrethrold lnpregnated papere should be requested fron I{IIO tn vLew of pyrethroid uee
1n fogglng and resldual houee spraylng.
- In view of the appearance of DDT resiatance ln adult vectora' susceptLbll lty tests
should be.pureued wlth DDT and other replacement lnsectl 'cldes.
- To pregerve the envl.ronment, lt le recoonended that lneectlcide spraylng by alrcraft
aB practlsed ln Al Atn should be evaluated to deternlne lts efflcacy and cost conPared wlth
house spraylng.
( " )@
- It ls recomoended that the doeage of teuephos be reduced fron 40 cc to 20 "./^2
and labourere should be retralned'to apPly the new dosage.
- It lB also recoromended that tenephos ernulelf labletemephoe granules partlcularly ln lrrigatlon watere andappl lcat lon and, lower cost .
concentrate ehoul.d replaceraln pools, in v iew of l ts easY
- Pyrethrold houee epraylng ehould be reserved for reoote areas where lt 18 dlff lcult
to organlze larvlcldlng on a repetit lve basls. Ln vierr of the relatlvely short perlod of
MAL/90 .3Page 244
effectiveness of pyrethroi.ds, t ining of spraying should be based on a thorough knowledge of
the epldenio logy of nalar la ln areas to be sprayed.
In the unpubl ished document of Far ld (1987), the country nalar la prof i le of UAE was
shown as fo l lows:- Popu la t i on : 1 .3 n i l l i on Populat ion at r lsk: 300 000
r984 1985 1986
- No. s l ides examined: 97 942 73 56f 70 829- No . pos i t i ve s l l des : 3 516 2 599 3 070- No. P. fa lc f lgrun casesl . 779 581 669- P. f;GTfiff i istance to chloroquine: Nil- Vectors oF Dalar la according to vector ia l importance - wl th ln format ion
on vector res is tance to lnsect lc ides:An. cu l lc i fac ies DDT/die ldr ini6lEifrEilr- DDT/dieldrin
- Maln vec$i conEi6.I neasures: Larvicidlng with temephos, ULV- Case detection: Through PCD- Developnent of PIiC at peripheral 1evel: Acceptable- Developoent of PHC at referra l leveL: Acceptable- Malar la contro l progranne: ls a ver t , lca l one eEaf fed by exPatr ia tes
Malarla training centre: Not available- Tralned DanPower: Available, nalnly expatriates- Specia l problens: IDportat ion of nalar la ; re l lance on expatr ia tes.
Froro lnformatlon communlcated to m{O/EMRO, data on the status of anti lDalaria
act iv i t ies in UAE ln 1988 show the fo l lowlng (populat lon:ro id-year est inate in l '000s) :
- Tota l populat ion: I 517- Populat lon of or lg lnal ly malar lous areas: t 517- Populat lon of areas c la ined to be f reed f rom nalar ia: -
- Populat lon Protected by extenslve house spraylng: ? [Not g lven]- populat lon l rotected by other ant i -vector measures: I 517 ( larv ic id lng & ULV)- Populat lon under survei l lance: ? [Not g iven, but f rom other ln forroat lon, a l l
populat lon at r lsk Ls under survei l lancel .
As sunmar ized ln the repor t of the Wld h l th s tat ie t . quar t . ( l lHO-, l99O) concerning the
w o r 1 d m a 1 a r 1 a s 1 t u a t 1 o n r n t i a g , t h e r e w @ o r u r b a n a r e a 6 1 n U A 3 , a n dnearly four-flfths of the populatlon l lves ln areas free fron nalaria rlsk. The nunber of
cases local ly t ransnl t ted has substant la l ly decreased, and a l l were scat tered and
sporadic. Sustained actlve rnalarla focl were not found anywhere.
In lran, Motabar, Tabibzadeh & Manouchehrt (1975) reviewed the history of nalaria
control and eradicatl,on ln the country up to 1973. Extenslve ualarlonetrlc surveys durlng
f948-1949 showed that :
- the nor th l i t tora l p la ins had ser lous ln fect lons; malar ia homogeneously
hyperendenic; -
- the southern part of the country had mesoendenic nalaria with hyperendenlc focl'
Malaria control was ltarted ln 1950 and after three years of DDT house spraying, a
comprehenslve nalarlometrlc survey conducted ln a number of vll lages ln the Casplan
llttoral in the north showed that only 140 positive cases were detected anong 18 548 blood
sl ides exaulned, g iv lng a parasi te rate of 0.757". In 1957, the area was re-aurveyed and a
parasi te r " t " o i 0 .072-wa" recorded. l . [a lar ia contro l l tas converted to an eradicat lon
p.ogr"Dl0" in 1957; DDT spraylng had produced such pronislng results that nany parts of l
Iran, includtng Khuzestan plalns were almost clear of oalaria. Accordlng to the plan of
nalarLa eradication by the }lalarla Eradication Organlzatlon (MEO) and WIIO, the country na6
divided into operatlonal zones, and the North was ln the consolldatlon phase, and the South
in the at tack phase. An. s tephensl , the main vector ln the south, deveLoped res is tance to
DDI in 1957, and oof wffi!ff i l th dieldrln. In 1959, dieldrin spraying was
vBc/90.3l , tAL/90.3Page 245
dlecontinued because stephensi developed reslstance to lt, and subsequently DDT spray{ng
hras relnrroduced. fn aaaitton to the reslstance of ! l3.p!Ens! to DDT and dleldrin' there
were other technlcaL and operat lonal d l f f lcu l t ies hanper lng Progrese in the South:
- the exophaglc and exophi l lc habi ts of other vectors such as f luv lac l l ls , IseeSubsect lon (1) , under 2.9 above lnc ludlng recent ln forrnat lon f rom Mr N. EshghyJ;
- the lack of roads and d ispersal of v l l lages;- the dlff lculty of achleving total spray coverage because of tribal and 1ocal
movementa.
Consequent ly , nuch research was carr ied out to f ind a solut lon to the d i f f lcu l t les ln
the ref ractory zones. Insect lc ldes such ae fenth lon, DDVPr nalath lon and propoxur were
tesred ln v l l lage- and large-scale f le ld t r ia ls I fenl t roth lon (Sunl th ion) was a lso tested
in large-scale f ie ld t r la ls - see Subsect ion ( i ) under 4.614.7 above] . A p l lo t Pro jectusing nedlcated salt was also conducted. The DDT house spraylng canpaign ln the South was
supported by one to cwo rounds of nalathlon. In addiElon, various supplenentary neasures
such as larvlcidtng ln urban and perl-urban areas with an oil/detergent mlxture, and
blologlcal control using Garnbusla affinls were utl l lzed (eee under paragraph 4 below).
With ihe lntroductlon of 6ese neaeures-fn the South, a reductlon of 30-902 in the paraslte
rate was observed. The nuober of cases luported, nostly fron wlthln the countryr lnto
consolidation phase areaa fell so low that about 7OZ of. the Protectlve sPraylng was
reduced. In 1973, 815 post t tve case6 were detected ln coneol ldat ton phaee areae wl th a
populat lon of 16 880 O0O, g iv lng an API of 0.05/1000. 0f the 815 caeee, 367 were lnpor ted '
te7 retapees and the rematnlng were lnduced or Lndlgenoue. Ln attack phaee areas wlth apopulat lon of 9 314 000, the API ln 1973 was 1.8/1000 compared wl th 3.5/1000 ln 1969.
The problem of nomadl.sm hag been one of the naln obetaclee faclng oalarla eradtcatlon
Ln lran. This probleo nas studled by Motabar (1974) who revlewed the attenPts to control
malarla among nonads in eouthern lran. Nonadien has a epeclalrplace ln Iran and ls
d lspersed th ioughout a lnost a l l par ts of the country (F lg.25)^. In epl te of lncreaslng
urbanizatlon, the nonadlc way of l l fe ls far fron conlng to an end. The great annual
nlgratlone fron eunmer to wlnter quartere and vl.ce-veraar coverlng long dletaoces and
pa-elng through nany vlJ.lages and tonne create eoclal and health Problerns. For example,
these nigratlons play an tEportant role Ln nalntainlng nalarla transuleslon aDong
Ghashghai, Bakhtlarl, Khansl.-Baegerl and Lor trlbee. In southern Iran, nooadlc ulgratlon
ls thi r1ost Lnportant form of populatlon moveoent, the pattern of whlch ls regular and
etable. The comrnencement of oLgratlon and lts duratlon Day change fron year to year
depending on r6eteorologlcal cotdltlons, the condltlon of paeturear governnent Pol' l t lce and
other factor6. Motabar ( loc.c i t . ) covered the fo l lowlng aepects:
(a) lfalarla transnlssion and : The epeclal characteri.stics of nonadlc l lfe
nentionedffiave an effect on tffi;Iaenlology of nalarl.a and lte control.Epldenlologlcal etudles carrled out all over the country during prevloue yeara has shown
that ln.o-t pkc"e, trl.bal Dovenenta ueually do not affect the lntenslty of roalarla
tranem1selon, eepeclally ln areaa wlth a short tranenlsslon aeaaon (3-4 uonths). In theee
areas, olgratlon starts before the beglnnlng of the transDlesl.on seasonr and canplng eites
of su*er quartera are eelected oalnly ln hll ly and oountalnous areaa unfavourable for
nalarla transoleelon (Shaheavan trlbe, East AzerbalJan). If nalarla transolsslon doee
occur, lt can only produce sporadlc caaea as confirmed by the nalarla eradlcatlon
prograope. Iu th! eouthern !.rt of the country, 1.e., eouthern slopee of Zagtoe chaln and
along the perslan Gulf and the Ouan Gulf l l ttoral, nalarla transnlsslon occurs ln vll lages
and nomads who camp around vil lages, aB they offer hoete and shelters for vectora
(Ghashghal trtbe). In this area, the nalarla eradlcatlon programe had several eetbacks as
. r"eoit of operatlonal (movenent of trlbee and extenelve use of teoporary dwell lnge such
aB tents aud surnner huts) and technlcal problens.
In rrlnter quarters of the south, the transDleelon aeason ls long - about nlne oonths'
The developnent of organochlorlne resistance ln the oain vector, gjs!!ggg.!l_""9 !f:.e x o p h a g 1 c a n d e x o p h 1 l i c t e n d e n c l ' e s 1 n t h e s e c o n d a r y v e c t o r s : s u p e r p 1 c p g s ' j f s . a n dd-thafi in the nfify areaa of the zagroe slopes, oade the Soulh a-bleD area for nalarla
ffillcatl.on.
vBc/90.3ual/90.3Page 246
In sumer quarters, however, the t ransolss lon aeason lasts only three or four months,
and the actlvlEy of the vectors sacharovl and ggjg2lctus starts from Ju1y. Both vectors
w e r e s u 6 c e p t i b l e t o D D T w h e r e ' . G f f i - f f i t r o t G @ t n g . [ L a t e r D D T r e s i s t a n c eappeared in sacharovi dur ing L97O-L973, see Subsect ion ( i ) , Manouchehr i e t a l . (L974) underI above l .
The tribes usually leave winter quarters for sumrner quarters before the beginning ofghe transm|ssLon seaaon (ltarch-Apr11) when most of the nigratory route ls not yet in the
transnlss lon seaaon, thus they escape infect lon. In JuIy, the condi t lons for t ransmiss ionare sul . table and reroain so wel l ln to the winter quar ters. As a resul t r t r ibes can contract
nalarla in surnmer quarters or on their way back to winter quartersr although due to thenalarla control canpalgn, the rlsk of transmlsslon ln winter quarters has become low but afew act lve foc i s t l l l ex ls t . The d isease is t ransnl t ted f ron stable v i l lage people tot r lba l people or v lce versa. Rarely , an ln ter- t r iba l nalar la t ransmlss ion ls establ ished
when condition6 are favourable - vector density above the crlt lcal level.
(b) gontrol by resldual spraying and funpregLatlor.r € tents: Several f leld trials werec o n d u c t e d s e h t r i b e s 1 n K a z e r o u n a n d F a s a o f s o u t h e r nIran. Var1ous formulatlons of DDT, dleldrLn and IICH were used at different dosages forspraylng or lnpregnation of tents. The effect, also measured on dlfferent tent naterlals,was evaluated by chenical est inat lon of lnsect lc ide restdues, b loassay tests andentonologlcal observatlons. Briefly, the results indlcated that spraying tents roay be anef fect lve neaaure agalnst the local vector , but the res idual ef fect is shor t , par t lcu lar lyln the case of tents being noved. The roovements and scatterlng of nonad populatlons plusthe dlfftcult topographlcal conditlons reduced the operatlonal efflelency. Therefore,spraylng or lnpregnatlon of tenis wlth residual lnsectlcides cannot be consldered adequatefor lnterruptlon of nalarla transmleelon ln these populatlons.
(c) Uee of nedlcated sal t : A p i lo t s tudy for the appl lcat lon of nedlcated sal t wasd e v e 1 o p e d @ c e , a 1 a r g e r s c a 1 e t r 1 a 1 w a s P r e P a r e d c o v e r 1 n g a b o u t l l 0 0 0nomade of the sane t r lbe and 6 250 set t led v l l lagers (c i t lng Motabar et a l . 1971). Theprellninary stage carrled out in 1962 lnvolved the followlng: geographlcal reconnalssance'deternlnLng the aourcea of salt in the area, studying the preparation and dlstrlbution oftable salt, decldlng on the drug of cholce (chloroqulne/anodlaqulne), tralnlng of agents,and provldlng mixlng nachlnes and other equlpnent. Operatlons started ln Aprtl '1963 andcontlnued untl l 1966; the followlng were the najgr actlvtt les:
- Preparatlon of nedicated ealt.- ltonthly dlstrlbutlon of ealt on a tent to tent basis among one grouP of nonads. In
another group, dlstrlbutlon was at 6-nonth Lntervals unti l the beglnnlng of 1964 when itwas changed to nonthly dlstributlon.
- Checklng salt consunptlon as well as parasltologlcal and entornologlcal. evaluatlon.Chlorogulne salt was dlstrlbuted durlng 2 l l2 years and anodlaqulne during 18 nonths.These produced a slgnlflcant reductlon ln nalarla cases, the paraslte rate dropplng froo7.892 ln 1962 to 0.012 tn 1966 among the nomads, and f ron L7.32 tn 1962 to 0.052 ln 1966 lnthe v11lagere. The eet lnated cost of th ls programrne was US dol lars 0.20-0.25 per capl taper month, excluding entonologlcal actlvlt les. It had been thought that thls lndirectnethod of uass drug adnlnlstratlon would be easy, cheap and qulte effectlve conpared wlththe ueual drug dlatributlon. I lowever, Lt was found that a paraslte reservolr stl l l existedfor soue tl.De as breaet feedlng infants nere not protected. It was aleo reallzed that theprogranme rrae costly and not suitable for use in lran. The nalarla incidence began to riseas aoon as nedicated salt admlnlstratlon was discontlnued.
Another pllot proJect was carrled out ln Fasa area, F4rs province by the MEO in whichDDT spraying was applled continuously at a dosage of 2 g/n', ln an attelDPt to sPray everynewly constructed tenporary dwell lng. Thls was conblned wlth fortnlghtly drugadnin l .et rat lon. The resul ts ln th ls area (wi thout .@.! ) were aLmost sat ls factory.andindlcated that lt nay be posslble to lnterrupt nalarla transolsslon Ln areas of tribalDOVeEenta.
(d) Malar la eradlcat lon operat lons: Malar la eradlcat lon ln the South was resuoed lnl 9 6 8 , r n t a r e a s . S p r a y 1 n g w 1 t h n a 1 a t h i o n a n d D D T w a s
vBc/90.3MAL/90.3Page 247
carr ied out 1n some regiona a6 of ten as f ive t lnes a year . There was fu l1 survel l lancewi th t lne ly radlcal t reatment of posi t lve cases, mass drug adnin is t rat lon ln reglons where
spraylng was less ef fect lve, larv ic id ing around c i t ies and towns, and abundant d is t r lbut ion
of Garobusia fish. Speclal attention was glven !o coverage among nomads duringNovelober-December 1968 at the end of the t ransmi.ss ion season ln wlnter quar ters. The
ent i re t r lba l populat ion recelved nass radical t reatment on a 7 'day schedule. Coverage was
94"1 and resul ts were sat ls factory. Blood smeara nere col lected at randon dur lng thefo l lowlng oonth and a considerable decrease ln the parasi le rate was observed. Dur ing the
followlng years, attempts were made to find the rernalning lnfected foci and to apply nass
drug d ls t r ibut lon us ing 7-day or 8-week schedules. Sects of t r lbes at r lsk of in fect ion in
wlnter quarters also received prophylactic drugs. l loreoverr durlng nigratlon to ouuDerquarters, they were glven 300 ng chloroqulne and 30 ng primaqulne (presunptlve doses for
adul ts) . In Bunmer quarters ln ln fected areas, nonads l tere Protected by spraylng
operat ions, survei l lance and drug adnin ls t rat ion. The post t iv l ty rate decreased f rom 2.857"
ln 1968 to 0 .192 h L972 [w r i t t en l nco r rec t l y i n t he o r l g i na l PaPer as 9 . lZ ] . No t a s i ng le
case of P. fa lc lparun was detected s ince 1969.
The problen of blood transfuslon and lts roLe ln lnduced nalarla ln lran was studledby Edi lss lan ( f974) . Over l l l cases of t ransfueion nalar la were recorded dur lng the I0year6 froo 1963 to L972. Of' theee, 737( were P. nalariae and 277 P. vlvax. Nine cases of
transfusLon-induced P. oalariae were studled. In two blood donors who were proved to be
carrlers of l. natarT4fftf,Ffluorescent antlbody technlque, few oalarla parasltes ltere
detected tn ttrt f i lns nade fron blood concentrated by centrlfuglng.
The presence of P. vlvax malaria wlth a long lncubatlon perlod was susPected lnnorrhweet lran. Sarffif;;;fralnl & Afshar (L974) lnvestlgated the poselble presence ofsuch caees 1n nestern Iran in vl. l lages selected on the baels of detectlon of P. vlvax caaesdurlng the early months of f lve y".i" (1968-1973) as seen Ln the fl les of locffiTi?lae r a d 1 c a t 1 o n u n 1 t s . T h e v e c t o r s o f E a l a r l a 1 n t h i s a r e a a r e : @ s . 8 . , g ! g g !and ggpgIglgg; the 1a6t epeclee seemed to be the nost important. As regarda the hunanpfaenodla, aglvax, P. falclparun and P. nalarlae had been recorded before the nalarlaeradlcatlonlT6lE6ne and were nost prevalent. Durlng the etudy, P. vivax ltas about theonly speclea transoltted by the anophellne vectora. A sero-epldenlologlcal study ofP. vl.vax wl.th euepected long Lncubatlon perlod and presentlng the flret synPtons ln earlyeprlng before the start of eeaeonal actlvit lee of the vector, wa8 carrled out tn 92selected vll lagea wlth a populatlon of 38 726 tt tno adJacent areaa ln l laoadan and BlJar'nestern lran. A total of 3553 blood eanples for microscopical examlnatlon and lndirectfluoreecent antlbody testlng (IFA Eest) were collected in 12 weeke during the early monthsof 1973 and 1974. Altogether aeven caaes nere parasLtologlcally poslttv" (3S), and98 caeee were eerologlcal ly poel t lve ( t l t ree L/2O to l /640>. of the sevenparasltologlcally posltlve caaes, three were serologlcally negatlve. Ae these caaesappeared at the beglnnlng of the aeaaon of vector actlvlty, they could be coneldered due tonew transnlsglon. The reeults of examinatl.on of 1534 blood sanples collected fron childrenup to 15 years old ln eelected vll lagee ln the l lanadan area at the end of the 1973transnleslon seaaon showed only one eerologically posltlve. Also, there ttas no record ofany oalaria case ln the area during the early uonths of, 1974 before the start of thepresent etudy. These reeults ehondd that the lnfectlon rate waa too low to reveal th'eoccurrence of 3:g!Ig wlth a long lncubatlon perlod.
Ae prevloue serological and paraeltologlcal etudl.es in nalarlouo areaa of southernIran ehowed the efficlency of the IFA teet ln deternlnlng nalarla prevalence, Edrtsslan'Ghorbanl & Afshar (1935) carried out a croga-sectlonal sero-epldenlological eurvey ofmalarta during 1975-1982 ln north, northwest and eouthltest Part6 of lran which were underconsolldation, late attack and attack phaees of the nalarl.a eradlcatlon PrograDmetreepectively. In each study area, aeveral vll lages or grouPs havlng different oalarlahlstorles, varloue ' laria condltlons or special epldenlologtcal features nere selected.In eaih vil lage or group, blood eanples were collected lncludtng thlck and thln bloodsmears, and plasma 1n heparinized'capllJ.ary tubee, or drled blood on fl l ter PaPer fron noet
of the populatloo.
wc/g0 .3MAL,/90.3Page 248
The nalaria
Areas
the areas saroPled was:
Local l t ies
RudsarRashtAnol
Suspectedloca l l t i es
Presentrnalaria status
Consol ldat lon
PrevaLentplasnodia
P .v . & occas lo -ifiIy P.u.
status of
Provtnce
North Gilant l
MazandaranGtlan &
Northwest West Azer-baljan
I'lakuUrunlyehSardasht
l{alaria-f reeConsolldatlonLate attack
P.arlFfil c occasio-i larry P.r.
Southwest Khuzestan Izeh(wlnter quar-ters ofBakhtiarY trlbes
Attack P.v. & occaelo-i?Tiy P.f.
I n t h e l z e h a r e a , 4 3 S p a . l r e d p l a s n a a n d d r i e d b l o o d e a n p l e s w e r e a l g o c o l l e c t e d f o rcomparlng the LFA tesi results. Drled blood sanples fron the resident populatlon and new
arrivals ln locallt les ln Gllan ana uazanaaran provlnces ln the north and also fron nomads
of Bakhtlary trlbes in the Izeh area ln the southltest (on entry and exit) were collected by
the local nalarla survell lan"" "g.rrl"
and sent to the central laboratory ln Teheran for IFA
testlng. Fron professl.onal blood aorror" at the Red Crescent blood transfuElon centre 1n
Rasht, Gllan province, blood eanples were collected ln heparlnlzed vacutal'ner l0 nl tubes
a n d s e n E i n a t h e r m o s b o x o f l c e t o t h e c e n t r a l l a b o r a t o r y ' P l a e B a a n d d r i e d b l o o d s a m p l e errere teated by IFA wlth one or two oi--it.-p. ttr".*, P. faic{Parun and P' nalarlae antlgeng
prepared fron malarla parlents. Blood sneais t"." .* cat nGFo-aaiTiTs ln each
study area. Anong Persons examined ln Gllan and Uazandaran provlnces' especlally blood
d o n o r s , t h o s e w h o s i r o w e d n a 1 a r 1 a a n t i b o d t e s 1 n h 1 g h t i t r e 8 ' - r t n a g 9 ' . o r ! : @antlgens but in whom no nalaria p"tt"i i"" were found ln routlne rolEroecoplcal examinetlont
the concentratlon technlque was used to detect row parasltaeola'
The authors explalned that 9 t3o Persona were studled for roalarla antlbodlee and
parasltaenla during Lg75-Lg82. - The data fron IFA tests lndlcated probable oalarla
transol.ssion ln the consolldation pt'."" area of Gllan before any report of autochthonoue
naLarla and where transolsslon becaoe evldent a year later' - Ir nlne IFA eero-posltlve
cases wlth hlgh malarla antlbody tltres, detected no6t1y wrth u4!1ae antlgen' ttto
asy'pro.artc parastre carriers "f
;:-; i94eq t t" a"i""tea UyffiGst and paraelte
concenrratlon technlque anong t""rk-. ' i i i ig" ln t ' [azandaran and professlonal blood
donors ln Gllan who dtd not reoemb;;-;;y malarla hlstory durlng the past two decadee' Most
probably, ttre ottrer "".r"o
htghly sero-pbsltl 've caees we-re also-Paraslte carrlers wlth
subolcroscoplcal parasltaell l.a. ff l te!t results tlttt #4*g.antlgen
reflected the
nalarla hletorles ln the study.r"" oi nest AzerbalJanffir than p' vlvax antLgen'
Flndlnge ln the nomads of Bakhttat' iifU"" shoned tiat ttre nooads wffi6G expoeed to
nalarla lnfectlon ln the wl.nter qut.t"." of Izeh area' but they were better protected by
malarla control meaaures nainly "t. iop"opt'ylaxls,and-ihenotherlpy
when they l lved in thts
area. Conparlng the result" of tt"-i ia it '"t on 438-p"it"a pfaeta and drled blood samples
tested wlth p. vlvax a.ra p. t.fgl!"Igq antlgens, theie was tto slgnlflcant dlfference
berween rhe sero-post t lv i ty , . . " " .Tor ; ; ; ; ; tn ' t t re l i r "a b lood eanplee col lected on f l l ter
paper, the Eero-p;i; i;. rare-and the geornetrlc mean of reciprocal tLtres aBong
"".o-io"ft lve cases were consLderably lower'
vBc/90.3MALI9o.3page 249
ZaLm (1987) rev iewed the recent Dalar le Bi tuat ton ln I ran and d lscussed the futureproepects of contro l . Ualar la contro l ln nost of the nor thern par ts of the Zagrosmountalns wlth a populatlon of about 35 nll l lon ls ln the consolldatlon phase. From March1985 through March 1986, out of I 024 727 bLood s l ldes col lected by ACD and PCD, 5 246 werepoel t lve (95.L2 ! :JS, 3.42 P. fa lc tpqrqn, 1Z P. rnalar lae and 0.52 ntxed) . About 877 of .these cases were lnpor ted in to t .h ls consol ldat lon phaee area. The area ls s t l l1 underentoroologlcal /parasl to loglcal survei l lance s lnce nalar la t ransnlss lon could resune f roncases coning f ron the nain endemic foc i of the country or f ron outs ide. An. nacul lpenniss.s. ls the naJor vector of nalarLa ln the Gaspian Sea l l t tora l , whl le sacharovl andsuperplc tus are the pr inc lpal vectors ln the centra l p lateau.
The southern parls of t.he Za,gros range are stl l l under the attack phase. Thts area,wl th a populat lon of about 13 n i l l lon can roughly be dtv lded lnto two sect lons. One arealn the west and southwest wlth a populatlon of about 9.7 nll l lon where toalarla transmlselonhas been substantlally reduced; and the other in the eoutheastern corner of Iran wlth about3.3 n i l l lon people (2.2 rura l and l . l urban) where ualar ta t ransmlss lon st l l l occura atvary ing degrees. Uost v l l . lages ln the la t ter area are sroal l , scat tered and lnaccesslb lewl th few people. From March 1985 through March 1986, out of I 670 980 b lood s l ldesexaolned ln the actack phaee area, 20 400 were posltlve (83.32 !:JS' 16.92P. falclparun and 0.92 rntxed). An. stephensi ls the chlef vector i.n Khusestan plaln andPers lan Gul f l l t tora l , and f luv lat l l ls and superplc tue are secondary vectors.An. cullcifacies ls the maln vector Ln the southeaetern corner of lran. Reference has beenroa<le to fns€ct lc lde reeletance ln nalar ia vectors ln I ran [eee Subsect lon (1) under L ' 2 .L2and 4.12 abovel. Followlng oalathlon reeletance ln sg@.!, propoxur has been ueed forhouse apraylng Elnce 1978. It ls lnterestlng ttrat TEET6TiiE to rnalathlon ln adultstephensi dld not decrease the suscepttbll l ty of lte larvae to nalathlon and remephos. TheIatter fa preeently used along wlth ol1 for larvlctdtng. Durlng March 1985-March 1986' 783tons of propoxur were appJ.led to houeee ln one or tno rounds per year, oostly ln the southcoverlng a populatlon of 3.7 u1111on. In addltlon, 289 tons of DDT were ueed, ooetly lnthe central and lreatern provlnces coverlng a populatlon of 1.3 ntl l lonr where DDTreglstance ie not yet a problen (e.g., 1o gg3ggg!g!E). Malathlon (4 tone) was only usedln northeastern Iran (Moghan, Easc AzerbalJan provlnce) where sbcharovi. ls responalble fora snall focus of transElssl.on cloee to the USSR border. A total of 4 401 910 lltree of o11and 12 187 lltree of tenephoa nere used ln areaa under the attack phase as oppoeed to4 7L2 476 1 l t res of ot l and 19 459 l l t res of tenephoe ln consol ldat lon phase areaa. [Forthe proepect of nalar ia contro l ln I ran aB discussed by Zaln ( loc.c l t . ) see underparagraph 4 belowl .
NaJera & Zulueta (1986 - unpubllshed report to lf l tO) vlslted Iran durlng 27 January -
15 February 1985 to review the anttnalarla progranne and advlse the Ulnlatry of l lealth onnew approachee and nethods baeed on Lntegratlon of antlnalarla actlvlt les wlthln the PIiC8y8tem to replace the exlstlng nethodology of nalarl.a eradlcatlon. Baeed on the avallabledata, the oalaria situatlon Ln Iran was descrl.bed as not being unlform. The central andnorthern reglone with a populatlon of about 33 ntl l lon are, ln nost placee, practlcallyfree frou oalarla. fhe eouth-rrlth a populatlon of about 12 ntl l lon has a coneiderablenunber of nalarla transmlaelon focl. It ls fron the southern reglon that the dleeaeespreads to the central and northern parts of the country through nlgrant labourere andtravellere. Consolldated data of the past 20 nonths showed that 702 of the oalarla caaeaorlglnated ln the provlnces of Hornozgan and Slstan-Baluchlstan. There' the preeence of a
conslderable nuober of refugees and travellers froo Afghanlstan and Paklstan nay havecontrLbuted to perslstence of oalarla traneDlselon. Nevertheless, 1t ehould be reneroberedthat there has been a substantlal anount of nalarla ln the eoutheasteru Part of Iran before
the lnflux of the Afghan refugees. There ls no doubt that the Afghan refugees eeeklng work
and novlng throughoui the country have contrlbuted to the epread of the disease. Of 5 445nalarla casea classlfled ae 'riuported'r during Aprll-Noveuber 1985, the naJority were Afghan
workere. However, the Afghan labourers l lke other travellers oay have been infectedlocally and not necesearlly ln thelr country of orlgln.
After revlewlng the ACD and PCD as well as the newly eetabllehed PHC' Zulueta & NaJera( loc.c l t . ) concluded and recorended the fo l lowlng:
vBclgo. 3r'rAL/90.3Page 250
( l ) The malar la s l tuat lon ln l ran, a6 ln oost countr les wi th act lve ant lEalar la
progranmes, has not shonn lnprovement durlng the last 15 years. The Present problen showe
a narkett focal distrlbutlon wlth about 707 of nalarLa cases occurrlng 1n
Slstan-Baluchistan, and even ln this area cases are rnore concentrated ln sone dlstricts and
local l t ies than ln others.
(2) Efforts to lnprove eradlcatlon nethode such as replacenent of insectlcides by new
and more effectlve conpounds, extensLon of larvlclding and funprovement of general
operatlonal standard" h"tr" at best produced only tenporary lnprovements whlch cannot be
nalntalned.
(3) The developnent of the PIiC systens offers more pronlse for the provislon of
sustalned progress Ly tne best use of reeources for oalarla Danagement (dlagnoslst
t reatment fac l l l t ies, and referra l o f eevere caaea and t reatnent of fa l lures) , and by
provldlng epidenloloifcaf guidance for other antloalaria actlvlt les (lnsecticide spraylng
an<t larvlcfifng). The atructure, experlence and knowledge of the exlstLng antlnalaria
eervLce can nake lnportant congrlbutlons to the develoPDe1t of PHC'
(4) As operatlonal reeponslbll l t lee are belng transferred to the general health
eervices, every dlstrlct nealcat offlcer wlIl need to know about nalarla control 1n order
to organlze health care wlthin hls dlstrlct lncludlng:
(a) ttre selectlon of approprlate dlrectlves, approaches and technology for each
dletrlct and poseibly for dtfferent coDnunitles baeed on stratlf lcation of the
nalaria problenl
(b) the appreclatlon and nanageoent of.social, behavloural and econonlc factors
ln addltlon to technical ohee in designlng control lnterventionsl
(c) approprlate flnanclal plannlng, considerlng the abl1lty and wll l lngness of
peopll- to share ln the costa, or alternatlvely plannlng a urore centrallzed
solutlon tO COst Coverage.
(5) ttre dlagnosls and treatDent of oalaria should be lntegrated as soon 48. posslble
lnto the PHC syeteu. Thls inplles a revlsion of present Practlces of ACD and PCD 8o that
dlagnoetlc techntques are applled only when they,can help 1n treatment of Patients. ACD
and presunptlve tieatment ehould be dlecontlnued and replaced by effectlve cllnlcal
treatment ae deflned by the l l l tO Sclentlf lc Group on Malarla Cheootherapy (l l l tor 1984' p. 79)
(6) Ideally, treatment should be based on mlcroscoplc dlagnosle, but as thls facll l ty
Le very rarely avallable at the perlphery, treataent w111 have to be baeed on clinlcal
dlagnoils in oost Bltuatl.one. The collectton of blood slldes, to be examined days or weeks
aftir collectton, cannot help ln guldlng treatnent and should, therefore be dlscontlnued.
Facl l l t lea for o lcroscopic atagnoi te are, never thelesa, eeeent la l a t the f l rs t referra l
level for the approprlale diagnosle of eevere case6 and those fall lng to reepond to the
treatEent given at the periphery. Blood fl lu collectlons aDong the general population or
fever cases ehould be retalned as an epldeulologlcal Eool to lnvestlgate abnornal lncreases
of fever cagea or treaEnent fallures.
(7) Exlstlng nalarla staff can be ueed as a basls for bulldlng uP the core of
epldeolological iervlcee needed for PHC support. Malarla eurvell lance agents by vlrtue of
thelr lot1nate knowledge of areas of their actlvlty oay, lf glven complementary tralnlng ln
bael.c epldenlological oethode, act as asslstante to the eptdeniologlst at PllC central
level. Exletlng nalaria epldenlologlsts rnay also contrlbute to Lhe bulldlng up of the core
of epidenlologlcal c6upeteirce at dlstrlct and provlnclal levels. These epldenlological
servLces ahould be abll to ldentlfy area6 where vector control ls needed, nonitor the
spread of paraslte reslstance to drugs or vectors to lneectlcides, detect epldenic
oltbreaks qulckly, and call for technlcal assistance from speclallsts at central level or
at the Instltute of Publlc l lealth Research.
vBc/90.3ual/90.3Page 251
(8) Evldence shows that extensive use of lnsect ic idee outs ide Ehe t rue foc i oft ransniss ion and thei r appl lcat ion wi thout adequate coverage has had l i t t le or no ef fect onthe malarta sltuation and has resulted ln heavy expendlture to the Malarl-aEradicat ion/CoronunicabLe Diseases Contro l (ME/CDC). Residual house spraying should 'therefore, be l ln l ted to wel l def lned areas of nalar la t ransmiss ion and appl ied adequate lyand at the appropr late t lne.
(9) Vector contro l measures should be appl ied in areas where malar ia cannot beproperly handled by the PIIC lnfrastructure, such as a hlgh lncidence of 3-:-jgf$E.un,seasonal outbreaks of P. v lvax as weLL as cases of epidenlcs. Three main vector contro lin tervent lons should be considered:
(a) pernanent environnental nodlflcatlons whenever ecologically and econornicallyfeas ib le ;(b) house spraying or larv lc ld ing as a regular in tervent lon;(c) tenporary or energency vector control in responee to new probleus orepldenics. I t ls necessary to pr ,ov lde resources as requi red.
( f0) The replacement of propoxur, Lf technlcal ly feaslb le, rnay be desl rable due to l tsh igh coet . Cr l ter ia for a r 'ep lacement lnsect lc lde should inc lude: the suscePt lb l l l ty levelof vector epecies, tox lc l ty and requl rements for safe uae, acceptabl l l ty by locallnhabl tante, durat lon of ef fecElveness on local Lndoor sur faces, and coet . Feni t roth lonnay offer the best advantages i.n terns -of effectlveness and cost, although for safety itrequires rnore strlct personal hyglene by spraynen, more tralnlng and supervlslon. Otherpotential candidate lneecclcldee euch as plrlniphos-nethyl, bendlocarb and chlorphoxln needuore detalled studles under local conditlons, and w111 not be advantageous ln terns of thecost. Long actlng pyrethrolde such as pernethrin and deltanethrin nay show crossreslstance to DDT and have narked repellent effect. When considering the eventualreplacenent of propoxur, the existlng large stocks of thle lneectlclde avallable for IG/CDCoperat lons should be used up f l rs t .
(11) Inplementation of the above recomnendatLons w111 requlre an lnportant effort lntraLnlng and re-orl.entatlon of staff of the general health and antlmalaria servlces.Health workers ehould be tralned ln general epldenlology and control of nalarlapartl.cularly at f leld level. Encouraglng connunlty partlcipatlon w111 be an loPortanttool. Thls tralnlng and re-orlentatlon should be developed Jointly wlth the PHC aysten,antlnalarla gervlce and Instltute of Public Health Reeearch, whose technlcal competenceshould be approprlately ueed.
(f2) It lE eseentlal that the antlnalarla progranne nake the best use of the researchcapabll lt les of the country to eolve problens and plan new approaches. As theepldenlologlcal eervlces develop, reeearch ltens can be brought to the attentlon of theInetl.tute of Publ.lc ltealth Research so that studies are relevant to the country'.a neede.trReeearch and developoentrr or rrlearnlng by dolngrr approaches can be adopted by the healthservlces theuselves wlth the technlcal aseistance of the Institute, and nay lnclude:
(a) lnproveuent of underetandlng of the epldenlology of local problens such asparael te res ls tance to druge and vector reeletance to lneect lc idesl(b) tne lnfluence of eoclal, cultural, behavioural and economlc processes ln theepldeulologlr and control of nalarlag(c) approaches to tralnlng non-profeselonals so that theyactivit l.e8 ln addltlon to thelr own;(d) ways and means of provldlng guidance and supervislonmalaria experts;
can cope wlth antlnalarlal
by health eervlces and
vBc /90 .3MAL/90.3Page 252
(e) appropr iate lnplenentat ion at co l rnuni ty level of nalar la contro l , contro l o f other
pr ior i ty d iseases and heal th care act iv iEies '
( 1 3 ) T h e e x l s t e n c e o f S . f " l c l P a r u ' s t r a l n s r e s i s t a n t t o c h l o r o q u i n e d e m a n d s a s y s t e nfor monitoring the epread or intensiff it ion of the problen' This should lnclude reporting
of treatment failures from the periphery and the perfort?^9" of ln vivo and in vltro
tests. These tests should be perforroed at the provincial leve1 ff iEs whtffie-
res is tance is present . I t has been emphaslzed that the Presence of drug res is tance at the
RI or even 1ow f requencles of RI I levels , does not regui re a change, in the use of
chloroguine for c l in ica l t reatment at the per iphery, but the provis ion of second l ine drugs
at the referra l leveI for t reat ing n icroscbpi 'ca l ly conf i rmed aevere ot , - , - - ^c - ' )^ ^cc^
chloroqulne-res is tant cases. This is essent la l - because of the h igher r isks of s ide ef fects
and considerably higher costs of alternative drugs'
( 1 4 ) T h e i n p l e r n e n t a t i o n o f t h e n e w s t r a t e g y w i l l r e q u i r e a c o n p l e t e r e v l s i o n o fr e P o r t i n g p r o c e d u r e s a c c o r d l n g t o t h e a p p r o a c h a n d m e t h o d o l o g y a d o p t e d .
( f5) The need for epidenlo logical capabi l i ty(Ostan) ls stronglY recomnended.
both at central and lntermediate levels
In the unpubllshed docunent (1987), the country nalaria profl le of Iran was:
- P o p u l a t i o n : 4 8 . 2 n i l l i o n P o p u l a t l o n a t r l s k : 3 5 n l l l l o n
1984 1985 1986
- No. s l ides exaoined 2 7g4 774 2 8 lO 543 L 633 467
- No. posl t ive s l ides 30 835 26 363 27 734
- No. P. falciParurn cases 4 465 3 7O9 7 528
- P. fa lc iparum resls tance to chloroquine: Reported f rorn southern provlnces
neighbouring Pakls tan.- vectors of nalarla accordlng to vector importance - with lnforrnation on vector
res isEance to insect ic idesn".-"iJi i l""i DDT/DL; mal-athlon {n' oaclrl ieg'Irnlg-"-:: ' ("otth) DDT
nr,.-?lilEEffi's trE;r,?qqorthwest) DDr
L._sg"rpr"t*, Elff i i ies (eoutheast) DDT/DL
I'n.-d'tEaf- Main.r""ftAffif measures: house spraylng wlth propoxur and DDT; larvicldlng wlth
o11 and tenephos; use of larvivorous flsh'. C a s e d e t e c t i o n s A c D ' P c D a n d a c t i v a t e d P c D l n a l l d i s p e n s a r l e s .- Developnent of PHC aE peripheral level: Good- Development of PIIC at referral level: Acceptable- }talaria ptogi.tt.t ls well organized and actlve- Malaria training centre and bianches: Avallabte through the Instltute of Public
Health Research- Trained DanPower: Sufficlent- Speclal p.oll"t": UultlPle vectors, nultiple vector reslstance' populatlon movenents
and chloroquine resistance 1o 3i--I9]g!2gg'
Fron lnformationactlvlt les ln lran 1n
comunicated to WIIO/EMRO, data on the
1988 show the followtng (PoPulatlon:status of antlnalaria
nid-year est i rnate ln 1000s) :
vBc,/90. 3MALI9o.3Page 253
- Tota l populat lon: 53 000- Populat ion of or lg inal ly Balar lous areas: 43 000- Populat lon of areas c laf tned to be f reed f ron roalar la : l0 000- Populat ion protected by extensive house spraying: 3 544- Populat lon protected by other ant i -vector ureasurea: ? [Not g iven]- Populat lon under survei l lance: 53 000- No . i r opo r ted cases : 5 684 (5 658 f ron A fghan i s tan ; 2 l f r on Pak i s tan ; 5 f r on l r aq ) .
A s s u n r o a r i z e d 1 n t h e r e P o r t o f t h e w 1 d h 1 t h s t a t 1 . @ ( m t 0 ' 1 9 9 0 ) c o n c e r n 1 n g t h ew o r 1 d m a 1 a r 1 a s 1 t u a t 1 o n r n t b a a , 3 2 0 o 0 @ I r a n 1 n 1 9 8 6 a n d t h enunber lncreased to 53 000 in 1988. Sone 5 700 cases were inpor ted main ly f ron
Afghanlstan. The areas wl th nost d i f f lcu l t les inc lude the southeastern par t of the country(Hernozgan, Sis tan-Baluchistan, and the t roplcal par t of Kerman Provlnce) .
Zaln (199f - unpubltshed worklng paper to !l l l0) updated the ualarla situatlon tn lran,
andF i g .
preQented a map showlng the nalar ia lnc idence ln d l f ferent areas as reproduced here as
25t. Malaria ln nost of the northern parts of the Zagros range of nountalne has
been wel l conrro l led. In 1989, out of 437 833 b lood s l ldes col lected by ACD and PCD' 4 444
were poe l t i ve (90 .92 Pd l yex , 8 . lZ P . f a l c i pa run ,0 . lZ P t na1a l l 3e and 0 .82 ro l xed ) . Abou t
83.52 of these case6 w-ere inported lnto the area, nalnly fron Afghanlstan.
The southern part of Zagros range with a populatlon of 10.5 nil l lon has been dlvlded
lnto two areas (as shom by Zain, f987). The recent nalarla sltuatlon ln these was shown
as fo l lows:
- 1n the area of the west and southwest , wi th a populat lon of 7.6 n l l l ton, nalar la
t ransuiss ion has been substant la l ly reduced, despl te the preeence of nul t lp le vectors:
sacharovi . superplc tu6. s tephensl . f luv iat i l ls and d ' thal l . In 1989, a tota l o f 1501
roatarta caees-taimoriEiEJf,rsarea-(95J2 P. vh'ax' 3.52 l-..1!g1g1gggg and 0.92nlxed ) .
- ln the area ln the southeast corner of l ran, wl th a populat lon of 2.9
nalar la t ransmlss lon st l l l pere ls ts . In fact , about 9OZ of the tota l caaeaIran Ln recent years, cone f rou th is ar€a. In 1989, out of L 24O 294 b loodexaolned, 52 527 were poel t tve (61.62 L.11!g, 37.42 P. fa lc lparuu and l .1Z
maln vectora are sLgegsgl "rd
gg}lg!!g!g, whlle fluvlatllls, auperplctusae secondary vectire.
After glvlng the amount of propoxur, DDT, tenephos and dleeel o11 used for nalarla
contro l fn iSgg, Zalm ( loc.c l t . ) renarked that lnsect lc lde reel .atance created f lnancla l
lupllcatlons to the nalarla vector control progranme Ln Iran due to shlft lng fron DDT to
nalathlon and later to the Eore expeneive lneectlctde, proPoxur. In addltlon to the
tn i t la l h lgher cost of the lnsect lc lde, there has been a substant la l lncrease ar ls lng
lndl rect ly f roo the lncreaee of f requency of appl lcat lon (e.g. , lncreased cost of labour,
t ranaporr , sgorage, eafety c loth lng and others) . The posslb l l l ty of uelng an a l ternat lve
lneect lc lde (e.g.1 p l r in iphos nethy l ) ls belng coneldered'
I . 4€gh.r fs t . t , (eee Flgs. 14 a E b) Zahar (197f - unpubl lshed rePort to I { I l0)
1 n v e s t 1 g f f i " " o n " f o r t h e P e r s 1 8 t e n c e o f o a 1 a r 1 a t r a n s n 1 s s 1 o n i n K a n d u z u n 1 t 1 n t h enortheastern par t of the country, as showa i .n Subsect ton (1) under 3.6/3.7 and 3.10 above'
Based on the resulte of thls lnvestlgatlou, recomoendatlons were nade ae follows:
(a) Tlnlng of the annual DDT spraylng rour}d: Since epldenlologtcal/entooologlcal1 n f o r n a t t 6 a r e r e q u 1 r e d t o e u P P o r t t h e a s s u n p t 1 o nof the occurrence of iarly sprlng nalarla transnLsslon. In the meantlne, baeed on
clrcumstantlal evldence fron obeervatlone made ln 1970, efforts ehould be nade to conPlete
i:-ffie,uced-by perulssion of Dr M. zaLs.
n i l l lon,recorded lna1 ldes
ulxed). Theand d- thal l act
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the annual DDT spray round by the end of Aprll ln areas with hlgh vector outPut or at^thelatest by the f l rs t week of Uay 1n the dr ler par ts of Kanduz unl t . [Fur ther ln fornat lon on
the star t o f the t ransmlss lon aeaaon was provided later - see Dukhanlna & Qadeer et a l .( L974 ) be low l .
(b) Operat lonal defects ln spray coverage: Ser lous ef for ts should be rnade to lornprovethe qual l ty of spraylng-by adequate t ra ln lng of spraynen and to lnpose st r ic t superv is ion.Speclal squads should be organlzed and aeslgned in each operational unit to sPray sumoerhuts a6 soon as they are constructed. Tfuoely rernedlal spraylng of replastered prenlses
should a lso be deal t wl th ln those areaa where replaster lng ls comnon. Heal th educat ionact lv i t ies should be inplenented to overcome the refusal of lnhabl tants to have thei rhouses sprayed.
(" ) : DDT houee spraylng should be assls ted bys u p p 1 e o e n c u 1 a ; 1 ' 1 n t h e r 1 c e c u 1 t 1 v a t e d a n d s w a r o p y a r e a s w 1 t h ahlgh vector output . Theee Deasures wl l l a lso par t ly of fset operat l .onal defec ls whlch naynot be eael ly detected and overcone ln t lne. Vector outPut is ext remely large in r lcepaddy areas compared wlth thoee recelvlng less water in the cultivatlon of dry e.rops suchas cot ton and nalze. I t Ls. lnpor tant , thus, that the area of Kunduz be ecologlcal lyst ratLf led. The fo l lowlng s i rpplenentary measurea were proposed:
- The use of larvl.voroug flsh: There are areas with large sltanps where lt would be
nore econontcal and feasible to utl l lse larvLvoroue fleh. Arrangenents should be nade toobtaln a etock of Ganbusla afflnls fron the nelghbourlng country, Iran. Two technlclansf r o n A f g h a n 1 s t a n w f f i - g o o n W I l o f e 1 1 o w s h 1 p s t o I r a n . o n r e t u r n , t h e y s h o u 1 dapply what they have learned on Ganbuela operatlons ln lran, prlnarlly in Kunduz ar€a.
- Internlaa".a drvr"g of rlff ishown ln Subsectlon (1) under 3.10, farroerst h e r n e e l v e r m 1 t t e n t d r y 1 n g o f r 1 c e d u r 1 n g 1 9 7 0 d u e t o a s h o r t a g eof water . A l though rapld lnplenentat lon of thLs neasure ls not foreeeen, especla l ly ln 'yeare wlth adequate rrater, lts value should be denonstrated to the general publlc.
- The use of larvlcldes: Since o11 and Paris green had been wldely used on a lalges c a 1 e r n @ r a f i n e a o f o t h e r c o u n t r 1 e s , t h e y n a y h a v e 5 o n e u s e 1 n K u n d u zarea, but the effect of the o11 on rice plants under local condltlons should be carefullystudled. The use of Paris green ls feaeible aa there ehould be no dlff iculty ln uelng roaddust as a dllutlng agent as adopted ln some other countrles. Tenephoe le a safe andeffectl.ve larvl.cide and lts granule.fornulatlon ehould gLve good resulte ln rlce fields.Alternatl.vely, the enulsion should be trled. A large scale larvicldlng Prograntne should beavolded sl.nce lt neceseltates a well-managed organlzatlon and strlct supervlsion. It tscheaper and nore practlcal to utl l lze slnpl.er devlces whlch can be handled by the farroersthernselvee. Although drlp cana aeen a prooielng devlce for the dlepereal of o11 ortenephoe eoulslon, exanlnatlon of the lrrlgatl.on system ln the Kunduz area showed thatlarvicide would be waeted elther by runnlng onto dry land where lrrlgatlon canals ternlnateln bllnd ends, or by dllutlon where canals pour lnto the Kunduz rlver. Thus the. only useof drlp cane would be at f leld level, but thls would be cunbersone. Temephoe granules orParle green duet would be more convenlent. Hea1th educatlon ehould encourage faroers toundertake such taeke ae lt le seldon reallzed how nuch lnhabltants can contrlbute if theyare convlnced of the value of eluple health m€a8ur€e.
(d) Survel l lance act lv i t tee: A thorough assesenent of detect lon oPerat ionsr t reatmentand folloeup activlt les should be nade with a vlew to ensurlng that oalaria cases aredetected before they can lnfect the vectors. Any reductlon ln the reservolr of lnfectivecaaes enhances the effectlvenees of the attack Beaaurea, shortens the appllcation perlodand reduces the posslbll l ty of developlng lnsectlcide resietance. In areas with a nonadicpopulatlon, maa6 bl.ood Burveya or speclal fever screenlng should be carrled out before thenomads depart from, and as aoon aa they return to thelr vll lages. Supervlsors should beretratned to conduct more careful epidenlologlcal Lnvestlgatlons of posltlve caaea.
vBc/90.3MAL/ 90 . 3Page 256
(e) Strengthenlng of entonologlcal act iv lE ies: In v lew of the technlcal problens 1n
K u n d u z u . ' n t e n t o n o 1 o g 1 c a l s t a f f i s n o t s u f f i c 1 e n tin numbers and qual i ty to carry out the requl red act iv l - t ies. I t ls recomnended that at
Least one entopologist be assigned to each region of Afghantstan and at Headquarters.
Also, t ra ln lng courses should be conducted to ref resh the knowledge of ex is t ing staf f and
prepare new staf f to undertake entomological act lv i t les '
ALso in AfghanisCan, Onor i e t a l . ( f975) carr led out an epldenlo loglcal assessment of
the effectiveness of DDT house spraylng in Kunduz unlt. Two areas havlng sinilar.
ecologlcal condi t ions and the sane nal i r iogenic potent ia l were selected: one (B-9) was
sprayed wt th DDT Ln 1972 and 1973, and the other (8-7) was lef t unspray:d: -The 2ther .subsectors of Kunduz unit were under regular DDT spraying at a dosage of 1.5 g/E-. The
entonological resul ts nere g lven in Subsect lon (1) under 3.6/3.7 and 3 '10 above'
Parasltologlcally, examLnation of blood slldes collected by ACD' PCD and durlng
epidenlologlcal investlgations around posltlve cases showed the following (BER = blood
exar0ination rate; SPR = slide posltlvity rate percent; API = annual paraslte lncldence per
1 0 0 0 ) :
Unsprayed area (B-7) DDT sprayed area (B-9)
Year Total slldee BER SPRjFiZ -tog- f: fr1 9 7 3 6 6 r I 3 r . 8 1 4
API TOtAl Sl ldES BER SPR API
Z To,'tr- iis 5-:t' frq6 5 . 1 4 1 9 6 1 6 . 4 8 . 9 6 5 . r
. Ia 1972, with a very slnllar BER ln B-7 and B-9, there ltas no statl8tlcally
signlflcant difference between the SPR ln the tno area6' but the API was slgnlflcantly
hilher ln B-7. In 1973, the BER was rouch hlgher ln B-7 than in B-9 and both SPR and API
,o" i " . , " ry s ignl f icant ly htgher in B-7. Epldenlo loglcal lnd lces nere cooPared ln the
,rr,"prayed ar-a, B-7 and all other subsectors whlch had been regularly sprayed ln Kunduz
unit. Thls showed that the nalarla incidence nas slgnlflcantly hlgher in the unsprayed
area. It must be noted, however, that as a result of the sharply lncreased lncldence of
nalarta in B-7 Ln L972, the NatLonal Malarla Servlce, though wll l lng to continue the trlal,
felt conpelled to lntroduce addltional neaaures ln the area. Survell lance oPeratlons In
B - 7 w e r e r e 1 n f o r c e d 1 n l 9 7 3 a n d 1 a r g e n u m b e r s ( o v e r 2 0 0 0 0 0 0 ) @ ' . r edistributed around selected vtl lages. The lncreased dlstrlbutlon of antlnalarlal druge for
presumptlve and radlcal treatment, consequent to the relnforced eurvelLlance actlvlt ies and
the distributlon of Gambusia contributed to the reductlon of the rate of lncrease of
transrniselon ln 1972-i;me-uneprayed area, B-7, to the extent that the SPR was clo8e to
that of the DDT sprayed area, B-9.- In 1973, after two years wlthout spraylng ln B-7' the
nalari.a incldence grlatly lncreased conpared to the DDT eprayed area' B-9' Both the SPR
and API were slgnli lcantly higher ln the unsPrayed area; these lndlces ttere even more
sLgnlflcant when the results obtalned durlng the transoisslon nonths were considered
alone. However, durlng 1973 the BER was 3L:87.ln B-7 ln comparlson wlth only 16.42 ln B-9
lndlcatlng that houee vlsits were r1ore frequent ln B-7 than ln B-9' Thue, the dlfferencea
ln the two areaa were real and slgrrlf lcant and thls, together wlth the very relevant and
supportlng "rrtorofoti"i i-t loaftgs
[already shown ln Subiection (1) ae mentloned above],
provldes an ansrrer io the doubts as to the effect of DDT under the condltlons of Kunduz
unlt. The trlal glves a valuable lndlcatlon of what nay happen when DDT spraylng ls
withdrawn. To conclude, Onorl et al. (loc.cit.) pointed out that they are fully aware that
the problems of the area cannot be eolved by the contlnued use of DDT alone' It wae also
reallzed that DDT spraylng may becone less effective ehould DDT resletance 1n PglcFerrlnusincrease. However, ooi can
"tftf be used untl l f lnanclal reaource8 are avallable to
Lnplernent alternatLve and more efficient attack measures.
Dukhanlna & Quadeer et a l . (1974) preeented the reeul ts of
entomologlcal/epidenloiogical studles carrled out ln northeastern Afghanlatan aa follows:
vBc /90 .3MAL /90 .3Page 257
( l ) Transnlss ion sEson: Uslng the Organov-Rayevsky nethod ( in Det lnova, 1962) to
e 6 t i n a t e @ r o g o n y w 1 t h c a 1 c u 1 a t 1 o n s b a s e d o n t h e t e t r P e r a t u r e d a t a a tKunduz a l rpor t , i t seerns that rnalar la t ransniss lon may star t in ear ly May 1n th ls area.
I lowever, potent ia l ly dangerous fenales of vector specles havlng coopleted f ive to s ix
gonocrophlc cyc les, and even younger ones, were absent at the beglnnlng of May.
iotent la l ly dangerous fenales of @. appeared at the end of May or at the beglnnlng of
June, ana of puicherr tnus in the second hal f o f June or ln Ju1y. Malar la t ransnles lon is
due ro hyrcaniiS-Tfrff iElTosr of June whlle ln July the denslty of Potentially dangerous
fenales?6?T spectes was equally hlgh. In August, };g3ry had alnost dlsappeared and
the densl ty of Blcherr lnus was rather Lon. In Septeober ' a nel t densl ty peak of both
specles ras rec6Tffif, i1ast gonoactlve females ttere recorded ln the nlddle of October.
Ai the end of Septerober or at the beginnlng of October, dlapauslng lPre-hlbernatlng]fenales in the hyrcanus populatlon appeared, unti l the end of October when they forned l00Z
of the poputatl i i-n the above, Lt ls clear that the transDlsslon seaaon ln Kunduz area
starts at the end of May or beglnnlng of June and ends at the beglnnlng or nlddle of
October.
(2) plasroodiun speclee: 3g!g ls predonlnant in alL zones of Afghanlstan. In the
mounraln rlver .'at[iFF, offiEi?r outbreaks of 3lgllgIgg nalarla were recorded' rn
northeastern Afghanl"t.ttr 336 159 blood elldes were exanined durtng 1971, of whlch l0 754
w e r e p o s 1 t 1 v e f o r P ' v l ' v a x a n d 7 6 f o . 3 : . ! @ . 1 n 1 9 7 2 , o u t o f 3 0 8 4 2 0 b 1 o o d s l 1 d e sexanlned f 3 4lO ,oeiill-m-frlve f or p. vfvax ana onfy three for, P. falc{paruro. -
Souetlnesp. vlvax and p. falclparum are lnp6Tted froo eastern and southern reglons wlth nlgrant
!6piTiETons. -
(3) Seasonal occurrence of nalar la gqsgs:- lhe ualn feature of seasonal nalar la
d 1 s t r i b u t 1 o n 1 n t n 1 e t a n 1 s a p e a k o f c a s e s o c c u r r 1 n g b e f o r e t h eonset of the transElaslon seaaon, and a large increase durlng the thlrd quarter with a peak
ln August and Septe6ber. A11 caees occurring 1n the sprlng acqulred the lnfectlon during
the pievloue year(e). Malarla cases between January and the ntddle of June can be dlvlded
lnto: caees wl th c l ln lca l nanl feetat l .ons, and thoee wl th asynptoEat lc parasi taeoiae '
Epidenlologlcally, the caeea can be claeelfled as long-t.ern replases of caeee recorded ln
the prevlous year(s) , or aB long- tern re lapees of fever casea t reated wl th a s lngle doee of
chloioqulne, but not recorded ae posltlve nalarla caaes or aa nelt caaes whlch had no
ualarla symptous before, and were euppoeedly vlvax lnfecttons wlth a long tncubatlon
perlod. it" tncrease ln nalarla ""e!"
aurtngEe-flrst half of. 1972 wae explalned by the
iavourable cllnatic condltlons for }1g9., whoee denslty and eurvlval rate were unueually
hlgh ln June and July. Durlng the E-alf of the summer' tranamlsslon was effected
malnly by pulltrglrIogq whose longevtty Lt 1972 was leas than 1n 1971 (the proportlon of
pot"nlt.ttfaanger."s fenales were 9Z and 2O7, respectlvely). The data for June 1973
reseembled those of 1971; the longevlty of Ury wae conelderably reduced due to very
hlgh tenperature ln June. The gu-stlon of Efpreeence of P. vl.vax wl'nter atraln' l '€'1 a
straln wlth a long lncubatloa perlod, deservee attentlon. IETEl?oUable that the straln
found 1n Sovlet Mlddle Asla at Lenlnabad, TaZlk (- Tajtk) SSR, aleo occura ln Afghanlstan'
There ig ae yet no experlnental evldence of the presence of euch a straln ln northern
Afghanlstan and relevant studLes are, therefore, lndLcated'
(4) Aeynptonatl.c parasltaeula: In the courae of mass blood surveys ln Inan-Sahlb unlt
( n o r t h o r e r a n d a u t u D n ' a s 1 g n 1 f 1 c a n t n u m b e r o f a s y n p t o n a t 1 cparasltaeolas wae recorded. Thelr rate ln relatlon to all poeitlve casea varled between
io.sz (yaktout) and 65.52 (Kuldanan). uost of the as)rDptoEatlc paraeltaerntae found ln the
autu6n Burveys had oalarla tno to three months prevlously, but uere not detected' A large
proportion of a6yuptonatlc paraeitaeolas were observed atnong chlldren and adolescents (uP
io ie years old)-wiro accounted for 757 of cases. Thetr Preaence rendere the oalarla
eltuat1on more complex, and decreases the effectivenees of antloalarla oeasures'
Therefore, serlous attentlon should be pald to detectlon and treatEent of casee and to mass
radlcal treat6ent tn the nost lnfected focl. Asynptonatlc parasitaemla nust be
lnvesttgated and be coneldered from an lmunologlcal polnt of vlew.
wc/90.3MAL/90.3Page 258
(5) l{alaria tncldence anong chlldren: Malarlal infectlons were found arnong children of
a t t a g e - g c c o r d 1 n g t o a g e . A p p r o x 1 n a t e 1 y 5 0 % o f a 1 l c a s e swere between one and 16 years of age. Several severe cases wi th conpl lcat lons were
observed nost ly iu the younger age-groups. rn nor thern Afghanlstan, ch i ldren const i tu ted a
very ef fect lve reservoi r of ln fect lon. Fal lure to detect and t reat these cases has
conl iderable in f luence on the cont lnuat ion of nalar ia t ransmlss ion '
(6) Ant lnalqr la neasures and reconmendat lons for re inforceggnq: In nor thern
41r1r" i l "a res were applred year after year but
not succeed in in terrupElng nalar la Eransmiss ion. Even wi th reduced vector densl t ies,
accumulat ion of malar ia reservol rs anong the populat ion led to ln tensi f ied t ransmlss ion.
Thus, 6690 cases were derected ln 1969 and 9447 Lt 1970, wht le the nunber, lncr2ased. to.
f0 830 tn t97l and ro I3^4f0 tn 1972. DDT house spraylng covered 99 ro i l l ion n- in I97I '
and a lnost 105 ro l l1 lor , t '1r , 1972, but the ef fect was lnsuf f ic lent ' In t roduct lon of
Garnbusla ln l97l proved of value. For exanple, at Khondan where the fish ltere put in rlce
f le lds, vector-man bl t ing densi t lee at the end of summer l tere one-quar ler of those observed
at Rashldabad (wl thout -Ginbusia) . I f the f lsh d ls t r l lu t lon is .poor-and the densl ty in r ice
flelde ls reduced (less-66G?ee to five flsh per rn'), breedlng of 4l93!g}5g persists'
In 1971, several reservol rs fot $$!g breedlng were establ lshed, and 2 '7^n1111on f ish
were d ls t r ibuted in r lce f te lds wl th a tota l sur face area of 1.23 nt l l lo t t ' .
I l lbernatlon of Ganbusla ln reservolrs was successful and in L9l2t.tLsh were again
dist r lbuted ln r tc f rGlds wl th a tota l area of 2.98 n i l l lon m" Isee more deta l ls under
paragraph 4.1 belowl .
Regarding the e l ln lnat lon. of reservoi rs of in fect ion, measures were insuf f lc ient
because the frequency of house-to-house vLslts waa lnadequate and sonetlnes the delay
betneen collectlon and examlnatlon of blood slides was 15 days or ooE€. Thus, nalaria
casea could cont lnue Eo aerve aa reservol rs of in fect lon. In addi t lonr the 5-day reglnen
of prloaguine could not prevent relapses. In several vll lages, the nurnber of roalaria caseg
decreased followlng the lnprovenent of case detectlonr treatnent and dlstributlon of
Ganbusia. For exanple, at Khorndan, the nurnber of roalarla cases It 1972 was only half of
f f iEorded 1n 1971.
For the ftrst t lne ln Afghanistan, mass radical treatoent wae carrled out to ellninate
the dangerous reservoLr of lnfection ln several heavy foci in the Inan Sahlb unit ' In 15
vll lage- where maes radlcal treaEnent nas carrled out, the number of oalaria cases durlng
the first half of 1973 was lees than one-tenth of that recorded durlng the saoe period of
1972. During the saoe perlod ln control vll lages (wlth no naas radlcal treatoent), the
number of caees decreased to not even half that observed ln the prevloua year.
Based on the above, Dukhanlna & Quadeer et al. (1974) recommended the following to
strengthen the efflcacy of antlnalarla meaeures ln northeaateru Afghanistan:
(a) Selectlve house spraylng with DDT or an alternatlve lnsecticlde should contlnue
wherever Justlf led epldenll lolf".ffy and entomologically. DDT should be dlscontinued tn
the lrrlgated zone ri."r" pulclerrfrnle and IIry are vectors but lt would stl l l be useful
1 n t h e m o u n t a 1 n . r 1 v e r z o n @ t o r , a n d i n t h e p 1 a 1 n r i v e r v a 1 1 e y z o n ewl thPl4@-
(b) Introductlon of antl larval ueasures such as dlstributlon of @| in rice
flelds, nechanlcal Deasures of eource reductlon (drainage, f l l l ing lnr ltater oanageDentt
etc . ) , and larv lc id ing 1n r ice nurser l 'es ln May and June'
(c) Intenslflcag.lon and relnforceDent of surveil lance activit les for proopt case
detectlon and treattrent.
(d) Strengthenlng of laboratory eervlcea to ensure PronPt and reliable blood
exanlnatlon and speedy dtspatch of results.
(e) Ellnlnation of the nost iroportant malarla focl by nass radlcal treaEr0ent durlng
the non-transoleslon period, uelng chloroqulne and a fortnlghtly course of prlnaqulne'
d idEhe
(f) Appllcatlon of oass chenoprophylaxis durlngto be eelected on epidenlo loglcal grounds.
vBc /90 . 3MAL /90 .3Page 259
the t ransolss lon 6eason ln local i t les
(g) Other select ive supplernentary renedla l measures should be organl"zed, l f necessaryaccording to topographlcal and epldenio loglcal condlElons.
(h) Inprovenent of the qual l ty of antLrnalar la serv ice by provld ing basic and ref reshertralnlng and by strengthenlng supervlslon at all IeveIs. Realth educatlon ls an essentlalmeasure to be conplemented by regular lnfornatlon on nalarla work through press and radlo.
Polevoy et a l . (1975) s tudled the problen of nalar la ln nor thern Afghanlstan. Theylndlcated that the same four landscape-epldenlologlcal zones existlng tn Tajik SSR wereestabl lshed ln nor thern Afghanlstan, v iz : r lver va l ley zone, l r r igated zone, nounEain r lvervalley zone and Low h111 zone (low foothil ls borderlng Ferghana depresslon). There are twozonea wlthout natural condltlons for oalarla transmleslon: desert and hlghlande. Thelargest nuober of nalarla caaea were ln the lrrigated zone, where nost of the humanpopulat lon ls concentratedr r ice ls cu l t ivated on a large ecale, and vectora are exophl l lc :pulcherrlnus whlch shows lrrttabll lty to DDT and hyrcanus whlch ls resletant to DDT. Aftera 3-year etudy ( f97f- I973) , .var loue contro l l reaaures nere suggested and lnt roduced fordlfferent landecape-epldenlologlcal zonea. In the lrrlgated zone, DDT house spraylng wasdLscontlnued and attention focueed on therapeutic and prophylactic oeasuree, tncludlng masslnter-seaeonal chenoprophylaxls lr lth chloroqulne and prioaqulne. In additlon, larvalcontrol Deaaurea (larvlctdes ln rlce seed-plote, and @!gg!g ln all nater bodles) serelnplenented. Of great iuportance ls the lmproveroent of the roalarla control servLce,developnent of general health facll l t iee network, tralnlng of personnel and healtheducat ion.
Anufr leva et a l l (198I) descr lbed a t r la l o f house sprayLng wLth nalath lon suspenslonat a dosage of 2 g/n ' ln v l l lages e l tuated ln the t r r lgated zone of nor theaoternAfghanistan where pulcherrlnus and !1593gg, are the prlncipal vectors. The spraylng wasapplied ln late June 1978 wlth a coverage of. 94-967". For l0 neeks after epraying no
-
fenales of a potentl8lly dangerous age lrere found in treated vll lages and a 4.2-9-f,oLddecreaee ln oalarla lncldence wae obeerved conpared wlth the level tn L977. In untreatedvll lages, the proportlon of potentlally dangerous fenales varled fron 5.47" tr late June toL3.27 tn August and oalarl.a lncldence lncreaeed. Spraylng of prerolses wlth rnalathlonexerted a lower ef fect on @S
Kovchasov (1985 - unpubllshed aselgrunent report to WIIO) was posted to Afghanlatan asthe MIO Senlor ltalarla Mvieer frou 3 October 1979 to 25 October 1985. I le revlewedanElnalar la act lv l t ies and the rnalar la s l tuat lon up to the f l rs t hal f o f 1985.
(1) Hletorlcal background: Ualarla control nas started ln 1947 ln the town ofPullkhurorl ln northern Afghanistan, when larvicldes were applled ln and around the town, lnan ef for t to protect workere ln the newly establ lshed text l le lndustry . In 1948, ualar iacontrol denonetratlon zones were establlshed ln Qataghan (Northern) and Laghrnan (Ea8tern)provlncee, wlth the aeeistance of t lIIO, to deternlne the feaelblJ.lty of ualaria controlthrough lnsect lc ldes. Fron 1952, act lv l t les nere gradual ly extended to other par ts of thecountry and nalaria control contlnued untLl 1958, when on the basls of the excellentresults obtalned, lt was declded to launch a nalarla eradlcatLon progranme wlth theassLstance of ff i lO and UNICEF. As ln other countrles, after the lnttlal succees of theeradlcation progranme, najor setbacks occurred. In Afghanlatan, adninistratlve weakneseescould be ldentlf led fron the beglnnlng and nere later aggravated by technlcal problens.Aoong these nere the developnent of DDT reslstance ln cullclfacles a.d gjg$,! and theexophlllc behavlour of gulcherriuus and !ry.. vasFffii'16lGlatloiai6dts havealwaye posed dlff lcult problens for the lnplernentatlon of antlnalaria meaaures. A1so, avast lncrease ln breedlng p laces reeul t ing f roo t r r lgat lon proJects enhanced thernalarlogenlc potentlal of the country. I{hen the asslstance of UNICEF, the maln suppller oflnsect lc ldes, r ras phased out , i t ! ra6 soon real lzed that malar ia eradlcat lon could not beachieved. The Governloent of Afghanlstan, following the advice of a jolnt WIIO/UMP RevlewMlsalon converted the eradicatlon progranme lnto a control programme. WIIO contlnued toaseist the prograrnne and UNDP asslstance started ln 1975 contlnulng unttl the end of 1983.Assls tance f ron b l la tera l sources l ras a lso provlded.
vBc,/90. 3MAL /90 .3Page 260
(Z) org. t t i " " t io t t . l " t . , tccut
t .A11 " : l lv i t les
of
M C P a r e c a r r i e d o u M a 1 a r i a a n d L e 1 s h n a n i a s l . s I n s t i t u t eI la ter named MalarLa and Parasi to logy Inst lcute] , a semi-autononous body, d i rect ly under
the Mln ls t ry of Publ ic Heal th (Upf f ) . The MCP mainta ined i ts ver t ica l s t ructure and the
whole country ls d iv ided into s ix maLar ia regions each headed by a Regional Malar la
Director . The of f ices of the malar ia reglons are located in the fo l lowlng: Kunduz,
Mazar ishar i f , Kabul , Ja la labad, Kandahar and Herat . Each reglon compr ises 3-8 Malar ia
Uni ts (see Fig. 14b) . Each malar ia uni t is subdiv ided lnto 4-6 superv lsory areas (SA) and
each SA is covered by 4-6 survei l lance agents. By the end of 1981, there were 33 nalar la
uni ts , but af ter adrn in is t rat lve reforms in 1982, thei r number has been reduced to 28 ' A
large number of per ipheral laborator ies have been establ ished dur lng 1976-1979' but
gralually thelr nunber has been reduced due to dlff icult worklng condltlons. The nunber of
ia lar ia personnel has been reduced year af ter year due to d i f f icu l t work lng condl t lons '
request for rn l l i tary serv ice, and re luctance of phystc ians to work ln prevent lve nedlc ine '
Personnel of Baslc l{ealth Services (BHS) fron the beginning of the UCP lrere not
engaged in ant inalar la act iv i t les. Al l contro l neasures had to be per forned by the staf f
of the l lalaria Institute. The problen of integration of the Malaria Instltute lnto BIIS has
been dlscus6ed but has not so far been resolved; the maln reason being the weakness of BHS
in the country. In 1981, the MPH trled to lntegrate the roalarla services in two provlncee
(Baldh and Jalalabad) lnto Sanltary-Epidenlological (SE) statlons, buE it has not been
achieved due to lack of personnel ln SE statlons. I{hat ls feaeible and ls already ln
piogt""" is to train nalaria personnel (super-yisors and survell lance agents) in some basic
" .n i tary-"p idenlo logical requl rements concernlng schools, factor les, food enterpr lses aad
publlc ."t lUtf"tuents ln order to prevent and control Ehe spread of cotnmunlcable dlseases
and to increase the standard of hygiene ln the population. Follolvlng the resolutlon of the
38th WorLd ltealth Assenbly ln l lay i985, tottl"h recommended that malarla control be developed
as an ln tegra l par t of the nat lonal PHC system, the MPH ordered a l l prov lnc la l heal th
offlcers to include meaaures for nalarla tontrol and prophylaxls tn the Plan of Actlon of
a l l centres of BHS. The basic heal th centres and subcentres I tere requested to adln ln ls ter
radtcal treatment to cllnically diagnosed nalarla Patientsr where laboratory servlcee are
not avai lable. I t was a lso request ;d to establ lsh volunteers ln each v i l lage to aeelst in
malaria control by dlstrlbutlng antimalarlal drugs after brlef tralning at the nalar-la
unit. In order to obtain support and asslstance fron various lnstl ' tutLons to the l ' lCPr an
intersectora l co n i l tee is being establ lshed wl th par t lc lpante f ron 15 rn ln is t r ies and
organizations under the chairmanship of the Deputy Mlnlster of Publlc ltealth' The
.orrltt"" w111 perlodlcally dlscuss the nalarla sltuatlon and reconmend neceaaary
correct lve Deasure6.
(3) Strategy for oalSf ia contro l ; oblect lves and t4rgeqs: The fo l lowlng st rategy has
been lnplenented s ince 1977:
(a) Areas wi th API over 40/1000-spraylng operatlons obligatory lf the vector le susceptlble and endophll ic'-If the vector is exophll ic, arug adnlnlstratlon, larvlciding and blological
control should be considered.(b) Areas with API 2!:l-91-l-999
-Mass radlcal treataent.-Enhanced survell lance.-SpraYing oPerat lons.-l lase drug ProPhYlaxLs.
(c) Areas wl th API 10-20/1000-Anti-relapse treatm6n-E-of positlve caaea obllgatory durlng lt lnter oonths'- } l a s s r a d l c a l t r e a t m e n t o n l y w h e n t h e l o c a l l t y l s h t g h l y v u l n e r a b l e a n d
recePt ive.-Enhanced supervlslon and surveil lance mechanlso'
It should be kept ln rnind that nalarla ln Afghanlstan ts of an unstable tyPe' Due to
unpredlctable changes ln cllmatic conditlone and human ecologyr ellergency sltuatlons may
requlre tlnely and ry measures. Thus, the general etrategy has been nodlfled and
adapted over the yeiff i sult local conditions. fn 1982, an energency plan for malarla
control ained at establlshlng a system of feaslble measures was elaborated' The lmportant
part of the plan waa to provide the populatlon at rlsk wlth antloalarlal drugs' Eruphasls
was laid on health educatlon "nd
corrurrlty partlclpatlon as well as adnlnlstratlve suPPort
f roro local governors.
vBc/90.3MAL/90.3Page 261
The object lves and targets of nalar la contro l uP to 1983 were:
- To malnta ln the reduct ion of roalar ia lnc idence in areas of low oalar logenlcpo ten t l a l t o l ess t han l / 1000 .
- To achleve progresslve reduct ion of malar la 1n areas of h igh nalar iogenlc potent ia lto less than 15/1000.
Af ter 1983, the obJect lves and targets were changed as fo lLows:- To reduce rnalar la norb id l ty especla l ly ln those unl ts where there were large
ep lden l cs .- The targer being a reduct lon of API to less than 10/1000 in the country.
(4) l ' taior oroblems tn nalarla control
(a) Technlcal problens:-Reslstance to DDT 1" g!!g!!gg!g and g.1!g$! as well ae in !g!$!g andhyrcanus.rExophlly and exophagy of Pulcherrl'nue and UIS.-Nornadl.sn: More than two ni-lllon nonads are Ln constant movement throughout thecountry Ln search of paeture. Most of the nomads orlglnate from ualarta encemicareaa and then lntroduce Dalarla ln non-endenlc areas.
(b) Operat lonal problens: -
@ r n a n y 1 o c a 1 1 t 1 e s d u e t o r o u g h m o u n t a 1 n t e r r a 1 n , a s t ' e 1 1 a sdl f f lcu l t les created by war condl tLons.-Lack of suf f lc lent per ipheral laborator les.-Reduced posslbll l t les for spraylng opereElons, radlcal treatnentr rnase drugadnln let rat lon and other act lv i t les.
( " )@f f i m ' n y a r e a 8 r e e u 1 t 1 n g t n d e 1 a y 1 n r e p o r t 1 n g a n d e v a 1 u a t i n g
the oalarla sLtuatl.on.-Reluctance of BHS to particiPate ln nalarla control.-Adninletratlve procedures whlch lfunlt the flnanclal f lextbtl lty of ualarlaun l t s .-Inabll lty to provlde lnsectlcldes and drugs to the oalaria unlte Ln tlne due topoor t ranaporta ln systeE.
A11 these problens hanpered the tlnely luplenentatlon of the planned antinalarla measures
and reeulted ln an lncrease ln rnalarla norbldlty each year.
(5) Uethode of nalarla control: The nalaria control prograune ln Afghanlstan lnherlted
t h e t e c h n @ 1 c a t 1 o n P r o g r a D D e . I | o w e v e r , a e t h e c o n t r o 1 P r o g r a n n eprogresseil, shlfts ln prlorlt les for applylng thoee techniquee occurred according to theprevall lng local clrcunstanceg. The nethods used were:
(a) Geographlcal reconnalssance (GR): The GR fron the tftoe of nalarl.a eradlcatlon wag
g r a d u a u y s t o a 1 a r 1 a u n 1 t s , b e c a u e e o f d 1 f f l c u 1 t 1 e s 1 naccess to vll lages. Llnlted GR, however, ls belng carrled out ln the central area of sone
ualar la unl ts .(b) ACD: Fron 1980 to 1985, the ACD actlvlt lee and survell lance agents have been
reduced so that ACD wae conflned to the provlnclal centres where securlty Deaaures allow
ACD to be perforned.(c) PCD: Deeplte the reductlon ln nalarla laboratoriee from 1980 to 1985' the number
of slldesEllected by PCD has lncreased, lndlcatlng that more nalarla iatl 'ents went to the
exlsting nalaria laboiatories. Most laboratory work has been performed at the to$n centres
rather than at the perlphery. Recently, noveneots and settlenent of the populatlon fron
vlllages to provlnclaL centres have been observed, lnc.reastng the number of patlente
dlagnosed by the unlt centres.(d) Epldenlo loglcal lnveet lgat lons: Invest lgat ions were p lanned as fo l lowe:
-For a l l P. fa lc iparun cases-During
"'Gffi i i-Gly sprlng (March-May) to dlfferentlate between luported'
lndlgenoue and relapees.The available data fron the roalaria unlts are inconplete. Due to increaslog nunber of
cases, epldenlo loglcal Lnvest lgat lon of P. v lvax cases could not be carr led out rout lnely '
VBc, /g0 .3MAL,/90.3Page 262
( " ) @ t-Presumpt ive t reatment : This was g lven to suspected cases found wi th fever dur lngA @ o f 6 0 0 n g c h 1 o r o q u 1 n e * 2 5 a g p y r i n e t h a n i n e ( a d u 1 t d o s e )dur lng the t ransmiss ion season (May-October) .-Radical t reatment : Thls was per forroed to a l l n icroscoplcal ly conf i rmed cases asf a I 6 m ; u r s e o f c h 1 o r o q u i n e ( t o t a 1 a d u 1 t d o s e I 5 0 0 r o g ) a n d 7 - d a y c o u r s eof pr fuoaqulne (dai ly adul t doee 22.5 rg) . Drugs for the f i rs t day of l reatnentwere given by roouth, whlle the remainlng tablets ltere handed Eo the Patient withLnstruct ions as Lt was not feasib le Eo g ive Ehe tablets dai ly . Due to lack ofheal th educat ion, the najor i ty of pat lents d id not fo l1ow the 7 'day t reatment 'abandonlng ! t a f ter the end of fever at tack6. This resul ted in a large nunber ofrelapses and constltuted one of the lnporEant setbacks to the prograrorne.-Ant l - re lapse t reatngnt : Thls was g lven to posl t lve cases recorded the previousy @ r 1 n a q u 1 n e , 2 2 . 5 n g d a t 1 y a d u 1 t d o s e ) d u r 1 n g w i n t e r m o n t h swherever possib le. Due to d l f f lcu l t work lng condi t lons and inabi l i ty to reachpat lents, th is type of t reatDent nas not proper ly done. Ef for ts were made,however, to enaure that such treatnent was given at least ln the viclnlty of unitcentrea.-Uass radical treatroent3t@
Using the saoe scheme of radlcal treatnent, na88 radlcalon eptdenlologlcal grounds but lts appllcatlon lras very
l ln l ted.-Mass d.gg_p.g,[]95!9.: Thls was carried out ln hlgh nalarlogenic potentlal areasu @ n e + 4 5 n g p r 1 n a q u i n e ( a d u 1 t d o s e ) f o r t n 1 g h t 1 y , b u t I ' a 6 n o tapplled on a large scale due to operatlonal problens.
(f) Resldual house spraylng: This renal4s the lnportant oethod ln the controlp r o g r a n n e @ o f I . 5 r y / ^ . w a s a p p 1 1 e d 1 n a r e a s w h e r e e u p e r p 1 c t E ,prevaLled, e.g. , v l l lages ln the mounta lnous areas. Malath lon at a target dose of 2 g/a-was applled ln areas where stephensl and Sgfl@ predoninated. House spraylngfo l lowed the establ lshed contro l Etrategy; recent ly , however, spraylng operat lons wereconf lned naln ly to prov lnc la l centree, n l l l tar ) r canps, barracks, schools, etc . , butspraying ln v l l lages was l ln i ted due to unset t led condi t lons. Star t lng f roo 1982, spraylngoperatlone have been perforned ln 23 out of 28 nalarta unlts, but coverage ltas rather lowranging fron 502 to 757. Due to lnconplete reporting, lt was not possible to evaluate thereal effect of epraying ln vll lages. Thls was corrected ln 1985 when the naxoes. of sprayedvll lages and localit les were requested along wlth norbldlty data for every vll lage ln thea rea .
(g) Lalval contro l ,-t i ivicl l lEg- Tenephos 500 E at a target dosage of 10 mg/v- was applled ln thecfifGffibul , Jalalabad and Kandahar with good results, as the larvaldensltles nere very low, ranglng froo 0.28 to 0.36 per dlp ln Kabul andJalalabad.-Blo logical co l t ro l , @ have been wldely d is t r ibuted _.a@ce@ ln Kunduz ln 1971. In 1976, 32ntll lon ftsh were released, although ln recent years the nunber has been sharplyreduced.
(6) Entonologle.al acttvlt ies: Durlng the 30 years of the rnalarla control progranne lnAfghanletin, stuaie--n-tf i- anophellne fauna of the country, vector species and thelrvectorlal importance, blt lng and restlng behaviour, Ean-vector contact, l l fe expectancy ofvector epeclee, duration of the gonotrophlc cycle and eusceptlbll l ty level of vectors tovarious lnsectlcldes have been conpleted. DDT resistance has been lncreaslng in four outof f lve species: 9!@1., cullcifacies, !g!$!ggg and U,!!ry, while suPerDlctusreoalned susceptible. [ *rperplctua naa recorded reslstant to DDT ln Afghanlstan - seeSubeect lon (1) under,2. l2=T; ;e l -A11 vectors were found suscept lb le to malath ion. Frompreclplt ln teats, a large proportlon of superpictus and glggsg! had fed on bovlds, whileonly a few had fed on roan, although abou-so-fif. the fenales of the tno specles were caughtln bedroons. This zoophLly ner l ts fur ther lnvest lgat lon to establ lsh the reaLepldenlologlcal elgnlflcance of these tlro vectors ln Afghanlstan.
( 7 )the
The nalar la s l tuat ion: The overal l Dlc ture of the nalar la s l tuat lon can be seenf f i t 1 o n d u r 1 n g l 9 8 0 - 1 s t 6 e D e s t e r o f 1 9 8 5 a s s h o w n 1 n T a b l e 2 0 .f rorn
1 9 8 0 - 1 9 8 5 ( r s r
vBc/90.3r,rAll9o.3Page 263
senester)Table 20. Reeul ts of b lood exanlnat lon dur lngln Afghanistan
N o . s l l d e eYear co l lec ted
No. pos i t l veP . v . P . f .
4 78 7
1 1 01261766 2
ualar lacasea.
47 28587 443
110 309r27 340176 73962 139
SPRZ
7 . 91 8 . 32 2 . 823.62 8 . 827 .3
APS / r 000
5 . 39 . 8
L2.4r 4 . 319.97 . 0
1980 595 607r98r 478 0701982 483 6291983 538 4381984 612 6451985 227 713
2683090 1 8937306l 1 3
L 7i34291403433
26
Slnce 1980,ln 1984 wlrh 176F 1 g . I 4 b ) .
the739
lncldence ln the country has been lncreaslng reaching a peak
The nost affected regl.ons ltere: (see reglons and unlts ln
The Eastern res lon: The nost ser lous s l tust l .on occur6 ln th ls region, especla l ly in
J a r a 1 m n 1 t s 1 . w h e r e 1 a r g e e p 1 d e n l c s h a v e b e e n d e v e 1 o p 1 n g s 1 n c e l 9 8 3 . I nJalalabad, slx supervlsory area6 coverlng 46 vll lages wlth 42 067 people showed an API of
Z3Z - 674|LOOO ln 1983. The eane areas were badly affected during 1984 and 1985 wtth
lncreased norbtdtty. The hlgh denslty of gt.ph.Ts,l and g9}1g!]!g!5 assoclated wlthpulcherrlnus and Ercanus caused by favourlTG-ilTiatlc condltlons, and the lnabl1lty of
?11g-Til;E;a'tarta-lffi-n-nel to reach these areas to apply antlDalarla meaaureE' ltere the
maln reason for th lg a larn lng epldeolo loglcal s l tuat lon. The sane condi t lons have a lso
exlsted ln Laghoan unit where a large epldenlc wae developlng ln 1985 ln slx supervlsory
areaa coverlng 124 vtl lages wlth a populatlon of nore than 50 000'
Northeaetern gg!g: In thls reglon, the nalarta lncldence has been increaslng ln
u n t t s f f i u a n ' F a 1 z a b a d a n d K u n d u z . T h e n a 1 n v e c t o r a 1 n t h e p 1 a 1 n a r e a 6Kunduz and Inan Sahtb are a5 nentloned above pulcherrlnus and !gg1i, which are
exophll lc. Theee tlro vectora nere apparently not aliected by house epraylng. Thepredoninant vector ln the h1lls of Falzabad and Taloquan 1" gyIggPS whlch le
iuscept ib le to DDT [see renark on DDT res ls tance ln th le speclee above] , but obvlously
lltr lted houee spraylng wlth DDT durlng 1983 and 1984 has not reduced the Lncidence of
nalaria ln these two units
iou,of
the
The Central reglon: Out of the flve rnalarla unLte of thts reglon' Khost was affected
' 0 o s t m a 1 a r 1 a 1 n c 1 d e n c e 8 t a r t e d t o d e c 1 1 n e . T h e 1 a r g e 8 c a 1 e h o u e e s p r a y 1 n gwl th rnalarh lon ln 1983 and 1984 agalnst scephensl , ggl lcr fac lg?-and 9u+9f4!9t t ls 11: .b""" .effecrlve ln reduclng the oalarla lncldeiff i i-767T000 inl982 to 5.6/1000 ln 1984' and
fur ther to 1.4/1000 in the f l re t aemester of 1985. I lowever, l t le lnpor tant to note that
the naJorlty of the populatlon of Khost left thetr homes ln the PaBt 2-3 year6, whlch nust
have contrlbuted to the reductlon.
The Southern reglon: Thie lncludes four oalaria unlts and the Dai.n vectora are
e t e e n @ a n d 9 s s I ! & g . T h e . r n a 1 a r 1 a 1 n c 1 d e n c e 1 n H e l n a n d a n d K a n d a h a runl ts hag repalned at a medlum levei -Er tng the past 2-3 years (API: l '2 .4- I7.9/1000). The
ef fect ive.spraytng operat lons dur lng th ls per lod ln eeveral h ighly af fected auperv lsory
areae together wi th enlgrat l .on contr ibuted to these good resul ts . Due to d l f f tcu l t ter ra in
and lack of nalarla personnel ln Zabul and Uruzgan, no lnforrnatlon on the rnalaria 61tuatlon
has been received slnce 1983. Increaeed norbtdity should be expected. A dleturbi.ngp h e n o n e n o n 1 n t h e S o u t h e r n r e g 1 o n 1 s t h e 1 n c r e a s e o f L @ . A c t u a 1 1 y 'i. falclparun lnfectlon exlsted for a long tlue ln thls reglon, but lts l-ncldence was
reduced to a mlninun ln 1979-1981. Speclal attention concerns the sltuatlon ln l lelnand
untt where P. falciparun caaea have sharply lncreased elnce 1982. It ls not known whether
t h e s e . c a s " s @ o u a o r 1 n p o r t e d f r o n P a k 1 s t a n . N o t e s t 8 o n t h e s e n s i t 1 v 1 t y o fP. falclparun to chloroquine have been done 1n Afghanlstan. Bearlng ln nlnd the preeence
A;fr'ffi;A;fre-re6lstant stralns of L-{.a1.1p.rur in Paklstan, it could be that euchstrains night be transmltted ln thesil6?dEi-Ereas. IIn fact, eensltivlty tests carrledout in ltay 1986 proved P. falciparun resistance to chloroqulne ln an Afghanl Peraon ln an
area borderlng PaklstanEEEffi l , 1989 under paragraph 2 belowl .
vBc/90.3MAL/90.3Page 264
The Western region: The nalar la_sLtuat ion here showed no ser lous problen; the API ln a l l
four malar ia unl ts var ied f ron 0.1 to 7.3/1000. Again, an lncreaelng nunber of
P. fa lc lparurn ln fect lons mer i ts fur ther invescigat ion '
(8) Seaeonal occurrence of nalar ia cases: Analys lng the nonth ly d isEr lbut lon of malar la
; ; e r o f 1 n f e c t 1 o n 6 o c c u r r e d d u r 1 n g t h e w 1 n t e r n o n t h sand even up to the beginnlng of the transnlsslon s€aaoro Thls rneant that all rePorted
nalar la cases dur ing i t r " t f i " t semester should be regarded as re lapses f rom the prevlous
year, hence the inp;r tance of conplete radical t reatment . This was repeatedly polnted out
as one of the key probLems for the nalaria control Programxoe. Unfortunately, the lnabll lty
of nalar ia pereonnel to per forn ProPer ant l - re lapse t reatnent in a l l un l ts 1s one of the
weakest potnts of the control programme. Serious Deasures have been taken to ensure this
t reatnent by the end of l (ay 1986 ln aLl uni ts '
(9) Evaluatio : The followlng data ehow the level of API
dur ing the past f lve Years:Nurober of nalaria unlts wlth API
APr/r000
Less than Il - 10
>r0-20Over 20No data
rgsow 1983 1984
It ls clear that sLnce l98l the nunber of nalarla unLts with API lese than 1/1000 has
been reduced, whlle those wtth ApI of more than 10/1000 lncreased. Thus, the planned
targets of the malarla control progranne have not been achleved. The reasons were
suomarized as follows:
(a) The exlstlng uneettled condltlonsaccordlng to the control strategy.
have not perultted the nalarla peraonnel to act
(b) Due to dlff lcultles ln transportatlon and communlcatlon, antloalarl'a druge aod
lnsectlcldes reach the untts too late.(c) Due to operatlonal problems, antl-relapse treatnentr coDPlete radlcal treatEentt
maes drug adnlnlstratlon and full scale sPray operatlone could not be carrled out'
(d) The contlnued reduction ln nalarla personnel and the reluctance of BIIS to
partlclpate ln malaria control ltas an lmportant setback'' (e) Lttt le hae been done to attract connunlty PartlclPatlon.
some new inlt latlvee have been undertaken lately to redrees the exletlng deterloratlng
sltuatlon: the provlslon of more antlnaLarLal drugs, organizatlon of oass antl-rel 'apae
treatnent, Dass drug prophylaxle ln areas of great nalaiiogenlc Potential ' expanalon of
spray operatlons, tnv|tvlnent of BltS ln malarla control and encouragement of coomunlty
partictpatton. The future w111 te11 lf better reeults are obtained.
In a visir ro Afghanlsran froro 20 Aprll to 23 June 1985, Delftnl (1986 - unpubllshed
;:;;;-r"r.t i" eltuation. The nuober of nalarla caaee detected hasr R d r - - a t , 1 / r n o o { n l 9t E P g l L L V w . r v l 7 r s !
consranrly been lncreaslng since 1980. whlle ABER and API were L5.92 iij,1'tl*9:^t:.'-?.'-t^i
:::;:H;:trl=.n""L"1ili;;-i' igis were 7.82 and 2s.7/rooo, respectlverv' rhese flgures. ^ - ^ ! ^ { - ^ a * r 1 a } a
;;::;i; ';;i i";;;"" of a worsenlng eltuatlon. rndeed, populatlon coverase le lncomplete- L - ! - ^ - l i ^
r"i ."iit"ii""ri.ia"nce fLgures Itould glve a nill lon casea Per year wlth a trend to
increaee through epidenl.c i..r.". The Northeaotern and Eastern reglone l?::-":11:::
"il";i; ;;;i-i; ;;;-;;".;"ii-r"r..ra unlte and !+-g-le-the.responslble
paraerte'- - ^ ^ ^ l - | a e z | a ril;";.;;'i"n.'i'l"i;"-;;;;;;;-;h;_'p|"''"o""@::"::''l^::Tu::
;;;;i;'P:;i;;;". A caee or p' i"riip"''- resistant' t6-EGGl6a.:: ili-Il:l l*j i I l "o" l i . . . : ; ; ; ; . . i ' ; . l " ; ; ; . "" i . f f is ian[seenoredetal1eunderparagraph2
49573
49
l 04I
3t 3453
514I64
l 3t042I
be low ] .
vBc/90.3MAL/90.3Page 255
In another v is l t to Afghanistan dur ing I l June - 7 July 1987, Del f ln l (1987
unpubllshed report to WHO) evaluated the progress ln lnplernentation of the Plan of Actlon
of Apr l1 1985 as fo l lows:
(a) Residual house spraying: The 1986 p lan envlsaged cover ing 554 352 people out of
s . a n r r r r m z ) . A r e a a c c e s s 1 b 1 1 i t y , a v a 1 1 a b 1 1 i t y o f s u p p 1 1 e s a n depidenlo loglcal pr lor i t les were the cr l ter la for se lect lon of areas to be sprayedt but the
modest target has not been met. 0n1y 220 931 people (39.97") I tere actual ly protected by
house spraylng. Logist ica l d i f f icu l t ies d ld not Perni t the t ransfer of DDT f ron Btorage to
spray area6. Only 8.1 out of 35 tons of DDT could be ut lL ized for nalar ia and
le ishnanias i6 contro l . The remain lng 27 tons I tere le f t to be utL l lzed tn 1987. Al l 18
tons of nalath lon whlch had a l ready been d is t r lbuted ln the f le l f were ueed. Analys ls of
the coverage ln var lous reglons showed that out of e lght regiona' , the Southea6tern and
Western reglons lrere covered whlle no spraylng at all was carried out in the Southwesteru
region and only 4.6"1 ot the target populat lon was Protected ln the Centra l region. In
other reglons, coverage ranged between 38.2"A and 56.82.
(b) Ant i larval operat lons: A tota l oof I 230 000 people ln the c l t lee of Kabul '
J a 1 a 1 a b a d a n d K a n d ? 1 i f f i h e d u 1 e d t o b e P r o t e c t e d b y t e n e p h o e 1 a r v 1 c 1 d 1 n g ( 6 8 6l l t res) . A l though only 289 l l t res of tenephoa were aval lable ' targete could be net by
uslng d lesel o11 and d is t r ibut lnC $!gg!g (2.4 n l l l lon f tsh) .
(c) Case detect lon and t reatnent act l jv l t les: The tota l number of nalar la caaeg
detected ts repor t lng to nalar la unl ts) was
422 4L5. Mass radtcal treatment sas adrnlnletered to 1l 459 people, anti-relaP8e treatDent
to 7L 207. Although single dose treatnent and nass prophylaxis were not recomnendedr theee
.were adrnln is tered to 93 354 and 78 294 persong, respect ive ly . The study of drug
utll lzatlon showed that antlnalarlal drugs supplled by WIIO and partially by UNICEF were
suf f lc lent for 1986 requl renents.
(d) I lealth educatlon: Connunlty partlclpation has been sought through nass media,
dtstrtbutl6ffioi-ters and showlng of educatlonal f l los. It was to be prorooted ln:- house spraylng of vll lages by selected voluntary collaborator8- adolnlstratlon of radical treatDent to all suepected nalarla cases and
stlnulatlng the lnhabltants for the full lntake of drugs durlng the 7-day perlod.
In spl te of these ef for ts , conmunl . ty 'par t i .c lpat ion le s t l l l lack ing.
(e) Epidern lo loglcal analys ls of the nalaf la . s l tuat lon: Act lv l t les ln the f ie ld were
great ly r out ln 1986. obeervat lons in
sone lndlcator vll lages ln only four regLons and sPot surveys ln sooe areas enabled the
eet lnatLon of densi t lee of var lous vectors. Suscept lb l l l ty teste ehowed superDlctus ln
Kabul nas susceptible to DDT and nalathlon, .@.! ln Kabul and Jalalabad susceptilbe to
nalathlon, and fluviatl l ls ln Jalalabad eusceptlble to roalathlon.
Analysls of parasltological data showed that the nalarla situatlon further
deterlorated cogpared wlth prevlous year6. I{lth the exceptlon of 4 955 ca8ea detected
through epldenlo logical lnv let igat tons (112 630 cases exanlned) and 14 675 detected by ACD
Og 664 e ianined) , the bulk of posl t lve caae6 cane f rou PCD (402 805 cases out of 9f3 815
exanlned). Fron as few as 36 195 caees detected ln 1979 n l th API of 25.7/L000, the nunber
derecred in 1985 vae 227 851 wlrh API of 25.7/LOOO. Fron 1985 to 1986, the nunber detected
hae near ly doubled, I .e . , 422 415 wl th an API of 47.p/1000. In addl t lon, the nunber of
detected p. farc lparum cases has lncreased f ron 143 ln 1985 to 509 ln 1986, posing a threat
"i .i"
"p;;mifr1912gt"r srrains reslsranr ro chloroqulne. .Th: r:::-.ff_::::9^i:-:?-:
;;"-i; lt"-i""1";;;a-mt=;;rhern reglons bordering Paklstan and the ussR' resPectlvelv'
Large epldenlcs nere occurrlng ln the whole Eastern reglon (Laghnan with API of 592'3i
Ja ta taUaa , AP I 368 .7 ; Kuna r , Ap f o f 1 f5 .3 ; and Gaz iabad , AP I o f 50 .4 / f 000 ) ' I n t he
f-aiff ic.cit.) presented a nap showlng that Afghanlstan ls now dlvlded lnto elght
reglons: Northeastern, Northwestern, Centra l , Eastern, Southeastern, Southern, Southwestern
and Western reglons.
vBcl90.3tlAl,/go. 3Page 266
Northeastern reglon, Taloquan and Badakhshan recorded the h lghest API :79 '4 and 87 '7/L000
re6pect lve ly , but other unl ts were 6everely af fected ' Inconplete resul ts recelved f ron
var lou6 provlnces ln the f l rs t f lve nonths of 1987 showed that , fo l lowlng the wlnter
decl lne ln t ransulsalon, the s l tuat lon has fur ther deter lorated comPared wl th the f l rs t
f ive nonths of 1985 as tholtn below:January to UaY
Examlned ffiry1 P'f 're86f f i f f i f f i4 lases1987 23 5gB 5 809 24 '5 24 cases
If one conslders that nany cases go undetected by the existing nechanlsus ' the
gravlty of the sltuatlon oay bL ful1y ippreciated' The one n111lon cases whlch occurred
last year 1tay very well double aurfni f-SbZ. Thls-consl'tutes a threat to nelghbourlng
countrles whose nalarla control progi"rr"" are well advanced. only through collaboratlve
ef for te cao poeslb le f lare-ups be k lpt under contro l . An ef fect lve contro l programme ln
the present epldenlologlcal sltuatlon would require extenslve anti-vector neasures' At
present thts 16 unreal.istlc. The alternatlve ls to concentrate houee spraylng operatlons
ln the noret eptdenlc areas and to use antl6alarlal drugs on a large -scale to reduce
eufferlng and nortallty. Vll lage treatment centrea ehould be created by conrounity
partlclpatlon, volunta-ry collaborators and Lntersectoral collaboratlon' The broad strategy
for nalarla control to be followed le antl larval operatlone and enhanced partlclpatlon of
BI|S ln cage detectl 'on and treatoent'
In the unpubllshed docunent of Farid (1987), the country nalarla profl le of
Afghanletan waa shown as followe:
Populatlon: 18. I o t l l ion
No. elldes exanlnedNo. posl t lve e l ldeeNo. P. fa lc lparun caaesP. fffiTiffiGlstance to chloroqulne:iGctoie of roalarla accordLng to vectorLal
Populat lon at r18k: 8.9 n l l l lon
1984 1985 1986
905 697 988 | 052 s74720 227 815 377 808391 r53 473
Conflrned along border with Pakistan
Loportance - wlth lnfornatlon on
505r 5 5
vector resletance to lneectlcldeE:An. cullclfacles DDT/dleldrln
e-rcanus --DDT
/d Ie ldrt n6ffi;f DDr/dLeldrlnffin" IDDT reslstance_ recorded _ "::-T:::I- Maln vector control measurea: Larvlcidlng wlth tenephoe; houee spraylng wlth
DDT and oalathlon.- Caee detectlon: In the capltal, Kabul, and other roaJor tonns through PCD & ACD'
- Developnent of PI1C 8t peripheral level: Infornatlon not avallable'- Oevelopnent of PltC at refeiral level: InforroatLon not avallable'- t{alarla control prograDme: ls lntegrated wlth other paraeLtic dl 'seases control
progra@e8, nalnly lelshosnlasls and lntestlnal parasltlc dleeasee'- Ualaria tralnlng centrea: Exl'et ln Kabul- Tralned EanPower: Insufflclent- Speclal probleoe: Prevall lng conditlone
Fron lnfornatlon connunlcated to lllto/EMRO, data on the statue of antlmalarla
actlvlt l.ee ln Afghanlstan lD 1988 show the followlng (poPulatlon: nld-year estlmate ln
1000e ) .- Total. PoPulatlon: 18 140- lopulall-bn of orlglnally nalarlous areas: 8 874- P o p u l a t l o n o f a r e a e c l a l n e d t o b e f r e e d f r o u m a l a r l ' a : -- Polulatton Protected b.y extenelve houee spraylng: 426- populatlon protected by other anti-vector'r".", i i"" (larvlcldlng) ? [ttot glven]
- Populatlon under survell lance: 8 453
Ae eumarized ln the Wld hlth 8t?t+9g. q9arg. (WBO, 1990) concerntng the world malarLa
elruarl.on ln 1988, Afghanlstan had mTodGffir """""
ln 1987 (data lnconplete); sone
407 of. the caaes were-found posltlve between 1985 and 1987. Hlgh norbldlty ratee ttere
vBc lgo .3l4AL,/90.3Page 267
recorded in Laghroan, Kunar, Jalalabad, Ghazlabad, Kunduz, Inansahlb, Taloquan and Falzabad
unl ts . In 1988, 379 000 cases were recorded, sone 2000 of which were $]g! igr but
lnfornatl.on iB lncomPlete.
In pakls tan (see nap of F lg. 26)1, severaf 999!r9rs d lscussed the h ls tory and
developnf f in t lqa lar la act lv i t les. Mashaal (L962) br tef ly rev lewed the f ind ings of the
pr"-ur .d l "atLon 6urvey carr led out 1n 1960. Malar ia was wldely d is t r ibuted over lhe
courr t ry except 1n roounta inous areaa above 1200-1500 n a l t i tude, where the posi t lve case6
had cone from malarla endenlc lowland areas. Case dlstrlbutlon was llnked with rlver
val leys, f lood areas and l r r lgaEion echemes. Malar ia preval led ln PunJab a long the banks
of f lve maln r lvers and was moat severe ln areae l lab le to extenslve per lodlcal f looding
such as Sia lkot and Shelkhupura d ls t r ic ts . In Sind, malar lous areas centred around the
Indus rlver basin fron Sukkur to Hyderabad. In the North Western Frontler provlnce (NWFP),
rnalarla rates were hlgh ln Kohat and Bannu dlstricts although these were not subjected to
f loods. An lnterest lng feature le that ln Paklstan, l lke many other countr les, even ln the
most af fected d ls t r lc ts , nalar la endernlc l ty was uneveu. Spleen ratea var ied f ron 0 '02 to
902 in the sane d16trlct. Malarla lncldence was highest where standlng water could be
found durlng nost of the year. Age-wlse, usually the 5-9 year grouP was the roost affected'
but in Shetihupura dtstrlct.ratea were homogenouE. In some areaa roalarla can no longer be
consldered unstable. In uost of PunJab and ln roany dlstrlcts of Slnd and even the lower
quetta regton, nalaria was meso- or hyperendenlc. l lowever, there were a few areae where
oalarl.a wae unstabLe. The lnportant change ln the epldeolology of nalarLa ln Paklstan was
probably not related to any nodtttcatton ln vector behavlour but connected wlth the
extenslve developnent of lrrigatlon schemes.
Farid (1g74 - unpubllshed report to l l l lO) gave rore detalls of pre-eradicatlon
nalarlometric/entonologtcal surveys carrled oui ln 1960, and descrlbed the sltuatlon under
eradicatlon operatlone durlng L96L'L974.
The epldeolologl.cal features of ualarla fron pre-eradlcation surveYs:
(a) Malaria ender1lclty varled from one "r""
ao another, but was always hlgh- ln the
alluvlal beds of the Indus rlver and lts nany trlbutarles, and along valleys wlth perennlal
or se6i-perennlal streans ln the nountalnoua areas ln the north and west. Sp1een
exaolnat lon ln 693 v l l lagee selected at randon ehowed that 6.32 were f ree f rom malar ia,
26.87" hypoendenlc, 54.81 Deeoendetrlc, and l2Z hyperenderole.'
(b) The lncrlnlnared vectors nere gg@lg and g!sls.! ln the alluvlal plalne,
and .gggpg. in the northern and western hll ly reglons. Suspected vectors nere
ttuvGiffi i i iE'pulcherrlnus ln the northern areaa. The flrat three vectors showed peak
e f f i F o r t o i ! f f i I 6 ? t e r p e r 1 o d e f r o m A p r i 1 t o N o v e n b e r d e p e n d 1 n g o n t h e 1 r e c o 1 o g yand local cltnatlc condltlone, though durlng June thelr deneltles dropped sharply when the
relatlve huutdlty (Rtt) dropped below 452.
(c) The low tranemlsslon i jeason nas lntroduced by a rlee ln vector nunbers durlng
Aprll and May, but wae checked later by the dry weather ln June. The {ntenslve
transniss lon 6eaaon extendlng f ron 'July to Oct tber resul ted f ron a sharp r lee ln vectbr
deneltlee of vector populatlons havlng a longer l lfe span because of hlgh RH durlng the
ralny and.flood eeaeLnl. The surge oi cases durlng Uarch-May was rnostl 'y due to P. l l l*l
reJ.apeea contrected durlng the precedlng year. No transolsslon wae observed above 1500 n
al t l tude. Resul ts of pre:eradlcat lon surveys dur lng May-July 1960' .1. . . ' before the
Lntenslve transmlselon sea6on, gave an overall paraslte raEe of LL.4Z (53.77. were !$r45.62 p. falclparurn and 0.82 P. nalarlae). The annual oalarla load ln the populatlon ltas
about lff iTffiases wirh ;i-ff i 000 deaths attributed dlrectly to malaria.
Ilte nalarla sltuatlon under nalarla eradlcqlllenr-lEl:lY:
The Malarla Eradlcatlon Progianne (lGp) developed as a vertlcal programrne dlrected by
an autonomous Central l,talarla Eradlcatlon Board, progressed ln stages to lnclude all
i ff i-cred by Dr Il.R. Rathor, Reglonal Advtser, VBC' WBo/EMRo.
vBc/go.3MAL,/90. 3Page 268
Fig - 26. Provlnces and Pr inc ipal Cl t ies of Pakistan, L974'
JAMMU AND KASHMIR
N W F P
t Rawalpindi
Gujranwala o
LahSargodha o
Lyallpur e
A F G H A N I S T A N
T H E P U N J A E
' lh l t n.
Khuzdara
E A L U C H I S T A N
8.ha
I R A N
(lrtteo
I N D I A
\
I
c H l r ' , | A
l 0 O l 5 O . i l l c r
vBc/90.3MAL,/90.3Page 269
oalarlous areas under a tirue-llnlted nethodology based on total coverage wlth DDT residual
house spraylng for three to four years, followed by three years of survell lance. The
auccesses and setbacks can be summarlzed as follows:
(1) Dur lng f961-1969, the at tack phase based on tno rounds of DDT spraylng for three
to four consecut lve years resul ted ln aLnost coroplete ln terrupt lon of nalar ia t ransmlss lon
and a drast ic reduct ion in rnalar la rates; the SPR reached l ts lowest level of 0.072 ln
Lg67. In that year , however, a aevere nalar ta epldenlc hLt Karachl c l tyr prevLously
considered non-malarlous fron studlee carr:ted out on the loca1 vector' gj!!ryl, and hence
the clty was excluded fron the eradlcatlon progranme lsee entonologlcal and parasltologlcal
s tudies ln Karachl c l ty in Subsect lon (1) r , rnder 4.12 abovej . Far ld ( loc.c l t . ) Polnted out
that the MEP of Paklstan dld not foresee tlhe steady lncrease in the nalarlogenlc potential
of Karachi area brought about by the sharp populat lon lncrease (1.8 n l l l lon ln 196l ' and
3.8 n i lL ion tn 1968) and the exten8lve pro jects of water supply, se l {age, roade, houelng and
control of t ldal wavea which 1ed to the creatlon of nunerous breedlng placee fot gleg1l
preclpitatlng a roalarl.a eplderolc ln the cicy durlng late 1967 when the estinated nunber of
nalaria ca6e6 frou August-November was 670 000.
(2) The Karachl epidenic seeded nany nalarla-free areas ln the northern part of the
country, and this coupled with the developnent of DDT reslstance and budget cuts a8 well ae
prenatlie transfer of areas under the MEP fron the attack to the coneolldatlon phaee' led
to deterlorat1on of the roalarla el.tuatlon 1n 1968 and 1969: prevalence rates lncreased to
0.232 in 1969 (about three t lnes h lgher than the 1967 level ) '
(3) Durlng L1TO-L974, many adverae factore led to the conplete deterl 'oratlon of the
Programme !(a) The war in l97L-L972.(b) The change ln US/AID pollcy by the
vltal conroodltles for the progranne.US/CDC leadlng to a halt ln the supply of
(c) The elow responee of the MEP In lntroduclngepldenlologlcally orLented antlnalarla nethodology wlthlnconforolty wlth the l{l lO revlsed etrategy'
(d) Ttre lncreasing resistance of the vectorg to
alternative Lnsectlcidee euch as HCH or oalathlon.(e) The populatlon growth ln urban areaa and the fallure of nunLclpallt lee to
develop effectlve rr.tto. cont;ol prograBBes. In addltlon, urban areae sere excluded frou
the origtnal MEP plan and ttrere wa6 no coordlnatlon between the MEP and loca1 bodles'(f) The fleld personnel were dernorallzed becauee of thelr tenPorary aPPolntnent8
and delaye 1n salary Pay6ent. Thls reeulted ln a hlgh turnover ln pereonnel'- (g) provlnclal health authorlt l.es began to dlstrust the MEP and there waE a lack
of cooperation in nalarla case detection o,r regLsterlng cllnlcally suspected nalarla casea
(euch t"s"" were reglstered under fevers of unknown origin to avold taklng blood fi lns)'
(h) The.6""o"" of quallty control for locally Danufactured DDT and chloroqulne,
and their exorbltant prlces "otp.t"i
wlth those of lnported eupplles, led to loss I 'n
efflcacy and flnanclal loaE ln l'[EP budgeta.- (1) The devaetatlng floode oi tg,Zl affectlng l0 rnll l lon people ln PunJab and Slnd
provlnces resul ted ln a nalar la eptdenlc: out of 2.13 n l l l lon Pat lents there were 790 000
nalarla caa€a. The epldenic roade the heal.th authorlt les reallze the dleruptlon whlch thls
disease can cauae to the health and economy: nalarla caaes 1o 1974 con6tltuted at least 202
of pat lents at tendlng c l ln lcs.
Zulueta, ltujtabs & Shah (1980) revlewed the nalarla eradlcatlon prograune ln Pakl'stan
6lnce lte lnception in 1961 untl1 lts resurgence ln 1967' The resurgence reached epldenic
proportione in- punJab in 1972 whlch could not be dealt wlth at f irst due to 1181ted
reaources. I louse lpraytng with DDT and HCtl ln 1973 and 1974 were lneffectlve where the
vectora were already reslstant to the two lnsectlcldee. It wae onty ln 1975 that, ln vl 'es
of the contlnued htih prevalence of malar{a, the Governnent of Paklstan launched a newly
orLented Malaria Control Program,ne (MCP) ' wlth the suPport of l l l l0 and USAID to reduce
roalarla to a Danageable Level. A 5-Year Plan of operatrons for the new MCP was approved ln
1975 and a loan alreenent between the Governrent and the USA wae elgned the sam yeer'
a nore flexlble andavallable flnanclal resourcee ln
DDT and the non-avallabil ltY of
vBclgo.3l,1aL,/90. 3Page 270
Zulueta, l {uJtaba & Shah ( loc.ct t . ) fur ther rev lewed and analyzed the data col lected dur lngL970-L977 and forecaet the future developrnent of the nalaria sltuatlon ae follows:
( ' ) @ : T h e M C P 5 . Y e a r P 1 a n o f o p e r a t 1 o n s c o n e 1 d e r e d h o u s e s p r a y 1 n gwlth malathTon tfre nost effective measure for reduclng rnalarla prevalence to a Danageablelevel. Malathlon nas to be applled for two or three years ln areas of hlgh and roedlunendenlclty, where the long uee of DDT and HCII hae led to the develoPment of reslstance toboth lneect ic ldes ln cul lc l fac ies and stephensL, the two pr inc lpal vectors of ualar la lnt h e c o u n t r y . o o t a n d f f i b e u l f f i T e a s w h e r e t h e n a 1 a r l a i n c 1 d e n c e h a s a 1 w a y sbeen low and where these lnsectlcides have not been used nuch so that the vectors haverenalned relatlvely sueceptlble. However, becauee of a shortage of nalathlon, areas ofhigher endeniclty showlng a less favourable entonologlcal trend had to be put under eitherHCII or DDT. A conparatlvely snall anount of fenltrothlon (Sunlthlon) wasrused ln Punjab onan experlnental basis. ttal-athlon nas applled at a target dosage of 2 g/n- but, forreasonsrof econony, part of the nalathlon-protected areae ln PunJab ltaa treated withL.5 g/a'. In noe! areas, two rounds of nalathlon epraylng were carrled out; onlyexeeptlonally (tn areas of a ehort transnisslon aeaaon or because of late dellvery oflnsectlclde) a qlngle round was applled. I{lth DDT, one round was applled at t}e usualdosage of 2 g/n', and wlth HCII, two rounds were appll.ed at a doeage of 0.3 8/m'. Thepopulatlon to be protected ln the country by houee spraylng was estinated. at 41.3 nll l ionln 1976 and 49.3 ntl l lon It 1977. The latter f lgure repreaented approxloately 902 of therural populatlon (54.4 ntl l lon) and 662 of thd total populatlon of Pakletan (74.5
nll lton). Theee target f lgures, however, coul-d not be reached and the coverage achlevedaccordlng to the lneectlclde ueed tn 1977 vae 77.I2, 46.92 and 82.37 for nalathion, HCH andDDT, reepectlvely. Several reasona accounted for the Lnconplete coverage. Apart frondelaye ln arrlval and dletrlbutlon of lnsectl.cldee, there nas a ehortage of funde 1n Slndprovlnce durlng 1976. Thls reeulted ln an lneufficlent nunber of spraynen and coverage Irtasas lon ae 31.52 ln nalathlon-sprayed area8, but adequate funds were provlded ln 1977. MoreBerloue adnlolstratlve and organizatl.on problena aroae ln PunJab tn L977 when lt wasdeclded to eetabllsh fron I Jul.y a Couounl.cable Diseases Control Progranne (CDCP) intowhich the UCP wae lntegrated along nlth other provlnclal health servlcee. Thls was donewl.thout the neceseary preparatlone and tralnlng of personnel, contrary to the progresslvelntegratlon foreseen ln the Plan of Operatlone, and deeplte the recornroendatlons oade earlyln 1977 by an External Revlew Tean for the nalarla progranne. The nalarla personnel forcewae reduced by nore than 200 and coverage ln PunJab durlng the eecond spray round, carrledout after the eetabllEhnent of the CDCP was only 32.5Z ln areas under nalathlon and 24.5trln HCI| areaa. Theee dlff lcultlea nere aggravated by caees of oalathlon lntoxlcatton ofBpraynen ln 1975. A toxl.cologlcal lnveetlgatl.on carrled out ln July gave the flretlndlcatlon of poleonlng freguency anong the epraynen (clt lng Zulueta & Hashln Malllck -
unpubliehed report to I{BO, 1975). An extenelve lnveetlgatlon carried out later by a teanfron the CDC, Atlanta, USA, eetlnated the nunber of oalathlon pol.sonlng caaea was 2800'flve of whlch were fatal (clttng Baker et a1. 1978 - eee below). A very serlous view wastaken by the Governoent and supportlng agencLee and to prevent a repetltlon, sanplee of theoalathlon ueed ln 1977 sere systenatl.cally exarnlned ln liltO-approved laboratorles ln Europeaad USA. A rlgoroue tralnlng prograome wae carried out to enaure the appltcatl.on of safetyEeaaures lncludlng wearing and waehlng of protectlve clothee iesued by the Dl.rectorate ofltalarla Control. At the aame tlDe, laboratory facll l t les nere establlehed ln all provlncesto deternine blood choll.nesteraee levels among spray pereonnel. Thus, no serious case oflntoxlcatlon wa8 seen ln L977, although lntoxlcatlon synptons and chollneeterase depresslonnere occaslonally observed.
(b) Survell lance actlvit lee: Since the beglnnlng of the l{alarla Eradlcatl.on Progrannet n p a t 1 g t @ c t e d b y A C D a n d P C D . B 1 o o d f 1 1 u s c o 1 1 e c t e d f r o n v 1 1 1 a g e sby survell lance agents (known as oalarla supervl.sors) represented 9lZ of the total nunbercollected by ACD and PCD accordlng to 1977 data. The 9Z PCD contrlbutl.on frou hoepltals'dlepenaarles and other health eetablietrnenta waa dlsappolntlngly snall. DesPlte efforts ofthe l{CP and recor"'nendatlone of External Revlew Teams (1977,1978 and 1979)' the PCDcontrlbutlon has renal.ned eubetantially unchanged. Most blood fl lne ttere' thus' collectedby ACD and reeults of thelr exaolnatlon at MCP laboratorLes provlded the best lnfornatlonon the effect of varioue spraylng operatlons and long-term trende of nalarla ln thecountry. Results of ACD and PCD eurvelllance aetlvltlee durlng L970-1977 are ehown ln
vBc,/g0. 3MAL/90.3
,Paie 271
ITable 2 l ' . The resuLts show a reduct lon of the posi t lv l ty rate of 767. af ter two years of
control operatlone [couparing data of l97ji wlth those of. 1977). Th" !:-l3fslt".* rate, anore senel t lve lndlcator , 6hows a st l l l larger reduct lon of 80%. Resul ts of Punjab tn L977have to be lnterpreted wlth caution, because of the progranme changes lntroduced ln JulyL977, aa shown above. Unt l l then, the resul ts f rorn PunJab provided the nost s igni f lcantlnforrnatlon on the effect of control operatlons. This can be attributed to the slze of thepopulatLon (582 of the total populatlon of the country) and the large nuober of cases foundthere durlng the last years (nore than 9O7i, of the total detected). The reductlon ofnalarla ln PunJab was clear and greatest l.n areaa under rualathlon. When 1975 and 1976resul ts were conpared (c l t lng Zulueta, 1977), there was a reduct lon of posl t lv l ty rates of59.3t . The reduct ion ln P. fa lc iparun rates ln the sane areas wae 77.3%. Correspondingf lgures in DDT-sprayed areas show a-0:32 l .ncrease ln posi t lv l ty rates and 14.32 decrease inP. faLclparun rates. In a few unsprayed areas of PunJab, wi th a prevalence too low to6erve a conpar lson, the reduct lon of posl t iv l ty and P. fa lc lparun rates werer respect lve ly ,27.67! and 50.27 (cit lng Zulueta, L977). Thus, although there nlght have been a reductionof nalar ia due to cauEes other than lnsect ic lde use, nalath lon appears to have c lear lybrought down the nalarla rates. The effect of HCH wae leee evldent and that of DDT n11.The results of NWFP 1n 1975 showed a reductLon ln poeltlvlty and P. falciparun rates of6L.27. and 792, respect lve lyr . ln nalath lon sprayed areas, a lnost the saroe as that observedln PunJab. The areaE under DDT or left urrsprayed ln NI|FP were too snall and of too lowendenlclty to be conpared, but the nalaria reductlon ln nalathlon areas waa ao great thatlt leaves no doubt as to the effect of thls lneectlclde. Concluslons cannot be drawn fronSlnd becauee of lack of data ln 1976 [because of low roalathlon coverage in 1976 as shownabovel . A leo ln Baluchlatan, low parasl te ratea and re lat lve ly snal l populat lon Protectedprevent drawlng concluelone regardlng lneectlcide effects. To assees the lnpact of thecontrol neasurea lt ls, therefore, neceaeary to rely nalnly on the results of PunJab andNIIFP.
( c ) : T h e r e s u l t s 1 n T a b 1 e 2 l s h o w E h a t , a p a r t f r o nt h e 1 a r g e f f i i 1 a d u r 1 n g t h e f 1 r s t t l { o y e a r 6 o f o p e r a t 1 o n o f t h e M C P 1 nI976-L977, there were Lnportant changes ln nalarla prevalence ln PunJab whlch cannot beattributed to control rn€€r8uF€8o Before ttre lntroductlon of nalathlon ln 1976, eubstantlalanounts of DDT and IICH were ueed ln PunJab and eleewhere, but due to reelstance to bothlnsectlctdes ln cullclfacleg and stel@L epraytng could not have had nuch effect, excePtin narglnaL areaE-ffiffi?Tarroulffiiry. other reaaona nust be sought to account forthe great changes ln the prevalence of the dlsease eeen durlng the years precedlng thelntroductlon of oalathlon. The nonthly parasLte a.d !.1!3Lg!ry rate6 ln PunJab fron thebeginning of 1970 to the nlddle of. L977 (when organlzatlonal changes in MCP lntroducedgreatly reduced the value of f lgures obtal.ned after June) were plotted as shown lnFtg. 27. Survel.l lance operatlons untl l then had been carrled out ln a regular ltay' theelldee collected by the 8aE survell lance agents and exanlned by the same nLcroscoplstsr 60that the reeulta can be consldered rellabl.e. Also, the large nurober of slldee collected(2-3 nllLlon annually) glves value to the PunJab data presented ln Table 2l and Ftg. 27.Theee clearly show an lncrease ln oalarla fron 1970 to L972-L973 when, after havlng reacheda peak, there waa a downward trend acceler:ated ln 1976 by the lntroductlon of nalathlon.The nuuber of ca8e8 detected ln PunJab tn L972 and 1973, reapectLvely 622 l3l and 576 L56,glvee a clear lndlcatlon of the hlgh prevalence of the dlsease, partlcularly sl.nceeurvell lance agents could only collect ell.des froro a l lulted number of potential casesdurlng thls perlod. But perhapa Dore reveallng are the positlvlty rates of 43.22 LnSeptenber 1972 aud 32.52 durlng the sarle nonth of 1973, whlch clearly lndicate thatepidenlc condl.t lons were then reached 1n PunJab. Also stgntflcant le the marked sprlngrl.se, probably reflectlng favourable neteorologlcal condltlons. Zulueta, MuJtaba & Shahfurther explalned that lncreased ralnfall dld not always produce an lncrease ln malariaLncldence. Preclpltatlon tn 1973 lras neJ.L above the annual average ln PunJab, but ln 1972and 1974 1t nas wlthln the nornal l lntts. Floods also do not always eeen related toLncreaeed nalarla transnl.eslon during the perlod under revl.ew. There were heavy floods lnPunJab ln 1973, a year of htgh t ransnlss lon, but f loods 1n 1976 had no v ls lb le ef fect onthe nalarla eltuatlon, although tn thts case lt nay be argued that the nalathlon spraylngcould have rnasked any effect of f loodlng. The fact that transrolsslon was reduced not only
iffi-T;;d Flg. 27 reproduced by pernrleslon of Dr J. de zuluetaof the Royal Soclety of TropLcal Medlcine and llvglene fron the PaPerShah (1980) .
and the Transactionsof Zulueta, MuJtaba &
vBc/9o.3MALI9o.3Page 272
Table 21. General resul ts of survel l lance operat ions 1n Pakistan: L970-L977.
Province Slidesexamined
Positivesf v
P.R. F.Rm Mix Total % %
t970PuniabSindNNflFPBaluchistanTotal
l97lPuniabSindNWFPBaluchistanTotal
ts72PuniabSindN\vFPBalucbistanTotal
1973PuniabSindNWFPBaluchistanTotal
197{PuniabSindN$gFPBduchistanTotal
1975PuniabSindN!fFPBaluchistanTotal
1976PuniabSindN\vFPBaluchistanTotal
tsTtPuniabSindNI$?FPBaluchistalTotal
2,762,574600,006439,37745,589
3,847,546
2,512,5395't9,2548t8,25368,708
3,999,754
3,054,043613,098669,03083,814
4r419,985
2,830,62Effi22r6789539lr'189
426rpgr
2,029,662579O7726,2&79,7n
3,@3,569
2,3€.29t936,090
763,2W24,16
3206,3U
t,994264333,,2r494,5935,9O9
2,857,854
1,727,013396,573505,3&58p65
2,687'2t5
5,001 80,1883,914 8,7431,205 8,138
776 1,07910,896 98,lt18
9,075 l@,0902273 9,M22,572 15,620
692 1476t4,6t2 L86?28
54,537 589282,674 6,897
688 9,515475 ?62
58,474 585,502
67,022 509)8394335 7,025
656 2,702805 808
72,8t8 520374
34,7& 257,5181,170 21533
486 7,0392o5 543
36,625 267,633
90,581 ll8i455* r2r7
2,486 24,778r92 103
93,W3 144,U3
32,966 72,6532,989 324'
689 9,5283M 154
36848 85,57E
3l4530
70
3910
l3
130 85p62 3'08 O'r8116 12,555 2'@ 0'65r25 92?L 2'rr o'2744 l,8ll 3'97 l '?0
4t5 108,699 2'82 0'28
2 252 168915 6'67 0'36o 64 rl25l l'94 0'392 L95 17,99 2'20 0'31o 2E 2,1& 3 ' l l l '014 539 2W.3o5 5'01 0'36
737 622,13L 20'37 l'787l 9'509 l'6 0''14
lol 10,203 l '5 O'1229 1,208 l '4 0'57
938 643,051 14'55 r'32
o ?05 576,156 20'35 2'371 9r l l27o l '? 0'66o 3t 3325 o'5 o'loo 20 1,593 l'7 0'88I 849 592,W 13'90 l'71
5 255 232,032 tl'43 l'713 39 3,67 l '4 0'45| 22 7,ff i l '0 0'070 14 7r4 0'9 0'26g 3n 28937 7'9 l '18
o 265 2@,061 8'n 3'80o 8 w93 4'97 r'62| 127 27,1X 3'55 O'330 5 290 l'20 0'791 ,lO5 28,2.82 7'43 2'93
9,9705,1&
E9208
L5,43L
26,8253,472\8n
28032,&6
0 187o 6 20 5 40 40 307
0 7 30 4 90 50 1 5o L42
105.432 5'28 l'636:170 l '85 o'90
10:163 2.06 0'14-454 l '26 0'85
r222r9 4'2E l'29
16J22 2'r3 0'58e,sez 2'16 l '30r.913 0'38 0'02-473
0.81 0 '3647,695 l'?7 0'57
P.R. - Parasite rateF.R. : Fdciparum ratcI - P.falciPanmto : P. ttbaxm - P. malaiacMix : Mixcd infcction
vBclgo.3MAL,/90.3Page 273
F L g . 2 7 . Parasite rate (toP l1ne) and 3:--f.1!g!33g t.t"Punjab, Paklstan ( 1970-1977) .
vBc/90.3l.tAll90.3Page 274
in areas under nalath ion, but a lso ln areas under DDT and HCH spraying, ind lcates, however,
that at least ln 1975 f loods d id not lncrease nalar ia t ransmlss lon. The re lat lve lncrease
of fa lc lparum malar ia dur lng t ,he past years ln Punjab has ra ised the quest ion of possib le
developnlnt of ch loroquine res is tance. However, despi te the r lse in 1975 of P. fa lc iParuro
cases in PunJab (90 581), there hras no ev ldence of res is tance according to in v i t ro tests
carr ied out the fo l lowlng year (c i t lng Rooney, L976) and subsequent in v ivo Eests prov ided
no proof of res is tance (c l t ing Muj taba & Shah, 1978). Thus, the re lat ive ly h lgh nunber ofp. ia lc lparun lnfect lons Dust have had other causes but i t does indicate a potent la l o f
Eail iGfon to be consldered when future trends ln this provlnee are studied.
IChloroquine res is tance in L fa lc iparuro in Punjab Isas rePorted la ter '
Zulueta, Mujtaba & Shah further stre66ed that the changes ln Punjab had no parallel in
other provinces. This was partlcularly clear ln NWFP where well conducted surveil lance
operatlons indlcated stable conditions of nalarla untlI the lntroduction of nalathion
resulted in a great decllne in the paraslte and 3x--lglclParrun rates in L976-L977. The
per lodlc l ty of nalar la seen ln PunJab i .s , therefore, a ref lect ion of the par t lcu lar
condl t lons of th is prov lnce, epldenlo loglcal ly d l f ferent f ron other Par ts of Pakistan as
nored by the ear ly invest lgat lons of Chr ls tophers (1911) and G111 (1928). The changes
observei durlng tgtO-tgtl and, ln partlcular, the epidenlc wave of L972-L973' f it well lnto
the cycllcat eptdenlc pattern of nalaria as studled by nany distlnguished workers after
Chr is tophers (1gt t ) . I f the factors which produced the epldeuice of PunJab are st l l l a t
work, deepi te profound ecologlcal changes f ron agr lcu l tura l act iv l t les and extensive uee of
pest lc ldes, and l f the 8-yeai per iodlc l ty pat tern noEed by Yacob & Swaroop (1944,1945) and
ty Macdonafd (1957) 6t i11 ex ls ts , the next epldenlc wave should be expected ln 1980 or
fb$f . That the epldenlc potent la l e .x ls ts seens a lmost cer ta in f ron what l taa seen between
1970 and 1977 and frorn the perslstence of L-{g!g!l3g ln Punjab (1686 cases detected In
1978 despl te reduced survel l lance) . Wftnout aaequate epidenlo logical v lg l lance and wi thout
suf f lc lent lneect lc ldes, there ls a ser lous danger that the eubetant la l gains rnade s lnce
the establiehgent of the MCP and the lntroduction of oalathion may be lost ln PunJab. Such
deter lorat lon wi l l lnevl tably have ser lous repercusslons in other prov incesr l thatever gains
nay have been achived.
Baker et a l . (1978) lnvest lgated an outbreak of nalath lon polsonlng that occurred ln
1976 aoong 7500 fleld workere ln the MCP of Paklstan. In July of that year' the peak roonth
of the outbreak, an eetluated 2800 cases of nalathlon poieonlng were found. Thdse could be
attrlbuted to lnapproprlate lnsectlclde handllng among 6Pray workers and to the lncreased
by-products in thro of the three nalathion'foroulations used. Cholinesterase depression ln
fleld pereonnel nas greatest ln those ustng lnsecttclde fornulaElons wlth the hlghest
concentratlons of lsonalathlon and other degradation produets. Workers wlth the greatest
dernal exposure to nalathlon (spraynen and nlxers) were nore severely affected than
supervleore. Chollnesteraee levels were hlghest on Monday and fell durlng the week,
reilectlng cumulatlve effect of repeated expoeure. ProscrlPtlon of contarolnated nalathion
fornulatlons and epeclal Lnstructlon ln pestlclde handllng effectlvely halted the episode
ln Septeuber 1976. Dermal abeorptlon resultlng froo excessive skln contact durlng rnlxlng
and spraylng nae the prtnary route of pesttclde lntake, whlle resplratory exPosure ltas
relatlvely unimportant. Degradatlon products ln nalathlon fornulatlons manufactured by two
flrns lncreaged the hunan and animal toxlclty. Although clear statlstical correlationswere noted between lsooalathlon concentratlons and toxlcity measurements, other mlnor
conponents Day also have contrlbuted to lncreased toxlclty. Carrlers and surfactants used
ln nalathlon nater-dleperslble powder manufacture are probably lnportant in the formatlon
of leonalathlon and other toxlc components 1n powders held under troplcal storage
condl t lons (c l t lng J.W. Mt les, unpubl ished work) . As a resul t o f these lnvescigat ions, a
conprehenelve tralning and nedlcal survell lance programne \tas developed to Prevent.""L.r"oc" of pestlclde toxlclty during 1977 spraylng season. A proepectlve study of
properly foruulated and handled ualathlon was conducted ln I977.
vBc,/90. 3MAL,/90.3Page 275
1nran, Siddiqui & Tausl f (Lg77) sumxoar lzed the roalar ia s i tuat ion in the NWFP, PakLstan
(see Fig. 25) , and descr lbed the c l ln ica l featuree of 76 chi ldren aged 40 days to I l years
seen at the Lady Reading hospl ta l , Peshawar, f roo Septenber to Decerober L975' The nalar la
eradicat lon Prograrnme was star ted in the NWTP ln 1966' DDT house spraying was used
ef fect ive ly unt i l vector res ls tance developed ln l97l when a malar ia outbreak occurred '
HGR replac la OOf and was ef fect lve unt i l 1975 when vectors became res is tant Eo th ie
lnsect lc ide. I t was dur lng the summer and autunn of L975 that resurgence of rnalar ia
occurred and was assoclated wl th l t fe threatening conpl lcat lons due to general
unfani l iar i ty of nedical pract i t loners wi th var ious modes of presentat lon of malar ia ' Froo
septenber-Deceober 1975, out of 130 exanlnedr T6 pat lents adni t ted to the chl ldren-s warc
in the above-ment ioned hospl ta l had posl t : tve b lood sEear6 of malar ia parasi tesr g lv ing an
ipn of 5g.5"A (7I p. v lvax, 4 P. fa lc lpaTur! and one rn ixed lnfect ion) . 0f the 76 chi ldren '
49 were males anaFiles ff iJGlxtnrrm age of l l years and a rnininun of 40 days. Fron
the authors- d iscusslon, the resul ls denorrst ra ied that malar la ln ln fants and chi ldren I tas
assoclated wl th conslderable ruorb id l ty and nor ta l l ty . Many of the cases requl red b lood
transfusion and some lrere left wlth resldual brain danage followlng repeated and severe
convulslons. The frequency of misdlagnosls can be attributed to the varied nodes of
pregentat lon of nalar ia , .na to the fact Ehat fever ls not of ten assoclated wl th shlver lng
and rigors especlally ln sndll bables whose sy6Ptoros uay be only pallor and restlessnesa or
excessive cry ing. t t is tory o i co ld perspi rat lon, excesslve l r r l tab l l l ty , refusal to feed
and anaemla with hepatoepienouegaly or only splenonegaly ln the ualarla aeason ehould alert
the physlclan to ttre possfUflltt of oalarla. The varled cllnlcal manlfeetatlons of nalarLa
are due to the fact, t irat the RBb paraeitlzed by the malarla parasttes locallzed ln varlous
organs or body systems glve r ise to a var lety of 6ynPtol0sr e.g. , pneunonl t ls t encephal l t is
or gastroenterit ls as these were the ueual rnanlfestatlons when most lnfectlon ltas ln the
lun! , bra ln or ln teet lnal t ract , respect lve ly . The conmonest sy6Ptome of nalar la ln
lnfants were 6evere anaen1a wl th hepatosplenlnegaly, pal lorr rest lessneas and l r r l tab l l l ty ,
as wel l aB a vague h is tory of fever wl th cold perepi rat lon whlch corresponds to r lgors in
adults. The study also slowed that anaemla naa Dore aevere ln lnfants than in older
children; infants between 3 and 6 nonths of age had lost the oaternal antlbodles to nalaria
and had not yet developed antfuoalarl" gatta-giobullns of their own' RBC destruction of
paraeltlzed and non-paiaeltlzed RBC te due to lncreased endothellal actlvity and the
iroductlon of a toxit substance releaeed by the Dalaria paraeltes' The flndtng of two
cases of beta thalassenia DaJor euffering fron nalaria trae lntereetlng, in vlew of the
evldence for beta thalassenla protect lng agalnst nalar ia . CerebraL nani feetat lons of
oalaria were gulte conrhon and were seen ln vlvax lnfectlon. A11 these patlents recovered
wl th t reatgent . The oor ta l l ty of cerebral nalar ia due to P. fa lc lparun ls known to be h igh
(33.32 ln the present etudy) . csF exarulnat lon should be carr led out in a l l na lar la ca6e6
wlth cerebral uanlfestaclois to rule out menlngoencephallt ls. ltalarla wlth bleedlng
rnanlfestatlons was of nuch lntere8t. A11 patlents In thls group were Dore than 4 years
old. Slx pat lents nere sdnl t ted because of b leedlng f rou the nose, guns or ln to sk ln '
l laeoogloblo tt" lees than I g/at ln all patlents and whole blood transfuelona were
necessary. An Lnportant haeiatologlcal itr,atng was thronbocytopenla ln soroe Patlents' A1t
patlents were lnfected wlth P. vlvax excePt one wlth P. falclparun lnfectlon' Severe
anaemta iraa aeen iu 29 pattei?i@a fros 2 r/2 nonttrilto-6@rs and all were adxoltted for
blood tranefuslon. They had been brought by thelr uothers because of paLlorr reatleagnesst
lrrltabll l ty and exceasive crylng. ttait of thern had a vague hlstory of fever' Blood
transfueion wa6 g lven to 15 pat l .e t t ts , the 'mothers of the others refused l t ' Two pat lents
dled of heart failure. The nortallty of thoee not given blood transfusions was unknown'
The etudy also showed that neonatal oalar'Ia was not unconmoD.
Lari, Burney & Akhtar (f982) noted that no sero-epldenlologlcal studles on maLarta
were carrled out ln Paklstan. Thby declded to carry out 6uch an investlgatlon ln the
Rawalpindl area (see Fig. 26) whlcir was under annual epraylng and had records of roalarla
posi t ive s l ldes col lect ld by ACD f ron 1975 to 1978. The area selected was three v l l Iages:
ioluen Haoeed, Chahan and Malpur, and wae carrled out durlng November, a Post-transmissionperiod. The eubJects available were echool boys and adult nales; blood samples conslsted
of th lck and th ln f i lus for mlcroscoplcal d iagnosis of nalar la . For the IFA test ' a f i l ter
paper sarople was obtalned fron a sinile flnger prick. The antigen used was obtained fron
infection of plasroodluu fleldl tnduced 1rr splenectonlzed Macaca mulatta nonkey. The
paiasrte straii-?iffiT[lffiffiation to the splenectonlzed uonkey was provided
vBc,/90. 3MAL,/g0. 3
P a q e z / b
by Dr C.C. Draper of the Ross Inst i tu te of Hygiene, London' Thick b lood sDear ant tgen
sl ides were prepared f roo the nonkey-s ln fec ied b lood when the requl red malar ia parasl te
densi ty was at ta ined. In the Present s tudy, the use of a dual ant igen system of
p. fa lc ioarum and p. v ivax was indicated but not pract icable because of the low endenlc i ty
in the area. o"r . - f f io i - " r iJ"" co l lected by ACD in the three v l1 lages dur lng 1975-1978
were tabulated. This showed that in 1976 Koll ian l{aneed and chahan experienced roore
intense malar ia t ransmiss ion; the SPR being 201l and 13 '82 respect lve ly ' Subsequent ly ' the
sPR decl ined reachlng 4.6% arrd 0"1 in 1978' respect lve ly ' In Malpur , the sPR showed a
steady decl lne *on4.17. ln 1975 to 07. in f978. The resul ts of parasl to logical exaoinat ion
and IFA test recorded ln the Preseot s tudy were tabulated ' Parasl to logical ly ' no posl t ive
case was observed by d i rect n icroscopy (9 i e1ldes exaoined). Serological ly , the posl t iv i ty
ratee in the three.r t t t rg"" , . r " 2g.22r 56.27. and 592, respect ive ly , wi th a Eean of ' 48 '67" '
The mean t i t res were I :36, l :44 and l :42, respect lve ly ' The The geometr ic mean of the
reciprocal r l t re (GURT) was ln the range ot t :as to 1:60; the overal l GMRT belng 1:56 ' The
GMRT of children and adolescents was hlgher than that of older age grouPe. The authors
reiterated that the study area had been under roalarl.a eradicatlon for more than a decade
and surveil lance data sho\red an increase ln nalaria transmlsslon ln 1976 foll0wed by
lnEensive measures whlch brought about contro l o f the d isease by f978' In Malpur v l l lage '
although ACD data of 1978 were negatlve, a nass blood survey c'arrled out by MCP the sane
year revealed a paraslte rate of 6.67.. The present study ltas conducted tn the nonth of
November durlng ghe post-transrnleslon perlod. The -parasltologlc'al data of the three
vil lages lrere negatlve lndicattng an .pp.t"ttt freedoo fron the disease' The IFA reeponses
in the three v i l lages, despl te some var iat lonsr corresPonded to the epldenlo logical
sltuatlon. Actlve transrnlsslon had occurred ln the area ln prevlous year6, whereas durlng
the study perlod, there was no lnfectlon in the sanples exanlned' Of the 42 serologtcally
posl r lve casea (86 exanlned), 20 had an IFA t l t re of 1:40 and 14 had l :20 ' Low IFA t l t ree
lndicate former nalarla. l l lgher Percentages of seropoeltivity and a higher nean tltre ln
the rower age groups (5-10 and Il-20 y"".I) coropared wlth older age grouPs could reflect
the epldernlologtcal situatlon ln the .."". After reviewlng malarla serologlcal studles
carrled ouE ln other countrles, the authora aEsumed that a tltre of l:40 roay be consldered
signt f lcant for oalar la ant lbody in the Present s tudy ' The nean t l t re in the three
vl l lages as sel l as ln the lower.g" gto lp" sere wlBhln the stgnl f lcance level and
therefore Ehe area cannot be consldet"a fi"" fron nalarla and should be regarded as
hypoendenic.
Pal & LzLz (L985) carried out an entonoJ.ogical/Parasltologtcal -survey in
Rawalp lndl - Is l .anabad area, nor th Paklstan (see-Ftg. zo) . B lood e l ldes ( th lck and th ln
blood fl lns) were collect;d fron 4000 persons l lvlng ln l0 vil lages (400 fron each) durlng
septenber-November 1982, 1.e. , post-Donsoon aeason. Dur lng the sane per lod 2924 anophel lne
mosqultos were collected fron lndoor premlses ln hunan dwelllngs by hand caPture' Sweep
neta lrere used for ouEdoor collectlons but nosquLtos restlng ln dralnage plpes or under
brldges were collected by hand capture. of th; 4000 personi exanlned, 152 had fever and
flve wlth an enlarged epieen. Oniy f4 Per6on6 ltere Po6ltive for malarla parasites:
10 p. vivax, 2 p. iatcfparun and 2-undeiernlned. ThL overall paraslte rate nas 0'352
i ; ' * f f i ' o l : i f f i " a - .o . . . z> . I s1a roabadareawaano tsp rayeds1nce l981 'and theparaslte rate tn March-Aprll 1981 vae 2.227. Seven sPecles of anophellnes were ldentlf led:
c-ul1e.lfacles, 9g33!g!, s:rb?lctus, 9E!g}+F:-{$!g!!!!g' Elg!g!gg1! and !lJE@''The denslry rras%FlnGllroons tfr;;Tn c.attle stiilil-rn-the latter, mosqultos were
found restlng near the roof, whlle in bedroons they rested on both cell lnge and under
furnlture. More fenale aosqultos were collected fron cattle sheds and roons wlth
corrugated lron roofs conpared wlth thatched roofs where they can hlde and c'annot be
c o 1 1 e c t e d . A n o p h e 1 l n e f e n a 1 e s r e a a i i n 1 g h t b u t t h e p e a k o f b 1 t i 1 g o f @ a n dstephensl was observed durlng the late troirs of the nlght. very fen mosquitos ltere
c.olLected fron outslde-reeting shelters. Dissectton oi guts attd salivary glande of feuale
anophellnes dld not reveal "oy
oo"y"t- or sPorozoite-posltlve specltlens' There ItaE no
substantl.al dlfference ln malarla '.""""
between the slburban areas of Rawalplndl and
Islaroabad, lndlcatlng that nosqulto breedlng places were unlfomnly dlstributed' Therefore'
Lt was proposed to lnprove the dralnage systeD to remove stagnant water' Careful vlgllance
t"s ,""ottinded to delect Dalaria casea ln all rural aleaa'
resul ts of a large scale f le ld t r ia l o f
out during 1980 1; an area ln Sheikhupura dletrlct 'Nas l r e t a l . ( f 982 ) ' r ePo r ted the
plrlntphos-nethyl (Acte111c) carrled
vBc /90 .3UAL/90.3Page 277
punJab, pakis tan. This t r ia l was an at teropt to f ind a eui table a l ternatLve lnsect ic lde '
Resistance of gglgg,i to nalathlon has already been established and there is, aleo' ae
yet unpubl fsnei@ce of nalath lon res ls tance in .cu l ic l fac ies ln Sla lkot d is t r ic t o f
i '"":rt 'provlnce (cirlng Ahroad, unpubli.shed data). riff i Iptro-e-nethyl was trled ln Nlgeria,
Indonesla and Indla w1itr good results and has a 1ow mamnallan toxlcity. The area selected
for the t r ia l l les between Aur5 At tar l and Sharqpur on the Lahore-Jaranwala road. The
river Ravi l ies on one slde of the area a:nd thus there was contlnuous flooding during the
rnonsoon season. The annual geographlcal reconnalssance in Decerober 1979 showed 26 virlages
ln the t r la l area compr ls lng 4785 ho,r""" wi th an average of . 2 .4 roons/house and 4.3
peop:.e/trouse. Safety pr"".,rt iotts were observed by spray teams and nixers and base-llne
blood chol tnesterase determlnat ions were nade. The resul ts are surnnar lzed as fo l lows:
(a) House rest lng densl ty : Slx v i l lages were selected for entonological evaluat lon of
t h e 1 n p a c @ r a y r e g i n e n e . O f t h e s e ' t r d o ! ' e r e s p r a y e d o n 2 e w i t hZ e (a. i . ) o f pt r in iphos-nethy l (257 ut .d.p. ) r one eprayed twice l t i th I g /D- ' one sprayed
onle wi th I g /nz, " r ,d
t ro were le f t as unsprayed contro ls . I {ouse rest ing de2el t ies-were
e s t 1 n a t e d D y p s c . N o @ w e r e f o u n d 1 n v i 1 1 a g e s s p r a y e d w 1 t h 2 g | m - " t o r t w 1 c ewlth I g/nz- tO monlhs after spraylng. In the vll lage sprayed once lt ith L g/^' ' excePt
for two feoales and one nale cu1-ictiacies collected 49 days after spraylngr no epecimens
were collecred unti l ZaZ aays-ffi!!6ltng. Denslties of cu11cifa919s and glggS! were
moderate to hlgh 1n the unsprayed vil lages fron Auguet to Decenber 1980 and increaeed agaln
ln May 1981. Throughout the evaluatlon perlod an occaelonal stgPlrensl wae collected ln the
sDrayed vll lages; t ie greatest inpact on.ggplg.' l was in ttre vttlage sprayed twlce wlth
\';j;2:';i;il;;i subpictus, putcirerrlnus-lEn-qgt?9ts (especlallv the flrst specles)were collected tn ET6-E6'irrTGT-The-unspralEZ-vllGges' none were found in the sprayed
vll lagee. A shortage of nanpower prevent.ed the use of other entomologlcal technlgues such
as wlndow traps and nan-balt capture, and the nuobers of vectors col' lected by PSC ttere too
low to allow ;eternlnation of the parous and sporozolte rates and HBI'
(b) Bioaseay tests: Two v i l lages spt 'ayed wlrh 2 g/^2 on 6 August 1980, and- l g /n2- ' #
on l0 augG|T'6ffiFectl.vely wei" ueld for bioassays; the tests nere rePeated at
approxinately 2-rveek lntervals. Fed and half-gravld sEeptrensl fenales susceptlble to
ualathlon and reared at the pakistan Medl.cal neeearch-ffit ahore were exPoaed for 30
nlnutes, and held for a 24 hour perlod. Unexpgsed nosqultos were kept away frorn treated
surfacee aB controls. When the dose nas 2 Elrt, nortali ' t les on mud, wood and ceoent
surfaces nere reaPectlvely 752, IOOZ.attd 87.57, 63 days after spraylng' Fron that t l 'ne'
Dorta l l t les on a l i sur faces, f " i t , Uni 601 nor ta l l ty wae st l l l recorded on t tood 9 l days
after spraylng. Wlth I g/rz, noitallt les on nud, wood and cenent nere reapectlvely
G7.57. , bSZ-. r ra eZ.SZ 47 lays af ter sprayj lng, fa l l lng to 46.57, 67.57" and 62 '57,
respectlvely, after 69 days. ltorgatitt lo ter. con'iderably reduced 90 days after epraylng'
(c) parasi to l0s lcal assessment : AcD was carr led out nonth ly . Posi t lve cases nere
recorded in 13 of the 26 v l l lage"r=. t i o f whlch occurred before spraylng ' No new cases of
nalaria nere detected in .rry oi the plrlnlphos-nethyl-treated vll lages' There waa evldence
that tranemlsston continued in the unsprayed vll lages'
(d) Effect on blood chollnesterase: Throughout the epraylng,th a total of 560 Ean daysmlxers and 12 sPray[len were involvec
Chollnesterase lev-ele renalned ln the normal range throughout the
tlro SuPervlsors r tttoand no absenteeLsn.epraylng, l r resPect lve of
the epray reglEen' wlth s11ght fluctuatlone of a translent nature'
synpt;o6 of iocallzed effect occurred ln a few ePraynen appLylng 2
not correlated wlth any reductlon ln cho.llnesterase levels. There
the occupants of the sirayed housee; the odour of pirinlphos-nethyl
Inf,reguent nlldg/u', but these rterenere no conPlainte frorn
was leee obJectlonable
than that of oalathion or fenltrothion'
Str lck land et a l . (19S7) noted f ron l l terature that nalar la ln PunJab, Paklstan, ls
claeeically conaldered to be eeasonal and unetable. Epldenics have recurred at lntervals
of about e lght years, the last orr" i " f r rg ln 1972-1973. Af ter 1974, ualar la prevalence
rates agaln fell and reached very low levels between 1978 and 1980 (cit lng Zulueta' l{ujtaba
& Shah, 1980). However, ! f ep ldentcg l tere to foLlow the 8-year recurrence pat ternt the
next epideoic would be expected fn i t re ear ly 1980-s ' Str lc l land et a l ' ( loc 'c l t ' ) r
vBclgo. 3wlJ./90- 3Page 278
therefore, declded to s tudy in deta l l the epidern io logy of nalar la in four v i l lages inpunJab dur ing the a l ready delayed ant ic ipated epidenlc. Deoke, Pla i r , Baghiana and Khankee
vi l lages in Kasur d is t r ic t were selected for c1ose noni tor lng f rorn August 1983 through
January 1985. Pre l i rn lnary epidenio loglcal , entomologlcal r Parasl to logic-a1 and c l in ica l
s tudles carr ied out f ronn Noveuber 1982 to January 1983 had shown that the prevalence of
malar ia, par t icu lar ly P. fa lc iparun lnfect lon, was very h igh in these v i l lages ' lhe '
v e c t o r i a 1 c a p a c 1 t y o r f f i E r v e c t o ' , @ , w a s a 1 s o h 1 g h e r t h a n h a d b e e nreported frorn other vil lages ln Lahore aE-Tc:tfrry Relsen & Boreham, 1982; Mahnood' Sakai
& i kh ta r , 1984 ; Mahnood & Macdona ld , 1985 - see Subsec t i on (1 ) unde r 4 .10 and 4 . l l above l '
None of these v i l lages had been sprayed dur ing the preceedlng 3 to 4 years and they are
located on elther si.de and withln zo-2oo n of the Rohl lrrigatlon draln, which provldes
sultable breedlng places for anopheline nosquitos throughout the year' Wlth the exception
of th is dra in, the four v i l lages are typ lcal of roost other Punjab v l1 lages around Lahore '
F le lds are i r r lgated wi th water f ron tube-wel ls and canals v ia channels for growlng r ice,
wheat , sugar cane, and other crop6. Dur lng per iods when f ie lds are f looded and dur ing the
ralny se.ion fron rnld-July to uld-Septerober, standlng ground water provides additional
breei lng s l tes for anophei l t " " . The procedures adopted ln th ls s tudy were as fo l lows:
- study of the human populatlon: When the study began, the. population of 3 of the 4
v l l lages ranged f ron 300 to 1ZOO Person6. The four th and largest , Khankee' had 5500 people
of whoro 1385 were censused durlng the flret survey. These llved ln the perlphery of the
vil lage near both the draln and a large connecting canal. In additlon, durlng the second
and third maas survey6, every elghth house ln the renainder of the vllIage was randoroly
sanpled, its population censueed and blood fl1ns taken. I lowever, the entlre populatlon of
Khankee had ac.cess to the speclally established cllnlcs ln the study area. With the
addltlonal surveyed populatlon of Khankee and nels lnhabltants ln all four vil lages' the
populatlon studled tncieased by 641 betseen the flrst and last masa survey, roaklng the
tota l examined 4047 persons.
- Collectlon of blood fi lns: Two lndependent nethods were used to assess roalarla
prevalence:- (a) Mass malarla aurveys (US): A nap of each study vtl lage was drann and
indlvidual housee nunbered. Teane coneletlng of one phyeician and one blood collector
vlstted each house and recorded blographical and cllnical data on a form. Thick and thln
blood fl lns were takeo frou all vl l lagers who consented. Three systenatlc house-to-house
surveys were conducted: the flrst 3usi before the minor transmlsslon season (t-tarch-APr11
1984); rhe second ar rhe beglnnlng (July-August 1984) and Ehe thlrd (January 1985) after
the naJor autumn nalarla tranenlsslon a€a8on. Durlng the houEe vlslts, houeeholderE were
questlined regardlng deathE among menbers slnce the last vlslt. An effort was made to
estlBate both total oortallty and rnortallty due to nalarla durlng 6easons of low
(Aprtl-August) and hlgh (August-January) transolsslon'(U) Cllnlc
",rr.r"yi (CS): Outpatlent clinics were held by l-3 physlcians and 3-5
paranedlc6, u6ually tortntltrttY, in ea.h viUage. Each patlent was registered, h1s or her
house number and other personal data recorded and tenPerature taken. The phyelclan used a
etandard forn for recordltrg the nost comnon Byuptotos and slgns. Physical examlnatlon was
llnlted to the patient-s aiea of couplalnt, nlth the exceptlon of chlldren under I0 years
of age who had abaodnal examinatLons for detectl.on of splenic and hepatlc enlargenent' A
clinical dlagnoels wae oade and nedicatlon prescirbed by the physiclan. If he suepected
roalarLa, oral chloroqulne was given, 25 mg Lase/kg of body welght over 3 days' Thlck and
thln blood fl lne ru." tak.tr fron every petlent. The nuuber of patienta aeen and blood
filne taken usually ranged betneen 25- f; the snallest and 150 ln the largest vll lage' The
nethods of etalnlni blooa fl lns and counting the parasl.tes during nlcroecoplcal examination
were descr lbed.(c) Data proceesing and stat is t ica l nethods: Cl ln lca l and parasl to logtcal data
were coded aod fed tnto a olcrocouputer. l lalarla prevalence at a glven CS or l lS t 'as
expreeeed as parasl te rate (1.e. , lhe percet tage of parasl te-posl t lve Pat ients or v l l lagers
.ro.rg all blold fl lns exaulned). Vll lage-conblned average.nonthly parasl'te Prevalenceratea were calculated as algebralc neani of lndlvldual cllnic. resulEs, clLnlc-derived rates
belng coneldered as unlts of collectlon. They were shown aa means and Ewice the standard
error of the Dean, the eanple slze betng the nunber of cllnlcs heLd ln the four vll lages
during the nonth.
vBc /90.3UAL/90.3Page 279
Results nere glven ln several tables and graphs. Fron the authors discussion, there have
been recurr ing epldenics of nalar la for rnore Ehan a century in PunJab (c i t ing Chr is tophers,
l g l l a ; G111 , 1920 ; Schu f fne r , l 93 l ; I i l c ks & MaJ1d , 1937 ) . The pa t te rn cons i s ted o f 5 o r 6
years durini which nalaria was nild and separated by one or two years of severe epideoics
and narkedly lncreased nortallty. I ioweve:c, some of the reports descrlbed areas where
nalar la was endemlc and stable is"h, t f fn" . , , l93 l ; Macdonald & Maj ld, l93 l ; Hicks & Maj id '
1937). These areas were near a body of water or l r r igated land whlch provided lncreased
anophel ine breeding s i tes. Thls re iu l ted ln a 1ocal t ransmlss ion Pat tern s ln i lar to that
observed ln the prEsent s tudy v l l lages, i r r which the dra in prov lded l ta ter for nore regular ,
sustalned and extenslve breeding of cullc1faclqq. Reference was made to Hicks & Majld
(1937) who concluded thar the flucrui6G-Ii-i i laria ln the Karnal dlstrlct, about l l0 kn
north of Delh i , were a lmost ent i re ly due to f luctuat lons ln the in fect lon which was
Lnfluenced by the ganeiocyte rate in the local huroan populatlon and the local denslty of
cul ic l fac lee. Grei ter , n l re pro longed, and coi re is tent exPosure to ln fect lve noequl to b i tes
il"!-#ilffi to graduaily Lncrease funnunlty ln the hurnan populatton and cause nalaria to
b e c o n e e n d e r n 1 c ' , , d " t . b 1 e . T h e s e a e o n a 1 p r e v a 1 e n c e r a t e s o f @ s p e c 1 e s 1 n t h epresent etudy v l l lages were s ln l lar to those among chl ldren ln Karnal d ls t r lc t ln that :
(a) Peak lnfectlon of P. falciparum occurred ln November'(b) Fol.lowlng rhar ttreFiEE-?@Eua1 decllne untll the next septenber.(c) I rlee ln P. vlvax lnfectlon rates occurred ln April and June.(d) peak of tn?ffi i-for 3:31g orccurr€d earller ln the tranelolesLon season than
f o t l @ . -
I r wa6 nored thar Macdonald & Hicks ( f931) and Hicks & Maj ld (1937) took b lood f l lns
only frou children, who had hlgher paraeiBe ratea than adults, partlcularly ln areas where
nalaria was etable and endenlc. When thls age dlfference Itaa taken lnto account, the peaks
of prevalence rates were el.nLlar to those obtalned over 50 years ago: for P. -f3lgiParun,betseen 282 and 501 durlng October-November, and for P. vlvax betneen 18% and 24L Ltt
Septeuber. The authors wondered why P. vlyex tnfecttG-lEdonlnated early andp. falclparum ones occurred later aurfrE-Ef"-Eransmisslon aeaaon. It was suggested (clttng- -FEriif i 'dff iI98g) rhar p. vlvax has a greater ablIlty to produce gametocytaenia when
condltl.one becone favourlTffiT transnlsslon during July-Auguet after the raLns begin.p. vlvax aleo has a relatively larger gaoetocyte te""r.toir (observed ln the Present atudy),
l-f6iFctlt lcal tepperature for sporogony (nore lnportant durlng the nlnor April-May
traneo1eslon seaeon), and a ehort,ei lncubatlon perlod. On the other hand, because of lts
short l l fe span, T. ialcl,parup usually beglns with a low gauetocyte reservolr (observed Ln
the preeent stuayfiiE!1ffi-frlgher tlnpeiaturee for eporogony' and has a longer lncubatLon
pertoa than P. vlvax. The reaeon that Wernsdorfer (1980) gave for the relatlve
predonlnan""EEg]"fp.rur ln the late seasou (Septenber through Decenber) ls that lt
could suppress @ Sr""th because of lts greater vl-rulence ln hunans.
Str tck land et a l . ( loc,c l t . ) fur ther noted that survel l lance oPerat ions conducted by
the I.{Cp of pakletan reported a preponderance of P. vlvax over LiblglParum between 1970
a n d l 9 7 7 1 n P u n J a b . T h e r a t 1 o o f c a e e e r a n g e d r 6 i o G , T v e r a g e f f i - i 9 7 0 a n d 1 9 7 1 t oan average of Juet over 2:1 for 1975 through \SZZ (ct t ing Zulueta, MuJtaba & Shah, f980) '
Contrary to thls, the preeent study shohted that 3:-jalclparqt predonlnated: towards the end
of the 1984 t ransmisal .on aeason the rat lo , of p. Efcfparun to,3g1"g- exceeded 50:1. One
pose1b1eexp1ana t1on ,nen t1onedabove , ' ' asEh ; f f i - -F rEmE"o f@ln fec t i onsnaysopp""ss p. vlvaxl inother explanatlon Eay be that the extenslve use of chloroquine ln the
pre3ent e@G-treat cllnlcally suspected oalarla cases may have suppressed tl" L=P
infect ion, wtr t te chlorogulne-res let" t r i l - t " t " t " " . " t pers ls ted*(c l t ing Fox et a l . ' 1985) '
llowever, thls doee not explaln why ttre Eilffii ttre present study were sl'rnllar to those
of Hlcks & MaJid (1937). The """L"
of th,ose authors rtere not treated. It l tas assumed that
the ecology oi nalarla tranemlselon In Ehe two areas was slmilar wlth greater and more
p r o 1 o n g e d L r e e d 1 n g s l t e e f o ' @ . . I n b o t h s 1 t u a t i o n s , t h 1 e f a v o u r e d s t a b 1 1 i t y o foalarla wlthout rnarked fluctuEf6nffi-Elansnlssl.on ae ltell as a PrePonderance ofp. falclparun over P. I lIg. A very high asexual stage and garnetocyte parasltaeula ratea
in infants were obs;;vEd-G the l{S perforned 1n January 1985, whlch confirrns that there was
heavy transmlsslon of P. falcloarurn durinLg the 1984 tranemlsslon aeasorl.
* See Pos tsc r i p t , p . 315 .
\rR.. ,/o n ?wAL,/gO.3,Page 28O
Regard ing ma la r i a r l o r t a l i t y , S t r i ck land e t a1 . ( l oc . c i t . ) no ted tha t an ep lden l c o funstable malar ia usualJ.y causes h igh nor ta l l ty because the populat ion has not bui l t upfuonun i t y ( c i t i ng Ch r i s tophe rs , l 9 l l a ) . Enden i c s tab le na la r i a 1s be l l eved to cause l essrnor ta l i ty especia l ly in young chi ldren (c i t ing Bruce-Chwatt , 1980). The pr lnc ipal nethodof def in ing epidenics is to calculate the excess of nor ta l l ty due to febr i le l l lness dur ingthe nalarLa t ransniss ion season. In the study v l l lages, no lncreased Dorta l i ty due toroalar ia was detected among 4000 lnhabl tants. A h igh prevalence rate of both asexual s tagesand ganetocytes ln chi ldren associated wi th a low morta l l ty rate fur iher polnts to endenlcand stable malar ia. There are many v i l lages in Punjab c lose to perennla l water sourcessui table for cu l lc l fac ies breedlng and i t ls 1 lke1y that these areas a lso haveepideniologic;FA?6;; and stable nalarla. The stablLlty of malaria is very inportantwhen conslder ing contro l methods. As chloroqulne-res ls tant P. fa lc lparun nas detected lnthe present s tudy area (c l t ing Fox et a l . , 1985 - see under paragraph 2 below), Str ick landet a l . ( loc.c i t . ) reco. 'ended that th ls focus of P. f3}gLpgg should be eradicated throughthe l iberal use of residual insecticldes and tte t-r"iTr&frTall subjects withP. fa lc iparun parasl taenlas wl th pyr lnethanlne/sul fadoxlne (Fansldar) , (c i t lng Str lck lande r a 1 . , 1 9 8 6 a & b ) .
Fox et a l . (1987) conpared the resul ts of MS and CS for detect ion of ualar la cases lnthe sane four s tudy v l l lages ln Kasur d lsbr ic t , Punjab (see Str lck land et a l . , 1987) -
shown above). The sarnpllng dates were the aane as those shown above. The results showedttrat although the MS and CS populatlons were dlfferent, the dlstrlbutlon of totalparasi taemlc cases accordlng to age-groups eras general ly s i rn l lar . A greater proport lon ofchl ldren and enal ler proport lon of adul ts at tended the c l ln lca, conpared to the tota lconmuni ty , but the proport lon of to ta l nalar ia posi t lv l ty among the d l f ferent age-re latedsubgrbups was the same ln the MS and CS populatlons wlth two exceptlons: nore cases ofroalaria were detected in the 5-10 year age-group, whlle fewer cases were detected ln theadult groups ln the cllnics than ln the MS. The correlations between parasitaemta ratesdetern lned by MS and CS were posLt lve and h ighly s lgni f lcant for both P. fa lc lparun andP. vivax. For P. falciparun , aLL L2|CS palri (4 vi. i:.ages sampled 3 tt i iEEFEiffittatEsi1Ei For PT ;i- 'ax, onit one of the MS/CS palrs gave statistlcally slgnlf lcantdlfferences; Xffin[;-e had a hlgher P. vivax parasltaenia rate durlng the CS than durlng theMS ln Apr i l 1984.
As discuseed by the authors, ACD and PCD are currently used ln Paklstan fordeternlnlng nalarla prevalence rate6. Both nethods are more approprlately applled ln areaswlth lower oalarla transmLsslon than nas present in the four vll lages etudied. ACDrequiree conslderable man-houre, and therapy ls based upon cJ.inlcal dlagnosls of nalarla.When perforned properly, ACD glves lnfornatlon on the prevalence of cllnlcal nalarla. This1s particularLy loportant when baslc health unlts are not readlly avatlable or thevll lagers do not utl l lze nedical facll l t les. PCD requlres lese manpower than ACD.Ilowever, all patlents wlth fever do not have blood fl lns stalned and examlned ln the basichealth unlts. Therefore, the results are not readlly avallable to the health care workerwho often also glves presunptlve treatnent baeed on clLnlcal diagnosls. However, PCD lsmuch more coet-effective than ACD desplte the weaknesees of both. Nelther ACD or PCD areable to detect the o11go- or asynptonatlc nalarl.a lnfectlons whlch ln turn can lead toheavy transnl.ssLon and lncreaeed number of new caaes. It ls rrell known that the proPortlonof aeynptoaatic carrlers Lncreaeeg wlth lncreaaed malarla prevalence and decreases wlthdecreased prevalence. The only way that a focus of hlgh nalarla prevalence can beaccurately detected Le to perforu surveLllance dlrectly in the coonunl.ty. To this end, amaa6 aurvey (l-ts) ie advocated, whereby every house, or randonly selected houees, arevlslted; the resldents are questloned regardlng fever and other synPton6 of nalarla.Ilowever, MS are very tlne coneumlng: they requlred 100-280 nan-hours, Lncludlng 40-120physlclan-hours ln each vllIage. Slnllar lnformatlon was obtalned fron CS whlch requlredor.Jy I/7 to 1/10 of the nan-hours needed for the MS. In additlon, the CS provided usefullnfornatlon regardlng the norbldlty due to nalarla and to other diseaeee, and provtded
llntted prinary health care to the conmunlty. If the blood fl lns ltere stalned and examlnedduring the cllnlc, malarla chemotherapy could be ratlonally based on conflrmed rahter thanon presumptive dlagnosls. It was surprislng to flnd such an excellent correlatlon betweenthe two surveil lance methods.
vBc,/90.3l'1AL,/90.3Page 281-
The authors ccncluded that the CS wlth a fractlon of the efforts of the MS' -give an
excellent estinate of the polnt of prevalence of roalarla in a conmunity, and, tnereforet
recoomended that the CS be uti l lzed along wlth ACD and PCD for oalaria survell lance lnpaklstan. The CS could be perforroed in conmunLtiee where ACD and PCD show that nalarla ls
present. The CS rnay show a nuch greater nuober of cases ln a conmunlty than would be
"*p""t"d by ACD and PCD, since the anount of asyoptomatlc or oligosynptonatlc nalaria in
Punjab n lght be considerable.
Str lck land, Fox & I iad i (1988) repor ted the resuLts of an lnvest lgat lon on splenonegaly
and assoclated nalar ia ln fect lons ln chi l ldren of the sane four PunJabl v l l1ages near
Lahore, as shown above. Malarla prevalence was greater in these vil lages than ln nearby
slntlar, but dryer area6. Routlne examlnatlon for detectlng sPlenonegaly ln chlldren under
13 years of age nas star ted ln l larch 1984 at outpat lent c l ln lcs held in the four v i l lages.
The roethods of epleen palpatlon, as well as exarolnation of blood fl lns taken fron each
chi ld were descr lbed. For etat le t lea l arra lys ls , c l ln lca l data were recorded d i rect ly on
lndlv idual c l ln lc sheets, t ransferred to data code sheets and entered ln to 8
microcomputer. The chlldren were dlvtded into groups according to:(a) the Eonths they vlalted the cllnlcs;(b) thel r ages;(c) the preaence or absence and relatlve exBent of splenic eolargenent;(d) the pr"""tr"" or absence of, and epecles causlngr oalarla lnfecclon;(e) the parasite densl.ty after logarlthrnlc transfornatlon.
As dlscussed by the authors, eplenonegaly and paraeltaenla were conpared ln 2891
chlldren examined dlrlng 13 consecullve rnonths. The average nonthly spleen rate varled
fron 0.05-0.13 before the monaoon malar la t ransuiss lon season to 0.18-0.27 dur lng and af ter
this season. Moderate splenlc enlargement reached a peak durlng the nalarla tranaolsslon
season, whlle.the htghesi proportloni of very enlarged spleens occ.urred towards the end of'
and after, the trans6leslon aeason. The paraslte rate itas greater than the spleen rate at
all ages of .Utar"n exanlned. Thls sugg"ste that lnnuntty to lnfectl 'on waa not developlng
ln nais durlng early chlldhood. Inrounlt;y to P. vlvax developed nuch earller than to
L falclearunl P. vlvax paraslte r.t".td aei; ' iFa?opped qulckly wlth age, and
Fe-non-egaly wasTiEl?it icularly associated with P. vlvax tnfectlona, aa very large
"p1""rr" !nd-L. vtvax infeetione were rarely aeeoc.lff ihls, howeverr rras not seen ln
. fal. iparuffi lorrs. P., falglrparun parasl.te rate and the geonetrlc Dean parasltaernia
denslty were not reduced rn6ffiEe groups. The older chlldren had higher spleen
rates and a greater proportlon of larger spleens than the lnfante and younger chlldren'
Those wlth Bp1eno."g"1y- had higher Dean paraslte deneltles than the chlldren of the eane
age group6 who dtd iot-have paipable spleens. Cllnlcal dleease due to P. falclparun
infecrlon was equally f requent ln older chlldren as ln the younger age f,ottlfi...T;m!K h a l l q , 1 9 8 6 ) .
The authore interpreted theae results as followe:
(a) A hlgh level of lnnunltl to LIB ltas present in the connunltyl parasltaenLa
denelry, dlseaee and splenomegaly caulE-try1lg were nlninal ln the youngeet
chlldren. Thle could be due to Sreater prevEffi inunlty exPosure to P' vlvax and a
quicker and nore effectlve tomune resPonse-to 3:-l4Iax than to p. fatcfiiiG-Gtttng
Bruce-Chwatt, 1985; Qulnn & Stricklani, t la6; ff i[-- 1986)'
(b) Comunlty lonunity to P. falclparuo was low. Splenonegaly was frequently Present
tn assoclarlon wiih acure ir. f"la;afiG-GEcElons. Ae reported.earller (elt ing
Chr i .s tophers, L924; Macdonald e UajTt i lg3 l ; Hicks & l laJ id, 1937) ' ch l ldren of a l l ages
wlth noderateJ.y enlarged epleens haa trfglher density of larasltaenlae (more assoclated nith
acute lnfectlons), whlLe tirose wlth the largest spleene often had lower denslty
paraeit..rias (nore assoclated wlth lnounity). Blcauee of the relatlvely low, seaeonal
iransnisslon of p. falciparun in the "orror,ity,
the developuent of eo1ld lnmuntty and
splenonegaly perslstlng through nuch of chlldhood dld not occur' In other words' the
child-s iromune reaponse started anew dur'lng each l0onsoon transmlsslon aeason' Flnally, the
authore hoped that the study would stlnulaie others to re-evaluate splenoEetry ln roalarlat
slnce the findlngs nay dlff lr ln other endenlc locallt les wlth dlfferlng levels of oalaria
t ransmlss lon.
vBc lgo .3MAL/90.3Paqe 282
In the unPubllshed docunent
was shown as follows:
- Populat lon: 97.1 ' n l l l lon
- No. s1ldes examlned- No. Posl t ive s l ides
of Far id (1987), the country nalar la prof i le of Pakistan
Populat lon
I 984
a t r i sk : 97 .1 n l l l l on
19861985
2 843 833 265 194
| 725
732 184 2 897 85960 669 90 31220 296 29 538
<An. steDnensl'An. f luv lat i l ls
- " . , * f f i 1 o e a s u r e s : S p r a y 1 n g w 1 t h o a 1 a t h t o n ; l a r v 1 c 1 d 1 n g w 1 t h t e r n e p h o s 1 n
urban ar€84.- CaEe detectlon: through AgD, PCD and actlvated PCD'
- Developnent of PIiC at perlpheral level: Baslc health unlts exist ln the perlphery to
cover 15 000 people each. Further developnent ln the perlphery does not exist'
- Developoent of PHC at referral level: Acceptable- l lalarla control PrograEme: ls a vertical one, although activlt les are decentrallzed'
- Malarla tralntng centrea: Exlst ln Lahore- Trained manPower: Avatlable- Special problens: Agrlcultural practices
Inforoatlon coomunLcated to WIto/El'tRO on the
lncluded the following:
- No. L@-cases RI and RII levels conflrrned- P. fa lc lparum resls tanee to chloroquiune: Reslstance of
oaffi runiab Provlnce- vectors of oalaria accordlng to their vectorlal importance - wlth lnfornation on
reststance to lneect ic ides:An. cu l lc i fac iee DDT/die ldr ln
DDT/dieldrln; oalathlonDDT
and urban qalarLa.
ualar la s l tuat lon in Paklstan ln 1987
(.) gPgylg-oPelatlons: The country has been classtfled lnto three oalarlogenlc
srrara: hlgh, ."arif iff i . - i ir"-r.s
6ased upon the cunulative epldeniologlcal data
regarding the parasite loadr ltater logging, cliuattc conditlons, population movement and
other factors lnvo1ved l-n man-made t"II.f.-such as lrrlgatlon Projects and constructlon of
barrages etc. House spraying is reconmended rualnly ln areas of hlgh nalarlogenlc
potenttal, where there le daiger of a flare-up ln the pr"eence of an arople paraslte
reservolr as indlcated fron the previo,r" y".r 'transnlsslon. Slnllarly, focal spraying ie
lolt lated ln hlghly recePtlve and vulner"Ll" t."t" lrrespectlve of the level of
ualarlogentc potenital, Lut based on the Preeence o! an anple reservolr and vector
deneltlee. To estlmate the guantlt les of lnsectlclde regulred ln a provLnce, a team (wllo'
USAID and Natlon"i "rp"rt")
ta" forned and worked with the aeslstance of
Provlnclal/Reglonal/Dl8trlct offlcers. The planned spray targets nere-successfully
achl.eved ln all provlncee wlthout any naJor itfftcutty' A total of' -2 7.84 649 houses
(9 fZO 346 rogna) excludlng Azad Khashnii were to be eprayea f1 1 single round wlth 2
g nalathlon/m-. At the end of the spraylng operatl 'o-"i { lst 442 houees Q 882 827 roons)
were acrualty aprayed, glvlng. .o""'". i l oi ab'OZ of the houees' In thl 's way' 87'27' of the
populatlon *"r" prlt"ctid. In soroe loiallttee of PunJab, Slnd-and NWF provlnces a aecond
round of focal epraylng wae applled. These localtt iel were eelected on the basls of elther
ghe preeence of P. falciparun reslstance to drugs, or for belng vulnerable and recepttve'
The second round was appll.ed atter a gaP of at least one month after the end of the flrst
round, A total of.2 202 netrlc too" If '502 nalathf,on wdp nas consuned in the tlto rounds'
The actual doeage apglled ranged ftit- f .9 to 2 g/nz. ThL entlre spraylng oPeratlon Itas
cloeely supervleed by Provinclal, NatLonal ualarla offlcers, WIIO and USAID exPerts' Pre-
and post-spraylng surveyE were conducted by the dlstrlct enionologlsts to aaseas the lnpact
of spraylng on vector populatl 'ons'-
(b) Eptdenlologlcal sltuaglo+: The avallable data excludes those of the last quarter
of 1987 as the6e nere not recelved at the tlne of wrlt ing' Actually' durlng
October-Novenber, nalarla tranenlsslon lncreases ln Sind and southern dlstrlcts of PunJab
and Baluchlstan. Obvlously, thls w{11 alter the preeent resulte' Deeplte thls' the
nalarl.a sltuatlon le expected to be at least better than last year (1986)' lf not narkedly
vBc/90. 3MAL,/90.3Page 283
loproved. The reason8 are: f l rs t ly , a l l roperat lons especia l ly epraylng were auccessfu l ly
actornpl lshed ln a l l prov lncea; aecondly, uhe unexpected low ra lnfa l l d td not favour the
bul1d up of h igh vector densi t les. Theee condi t ions have resul ted ln a low malar la
lnc idence ln 1987. The fo l lowlng data show the SPR recorded in d i f ferent prov inces dur lng
r 985 - l 987
Sl lde posl t tv l ty rate (%) ln Paklstan
Province
PunjabSindNWFBaluchistan
1985 l ' 986 ]-2!2, (to the end of Septenber)
t . 4 93 . 6 73 . 6 82 . 4 8
2 . 1 33 . 0 63 . 5 32 . 3 6
2 . 4 93 . 6 05 . 8 02 . L 9
Total 2 . 4 8 3 . t 3 2 . 2 3
Theee data show an overall decreaee tn the SPR at a country levelr but at a provlnclal
level there waa a s1lght1y upward trend l:n Sind and Baluchlstan whlch ItaB attrlbuted to
Lnprovement ln case detectlon especlally .PCD. It le well known that the SPR of blood
slldes collected by PCD ls usually hlgher than that of slldes collected by ACD. The ratlo
o f & . . f . @ : P . v 1 v a x e h o I ' e d a d e c 1 1 n e f r o r n a b o u t 3 8 z 6 2 1 n l 9 8 5 t o a b o u t 3 2 z 6 8 .
( . ) @ : E n t o m o I o g 1 c a 1 s t u d t e s w e r e c a r r i e d o u t 1 n e a c h d i e t r 1 c tc o n p r 1 s 1 n @ e n s 1 t l e s a s w e 1 1 a 8 8 u 8 c e p t t b t 1 1 t y t o 1 n s e c t 1 c 1 d e s . Atota l of 770 suscept lb l l l ty tests were carr led out ln PunJab, NWF, Slnd and Baluchistan.
Of theee, 289 and 48I were carried out on cullclfacles and Eg*s.I, resPectively agalnst
DDT, d le ldr ln , rnalath lon and fenl t roth ion. These testa showed:DDT/dlelir in: the tno vectora remalned resistant to these despite their
dlscoilGGEiTor nany years throughout the country. No slgnlficant reversal to DDT
susceptlbll l ty has been obeerved.Malathion: Intenslve lnvestlgatlon r,evealed the preaence of resl.stance in 9!$i!9!'
w h t t e f f i c i e s r e r n a 1 n e d s u s c e p t t b 1 e e x c e P t 1 n a f e w 1 o c a 1 1 t 1 e e 1 n t w o d 1 s t r 1 c t s 1 ntunSauTffi iff iaelr et al.. (1982) abovel.
Fenl t roth loD: I ts use for nalar la co:ncro l nas star ted ln 1980. A large nunber ofauece!86@ste showed no reels.tance to thls lneectlclde ln the thro vector specles.
Fron infornation comrounlcated to WIIO/EMRO, data on the antinalaria activlt les ln
Pakistan ln 1988 show the fo l lowlng (populat lon: n ld-year est lnate in 1000s) :
- Total populatl.onz 102 928- Populatlon of orlglnally nalarlous areas z 102 928- Populatlon of area6 clafuoed to be free fron nalaria: -- Populatloo Protected by exteneLve houee epraylng: I 326- Populat ion protected by other ant i -vector neaaureo z 94 602 ( larv ic td ing)- Populat lon under survel l lance: 102 928
As sunmar lzed ln the l { ld h l th s tat ls t . quar t . ( } IHO, 1990) concernlng the wor ld nalar la
e 1 t u a t l o n . 1 n 1 9 8 8 , t h e n u o f f i P a k 1 s t a n c o n t 1 n u e d t o d e c r e a s e f r o o90 O0O |n 1985 and 64 000 ln 1987 to 50 000 ln 1988. Whl le the percentage of b lood s l ldee
found posl t lve went down ln PunJab ( f ron l .5Z to l . tZ and Sind ( f ron 3.72 to I .9Z) ' t t
lncreased ln NWFP ( f ron 3.77 to 4.LZ) and ln Baluchlstan ( f roro 2.5"1 to 4.62) . The re lat lveprevalence of P. falclparuu lnfectlone ln 1987 was about 527, ln Ealuchlstan and Slndp r o v 1 n c e s , 2 s z T n @ d 1 7 Z 1 n N W T . I n l 9 8 8 , 1 t d 1 d n o t c h a n g e t n S 1 n d , d e c r e a s e dsllghtly ln PunJab (262) and roae ln NWFP (212) and Baluchlstan (797").
Far id & Beales (1990 - unpubJ. lshed repor t to WIIO) v is l ted Pakistan dur lng 18-28 June
1990 to assls t Goverrment of f ic la ls in : rev iewlng the oalar la s l tuat lon and nalar la contro l
strategy; revlewing the I{IIO collaboratlon for rnalarla control; Proluotlng the use of the
Malarla Tralnlng Centre, Lahore for hurnan reoources developoent prlnclpally for Pakistan;
rev iewing operat lonal nalar la research needs. The najor obJect lve of the naLar la contro lprograpne tn pat ts tan ls to Busta ln a low level of nalar la (0.5 cases per 1000 populat lon)
at which malarla does not po6e a naJor publlc health problen. The programne hae recelved
continuous asslstance fron WIIO, although varylng in the klnd of contributlon. USAID
vBc /90 .3MAL/90.3Page 284
supported the programme f ron July 1961 to June 1967, f ron July 1974 to June 1980, and f ron
July 1982 to date. The Governrnent of Japan supported the programme f ron July 1980 to June
L982. The resulEs of the revLew were as fo l lows:
( l ) Ihe nalar ia s i tuar ion: Malar ia has been reduced f rom an API of 13/1000 in 1973 to
o . 8 7 / l 0 0 0 m 0 i n ] ' 9 8 9 b a s e d o n t h e c u r r e n t s u r v e i 1 1 a n c e s y s t e m . T h eincrease in the Apr f ron lggg to 1989 is bel ieved to have been due to bet ter case detect ion
and a drive to move towards PCD away fron ACD. The greatest increase in the API has been
noted in Sind, punjab and NWF provinces. Malarla transnission has been enhanced through
the polit ical sitult ion in Sind and lnported cases aTong Afghan refugees in NWFP I see roore
deta i ls below]. I , la lar ia contro l in Baluchistan in 1989 appears to be sat is factory '
P. fa lc iparun nalar ia is showing a low level (RI and RI I ) o f ch loroquine res ls tance in very
l in i ted areas where the Lests have been carr ied out [see nore deta l ls under paragraph 2
below]. At the moEent , res is tance has not yet posed a najor problen ' I lowever, records of
chloroqutne res ls tance have been increasing steadi ly at the RI level s ince 1984 and at the
RII level since 1987. The move away from chenical- vector control can be exPected to
accelerate the occurrence of drug r ls is tance unless aLternat ive nethods of vector contro l
are appl ied ef fect ive ly , and the use of low dose presuoPt ive t reatDent wi th chloroqulne is
substant ta l ly reduced. Nevertheless, ch loroquine remains an ef fect lve f l rs t l lne t reatment
ln Pakistan, eepecially in view of the hlgh lncldence of U!:g malarla ln nany areas'
(2) Malar la contro l s t rategy: The f lnancta l year Ln Pakistan extends f ron I Ju ly to
30 June; the pres"" , r p i ; , " . f r .Gr la contro l extends f ton I Ju ly 1987 to 30 June 1993' The
strategy adopted corr" i " t " o f f lve roaJor e lements: vector conErol , case detect lon and
treat6ent, human resourcea developneit, health educatlon and operatlonal research'
(a) vector contro l : This consist6 of h ighly select lve spraylng wl th nalath lon
based strictly on-if i@iologlcal situation at vllIage level. Thls has been adopted to
reduce expenditure, to "rr"orr..g"-the
developnent of non-chenlcal alternative nethods and
developnent of self reliance stnce the bulk of the lnsecticlde ls purchased with external
resources, and to ensure susta inabi l l ty of nalar ia contro l . Thus, the amount of nalath lon
used ln 1978 was 9000 netric tona, and this has been reduced to 1200 tons ln 1989 and 2000
tons in 1gg0. Thls last amount ls suf f lc lent to protect 2.5 n l l l lon people wl th 4 rounds
of nalathlon (assuming I kg and 5 persons/house). However, only one round ls applied - tn
July, but this does not cover the transmlssion season whlch ls about 6 nonths (June to
Novlober). Every year before spraying, a team of experts analyzes the nalaria data by
vIl lage to select .rl.tt.g"" to be sirayea based princlpally on the occurrence of
P. falciparurn cases. The roalari" proll"t ln Patlstan Ls largely rural excePt for KarachL
where stephensi le considered the oaJor vector. Such urban areaa are not neglected ln the
strategy whlch lnvolves roalnly "o.r."l
reductlon and larvlclding' ULV ts applled only in
eroergencles.
(b) Case detect lon Pnd t reat t rgnt : -The-st rategy is to increase case detect lon and
t r e a t m e n t a 1 n e d a @ o f i n f e c t 1 o n . P r e s e n t 1 y ' 7 5 7 " o f , b 1 o o d s 1 t d e s a r etaken by AcD workers and presumptl.ve low dose treatDent ls glven pendlng the results of
nicroscoplc examlnation. In thls regard, there has been a decentrallsation of the
capabiltty to dlagnoee malarla ntcroicopically down to the dletrlct leve1 ln the whole
"o,rnt.y (per 100 6OO poputatlon) and lt ls envlsaged to reach the BasLc Health Unlts
eventually (per 10 000 populatlon each). For thl;, 500 mlcroscopea were purchaeed tn 1989
with USAID funds.
(c) Human resources developnent: Present attention is focused on malarla
mlcroscopy tralnLng, and a t""trrt ' ff iGe has been- epecially establ-lshed' Tralnlng for
tn-servlce and new personnel ts cairled out at the Lahore l lalarla Tratning Centre' Medlcal
offlcers fron the health services have already begun to attend a course for 3 nonths ln
malarla control and thls capabll ity w111 be further strengthened.
(d) ttealth educatlon: This 1.8 lnportant and the progranrne wll l soon be starting a
canpaign of treatEfrffiEi-Ehrough televlsion sPots featurlng l0 key uessages for
nalaria.
( " ) @ : R e s e a r c h i s r e 1 e v a n t t o t h e c o n t r o l o f n a 1 a r 1 a a n dincludes such alternatlve vector dontrol Eeasures which are envlronmentally safe and
effectlve. The cause of ggga$,! reslstance to nalathlon ls uoder study' No declslon
vBclgo.3MAL'/90 ' 3Page 285
w111 be taken regardlng a posslb le change to an a l ternat lve tnsect lc ide unt l l operat lonal
research studies have been conpleted. There ls one entonologist plus a nunber of
technlc l .ans ln each d ls t r ic t . Suscept lb l l l ty tesfs are belng carr ied out on a large scale
wl th DDT, d ie ldr ln , nalath lon and fenl t roth ion. However, th ls ls expenslve and s111 be
reduced ln future to test only nalath lon and feni t roth lon. In 1984rthe reeponslb l l l ty of
nalarla research was asslgned to the Malarla Trainlng Centre, Lahore whlch was renaned theNat ional Inst i tu te of Malar la Research and Tra in ing.
(3) Resources for nalar ia contro l : The present p lan for rnalar la contro l ls est luated
t o e o s t R e r t ' h e 6 - y e a r p e r 1 o d . 0 f t h 1 s , a f o r e 1 g n e x c h a n g ecornponent of Rs. 787.81 n i l l ion Ls expecte, i l f ron the USAID grant . l | I10 cont lnues to a8616t
the progra ne wl th technical advisory eerv lces, 6ome supp1lee, equlpnent and t ra ln lng.
(4) Baslc heql t l l sery lqge: The developnent of baslc heal th servLces at the per lphery
b e g a n r n f f i g . T h e k e y . u n l ' t s a r e t h e r u r a 1 h e a 1 t h c e n t r e 6 ' b a s 1 c h e a 1 t hunlts and comnunlty health workers, as shown below wlth notes on tralnlngr lnforoatLon
system and conetra ints :
( a ) @ : E a c h c e n t r e 9 e r v e a a p o p u 1 a t 1 o n o f 5 0 0 0 0 t o l 0 0 0 0 0a n d 1 s i n t e n d e @ w o r o a 1 e d o c t o r s a n d o n e f e n a 1 e d o c t o r , a s w e 1 1 a esupporting staff. There are usually 15-20 beds, X-ray facll l t les and laboratory servlcee
ln each centre.
(b) Baslc l lea l th Uni ts : Each rura l heal rh centre has 5-10 r rsate l l l te" uni ts , each
s e r v 1 n g 5 0 0 0 @ T h e s e u n 1 t s I ' e r e o r 1 g 1 n a 1 1 y s t a f f e d o n 1 y w 1 t h n i d - 1 e v e lhealth workers under the supervlslon of the Rural Health Centre nedleal offlcers. Slnce
1986, there ls a nedical of f icer In each baelc unl t who ls superv lsed d l rect ly f roo the
Dist r lc t Heal th Of f lce (not the Rural Heal th Centre) .
(c) Coruuntty tlealth Workers (CHWs): Each baslc health unlt ahould have a
c o m u n 1 t y t r e a r & - ( . o n n u ' . t t 1 e s ) w l 1 1 s e 1 e c t t h e 1 r C I I W w h o 1 stheu trained by the staff of the baelc health unlt. The CIIWs were orlglnally volunteers
but recent poltcy lndlcatee that they ghould ln future be renunerated by the comnunlty they
6€rv€. Under the new polle.y of 1990, the CEt{s w111 be tralned for one year tn 12 naJor
area6 on how to approach patlents, how to deternlne the populatlon's problene and needet
how to prepare thl baslc populatlon lnfornatlor etc. Thts l-year trainlng wll l conalst of
8-10 day pirlode each oonth for 12 monthe Bpent at the Dl6trlct Hospltal for tralnlng on a
partlcular subJect. They w111 then return to the vll lage for f ield Practlce under
supervlslon.
(d) parangdlcal tralnlng progTanne: The nld-level health workers of the baele
h e a 1 t h u n i t e a r e o f e c h o o 1 1 n g t o t h e m a t r 1 c u 1 a t 1 o n 1 e v e 1 ,preferably wtth scllnce subjects. This requlrenent ls relaxed to 8 yeare ln the ca6e of
women ln order to attract then to the serv'lce. Durlng 1978-1981' USAID funded a ProJect(US dol lars 1.5 o1111on) to r ra ln theee paranedl .ca l s taf f ln prov lnces u61ng d ls t r lc t
hoepital staff ae teachers. The total tralnlng perlod was 18 months atd 27 tralnlng unlts
were establlshed each wl.th 25 etudente per year. Slnce 1982, thie proJect ItaB extended as
a prlnary heaLth care proJect uP to the plesent t lne wlth a grant of US d'olIare 27 '9
61llton.- Thls gave the GovernDent the opportunlty to bulld t3 health technLcian echools in
the provln"""r 5 ln PunJab, each wlth a capaclty of 100 Etudents; 3 ln Sind; 3 tn NWFP;
2 in Baluchlstan, each with a capacity of 50 students. These are Pernanent schools wlth
hoetel factl lt leE for the students, and lt Le Lntended that each schooL hae a Perr0anent
teaching faculty of one doctor ln charge aselsted by two senlor paranedlcals wlth 8-10
years oi service. There le a speclal budget for the echoolsr sone of which started
iratning i.n 1989. After thelr rralning, ihe health technl.clans wll l be postecl Ln rural
health centres and baslc health unite. The courses are run ln three serDeatera each of slx
monthe. The tra1nlng ls task orlented and the Job descrlptlon of health technlelans
includes the control of coomunlcable dlseases. The partlclpante are taught the
probJ.ero-solving approach to provide health prorootlve eervices (problern ldentif lcation'
exlsglng resource asseaament, proposed sol.utlon, developnent and lnplenentatlon of a plan
of action and its evaluatloni.- f it" currlculum lncludes malaria, tuberculoElsr leproey and
parasitl.c dlseases: how to ldentify then, and what people can do to control and treat
thero. Malaria and tubere.u1os16 are dealt wlth ln more detall because they are very cornnon'
vBc, /90.3MAL,/90.3Page 286
(e) Undergraduate .oedical tralni{rg: A managenent training progranrne has beendeveloped for the rura l heal th centre staf f , par t icu lar ly for newly graduated doctors.This is an Ln-service training progranoe supported by USAID which has provided a trainingadviser . To daEe, soDe 4000 doctors have been t ra ined. There is , howeverr a h igha t t r i t i on ra te espec ia l l y o f docEors pos ted l n bas i c hea l t h un i t s , whe re the fac i l l t i es a reninfunal . The undergraduate t ra in lng in the 18 nedical co l leges which produce about 4000doctors every year ls curat ive or tented. Thus, a 4-week postgraduate acadenic t ra ln lng hasbeen star ted in Punjab province to prepare doctors to work in rura l areas in prevent ivernedic ine.
( f ) In forroat ion systen: There are several systeros which seem to be separate. Thec o t r E u n i t y h e a 1 @ t e d t o c o n v e y b a s 1 c i n f o r n a t i o n c o n c e r n 1 n g 1 1 1 n e s s , b i r t h sand deaths in the conmunl ty to the baslc heal th unic , then d ls t r ic t heal th of f ice, d iv is ionand up to prov lnc la l level . At the sane t lme, there ls an of f ic ia l rePort ing of b l r ths anddeaths through Unlon Counci ls . In addl t ion, the malar ia Programme has i ts own report lngsysteo of paraslte-posltive cases only through ACD and PCD workers.
(e )@'
- Dl f f lcu l t to f lnd fenale students who neet the entrance requl renents and whowlsh to enter the serv lce.- A career s t ructure for heal th workers/ technlc lane has not yet been developed,unlike nurses and nldw{ves who have recently been given a good career structure.- The referra l systero is weak, pat lentg are kept wal t ing; a referra l note isessent la l before the pat lent Ls seen, and there ls of ten no neans oft ransportat ion for referra l .- The baslc nedlcal undergraduate t ra in lng Ls curat ive orLented wi th no proPertralning in preventlve nedLclne. The currieulun is now belng revlsed.- Supervlslon and nanagenent are very weak, since the nedlcal officer at thebaslc heal th uni t ls superv lsed by the d ls t r ic t heal th of f ice which nay be 60 knalray.
(5) The Nat ional Inst i tu te of Malar ia Research and Tra in ing (NIMRT): This Inst l tu tewas establlshed on 16 May 1985 by analgaroatlng the National l lalaria Eradicatlon.TrainingCentre, Lahore, wl th the Internat lonal Centre for Medlcal Research and Tra ln ing (Univers l tyof Mary land, USA, L962-L982 and the Paklstan ldalar la Research Centre, 1982-1985). Ihetota l number of senlor s taf f in the presenc InstLtute ls seven: one Dlrector , one SenlorSclent i f ic Of f icer , one Medlcal Of f lcer , one ScLent i f lc Research Of f lcer , t ldo AssisLantSclent l f lc of f leers and one Adnln ls t rat lve Of f icer . There are two vacant Posts: onePrinclpal Research Offlcer and one Laboratory Technician. The total nunber of etaff lnplace ts 53. The preeent functlon of the Instltute le tralning and sone research lfposeible. In 1989, the fourth year of NIMRT, nine research proJects of innedlate relevanceto malarLa contro l , two oaJor workshops, the f l rs t t ra lnLng of t ra lners couroe for nalar lanlcroscoplats, and slx courses for een:tor and Junlor staff of the Malarla Control Progranmewere carried out. There ls sufflclent baslc teachlng equlpnent, but there ls no video nornlcrophone sy6ten. The Inet l tu te ls equlpped for d lsc lp l lnes of vector contro l , enEonology(lncJ.udlng i.neectarLun) and parasltology. The Instltute suffers fron a shortage of welltralned teaching and reeearch professlonal staff, and nuch of the equlprnent i.s o1d or evenobeolete. Spare part6 are diff lcult to flnd. The alr eondl.t lonlng systen ls no longercost-ef fect lve, and the Inst l tu te euf fers f rom an lnsuf f ic lent e lect r lc l ty budget tonal.ntaln adequate l lghttng and ventllatlon especlally during the hot a€3aon. The presentconflguratlon has been established wlth research ln mlnd not training. Thus, there le nota slzeable lecture roon or teachlng laboratory. However, there is sufflclent accommodatlonfor t ratn lng a8 wel l ,as research but substant ia l renovat lon wi l l be necesaary.
(O) : Thls col lege was establ ished ln 1969 ast h e I n e t t , b u t t h e n a m e w a s c h a n g e d 1 n l 9 8 0 . T h ecollege teaches publlc health adnlnlstratlon to postgraduate students to take a leadershlprole and as future teachers ln varlous speclalt les such as Publlc l lealth AdninlstratLon,Diet r lc t Heal th Of f icer , l . ted ical Super lntendent and Uunlc lpal Hea1th Of f lcer . There aremore than elx courses lncluding two degree courses run by the College which 1s located ln
vBc/90.3MAL,/90 ' 3Page 287
bulldlngs adJolnlng the NIMRT. At present, there are 13 functional dePartnents lncludfng
epldenio logy, t reaf in educat lon, b lostat l .s t lcs, and rnedlcal parasl to logy. The col lege
fac. l l l t lee whtch lnc lude a male hoste l are ln constant uae. There are good teaching
laborator i .es, c lassrooms and l lbrary fac l l l t ies. There is a facul ty of 36 professors,
aesoclate profeseors, ass ls ta-nt professors and demonsLrators. In addl t lonr there are
several vacant posts. A new Pr lnc lpal . has been appotnted 1n June 1990r and he ie
lnterested lu uPdating the currlculum leading to a Dlploma ln Pub1lc l lealth to lnclude
baslc nalar lo logy. There ls an Lnterest ln of fer ing an l8-nonth Master Degree courge inpubllc Health and Malarla, whlch would lnply that future generatlone of Distrlct Healthgf f icers would be wel l . lnst ructed in the subJects of preventLve medlc lne and rnalar la
con t ro l .
Sulenan (1988) etudled the malar ia s l tuat lon among Afghan refugees ln Paklstan. He
sunmarlzed the extent of the problen of these refugees aa rePorted by UNICEF in 1984 and
other Bources. About 3 n l l l lon Afghans have n lgrated to Paklstan e lnce 1978. The refugees
were acconnodated 1n 317 camps ln NWFP and adJacent areaa, ae well as ln Baluchlstan andpunJab. Most of the sheltera are huts bullt by the refugees thensel'ves and the rest are
t"rri". They are free to come and go fron the canps, f ind ernploynent, graze thelr animals,
and operate buslnesses. Alnost all canpe are provlded wlth baslc health unlts or
aub-hlalth units whlch tend to be underatsffed and can hardly cope wlth the hlgh lncidence
of dlsease. A nunber of national and lnternatlonal agencles, both governEental and
voluntary, are trying to provlde heaLth eervicee to the refugeee, but they are worklng
lndlvidually wlthout effectlve coordlnatlon, and practle.ally all are focusing on thort-tern
curatlve redlclne. Sulenan (]oc.clt.) polnted out that it le fuoPortant to understand how
the refugeee have affected the epldernlology of nalarla and vlce verse; and why nalarla Is
ro." pr"i"lent anongst the refugees than ln the local populatlon, before eelectlng the
appropriate control E€8suE€s. l. lalarla control. officlals ln Paklstan belleved that Afghan
refugees brought a heavy load of nalarla lnfectlons wlth thern, whlch would lnply heavy '
rellanee on therapeuttc treatsent es a strategy for nalarla control. The obJectlve of the
pre6ent s tudy waa to test th ls hypothesis , wl th the help of appropr ls te ePldenlo loglcal
iata, agalnsi the alternative hypothesle that Afghan refugees belng suaceptlble to nalarle
at the itne of ntgratlon nere at hlgh rlak of nalarla lnfectlon ln Paklstan. Should the
second hypothesls be true, current nalarla control strategy hae to be revised wlth top
prlorlty given t,o preventlve ueaeuree. Sulenan adopted the followlng procedures:
(a) Cooparleon of age-speclfic .preval,ence: Conparatlve data on age-epeclfic prevalence
of rnalarla aDong Afghan refugeee and the local populatlon were obtained by a
croaa-aectlonal earple survey ln the tlro populatlon grouPe llvlng eide by side ln a
perl-urban corornunlty at Karachl 1n Septenber 198I. This coronunity waa llaaaan Colony (Bara
Itarket) located along the super hlghway near the Liyarl rlver brldge ln the northeastern
part of old Karachf cfty. The local Dlstr:lct Health and Malarla Control offle.lals
lndlcated thet the area is highly malariours wl.th no vector control carrled out for a long
tlne. An Mghan refugee tent vll lage con$tructed a year prevlously was sltuated c1o8e to
llaesan Colony where e Pathan populaiton had been li.vlng ln seni-pucka houses for about 10
years. Local guldee helped to enunerate the refugees and local people. There were 194
iaolltee of reiugees fron different parte of Afghanlstan. Syetelnatlc sarnpllng was fqllowed
for the local populatlon, surveylng every 9th or 10th household. Cluster saopllng was
applled for Afghan refugees, slnce a sinple randon or systenatlc sanpllng was dlff lcult to
appfy partly btcause cloeely related fanll les were clusEered wlthln a conmon hedge around
ttrefr t.nte, and partly because of cultural/l lngual problens. Each fanlly ln the sanple
\ras cenau6ed by .i" ..,a sex, and thtck and thln blood smears were collected from those
coneentLng. The ianple Lncluded 35 refugee faroll les (298 persons) and 3I fanll les of the
Local populatlon (298 persone) of whorn 18!| refugees and 213 locals gave blood .smears'Blood snears were 6talned wlth Gieosa folJ[owlng standard procedure, and the elldes were
examlned nlcroscopl.cally by experlenced technicians. Those who were found poeitive for
malaria parasltee were glven standard chlorogulne treatment'
(b) Conparison of trends: Other data fron NWF province (where moet of the Afghan
refugees are set t led) were used for eompar lson of refugees and local populat lon. Annual
estltrates of roalarla prevalence ln the two groups for the period L979-L986 were obtalned
fron the provlnc ia l o i f i " " " of the Malar la Contro l Progranne and the ProJect Dl rectorate of
I lea l th for Afghan refugees. For analys ls of t rends, data per ta in lng to crude prevalence of
oalarla were used slnci age-speclflc- records were not avallable. Prevalence estinates of
vBc, /g0.3MAL/90.3Page288
1986 for both populat ions were based on data for the f l rs t seven months (January to July)
only; the remain ing est imates for 1979-1985 were based on data pooled over 12 months of
" . " i -y" . r . preval lnce data for the loca1 populat ion f ron 1979-1986, and f roru Afghan
refugles f ron 1979 through 1982 were pr inai i ly based on ACD wi th n inor contr ibut ions f rom
pCD. prevalenee est loates for Afghan refugees f ron 1983 ontards were based exclus ively on
pCD, Thls change in survel l lance procedures resul ted f ron shl f t ing the resPonsib l l l ty for
malar ia contro l f rom the Malar ia Contro l Programme to the Proiect Dl rectorate of Heal th for
Mghan refugees. Thus, the prevalence data in the t l to populat ion grouPs f ron 1983 onwards
erere not exaet ly conpaiable. However, taken wl th the pre-1983 data, they provided usefu l
ln forroat lon for conPar ing t rends over the years '
The resul ts of th is s tudy hrere sunmar lzed in abstract No- 794 ln the Troplcal Dieease
Bul let in (TDB) Vol . , March r l -a l , uy Dr Kevin Marsh who a lso cornmented on the f ind ings as
reproduced below.r
7g4. "SULEI.{AN, M. l.falarla ln Afghan refugees in_Paklstan. lrar-rsagtlgns-.ot thg R9ya1
Sociery of Tropical l , Ied ic lne and Hygiene ( t9aa) (L) 44-47. Zoo1 Dept ' Univ ' Peshawar,
Pakistan.Since l97g about 3 nil l lon Afghans have roigrated lnto Pakistan and eettled ln the
North-West Frontler provlnee and adJac.ent trlbal reglons. This refugee populatlon is
subject to nany health problens and among theee nalarla 16 lnPortant' The lncreased
preialence of nalaria tn ffgtrans cotp"."- with the local populatlon has apparently been
ascrlbed by loca1 roalaria control ofit".tats tb the lnnlgrants bringlng a large rroalarlal
load" wlth then. The author sets out to test thls hypothesle against the alternative'
1.e. , that the tmrn{grants are re lat lve ly more suscept tb le and that thei r problens 6tem f ron
ooving into a malarlous area.
Two rnethods are used. Flrst, a croas-sectlonal survey wag made I'n a recently
establlshed Afghan Eent vil lage and an establlshed Pathan communlty l lving c1os9 together
ln Ehe north-east of old Karachl city: 183 blood amears froro the Afghans and 213 blood
axnears from Pathans htere exanined. -Overall
crude prevalence rates (3]t"nodiYT=Y1* ""d
P. fa lc iparuro conbined: Afghans 13.12, Pathans 7.52) were not s lgni f lcant ly d i f ferent ;
however. ase-adJusted rate l (Afghane i t t .OZ, Pathans 6.42) were s lgnl f lcant ly d l f ferent
l#- i i . ia , - i io .oor l . No posi r lve btood f i lns were obta lned f rorn the 7 l Pathans aged
)20 years whereas the 97 Afghane ln the same age grouP had a.paraslte rate of l0Z' (Ratee
for those ag,ed 420 ye.t" t"i" L6Z tn Afghans, tfZ-ft iathans). The author lnterPrets the
age differences as indtcating that the Fathan populatlon ls subJect to hlgh nalaria
transmlssion and responds by developing lornunlty whereas the Afghan populatlon renains
sueceptlble througho,rt fff". nre secona nethod'ueed by the author is.to comPare trende ln
malarLa prevalence rates ln Afghan refugees and the local populatlon ln the North-Weet
Frontl.er Provlnce uelng secondary data iollected by the Malarla Control Departroent and the
ProJect Dl rectorate of Heal th for Afghan refugees.^ The data cover the years f ron-1979 to
1986 and relare to an exarnlned poputltton ot \Z 000-270 000 Afghane and about half a
oll l lon locale for each year. itr l anatysis showe that the prevalence- of nalarla has been
lncreaslng l lnearly ln both populations over that t l l0e perlod, with the average rate of
lncrease ln the eigh.ts (Z.tOZi belng 5 tlnes hlgher than that ln the local populatlon
(0.6I2). The authir concludes that ihls f indlng agaln suPPorts the alternatlve hypotheeie
that the Afghan refugees have faced a nuch hlgh-r rtst oe malarla on entering Pakletan'
[sone polnts Dust be nade concernlng the analysle and lnterPretatlon of the data ln
thle paper. Flrst, a6 the author Polnts out, the nil prevalence ln the Pathans aged
)20 years exaoined cross-aectfonafil is very-odd' ft i trfs ls a populatlon subject to heavy
tranemisslon, as suggestedr on" to,rid "*p""t
sone adults to have low-level Lnfections'
Thls observatlon must lead one to ."t rtr"ttr"r the 2 populatlons examined were truly
conparable or lf dlfferene.es other than acqulred lonunl.ty contrlbuted to the patterns
observed. In any case it 16 not posslble io confidently declde between the alternatlve
hypotheses cited by the author on the basls of theee daEa alone' Secondly' the differences
l. Reproduced by pernlssion of the Tropte.al Di'sease Bulletin (Dr Carolyn Brownt
Edlto;/As'lstani i lrector), Bureau of i{ygiene and Troplcal 1tedlcine, London'
vBc/90.3MAL/90.3Page 289
between the rates of lncrease of prevalence in the 2 larger populatlons cannot be
consl.dered valid as the nethod of survell lance of the Afghans but not the local populatlon
was changed ln 1982 frou active caae detectlon to passlve populatlon rnonltoring. Thls
change would inevitably lead to a large aPParent increaee ln prevalence.
Io conclusion one has to say that the data provlded are ueeful to have (although notstrong enough to prove the case) but that there la l l tt le doubt that the author Ls correct1n his view Ehat the problen of roalarla in Afghan refugees Ls nostly due t,o thetr lncreased
susceptlbll l ty, and that preventatlve control neasureE ln the canPo should be tall 'oredaccordlngly . l
Kevin Marshtt
As nent loned ear l ler , i t ls usefu l to sunmar ize studlee carr ied out 1n Indla on the
slbllng specles A and B of the An. cullcifacles conplex ln relatlon to malarla epldenlologyand control, although Indla does not fall wlthln the geographlcal area under revlew. Torelate the prevalence of the tno s lb l lng specles wl th nalar la lnc ldencer Subbarao et a l .(1988b) selected the d ls t r lc t o f Bulandshahr in western Ut tar Pradesh, nor thern Indla,where the lncldence of ualarla was hlgh, and dlstrlcts of Jaunpur and Ball la (U.P,) andSaran (Blhar) 1n the eastern part of northern Indla, where the nalarla incldence was 1ow or
alnost zero. Entonologlcal and epldenlologlcal surveys were carrled out 1n the dlstrlcts
of Bulandshahr, Jaunpur and Ball la and Saran ln May, August and Novenber 1985 and Marchf986. In each d let r lc t , tno typee of v i1 lage6 nere eelected: v l l lages wl th r lvers or wl th
extenslve canal lrrigatlon, and non-rlverlne vll lages. The procedures adoPted were as
follows 3
- E n t o n o 1 o g 1 c a 1 6 u r v e y s : I n d o o r - r e s t 1 n c s @ w e r e c o l 1 e c t e d b y h a n d c a p t u r e
b e f o r e d a w n f r o n h u o a n d w e 1 1 1 n g s a n d c a t t l e e h e d s . o ' ' 1 y @ f e n a 1 e s w e r ecollected, but the preaence of other anophellne species ttas noted ln all surveys. Fron the
total cullcifacl.ea collected, half-gravld fenales were BeParated for naklng Polytenechronosone preparatlona.
- Epldenlologlcal Burveya: Blood slldes were collected fron Persons wlth fever or
those who had euffered fron fever up to four days prior to the surveys of vll lagee ln
Bulandshahr. Fron vll lages ln Ball la, Jaunpur and Saran dl.etrlcts, blood slldee were nade
fron voluntary donors who were febrlle or afebrlle. Fever aurveya could not be conductedln these three distrlcte elnce fever caaea were very few or abaent. Blood sll 'dee were
collected fron all the flxed vll lagee lrreepectlve of the preeence of cullclfacles durlng
the entonologlcal aurveys. The s11de6 were stalned wlth JSB stalnparael tes.
exanlned for nalarla
As surnmarized by the authors, ln Bulandshahr specles A and B were found, with sPecleg
A b e i n g p r e d o n 1 n a n t . B o t h P . v 1 v a x a n d 3 : - l @ r ' e r e P r e a e n t a n d t h e s 1 1 d e p o e 1 t 1 v 1 t yrate (Spi) remal.ned hfgh (5:F9T)-t-natcat@ffittve Dalari.a transml88lon. In contraet'
ln the three easter-rr dlstrlcts, epecles B wae predonlnant with an occaslonal occurrence of
epecles A. Malaria casea were aloost absent ln Ball la and Saran, whlle ln Jaunpur the SPR
wae 10.32 in May, but decreaeed Ln later surveys to 0.5-2.92, lnd lcat lng the absence of
local transmlsslon. In the eastern dl6tricts, malarla parasltes are regularly lntroduced
fron endeolc areas through olgrant labour populatlone. Although Ag. culfcffaclee s-.1.
occurred ln both areas, in" aitterence in nalarla lnctdence appeaied to be due to the
dl f ference tn the coopoal t lon of the stb l lng speclee, 1. .e. , the predonlnance of apeclee A
ln the western d ls t r lc t and l te absence ln the eastern d ls t r lc ts . Thte substant la tes that
epeclee A ls reeponeible for actlve nalarla transnieelon, whlle speclee B ie not. The
authors assuned that the difference observed ln the coopoeltlon of the two slbllng epecles
populatl.ons Day have been due to the dlfferencea Ln thelr breedlng sltes. In the rlverine
.rfitrg"" of Buiandehahr, no nosquito breedlng was found on the rlver banks becauee of the
embankment. l lence, ln both riverlne and non-rlvertne vil lages, cullclfacLes breedlng was
obeerved only ln raLn rrater collectlonE and stagnant water ponda and poole. In contra8tt
in a l l r lver ine v l l lages in the three eastern d iet r ic ts , cu l lc l fac iee. breedlng na8 observed
on the r lver banks. In ear l ler s tudles (c l t ing Subbarao et a l ' , 1987), specles B was-
predonlnanE where r lver lne breedlng na6 observEa Ieee Subsect lon ( i ) , under 4.5 above] '
Further, the authors presented a nap showlng the prevalence of speclee A and B and the
API recorded ln the present and prevlous studles (unpubllshed data) in certaln dlstrlcts of
ofand
vBc/90.3UAL/90.3Page 290
Uttar Pradesh and Bihar , as shown here ln F ig. 281. Since the present s tudy was
in l t i a ted i n 1985 , t he l a tes t va lues o f AP I , i . e . , r eco rded i n 1984 were p lo t t ed . I n t he
dlst r lc ts of Ghazlabad, Shahjahanpur and Nain i ta l where both specles A and B were recorded
wl th specles A predomlnat ing, lhere was a h lgh nalar ia inc idence. In Gorakhpur, Saran and
Bal l la , only specles B was encountered and these areas showed a 1ow malar ia inc ldence.
Theee f ind lngs are fur ther supported by the resul ts of s tudies carr ied out in nor thern
India where Plasoodiurn spo.o"o i t "s were found nost ly in species A, though species A and B
rdere pre6enrJ;1f f i ; :Sublarao et a l . ,1987, and Subbarao et a l . , 1988a) - lsee deta i ls in
Subsect lon ( i ) undei 4.11 abovel . The present s tudy for the f l rs t t ine provides ev idence
o f t h e r e ] - a t l o n s h i p b e t w e e n t h e s i b 1 i n g s p e c i e s o f @ c o n p 1 e x a n d t h e m a 1 a r i alnc idence.
Ae shown in Subsect ion (1) under 4.12 above, Subbarao, Vasantha & Sharna (1988)
d e t e r m 1 n e d t h e s u s c e p t 1 b 1 1 1 t y 1 e v e 1 o f g @ s p e c i e s A a n d - B t o D D T ' d 1 e 1 d r 1 nand nalath ion in CtraztaUaa d ls t r ic t , UtEar Pradesh, nor thern Indla. These authors carr ied
out f le ld observat ions dur ing 1984 to invesElgate the inpact of house spraylng wi th DDT or
HCH on species A and B in Loni block of Ghaziabad district. The experfunental area ltas
dtvlded into four zones. T[ree rounds of HCH or tlto rounds of DDT ltere sPrayed at dosages
and dates shown ln Table 224. Spraylng operations were inplemented by Malarla Research
Centre pereonnel ln zones I - I I I and by State author i t ies ln zone IV. For nosqul to
sanpllng, one vll1age lras uonltored in zone IV, two vil lages ln each of z6nes I-III. The
vlJ.lage- selected Ln zone I and III were non-riverLne, whlle those of II and IV were
rlverine. In each vll lage, f lve flxed capture stations were selected conprlsing both huroan
dwelllngs and cattle sheds. Mosqultos were collected durlng July-November 1984 by four or
f lve col lectors every 2 weeks at each catching stat lons. Col lect lons l tere nade by hand
capture and the denslty per Dan hour (MHD) for $g:lgflg!!g!g s.1. for each month was
calculated. Ovar les renoved f ron hal f -grav ld females of An. cu l tc i fac les s.1. were
processed for polytene chromosome PreParatl.ons.
. As d lecusaed by the authors, HC:H has been regular ly appl ied at a dosage of 0.2g/mafor the past 9-10 years for roalar ia vector contro l Ln nost of the v l ' l lages in
nor thern Indla, lnc ludlng v l l lages of Ghaziabad d ls t r ic t in Ut tar Pradesh. In areas
eprayed wtth thls regfunen, several studies by the Malaria Research Centre have shown that
nalar la t ransmlselon ls only s l lght ly , i f a t a l l , a f fected (c i t ing Sharoa et a l . , 1983).
The relatlve proportlons of slbllsng spectes A and B in the experlnental zones sprayed with
DDI or HCH, showing responEes of these specles to the lnsectlclde sprayed, were coDParecwlth earlier obeervatlons tn both rLverlne and non-rlverlng vil lages where long-term
studles were carr led out (c l t lng Subbarao et a l . , 1987) lsee Subsect lon (1) under 4.5 and
4. l l abovel , In thoee v i l lages, specles A predonlnated throughout the year and theproportlon of species B lncreased to 5-102 after the onset of monsoon in July; the lowest
lroportton of epecles B belng in non-rlverlne vll lages, and the hlghest ProPortlons of
6pecles B were recorded during Septenber-November: 35-602 in rlverine and 16-202 ln
non-rivertne vll lages. fn thi prieent study, the proportl.ons of species A and B. $Tabl-e 22)
ln zone I (non-r iver lne) and zone IV ( r lver lne) , both sprayed wi th HCH 8t 0.29ln- ' nere
sln l lar to those observed ln ear l ler etudles (of Subbarao etra l . , 1987). In r iver lne
vll lages of zone II where the hlgher dose of l lCH was O.5 glm' was sPrayed, the densltles
of An. cullclfacles e.1. wer6 conslstently loser than ln zones I and IV sprayed at the
s t a i , d f f i - c t o . 2 g | a . [ T a b 1 e 2 2 s h o w s t h a t t h e M I l D o f A n . c u 1 1 c 1 f a c i e e s . l . w a 6conelstently lower ln zoni II durlng Septeuber-Novernberl. notE epEEIes A and B occurred ln
all the experlmental vll lages, arlth specles A predonlnatlng throughout the etudy perlod'
except Ln Novenber at the itngte rlverlne vll lage roonltored in zone IV where the ProPortlonof epecles B lncreaeed to 622 urhen the UI|D of An. cullclfacles s.1. showed an exceptional
rlse late 1n the season (33 ln November - TaUIE-Z2).- fn OOT sprayed non-rlverlne vll lages
of zone III durlng July-October, the proportlons of epecles B ltere slgniflcantly higher
t h a n 1 n a n y o f t h t t h r e e z o n e s u n d e r H C H s p r a y t n g . I n N o v e n b e r , @ " . 1 .populatlon6 nere alnost abeent fron the DDT sprayed zone III, where only one specipen
I. neproduced by permleslon of Dr S.K. SubbaraoControl Aeeoclatlon, fron the paper of Subbarao
@rniss lon of Dr S.K. Subbaraothe paper of Subbarao, Vasantha & Sharna (1988).
and the Joqrnal of the Anerlcan Mer at. (IE65',61-and lledlcal and Veterlnary Entonology, frorn
vBc,/g0. 3uAL/9O.3Page 291
Flg. 28. Proport lons of An. cu l lc i fac les e ib l lng specLes A and B
and the malar la API recorded in . " r i ;T i -d ls t r lc ts of Ut tar Pradesh
and Blhar . Shaded areas ln p le d lagrans represent the proport ion
of specles A. F igures denote API.
5.72
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vBc/90.3uAL/9O.3Page 292
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Page 293
ldent i f led aB Bpecles A was recorded. Because th lE reduct lon of specle6 A occurred j -n^ '
in non-rlverine vll lages, where species A would be expected to predorolnate, lt was taken to
lndlcate d l f ferenEla l responses of specles A and B to the lnsect ie ldes used due to greater
suacept lb l l l ty of speeies A to DDT. As shown above under 4.L2 of . Subsect lon (1) '
laboratory suscept i .b l l l ty teste conf l rned that specles A 1s Dore Euscept ib le to DDTt
whereas Uottr specfes A and B appear to be aluost conpletely reslstant to IICH (clt lng Sharoa
et a l . , 1986, and Sharna & Mehrotra, 1986). Fron a l l the above studles, Subbarao, Vasantha
& Sharrna (1oc.clt.) suggesEed that DDT spraylng would be more effectlve than HCH ln
northern Indla. Due to the predonlnant fuoportance of specles A ln northern Indiat
select lve nonl tor lng the suscept lb l l i ty 1evel of th ls specles to lnsect lc ides ehould foro
the basle for any pol lcy of insect lc ide usage. In centra l Indla, specles A and B occur ln
assocl.atlon wlth specles C and/or species D, whlle only spectes A and B have been found ln
southern Indla. Tire authors underllned that the present etudy hae an lornediate value for
appllcation ln northern India and lt w111 be necessary to neasure and nonltor the
ineecticlde reapon6e of all theee stbllng specLes wherever they are aubJected to
lnsecticldal control by means of reeldual houee spraylng, larvlcldlng and other poaslble
reasures, 60 that ef fect ive 'operat lonal reglmes can be devlsed for each sLtuat lon.
The noet up-to-date recorde of resletance of P. faleloa_rrlg to chloroqulne ln the world
have been proJected ln a nap by l l l tO (1990) as ehown ln Flg. 29 . The f-ollowlng notee are
conpl1ed fron-the avallable publlcatlone and reeords recelved by the'rt lHO Clobal Monltorlng
of 3usgeptlbll l ty of Ualarla Paraeltes to Drugsr' lnvolvlng countrles of AeLa Weet of
Indla. -
In thle area, chlorogulne-re8l8tant P. falelparuro ln the local populatlon haE been
reporred froro sourhwest Saudl Arabla (not-6'6i6-l l i lEE Dap ae reeently tested ln 1990),
Yeren (north), Ooan, Iran, Afghanletan and Pakl8tan.
I n e o u t h w e 8 t @ ' t e 8 t s 1 n d 1 c a t 1 n g r e e 1 g t a n c e w e r e c a r r l e d o u t 1 n l 9 9 0 a tShagra locality, Arda area, Glzan reglon, Southern ProvLnce.
In Yernen (north), several casea were tested ln 1989 and reported es resistant.
In Onan, 16 pereone nere tested ln Decenber 1989 at Dries, t{adl Al Asltad and at A1
Iraql, offinon two were found to have resl.stant etralns (chlldren aged 3 and 12 yeare)'
In @r Edrissi.an & Shahabi (19S5) reported the results of a prellnlnary study
arrrled 6Fon P. falclparun nalarla patlente eeleeted frou out-patLents et the lran-Shahr
Malarla l,aborat6'iflu--ugust-Novenber 1983. Whenever poeslble, oner ttto or three ulcro
and nacro Ln vltro- test6 and gtandard 7-day !r vivo chloroqulne euscePtl 'blltty test8 were
carrted oufriEh patlent. The authore enpEast-eE that ln this etudy they were
inexperlenced and the poor condltlone tn their f leld laboratory caused sone problens I 'n the
growth of paraeltes 1n th" g1g teete. Neverthelessr aDong thoee sauples ln which the
lrowth of parasltes nas suc@ 32 out of 84 with nl.cro and one out of elght nlth Dacro
iests ehowed evldence of reslstance to chloroguine ln the area etudled. One ca8e was
reslstant both ln vlvo and ln vltro (wtttr both a locally nade and the l{I lO mlcro test
klte). The autfii;6-?Tgge86Fh;Frhle etudy aeeEs to i.ndlcate that reelstance ln the area
LB at RI level.
Edrlselan (f989) further lnvestlgated the resPonse of I. -EglclPar.ug to chloroqutne and
nefloqulne ln Iran. The lnveErigatton was carrl.ed out aurri!-T9E5:i9671n Iran-Shahr area'
Sletan-Baluchestan provlnce, and Bandar Abbae and Ulnab areaa, Hormozgan provlnce'patlent8 wlth P. faie.lparurn lnfection nere eeleeted arDong outPatleDts referrlng to the
t o c a t o a 1 a r l a c b o - r a t o r y ' a n d w h e n e v e r f e a e 1 b 1 e o n e ' t i ' o o r t h r e e 4 E , q : ' o a n d . o a c r o. . - - v \ J , - r . Y - - - - - -
in vltro chloroqul.ne susceptlbtl lty te6ts were perforned for each frTGnt. The reeulte of
@t""ponsi of p. falclparuro to c.hloroquLne ehowed that the etralns of the Paraslte
r ' e r e a e n 8 i t 1 v e t o t r r E f f i i b , b u t r e s 1 8 t a n t 1 n I r a n - S h a h r a n d B a n d a r A b b a e . A n o n 8patlent8 studled, there wire tno chioroqutne-resletant P. falclparun cases ln lran-Shahr at
T ; f f i r - c 1 o b a 1 M o n 1 t o r 1 n g w e r e p r o v i d e d t h r o u g h t h e c o o P e r a t 1 o n o f M r J . H e n p e 1 ,Informatlon & Docunentatlon, CTDr lHO, Geneva.
wc/90.3MALI9o. 3Page 294
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RI level , and 13 caaea of ch loroquine res lsEance at RI and RI I levels ln Bandar Abbas' ' The
r e e u 1 t s o f t h e i n v 1 t r o a 6 6 e s a m e n t o f t h e r e s P o n 8 e o f 3 @ t o c h 1 o r o q u i n e b y t h emacro- and nle-rffishowed resistanc.e of the paraslte to chloroqutne ln lran-Shahr and
Bandar Abbas, and l ts sat l -s factory suscept lb l l l ty in Minab. The responses of P. fa lc lparunto mef loqulne ln these areas rJere general ly sat ls factory, aJ. though eone innate to lerance
was observed |n a few sporadlc caaes. Of 38 pat lents wl th chloroqulune-res is tantp. fa lc lparun detected Ly ln v iyo-^and micro and macro in v i t ry testsr 3 were Afghan
frrigrfit", 5 paklstanls, ff i of 22 Iranlans, three had travelled to Pakistan a few nonths
befo ie per fornance of the tests. In addl t ion to these res is tant cases found anrong
fore lgnl rs ln the nalar lous. areas of the southeastern Parts of l ran, 14 lnpor ted
chloroqulne-reslstant P. falcjlpergs casea were also referred to the Protozology Unit ln
Teheran since October 156'6-TiFh'ese patlents had a recrudescence af ter treatnent with a
standard dose of ch loroquine. In seven case6r ' res ls tance was detected by the nacro-
1n v l t ro test . 0 f these 14 cases, seven pat lents were fore igners: four f rorn Afghanistant
F;Ffi Bangladesh and one frou Paklstan. The other aeven were Iranlans of whom two had
returned fron Indla, and five fron Baluehestan of lran. These flndtngs Lndi-cated that
chloroqulne-reslstant P. falclparuo Btrains have been Lntroduced by lnnigrants and tourists
to the malarlous areasEiTEIElGEern parts of Iran. Bandar Abbae seens to be the extreue
westward progre6slon of the teslstance in Asia which follows the subsequent sPread fron the
origlnal focus of Thalland/Canbodla.
Edr iss ian et a l . (1989) la ter repor ted the reeul ts of ch loroquLne suscept lb l l i ty tests
carrled out on P. falclparuu caaee eelected fron anong outpatl.enEs attendlng nalarla
laboratorlee inT;;Am[; and lllnab areaa, llornozgan provlnce durlng October-Decenber
1985 and Septenber-Oetober 1987. As sunnarized by the authors, the tests showed that
conelderable reslstance to chloroquine exlsted in Bandar Abbae area. Ln Minab, there was
s t t 1 1 a h 1 g h s e n s 1 t 1 v l t y o f L - [ @ t o c h l o r o q u 1 n e . A r a t h e r h i g h n u n b e r o fchloroqulne-reslstant P. falEiZffi-IEEee were found auong Afghans and PakistanL lnnigrants
and tourlsts who nost !fiTETffintroduced the reslstant sttalns of the paraelte ln these
nalar ious areaa Ln l ran. In the n iero ln v l t ro te8ts, P. fa lc lparun waa sensi t lve to
nefloqulne in both Bandar Abbae and ulnffiever, 1n-lGilG!5ii?-1c cases the growth of
the paraslte occurred ln the presence of rather hlgh doees of the drug, uP to 3.2 lnol-/ I
blood, whlch could be consldered to result fron lnnate nefloquine tolerant or resistant
stratnE of 3:Elg!Eg ln the study areas.
I o @ , D e 1 f t n 1 ( l 9 8 9 ) d e s c r 1 b e d t h e h 1 s t o r y o f " P : f ? } c 1 P a l r r l P ^ 1 " | . : ! 1 ? i _ i n a28-year-61iia-gnan-naLe fron Kunar ln the Eaetern region, close to the Paklstanl border.
On 17 May 1986, the patient nas referred to the Central Malarla Laboratory ln Kabul as a
nalarl.a caae not responding to chloroquLne treatnent. In collaboratlon wlth the Research
Unl t o f the Inst l tu te of Malar la and Parael to logy, Kabul , Del f ln l ( loc.c l t . ) carr led out an
in vlvo teat on thls case whlch showed that an RII level of resistance of P. falclparun to
Ei6E-qulne na6 pre6ent. The patlent reeponded well to treatnent of 1500 ng sulfadoxlne *
75 ry iyrlnethanlne glven over 2 days. The dlscovery of this caee serves to lndlcate that
P. falclparun reslstant to 4-anLnoqulnollnes hae establlehed ltself ln Afghanlstan, at
G;E-frThe-area borderlng Pallstan. Stepe have been taken to follow up for at least one
week all P; falclparurn caaes detected 1n the country by phe network of malaria unite in the
varloue provl.uces.
Io 3!3!g!g, Roblnson et al. (f984) reporqed the flrst confirned case of cllnlcally
reeletan:E...T-:lctJg nalarla fron Pakletan.r oa 27 July 1984, a 3l-year-oldPaklstani,Tffiff i !-ben llvlng ln the lK fron the age of 10, returned from a 5-week vielt
to Rawalplndl, Ielaoabad, northern Paklatan. Ite had not visited any other rnnlarlous area
1n the prevlous tno years, and dld not Btop anywhere durlng hls return fltght fron
Pakletan. On ll August he showed synptoms of a 2-day history of fever, rlgors, and
eptgastrtc dlsconfort. P. falclparurn was dlagnosed froro blood flhos on 13 August and he
FTF;ffiarion commrnlcated to lllto frorn WHO/E}(RO (Mr J. Henpel) and as shown ln the
report of Far ld & Beales (1990) the f i rs t record of ch loroqulne res l .s tance in L- la l " lp . rutLn Paklstan waa shown as follows:Date Dlstrict toc.ality
Oct-Nov, Shelkhupura Tarey-da-Kott 9 8 l
Drus tested No. tested No. sensltlve Level- gl-ges-='--
G6-cL
Chloroqulne Ftvornt
vBc/90.3MAL,/90.3Page 296
was t reated wl th chloroquine. On 16 August he was apyrexla l and h is b lood f l lns were
negat ive. On 2 Septenber, he was readni t ted wi th a recurrence of fever and eplgastr ic
d i s c o n f o r t . A u r o 6 d f 1 1 n s h o w e d r e c r u d e s c e n c e o f m a 1 a r 1 a ' r ! n 3 : . I . @ .trophozoites.Ile rnade an uneventful recovery on treatment with qffi in-Fgg mg intravenously
fo l lowed by 500 mg twice dal ly for 3 days and Fansidar three tablets ' I {e renained wel l a t
fo11ow-up 4 weeks la ter . B lood f ihos were rev iewed at the Malar la Reference Laboratoryt
London Schoo1 of Hygiene and Tropical Medlc- ine, where lE was-conf i rnef th ls was the f l rs t
c a s e o f R I c h 1 o r o q ' i ' " - . " " t " t a n t 3 @ m a 1 a r i a f r o n P a k 1 s t a n . -
F o x e t a l . ( 1 9 8 5 ) d e s c r i b e d a s e r l e s o f j l n " l v o a n d l n v l t r o t e 6 t s w h i c h d e m o n s t r a t e drhe presence of chloroquine resistance in p..FaTfrFrun i;-FGiJ;5, Pakistan' The study
a r e a w a s i n K a s u r d i s t r 1 c t , a b o u t 6 0 k n s o f f i I G . ( s e e S t r i c k 1 a n d e t a 1 . ' 1 9 8 7 1 F o xet a l . , 1987 under paragraph I above). For tn ight ly rnorn ing c l ln lcs were held a l ternate ly
in three nearby v i l lages: Baghiana, PlaLr and Deoke' A11 Pat lents repor t ing to these
cllnics had flnger-prick blood sanples lrrespective of thelr synPtotrts' Thlck blood smears
were Glemsa stained and examlnea seit-quantiiat' ively' Paraslte-posltive Patlents vtlth
moderare or hlgh iensrty or r.-fglft.;"n infectionl (but negatlve for P' Ylvax) t:1 -"9:d
three years o, ror" were etiff i ff iE study. Patlents wlth high paraslte counts ltere
lncluded ln both i i . ' i . to and ln vltro tests, whereas thoee with noderate paraslte counts
were ineluded in in vlvo tests onryT As discussed by the authors, of 66 patlents folLowed
up for up to 14 d;F;Ger e.hlorogulne treatnent' 53 had parasites sensitlve to
chloroquine, 10 had parasl tes wl th ear ly RI res is tance, and three had parasi tee wl th RI I
res is tance. Of . 42 P. fa lc lparun lso lat ls lnvest lgated by in Yl t ro test6 ' 12 were
s e n s i t i v e , a r o t " L o [ " f f i 2 r e s i s t a n t t o c h 1 o r o q u t n e l _ A n e x c e 1 1 e n t c o r r e 1 a t 1 o n I ' a sfound between the ln vlvo and ln vitro tests. IE was concluded that a hlgh prevalence of
chloroquin" .""i"tff i p. tt6-arur and a high level of resletance exlst ln the area
studied in Punjab, PakisEan. the i i66rs pointel out that this drug reslstance could
explain why rhe prevalence of p. f i i i iparuP infectlon was very hlgh (averaglng 25 to 357" ot'
c1lnlc artenders) during ana ffri l i , iTEiff i?ter the naJor 1984 rnalarla transnlsglon aea8on
in the v l l lages studled, despl te the in tensive use of ch loroqulne for Ereat lng c l ln lca l ly
suspecred nalarla cases- (cit lng Zafat et al., unpubllshed). Reststant--Li!3lgllry-
malarla nlght also have lncreased ln prevalence elsewhere in PunJab, for physic' lans froro
several localitres have conmented on an apparent lack of chloroqulne efflcacy ln clinical
practlce. Investigations are needed to deiernlne the rnost effectlve yet econooical
replacement drug, Aoodlaquine, another -aminoqulnollne cornpound closely related to
chlorogulne, ha6 shown great prornlse i.n treatlng chloroquLne-resistant u}1P.3g ln
semL-lornrne Patients ln KenYa'
Following this suggestlon, Khallq et al. (r9s7) evaluated anodlaqulne a6 a rePlaeenent
drug for treatlng falclparun nalarla io tto vll lages of the above Dentloned area of south
L a h o r e , P u n j a b , P a k l s t a n , w h e r e c h l o r o g u l n e - r e s l E t a n : P : f ? l ! 1 q i l " T - h a s b e e n r e p o r t e d 'P a t 1 e n t 6 w e r e a c r e e n e d f o r m o d e r a t e o r h 1 g h d e n s i t y . e . @ r f e c t 1 o n s a t f o r t n i g h t 1 yvillage cllnlcs dur1ng NovernberD"..uiU". igAA fo" lfrffiiEEEudies and ln Decenber 1984
for the ln vlvo studles. No patlent had been treated ff iforoqulne wlthin 3 weeks of
iii.i"itffipre'enr study. As suomarLzed by the authore, amodlagulne appeared to be 4
to g tloes more effectlve than chloroqulne when P. falclparum isolates ttere tested
in vltro. However, the recrudescence rate was grea;;;f i;;-502 af ter oral treatnent with'Zii
ff i-rroii"g"r". glven over two eucces'lve days. Thls lack of therapeutlc reaPonse
fron anodlaqulne oay have been due to eelectlon of reslstant parasltes ln the study
vil lages through extenglve use of chloroqulne for presunptlve treatrnent durlng the
precedl.ng I8 nonths. The authors concluded that anodiaqllne ls not a sultable replacenent
for chloroqulne for treatlng Afcfpaiui lalarla ln the ireeent study area desplte ry
sensi t iv l ty resul te suggest lng l t would be et tecElve '
3 .
The lnfornatlon that could be traced eoncerns eone proJects ln Saudl Arabla' Yenen
(North) , I raq, I ran, Afghanlstan and Paklstan '
In Saudi Arabla, the Project of A1 llassa Oaels sets a good exanPle of a cost-effectlve
.rra rlirfrffiA:f;;tgatton schene. Bahar (1986 - unpubllsied worklng PaPer to !rno)
Tl-see footnote on Prevlous Page'
vBc,/90. 3
. MAL/gO -3Page 297
descr lbed th ls proJect and lEs achleveDenta. Al -Hassa Oasl .s ls s l tuated ln the Eastern
province of Saudl l rabia (see Flg. 9) , 150 ko south o i Da.rn and 70 kn of f the Gul f . The
area conslsts of nany oasls local l t les. At the t lne of inp lenentat lon of the proJect ln
1970, Al -Hassa had a tota l populat ion of 200 000 of whon 100 000 l lved ln two townships and
the remainlng 1n 48 vll lages and groups of houses whlch were dlspersed over the oases
area. (More recent ln fornat lon showed that 350 000 is the est lnated populat lon of the
oaaes In 1984, c i t lng t tar ld l , personal cornnunLcat lon, 1986). The oases area belongs to the
oldest i r r lgated areas ln the Mlddle East . I t 16 faooue for l ts r lch agr icu l ture
part lcu lar fy tor l ts dates. The construct lon of the i r r igat lon and dra inage syoten I tas
i t " . ted 1n 1957 and eonpleted at the end of 1971. The obJeet lves of the seherne were to
increase the area under cul t lvat lon, reduce the wastage of water , lmprove i r r lgat lon
pract ic .es, and provlde adequate water . for donest lc use. The roean del lvery of a tota l o f
162 extst lng spr lngs was about 12.4 roJ/second. Besldesathe nany snal l ar tes ian sPr lngs '
t he re ne re 36 d r i l l ed we l l s w l t h a t o ta l y i e l d o f 1 .7 n - / sec . The a rea l r r l ga ted 'by
gravity was subdlvlded lnto 14 naln canal areas, supplled wlth water frorn the lndlvidual or
lrorrp - tttc" tapped sprlngs. Froro the sprlng tapplng adJustable by gates, the nater f lows
in the Daln canal and to 1ts branches. I{and-operated gates ln the naLn canal and at the
sub-canal lntake allow the regulation of the water level and flow. Flow and water quantity
are controlled by self-recording instrunents lnstalled at the venturl Deter at each
sub-canal branchlng. This ensures che control neceasary for an optluuo weter use for each
of the 170-cana1 . i " " " , the s lze of whlch var les between 20 and 320 ha ' Af ter so i l
analys is , the f le ld s t r lp to be i r r lgated was 140 n wlde, thus represent lng the la tera l
""rr"i distance. The outlet fron the lateral canal to the field functlons by neans of a
flexlble hoee slphon whLc.h can be lnserted at any deelred spot. The salt content of the
apr lng water necesst tated a constant leachlng of the sol l . As ln f l l t ra t lon in greater
depths was imposslble due to the lnperueable layers close to the surface, dralnage had to
be provided. Separate canal syster06 for l r r lgat ion and dra lnage nerer therefore,
conatructed. . Becauee of the long distances from the eprlngs to the cultlvated areas (uP to
25 ko), as well as the eandy 6011, l inlng of the nal.n lrrigatlon c.anals and of the faru
canals was inperatlve. othenrlse, the feedtng losses would have been rnore than 402 of the
farm canals. Due to the local eondLtlons, the more expenslve but durable l lning with
re lnforced concrete, eonstructed as prefabr lcated e lenents, wae chosen as eul table for the
large scale proJeet. A total of 16 bOO tt" wae irrigated by gravlty, whlle the plote tn the
upp". southnestern part of the project area (4 000 ha) were lrrlgated slth ltater raleed by
punp stattons. The lateral dralnage canals flow lnto the eub-dralnage canale whlch' l lke
ihe-natn canale, run ln the depressions of the correspondlng areas. Followlng the natural
slope of the terraln, one oaln outfall rune to the north, dralnlng the entlre oa8la' and a
second oaln outfall runs off the end of the eastern ParE of the oaele. Both outfalle are
led off the oasis borders to deeper depreselons c.ollectlng the dralnage nater ln large
lakes (up to 5 OO0 ha), where lt evapoiates and partly lnfl l trates through the dune chalne
tosards the Gulf. Thie prevents a future converel.on into swamps. Along wlth thls Projectt
the Forestry Departrnent of the Mlnlstry of Agrlculture and lrrlgatlon has Lrnplenented a
sand stabll lzatlon progranne through t-oreetaiton at the edge of Al-Haesa oaeis, in order to
stop the sand encroacnfng lnto the fertl le land. Thle proJect has not only been suceeesful
ln arrestlng the progr""- of the sand but has Lncreased water evaporatlon by treeli t
resultlng in the .""o*'"ry of narshy lands whlch aleo helped ln ellnlnating breedlng
places. The hlstory of nalarla "tri
tt" control slnce 1948 ln both Al-Ilasea and Qatlf oasea
of the Eastern provl.nce was reviewed [see paragraph I abovel ' Parls Sreen larvicldlng was
applied at weekly intervals ln swaups, poof" atd tnat.r coursea froro 1963 to 1966' wlth no
pilrr"rr,g reeultl due to rhe vast breedlng placeB. A fortnlghtly rnaee drug adnlnlstratlon
ln the heavily lnfected locallt lee for three consecutlve rounds wae perforrned ln the autuut
of 1966, ln order to suPpress the high lnctdenc.e of nalarla' At that t im, feastbll l ty
studles for the present irrigatlon aid dralnage proJect were already ln Progresst and the
construction work rtaa gtartea ftt tgOZ. In the euroner of 1970, the proJect bee'ac
operatlonal with part of the area being lrrlgated, and by the end of 1971, the entlre oaels
area was succesefully supplled wlth naEer fron the new lrrlgatlon systen' The tot8l co6t
of the pro ject r . " g i t "o-as 33 n l l l lon US dol lars. Fron 1976 onwards, no vector contro l
11easures have been lpplled ln Al-Hasa oasls, but ACD and actlvated PCD (APCD) have been
carrLed out regularly. The total nalarla casee detected (ACD + APCD) durlng L972-L985
lnclusive rtaa as follows:
wc/go.3MALI9o.3Page 298
Pe r lodACD + APCD
Ls72-Ls8s -iffi
Actual ly , the s lngle lndigenous case was recorded Ls L972, but subsequent ly no lndigenouscases nere repor tedl near ly a l l eases detected were lnpor ted most ly f ron the southwesternpart of the country or f roro Yeoen. At the present t ine (1986), in addl t ion to APCD, and
based on entomologlcal f lnd ings, l in l ted focal larv ic ld lng is belng appl ied to reducevector densi ty to a desl rable level .
To est inate the saving of cost of vector contro l t f cont inued tn Al -Hassa oasls in the
absence of an i r r lgat ion schene, Bahar ( Ioc.c l t . ) used the cost of spraylng Propoxur asapplied ln the southern part of Iran (Hornozga\ provlnee), an area very sinllar to that of
Al-l lassa, wlth glg@! (reslstant to DDT and dleldrln) being the nain vector in both
areas. Accordlng-to-tfe calculations qf Bandar Abbas Researgh Statlon in Hornozganprovlnce, the eost of propoxur spraying at a dosage of 2 g/n' In two rounds annually was
est l .nated at US dol lare 14 per capt ta per year (cost ln 1984). Aeeordingly , the eost of asinllar programme 1n Al-Hassa oasls would have been US dollars f4 X 355 000 population(est lnate of 1984), l .e . , 4 970 000 US dol lars per year , which rePresents an aPProxlnatesavlng as a result of an efficlent deslgn and operatlon of Al-Ilassa lrrlgatlon seherne lnSaudl Arabla. Considerlng the obJectlves of Al-Hassa lrrigatlon sehener lt ean beconcluded that, wl.th correct englneerlng desl-gn and praetlcer not only dtd it producegreaEer ef f lc lency and econooy, but l t a leo reduced heal th hazards. This has led toeavings tn health care coat and at the sane tlne the productlvlty of the populationlncreased. Another achievement ls the reduetlon of hunan suffering whlch is appreclated byLndlvlduals and the conntrnlty. The posltlve achlevenenC of thls project eannot be neasuredln econonlc teros, but lts inpaet on the healthy functLoning of the cornmunlty ls beyond ,doubt .
In the southern province of Saudi Arabla (see Fig. 9), efforts have been nade tolroprove the nalarla eituatlon as revlewed under paragraph I above. Bahar (1979 -
unpubllshed worklng paper to HHO) brtefly noted that the Governnent of Saudl Arabia hasprovlded aople nater supplles for agricultural and drlnklng purposes by buildlng a dan inlJadl Glzan agd drll l lng about 40 wells ln the surroundlng area. A reservolr of70 nll l lon ro' capaclty has been constructed at the upper reaches of Wadl Glzan. Thleprovldes a perDnnent souree of water whlch provides nater runnLng permanently fron the dandown etrean and createa suitable breeding plaees for arabiensls and 6erlg!!!!. The deepwelle provlde clean water for agrl.culturi, drlnklng aii-i-ltt"-onesti;GE; However,leakage of the punp and poor malntenance of the plplng systen reault ln the ereatlon ofmore peroanent pools hlghly suitable for breeding of the two nalaria veetora.
The report of the I 'talarla Advisory Tean of the ltealth Secretariat of the Arab State ofthe Gulf Area (Farld et al., 1985) lndlcated that the shores of the lake of Glzan daoespecially those altuated at Ardah Enarah ereatee a naJor problen when the nater recededcreatlng vast areaa sultable for arabl'ensle breeding. Thie was attrlbuted to faulty deslgnof the dan that did not foresee tiffiifEfr-trazards aseociated wlth the creatlon of thelake. Ae thte dan le situated Ln an area of dlff lcult aeeeeslbil l ty to larvlcidlng teans,DDT houee spraylng hae been applled as a protectlve Deaaure. The tean euggested that theposalbll l ty of appltcatLon of ternephoe by alrcraft ueed ln agrlculture every 15 days durlngthe oalarta tranemlssion seaeon ehould be explored.
h ISg (North), Chen Kuo, Delflnl & Ahned (1986 - unpubllshed report to mto)lnvestlgEEed ae a lmO tean the health hazards aseoclated wlth the constructlon of the Maribdaro and lrrlgatlon proJect. The lnvestlgatlon was carrled out during 0etober 1985 when theconstruetlon of the dan lras progreeeLng. A eunmary of the results follows!
(f) The dan: The Marlb dan is located at the southern end of the gorge ln Jabal (=
nouotaln)TAi;i; sone 3 ko north of the slte of the anclent Shebean dan and 11 ku west ofthe totrn of Martb. It 18 deslgned to retain the excess run-off of the flash floods (known
Total slldes exarnined No . pos l t l ve C lass l f i ca t l on o f caaesIndlgenous $rlapse ftoported
608 I 0 605Unclass i f ied
,
vBc/90.3MAL/gO.3Page 299
ln Arable as Se1l) f ron the mounta lnous catchnent area, 'prov lde in ter-seasonal s torager as
wel l as to protect downstrean st ructures agalnst f loods, and contro l the re lease of water
downstrean for l r r lgat lon. I t has a top wldth of 6 n, top length of 763 rn and a maxlnum
helght of 38 u. I ts crest e levat ion ls 1228 n above sea level ( rnasl ) . I ts sp l l lway ls
located on a natura l saddle, 6 ko south of the dan s l te between the Jabal Balaq A1 Awsat
and Hagt Sawad; the crest e levat ion of the saddle ls L222 mas1. The f low of f lood \ ta ter
over the epi l lway w111 be d lscharged ,nto Wadl Al Mas1l whlch ls outs ide the pro ject - area '
The tota l catchnent area ls 10 000 km' , cover lng por t lons of Mar lb, Sana-a, Dhanar and )Belda governorates. The reservol r when. fu l l a t L222 r rasJ- , has a sur face area of 30 '5 km-
and a storage capaci ty of 396 n i lL ion ru- . The shorel ine, approxfuoate ly 27 km longr ls
largely of iocky fornatlon. Although the nornal oPeratlng range of nater 1eve1s is not
def in i le ly known at present because of the uncer la lnt les 1n hydrologlcal predict lons, i ! is
expected that iso lated pockets of water rnay be. formed ln the reservoi r oarg ins when the
nater level is lowered. 0n the reservoi r s i te , there are 50-100 households (300-400
persons) which w111 be lnundated and need to be re located. There is some vegetat lon on the
reservol r s l te .
(2) The l r r igat lon systen and dra i ry : The t r r igated area ls s i tuated on both s ldes
o f W a d i A b 1 d a t o r f f i t r e a m . T h e u p p e r l { a d 1 A b r a d i s e x c . 1 u d e d f r o nthe proJect area because of l ts unfavourabl .e sol ls and topograPhy. In the pro ject areat
water for t r r igat lon wl l l be re leased f ron the reservol r through a conblned bot ton and
irrlgatlon outiet located on the rlght abutment of the dao. At the lowest oPeratloqal
level of the reservotr (at 1198 rael), the dlse.harge capae.lty of the outlet ls 25 rn"/see.,
whlch 1s adequate to rneet the estdrnated naxlnum deroand of the lrrlgated area. The naxluun
deslgn d lechi rge capaci ty ls 35 r ' / " " " . The water d ls t r lbut lon system was descr lbed.
l r ie i ly , nater re leased f ron the reservol r wl l l f low ln the l ta ter course of Wadl Abida,
frorn whlch lt w111 flow In concrete-llned naln canale. There w111 be secondary main
canals, branch canals, and f le ld d i tehes, but these \ tere not lne luded ln the pro ject and
w111 be deslgned at a later date by natlonal engineers of the Mlnlstry of Agrle-ulture. A
toraL land o i 6570 ha (gross) w111 be l r r lgated by sur face nater af ter fu l1 developnent of
the lrrlgatlon syeten. The naln crop6 wil l be: wheat (wlnter)1 sorghum, aatze and sesane
(sunroer); lucerne, vegetables and orchards (wlnter and euoner).
The dan construction started ln January 1985 and was scheduled to be conpleted ln
Aprl1 1986. The canals were ec.heduled for completlon lnNovenber 1987, but tt was probable
that the date was advanced to Apr l l 1987. The f l rs t s tage of l r r igat lon l tas exPected to
start fron the aulrrer of 1986r lf there le sufflclent ralnfall ln the catchrnent area for
6torage ln the reservolr. If the preclpltatlon ls unfavourable thls winter, it would be
posslb le to s tar t l r r lgat ion only f ron the winter cropplng season ln 1985.
Becauee of the relatively permeable eoils and the rather steeP land s1ope, the natural
drainage of the area ls good. However, to remove water surplus resultlng froro
over-l ir lgation or operailonal errors, a surface network of dralns dlscharging dlrectly
lnto the wadlE le required. In vlew of the proxlnlty of the irrlgated land to the wadl
beds, only a eecondary network 1s necessary; lts design and constructlon have not been
lnc luded tn the pro ject .
(3) The project area and htlnan populatlon: -The proJect area 1les within the Marlb
b a s 1 n a b o e d a r o u n d W a d i A b 1 d a a s 1 t e D e r g e 6 f r o n 1 t smountainous eatchnent to flow norEheaet Lnto the Rub-Al Khall (Enpty Quarter). Although
the altitude of Marlb town ls sone 1200 m, the catchroent area of Wadi Dhanah (and
subsequently Wadt Ablda) stretches bae.k to the central hlghland plateau of Sana-a, rising
t.o heights of 3000n. Cllnatic data for the proJect and the catchroent areas are very
s"-anty. In order to e6t lDate the c l luat lc condi t lons in these areasr t ransPosi t lon of
cllnatlc data fron slnllar areas rraa necesaary and was applled in the plannlng of the Marlb
Dan and I r r igat ion proJect .
vBc, /90.3MAL,/90.3Page 300
The tota l populat ion in the Project area was 13 5f8 at the end of L977 , as est iDated
by the construc. t ion conPany based on a demographic s tudy carr ied out by a team f ron the
swiss Technical Cooperat ion serv lce Ln L975-L976. Of th is tota l PoPulat ion, lE was
est imated that 1000 were nomads, 10 000 were engaged in set t led agr icu l ture ' and the
renalnder (2518) were engaged ln other economic act iv i t ies '
(4) Epidenio logical observat igng: The team reviewed the avai lable in fornat ion on the
e p i d e n i o 1 o g i c a I s i f f i e c o u n ! r y c o n c e r n i n g m a 1 a r i a , s c h i s t o s o m i a s i s ,le ishnanias is and onchocerc ias is , and descr ibed the s i tuat ion in the pro ject area wi th
regard to malar ia and schistosonias is . As far as oalar ia ls concerned, the avai lable
inforroat ion on the d lsease and i ts vectors in the ar id s lopes reglon comes f rorn l in i ted
data recorded f roro Ghab and Jauf set t leEents which are s l tuated considerabry nor th (about
150 kn and 70 kro, respect ive ly) of the Mar ib pro ject area ' -P ' fa lc ' iparun seens to be the
predoninant spee. ies tot towea ty P. malar lae and P. ' v ivax ' In these areas ' malar la is
h y p o e n d e r n i c . B o t h @ " " @ - h . . ' " - 6 , G G c o r d e d . T h e f o 1 1 o w 1 n g 1 n f o r n a t i o nwas obrained fron pfri l- ici"-ns-wortif,ff iT6lth centres oPerating in the project area during
the tean -s v i s l t :
- Mar ib heal th centre: 0f a tota l o f approxlnate ly 100 outpat lents ger day, 5 to- I0
patients are dlagnosed both clinleally and nlcroscop_lcally as malarla cases' The maxlnum
number of cases is rec.orded during June-September. The two techniclans ln e'harge of the
laboratory were trained at the Health and Manpower Instltute in sana-a for a three year
per tod. No posl t ive s l ldes were avai lable ln the laboratory for ver l f lcat lon of the
flndings by the tean. In the dally register, some of the cases were sinply recorded ast tmalar iar t wi th no spec- ies ldent i f lcat lon '
. - A1 Husun 41 Jala l heal th ceni re: Approxfunate ly l0Z of the outPat ients (about 40
dal ly) v ie i t lng th is healch centre are dLainosed c l ln lca l ly as roalar la ' No microscopical
ldent i f icat ion of the parasl tes ls per forned'
The roaJor l ty of Pat ients at tending l lar lb heal th centre were not par t of the local
populat.ion, but were nll i tary p"."or,rr"i conlng frorn varlous regions where nalarla is known
to be endemlc. I t was d i f f lcu l t , therefore, to assess the nalar la s l tuat ion ln the proJect
. i . . - t i " i - t te adta of the heal th e.enrres. io c lar i fy the malar la s l tuat ion, longl tudlnal '
para ls to logical and entomologlcal surveys need to be c.arr led out 1n the area ' The f l rs t o f
sueh surveys nas organlzed by the teao iuring the thlrd week of october 1985 ln
col laborat ion wi th the roalar ia proJect s taf f '
( 5 ) E p l d e n l o l o g l c a l f o r e c a s t s : T h e t e a n g a v e e p l d e n l o l o g l c . a l f o r e c a e t s r e g a r d i n gp a r a s 1 t i c d i s e a s e G 1 f f i r E h t h e d e v e 1 o P n e n t o f w a t e r r e s o u r c e s c 1 a s s l . f y 1 n garbl t rar l ly the pro ject area aa fo l lows:
(a) The reservoi r : The reservoi r wi l l const l tu te the largest water sur face ln the
area, If the lrater ln the reservoir can be malntal,ned at a relatively hlgh levelt the
shorellne wll l eonslst prlnarlLy of rock fornatlon' The posalbll l ty of ehorellne
vegetation ln eue.h a slluatlon w111 be low, and conseq,t"tt l l 'y the reservolr nay not Provlde
roaJor habltats for breedlng of toopt"ffrr.s and- snaLls' However, the water level w111
fluctuate durlng routlne oPeratlons. It 16, therefore, probable that pockets of stagnant
rrater of varlous slzes and duratioi *y be iorned along the shorellne of the reservolr'
Should aquatlc vegetatlon be able to gron ln-and "ro,rnd
these vtater collectlonst Potential
vectors of naLarll (arablensls and seigentll) and lnternedlate ho6ts of schietosomlasls
(Bulinus trune.arus .{3. ff"fff"r$-fi8;Ay ldentlfted in the arid slopes reglon' nay
gradually and eventually reae.h tt"=ptoi""t irea' - Besldes whlch the fundaroental l lnk for
transmlsslon wil l be the human etenlnt. It would seem that the rather hostl le envlronnent
ln the lnrnediate vlcinity of the reservolr (nostly rocks and stones) do not favour the
estabLlshnent of perDanent human settletrents. Plans to resettle the existing snall
populatlon are belng consldered. Nevertheless, the nomadlc populatlon nay have accegs to
the reservolr, but iocal authorlt les are planning to guard all a"'"tsses to the reservolr
area and Prevent nan/water contact'
(b) The existing nater equlE! _91_!e41
wc/go.3MAL/90.3Page 301.
and two a f . r " t " fon" : A t Present( 0 e t o b e r l 9 8 5 ) e 1 s s o m e d e s e r t - t y p e v e g e t a t i o ngrowing along the wadt bed and banks. onc.e the water starte to flow fron the reservolr to
in" r .a t , changes ln the f lora of the wadl bed and banks are !o be expected. Eventual ly '
due to the aval labl1 l ty of water , aquat ic f lora would be establ ished and the terrestr ia l
f lora a long the banks would thr lve. The ecological successlon of f lora ln and a long the
wadi , coupled wi th the cont lnuous presence of erater , would create a sul table envl ronment
for snal l populat lons, and breeding habi tats for rnalar la vectors. I luman carr iers of
roalar la and schistosomlasis are a l ready present ln the Project area, and thei r nunbers are
expected to lncrease in future. 0f par t lcu lar lnpor tancer ln re lat lon to sueh a r lsk, are
two secondary reservol rs resul t ing f rorn two d ivers ions: A and B. The former, wi th i ts
expected shal low water , nay become an ideal breedlng p lace par t lcu lar ly for anophel lnes,
wtr11e the latter, wlth its larger voluroe of water and greater depth may become a
recreat iona) . pool for the populat lon, hence the r lsk of sehlstosomiasis t ransuiss lon.
(c) The norrh and south canals f rog d lyegslon-P: Aceordtng- to the ex ls t lng
e n g i n e e r l n g a e i w r r r u e 1 l n e d a n d w o u l d , t h e r e f o r e , b euniu l table for breedlng nosqul to larvae and snal ls . Besides ' l t ls exPeeted that the
veloc l ty of the warer i for (O.O to I .4 n/sec) wt l l be suf f lc lent to d lscourage breeding of
anopheline larvae (the tean deflned the nlninun velocity to wash altay Dosquito larvae ae
belng in the range of 0.13 to 0.17 ro/sec) . However, i f the canals are not proper ly
nalniained, .ra.i" Day appear ln the sldes, enall pools nay be forroed fron eeepagesr and
vegetatLon nay grow oltela" and along the canals whlch nay becone favourable for breedlng
of anophellne l irvae and interruedlate hosts of eehlstosomlasls. It le not posslble to
predlct the consequences of nlnor canals on the transnlsslon of ltater-aaaoclated Para6ltlcd i " " . " " " as no p lans or .deslgns have been prepared for th is type of water course. Howevert
experience elsewhere has shown that snaller canals create nore probleros than naJor ones'
This could be t rue ln the Project area a lso.
(d) I r r igated f ie tds: Accunulat lon of sur face l ta ter ln l r r lgated f le lds 1s not
e x p e c t e d t o o c f f i . F i e 1 a t 1 v e 1 y p e r n e a b 1 e s o 1 1 , t h e h 1 g h r a t e o f e v a p o r a t l ' o n a n dth l p lanned i r r lgat lon and cul t lvat ion pat terna. Therefore ' the l r r lgated f le lde should
not constltute an area of concern wlt,h reepect to water-aaaoclated vector-borne dlseasee'
In concluslon, the above revl.ew lndlcates that nalarla and schietosomlasls are two
l lke ly candldate paraslc lc d lseases to establ lsh theroselves endeolcal ly , wl th probable
recurient nalarla epldenic wave6, ln the proJect area, unless Preventive neasures are
tfuoely and adequately aPPlied.
Flnally, the tean reeommended the following:
PreventLon of creat breedln habl tats for ualar ia vectors snall lnternedlate
hosts schletosonias
(.) E@: Since the reservolr nargln le largely rocky and the Governoent
intends to profiff i?ft lenent around lt and restrlct access, the reservoir ltself would
ntost probably not represent a health hazard. However, the reservoir ehorellne should be
kept under "1o""
obslrvatlon. If and when vegetatlon grolts and people_ are frequentlng the
shores, l t would be prudent that depressione on the reservol r oarg lns be e l ther f l l led 1n
to form a eonti.nuous donnelope tonards the botton, or provlded wlth sultable dralns to
conneet then wlth the naln blay of water, so that seParate water coll 'ecttons w111 not be
forned when the nater level Le lowered durlng routlng operatlons.
(b) I-{adl course: Thie, together wlth the nater pools behlnd the tlto dlverslon
welrs, could b€-fr;ff i troublesoni component of the whole lrrlgation system as f ar as
vector-borne and water-asaociated dlseases are concerned, because of lts relatlvely shallow
shorellnes where vegetatlon ts l lkely to grow. Ae the wadl beds are -sandy, there w111 be
sode seouring, silt ing and "orr""q,r"t!
meanderlng of the wadl-course durlng the first t lto or
three years of operatlon. It ls etrongly recoornended that the banks of the sadl and water
pools be kept under close observatiorrr-.rrd approprlate renedial actlon be taken' If and
when nosguito larvae and/or enalls are tounar-ttcirannel f lushlngtt should be practised once
( l )o f
vBC/90 .3MAL/90. 3Page 302
a week, by re leasing a large-quant i ty of nater ! t9 t . lh" reservol r for a shor t per iod ' to
wash larvae and srra i ls away f ron t te i r protected-habl tats to exposed p laees where they nay
be destroyed by adverse envi ronment" i - t " " to t " ' I t should be pois ib le to aPPropr iate ly
lncorporate the channel f lushisng t !q t ' i i " t " " t ln to the rout lne reservoi r operat ional
schedule, so that the f lushlng water would not be r tasted but ef fec ' t ive ly used for
lrrigation downs tream'
( . ) P @ : T h e n e e d f o r a d r a l n a g e n e t w o r k t o r e m o v e i r r i g a t i o n w a t e r s u r p l u s
has been ldent l f led by the responsi ; l " " "gr t " i t '
As surp lus water f rorn i r r igat ion usual ly
creates habl tat .s for d isease vectors and Intermediate t rosts, the provis ion of a suiEsble
drainage network should not be unduly delayed'
( d ) M i n o r c a n a } s : A s . n e n t i o n e d a b o v e , e x p e r i e n c e h a s s h o w n t h a t s n a l l e . a n a l s
usualJ.y create nore problems than,"3o. ones, hence i t is s t rongly recomnended that minor
canals should be so designed as to naintain a reasonably high fiow velocity and that they
should also be .o,r"'"t"-I lned 1lke the nain canals'
( g ) E f f i c l e n t n 4 n t e n a ? ! ! : I n o r d e r t o e n s u r e P r o P e r f u n c t l o n l n g a n d d u r a b i l l t yof the varlous stff itures 1n an it i ig"l i"" system' tlnely tt lttt"tt"o"e ls essential ' A
progra'me for rouglne malntenance of-the reslrvoir' ehorll ines' the marginal drainage
sy6ter06, the wadi uants, canals "r,i-aiitt '"s
and ttre various apiropriate structures' should
be prepared, adequately budgetea for-ina efflc.iently iuplernented' Vegetation removal
snolfa-foru an lntegral part of the maintenance Progranme'
(2) Preventlon 9f gontatnl-nat199 vtlgb-1199999'-agents: In areaa of settlenent or
reaegrlenent of populations, o.onesEffitei-uPPly aif ianltatlon facil l t ies should be
adequately .rra "oi.r.niently
provfaei. These facll l t les wll l not only have a direct lnpact
on the 6chistosomlasls t ransmiss lo i -pote" t ia l , but wl11 a lso Prevent uany cases of
pathologlcal gastro-intestlnal "yrra.'oi""
particularly lnfant dlarrhoeal dlseases already
highlY Prevalent in the 3re3'
(3) Prevention of oan,/vector and nan/wate!-teq!4!g
(") "1"d::::":.::::ill'r" new and o1d settle'enra
- l lealth educatlon for self-protec.tl;;,ttt '"tt uay lnc'lude the use of roosqulto
coi ls or rePel lents '
,,, ";"iiil:l' i::.i:.*;:'l::r:i":'.?';:;::ti:'i:'::":lili"I"iii:v:.*:'above, rlay reDove one of the najor rr""d" for dlrect nan/water contact' The following
;;;i;i";'i'""":';:J3!tt; lil"Hi;::"::::i:"toav "toord
be prohibited and wavs leadlng to
ltrlinillttiu"."or,u.ry reservorrs and canals should be prohibited' .
: :::i:i1'r::'iFlil"h':l;;::l::*: "';::l':: i:' J::if"::l ::::?*i;'carrlers in the ee.t area: A11 new
(4) Prevent ion o: in t rodue-t lon of DaFaslqe ' caTr-Lgfg ' ln Ene I ' tuJ- r^ . '^ lannant atea
" i l r ra oe-Ecreeneo ior - 'a l 'a ; stosomlasis and' '
@area should be Screeneo Ior | !arase t t le rs cou lng t t - ^^ -^ -
A11 nnc{ i {ve cases shourd be t rea ted and followed uP. Thtsother parasl t lc d lseasee' A11 poal t l " :
:?"" ::::il il 'nl^.!'tr*."-r"."g.ated irealth deliverv svste' whlch should be develoPed ln the
proJect area aa lndlcated below'
(5) EPldgrdologtcal surveil lance: This w111 have two aspects:
1.; corrrrrruo,r" rottrgogrt g =tt toleh lt,o,i""l-!"iltl, lnf t?i!IE!ilt"'- As a prerequlslte fiffiuoG, theTaT;f,-Infiastruffire of the projec't
area and lts health dellvery aysteEs need to be stre.,gltrened and-reoriented before the
irrigarlon scheoe ie fully conpletei itial"ia-i987) aia new populatlon settles ln the area'
- priroary health ."r" rork"rs should u"-t""po."iu1" fot. detectlng posltlve
ca6ea. glvlng treatDent Lr referrlrrg-at"t to health .'"itit"l They should also be tral'ned ln
vBc,/90. 3nAL,/90. 3Page 303
ldent l f icat ion of Dosqul to larvae and a few speci f lc snal l specles. These f lnd ings shouldbe recorded on forrns and reported to the supervisors regularly.
- At present , the two heal th centrea e.over a 1ocal populat lon of about16 000. Thelr s taf f need reor lentat lon courses to f l t heal th prLor l t les (actual andfuture) of the proJect area and the mechanisns of developing a PHC system. Refreshercoursea ln laboratory techniques are a lso requi red. Lt is foreseen that the populat lon ofthe proJect area w111 reach 28 000 ( inc luding faro lng and non-farn ing populat ions) . Such apopulatlon increase c.an be easl1y taken care of by the Present health centres wlth theaddl t lon of an appropr iate number of heal th unl ts ( l l such unl ts tor 28 000 inhabl tants) .
- Heal th centres should subnl t roonth ly repor ts to centra l bodles ( tn Mar iband Sana-a) responsib le for the heal th asPects of the developnent proJect .
(6) Correct lve neasures: Speedy renedla l Deasures are !o be appl led when requl redthrough a col laborat ive ef for t o f :
- Developroent pro ject adnln is t rat lve author l t ies and bodies- Mlnistry of ltealth and Minlstry of AgrLculture- Specla l lzed heal th teans wl th in the Uin is t ry of l lea l th- Local heal th author l t les and serv icee
Marlb connunityr.
In Southern Yemen, Zahar (1985) rev lewlng the ln fornat lon g iven by Nasl r (1984 -
unpubttsE?E-?Ei6ffi-mO) coverl.ng that area, noted that for agricultural development,efforts have been made to conaerve flood waters which run through rnany wadls to the sea.Construc.tlon of dans and developnent of lrrigatlon systelos already exist ln l{adl Tuban lnthe 2nd Governorate and l{adL Bana ln the 3rd Governorate. More dams are belng constructedln the 4th, 5th and 6th Governorates. Although agrLcultural developnenc has greatlylnproved the economlc status and led to prosperlty of the population, it provldedfavourable breedlng sltes fo" gIgll9glg and consequently the nalarla threat Lnereased. Inthe agricultural areaa of lUyaiA6ilf.atrel , where there ls a roaxlnuu agrlcultural yieldr-nalarla le prevalent and any laxlty in control operations could have most serlouerepercussiono on the hunan populatlon.
In ]gl$, the only lnfonnatlon avallable on roalarla and its vectors ln water-reaourcegproJeets Cones fron the old obeervations of l lacan (1950) carrled out durlng May-June 1943ln the vtclnlty of Hlndlya barrage sltuated on the Euphrates rlver. No new lnfornatloncould be traced on the nalarla sltuatlon ln thls barrage area, nor any otherwater-reaourcea and other developnent proJects in lraq. l lowever, the rec.ent oalarla'Bltuation resulting fron the nalarla eradicatlon progranme ln the country as a whole haebeen revlewed under paragraph I above.
In lran, ZaIa, Manouchehrl & Ershadl (1983) carrled out a faunistlc ourvey ln Minabarea for a year comencl.ng January 1982, to lnvestlgate the potentlal hazards associatedwlth the newly constructed l l lnab dan ln lnereaslng trosqul.to-transmitted dlseases. ForthLe, eanpllng of 4th lnstar larvae fron different types of breedlng places wae i.arrled outln lt lnab area as well as four surroundlng distrlcts. About 4000 nosqulto larvae belonglngto 17 epecl.es and four genera were collected. Apart fron specles cauelng great nulsance bytheir blt lng, there were species ksown to be of ruedlcal and veterlnary loportance. Fourlnportant nalarla vectors nere recorded: ggg@!, egp35g!g!gg, 1f.t1"t111" and 9-thall.Also, sone culiclne speeles knonn to transmit arboviiuses present in the area or brought lnby utgrating blrds frorn Afrlca, nere encountered. ltell planned studles, preferably startedbefore the utl l lzatl.on of the dan, would prevent the posslble health hazards associatedwlth lt. No other LnfornatLon could be traced on nalaria and lts vectora ln othernater-reaources aod developnent proJects ln Lran.
In g.ghan@ (see roap ln Flg. l4b), Bahar (L977 - unpubllshed report to !fHO)reviewed the s l tuat lon of nalar la and l ts contro l in l r r lgat lon proJects in the Southernreglod as rrell as the Central-Eaetern reglon which lncludes Kabul clty.
The Southern reglon lncludes four oalarla unlts: Kandahar, I{elmand, Uruzgan and Zabulwith the headquarters belng ln Kandahar clty. Itelnand valley unlt ls econonicallylnportant and has recelved hlgh prlorlty for malarla control. I lelnand valley proJeet ls
vBc/90.3MAL/gO.3Page 304
one of the largest l r r igat ion pro jects undertaken by the Government . The water is prov ided
froro the Helnand r iver ihrough the construct ion o{ a 90 n h igh rock- f i l l dan across the
r lver . Reservol r gross stor"ge is 1650 mi l l ion n ' . About 8500 ha are being l r r igated at
present in the rpf , " r Helmand basin. in order to wash the land and f ree i t f roxo mineral
" ' .1 i a"po" i ts , 1 t was p lanned to d ig 4000 km of dra ins to carry the water back to the
r iver . As a resul t o f th is pro ject , vector breeding s i t .es great ly lncreased. Malar ia
inc idence increased year by year as the i r r igat lon schene expanded. The API (c i t ing
Mr N . Eshghy ) f o r t he y " " r " I g74 ,1975 and the f i r s t 8 roon ths o f L976 e re re : 30 .22 , 40 '22
a n d 5 0 % , i e s p e c t i v e 1 y . E n t o n o 1 o g i c a 1 o b s e r v a t i o n s s h o w e d t h a t . ! r y - a n d s ! e P F e n s iwere breeding in the nain eanals. Dur ing 1976, depending on the suscept ib l l i ty of the
vectors to insect ic ides, se lect ive focal spraying was carr ied out e iEher by one round of
DDT or t\ro rounds of rnalathion. In addition, anti larval rneasures ltere iroplenented by
seeding G. af f in is in breeding p laces.
The Centra l -Eastern region conpr ises 11 uni ts ine luding Kabul c i ty . Recent lyr l t has
been sub-div ided into two separaEe regions: the centra l wi th i ts headquarters in Kabul , and
the Eastern wi th i ts headqu" i t " r " ln Jala labad. The Centra l region compr ises s lx uni te:
Kabul , parwan, Ghazni , Khost and Shahr is tan. The Eastern region conpr lses f lve uni ts :
Jala labad, Kunar, Laghroan, Ghazlabad and Kapisa. In the Eastern region, Ja la labad and
Ghazlabad whlch are parts of Nangarhar province were visited by the author. Nangarhar
province has a population of 840 000 of whon 150 000 l1ve ln Jalalabad town. Thls provlnce
is econonically very lnportant. Due to the favourable c.lfuoate and the Nangarhar lrrigation
project , 45 00b na aaat t tonal land could be brought under l r r lgat lon. The dan ls s l tuated
on Kabul rlver and the nain lrrlgatlon canal wae completed ln L969/L970. The expanslon of
l r r lgat ion and dra lnage cont l4ued. The API was probably lncreasing s lnce ln 1975 malar la
cases in Jalalabad weie at an epidenic level. Thls was conEalned by roass drug
adnln ls t rat ion and emergency focal house spraylng wi th nalath lon Ln the heavl ly af fected
loe.a l i t ies. L i rn i ted Larval contro l r " . " , t t l " inc ludtng larv lc id ing and d ls t r lbut lon of
Garobusla were belng inplenented ln Jalalabad town. Here the naln canal ls dlverted frou
;m=;fi"i" a"r crossing from east to west in the northern part of the town. The level of
the canal- is 10-15 n hilher than the ground of the town. The canal ls not l lned, so the
water infl l trates the giouna and seeps out all over the town. Durlng the ralny season, the
water seep8 ins ide houses and forees the res ldents to move out . These seepages create
favourable breedlng s l tes for nalar ia vectors. . The s l tuat lon was aggravated by d lgglng a
drainage canal p"..tt"l to the nain canal to draln the water percolated to the ground fron
the maln canal before reachlng the centre of the town. With the poor rnalntenance of the
draln, breeding p laces developed, af ter the execuclon of the Nangarhar proJect ; i t seens
that no organlaatlon has been responslble for the maintenance of canals and dralns' In
addltion, water Danagenent ln the flelds ls not efflClent. This causes not only lose of an
enormoua aoount of witer, but also creates vast vector breedlng areaa. At the tloe of
these observatlons, nalaila rdas being transmltted ln Jalalabad town and the situation nas
crit lcal. rn Ghazlabad nalarla unit, where land dlstributLon was lnplenented by the
Government after the conpletlon of the lrrigatlon schene, a grouP of 40 fanll ies moved to
the area. Alnost all menbers of the, fanll les contracted oalarla and had to abandon thelr
land and return to the hlghlands.
Bahar ( loc.c l t . ) fur ther descr lbed the s l tuat lon ln Kabul e l ty . The c i ty I 's located
in the centre of a valley where the Kabul rlver f lows fron north to south wlth nany
trlbutarles Joinlng lt. Thls results in a hlgh underground water level ln Kabul, and I 'n
sone places durlng and after the ralny se"sott, the, waEer seePs out formlng narshy areasr
whlch are suitabr! tor mosgulro breeding. Alihough the nalarla lneidence was not very hlgb
ln Kabul c.lty, the hlgh denstty of vect;rs and lnflux of nalaria cases fron the outsklrts
always makes possible the occurrence of outbreal(sof nalarla. Moreover, mosqulto bit lng is
a nulsance to lnhabitants. For nosqulto control wlthln Kabul c.ltyr antLlarval oeasures
were lmplemented. These measurea cooprlsed the dlstrlbutlon of Ganbusla and oll
Larvlcidlng (dlesel o11 nlxed"wfth 107 crank o11 and 2Z Trlton X=im)-; all breeding
places. A total ;; ;OO 000-;2 nas to be treated weekly. For more Penanent control ' the
provislon of eewerage systems and proper dralnage of eicesslve rtater ls highly reconmended'
vBc, /90.3MAL,/90 ' 3
, Page 305
Changes ln land ut l l lzat ion has of ten ln f luenced the nalar ia e l tuat lon ' I {ard (1977)
gave the Kunduz valley in northern Afghanistan a6 an excellent exarnple of a conplete ehange
in the epldenlo logy o i roalar ia ln a deser t -s tePpe habl tat . About 15 years ago' Pr lor to
lnt roduct lon of r r r rgatron ln the Kunduz val ley, superplc tus was eonsidered the nost
lnpor tant veclor of roalar la in th ls area. I ts la lvae bred in the only source of water :
" " "p"g"" of fa i r ly c lean vrater at the foot of snal l h t l ls . A nunber of other anophel lne
"p"" t - " were present but were of 1 i t t le or no importance in roalar ia l ransmlss lon '
fo l lowfng the in t roduct ion of l r r lgat lon, large scale agr icu l tura l scheroes were developed
ln the.r r t t "y which led to cul t ivat ion of r lce, cot t .on and nelons as the naln crops '
AssocLated nas an increase ln both human ancl cattle populations. Consequently, glS41S
dlsappeared froro the Kunduz valley as lts natural breedlng sltes becaroe contamlnated froro
tt" ""tfufty
of nan and cat,t le. New larval habitaEs ttere crealed by the standlng water ln
r ice f ie lds, over f low f rom l r r lgat lon d l tches and pol lu ted seepages' These provlded ldeal
breedlng condi t lons for pulcher i lnus ear ly ln the, t ransnl .ss ion season and^for .hyrcanus
towards the end of the sEiso-ilncldence of ?. vivax roae fron 5 xo 25X ln some
vll lages over a perlod of three years as a conaequencil? the vectorial changes' Durlng
the l t7o.s, nalar ia contro l became dl f f lcu l t because of DDT reeistance ln hvrcanus and
pulcherri lous, although susceptlbre, was found to avold surfaces sprayed vtfi i iSbE-[See rnore- -deta i ls ln Subsecf io i t r l , r r r i " t 3 .6/3.7, and under 3.12 for DDT res ls tance ln pulchsrr lnus-
whlch was recorded later]. Transnlesion was further facll l tated by the hablts of the local
lnhabltants. DurLng the rnelon harvestlng 6eason, the peopl'e slept ln the flelds near thelr
crops and durlng the hot sumlner Donths, nost of the vll lagers slept outdoors ln courtyards
which are near cagtle wlth no Proteetive Deasurea agalnst nosqulto bites
1o @, Eome lnf oroatlon is avallable on the effer:t, of lrrlgatlon assoclated with
the con6truct ion of cer la in dams on nalar la and l ts veetor6. Bahar (L979 'unpubl lehed
worklng paper to I{t lO) referred to the Indus basln where the lrrlgatlon netsork was a
blessiig tL ttre country for provldlng food and other agrlcultural products; hrater logglng'
however, hae provided Lxcel lent breedlng p laees for nalar la vectora: . i11!1!?!1" :^ :y . - - .
stephensl, aue to the absence of an effie-lent dralnage systeD' Three huge dans have been
construeted, namely l larsak, Mangala and Tarbela, whlch are expected to aggravate the
nalarla sltuation and other water related health hazards unless preventlve Deaoures are
raken. observations by lthe late] Dr S.M. ]luJtaba and Mr S' Ifttkhar Ahned, Ln one
dlstrlct before and after the construction of the Mangala dam on the shelon rlver southeast
of Islanabad, l l luetrated the lnpact of thls water-reaoureeE developuent Echeme on the
nalar la s i tuat lon in Mlr fur d ls t r lc t . The SPR increased f ron 0 '0257 I t L969 to 2 '257 ta
1975 when lntensive meaaurea had to be applled. Malarla control costs the Governoent of
Paklstan every year about 20 rdll ion US aottars. Proper deslgn and managenent of the
above-roentioned developnent projects would reduce the need for chenlcal control, and thus
nlnlmize the danger of- creatlng vector res{'stane.e to lnsectl'cldes'
Rathor (1987) polnted to the Ghashrna Right Bank Cana1 (GRBC) ln Pakistan' as an
example of how, Ln -ttre
absence of careful pl.anntng, nan-roade Lrrlgatlon scheDes can reeult
in the for! 'atlon of uncontrolled nater bodtes whlch provlde breedlng sites for vectore of
malarla and other dtseases. Ihe GRBC is an trrlgation canal brane.hl.ng off frorn the-rlght
bank of the Indue river at the Ghashna barrage "ta
t" envlsaged to run for alnost 270 kn'
Its branches and mlnor canals w111 run for an aggregate of another 650 kn to brlng the
water to lrrlgate 140 000 ha ln NWFP and 88 000-ha ln PunJab provlnce when flnally
conrnlss ioned ln 199l -1992. Dur lng stage l , 1 .e. , when the f l re t 38 kD of the canal were
te6ted, lt wae observed that the canal-losi water through the bed and-shoulders' In
certaln parts, seePage was a8 hlgh ae 451 of the flow of the canal' This nater nas not
only lost but eubnerged the standlng croP8, affected nearby vll lages and produced breedlng
places for vectore oi nalarla and oit"r vector-borne d18ea8es. Renedlal oeaaures such ae
llntng of the canal and constructl.on of dralns to take care of seePages are exPected to
rectlfy the sttuation. The secondary and tertlary dlEtrlbutlon channels also play a
s 1 g n 1 f 1 c a n t r o I e l n p r o p a g a t i o n o f n a 1 a r 1 a v e c t o r s . F o r e x a n p l e , ! @ , t h e B o s tlnportant nalaria .r""tot in Pakistan, thrives ln slow flowlng freeh rtater tertiary
channels. The water seeplng or leaking fron these e.hannels forna very ehallow fresh water
p o o 1 s w h 1 c h b e e o m e i d e a 1 b r i e d 1 n g p 1 a c ! s f o r @ . A 1 1 t h 1 s l e a d s t o a n 1 n c r e a g eln oalarla transmleslon.
vBc lgo .3MAL,/90.3Page 306
As par t of developDent , urbanlzat lon has been progressing ln nany countr ies ' In the
present leographical a iea, Karachl e. i ty is a good exanple of the ef fect of uncontro l led
urbanlzat ion on nalar la whlch has recelved the at tent lon of several authors ' Rahrnan &
Mutta l lb (Lg67/1968) cr i t ica l ly rev iewed prevlous studies in the Karachi area which
lndlcated that nalar la t ransnlss lon ex is ted not in the c i ty but in local i t ies outs lde wl th
c.u l ic i fac ies as the vector . I t was on the basis of these studies that the Malar ia
i f f i p ' o g ' . ' ' " d i d n o t i n c 1 u d e u r b a n a r e a s h a v 1 n g 2 0 0 0 0 p o p u 1 a t i o n o r n o r e i n t h eplan of operat ion for Pakistan. However, Rahman & I lu t ta l tb ( loc 'c i t ' ) and Rahnan et a l '
(1967/ f968) denonstrated that malar ia t ransmiss ion ex is ted in Karachi c l ty proper and for
the f i rs t t lne ine.r funlnated stephegsi as the pr inc lpal vector Isee subseet lon ( i ) under
4.12 abovel . These authors i loTfEa references indicat lng that roalar ia ex is ted
noderate ly in Karachl dur lng the 1930-s, and af ter Par t i t lon many lnnigranEs f locked to the
cl ty f ron aI I par ts of the indo-Paklstan subcont inent , thus the reservoi r of ln fect lon
increased.
Bahar ( Ig7g - unpubl ished work lng PaPer to wHo) pointed out that inadeguate sewerage
systens and waste wat ; r d lsposal t . t t . ! " t " t t t ln urban areas, especia l ly in Karachi have
establ ished nalar ia as an urban d lseale. In Karachi c . l ty , lmprovements in the water supply
secror have progressed steadi ly o ler the last few decadSs: ?:11y t : : : t aval lable to the
c l t y has Lnc reased f ron l l 4 00b r ' l r r 1952 to 348 000 n - i n 1978 , w i t h 332 o f t he
popl la t ion recelv ing nater !n 1978 by d i rect houee conneet lon. Thus, the bulk of c i ty
lraste water f inds lfs way Lnto the slrface drainage systen whlch ls poorly malntained'
creating stagnant pools, or ae.curnulates Ln pools ln low lytng areas, or f inds lts way to
two rlvers wlth sluggtsir rtow and high water table. The resultlng rnarshy condltions were
sul table for breedl iE of g lgp$l , ' the pr lnc ipal vector . Consequent ly , malarLa contro l is
an addltional burden on ttre treErttr budget of the nunlclpality.
Ward (1977) a lso sumnar l .zed the causes of deter lorat ion of the nalar ia s l tuat ion in
Karachi . S ince 1941, Karaehl has experLenced considerable populat lon growth ' Froro a-
popu la t l on o f 387 OO0 tn 1941 , t he m l t ropo l l s g ree t t o an es t lma ted 3 '8 n l l l l on i n 1968 '
The c l lnate of Karachl ls hot wl th n in lnal ra infa l l , and the c l ty ls surrounded by
seml-deser t . Under thege condtc ions, a rapid increase ln roalar ia occurred f rorn 1966 to the
nlddle of 1968 when lt was esrluated that 1O-ZOZ of the populatlon or 400 000-800 000
people were in fected wl th oalar ia . The vector was ident i f led as st rePhensi ._ Anophel ine
larvae were found breeding throughout the clty in surface water sultr as pools froro leaks in
the pubJ.lc water ayatem, in household water slorage containers and ln effluents froro sewage
creatnent plants. Thls water cane froo as far anay as 160 km fron the clty. The rnaLaria
epidenlc was clearly attrlbuted to problens in eta6te nater manageDent which were beyond the
control of the nuniclpality at the tine: senage effluent was dlseharged lnto adJoinlng dry
rlver beds where stephensl bred abundantly. A US tean of public health investigators
recommended sourcE reductLon proeedures.
Recently, a parasltologlcal/entonologlcal survey was carrled out durlng
Septenber-Oelober l98l to re-aaseas the nalarla sltuatlon 1n Karachl as reported by Nal' ln
er a l . (1985) [see resul ts of larval surveys ln Subsect lon (1) under 4.2 above] ' For
nalarla prevalence, tno typee of surveys wlre carried out based on blood sBear exaolnatlon:
clinie surveya and census-baeed househoLd surveys. }falarla control and district hea]'th
offlclals as well as local i.oforoante ldentlf ied localit les of reported high fever
prevalence. Areas of hlgh lnnlgratlon and former malarlous zonea were also included'
After notlfylng cornmunltLes, phyeLcians gave free examinatlons and nedication at local
fever cltnice. Glemsa-stalned thlek and thln fi lns of f lnger-prick blood frorn all Patlents
reportl.ng fever were ml.croecoplcally examlned. In household surveys, the decade-old Pathan
cornnunlty and the adJacent 8-roonth Lta mgn"r, refugee colony beslde the Liyarl River Brldge
at Hassan Colony (raio Bazaar) were studl"a ftt detall. Households and tents were nunbered,
censused and surveyed for fever hlotory, chloroqulne uae and the Presence of donestlc
anl.mals; blood apears were obtaLned frbn consenting uembers' Every elghth serlally
numbered Pathan household ltas surveyed, lncluding 38 of the 281 households present'
totall ing 327 lndivlduals, of whon 225 (or 97 of the total populatlon) had blood smears
uade. pathan householdg were typlcally dlscrete walled unlts whose occ-uPants were nernbers
of an extended fanily usually shirlng -one
hearth. The Afghan fanlly clans were divlded
lnto subuni ts , each shar lng a tent . Clan tent6 were c lustered wi th ln c l rcu lar brush
vBc/90.3MAL/9O.3Page 307
fences. Of 196 Afghan' r tenthold ' r fanl ly unl ts , 35 ( tota l l tng 225 lndlv lduals) were
surveyed, of whom f93 (182 of the tota l Afghan populat lon) gave smears. Based on tota lpopulat lon f igures, mean fanl ly s lze of Afghan tentholds was 5.4 persons, coropared wl th 8.7per Pathan household. No survey areas had been recent ly sprayed wi th lnsect ic ldes. The
resul ts r rere as fo l lows:
- C1 in t c da ta :
A 6u 'nary of c l1nlc data fo l lows:
None of 258 other lndlvldualg fron whon-'blood sneara nerelocallt les were po61t1ve. These lncluded Bengali-BurroesetMalvarl, Madrasl, I l tndustani and ll lndu ethnic grouPs.
P . f .
4 9
taken ln Landi 6 and Oranghl 5Bengal l , B lhar l , Punjabl ,
Locallty
Hasan Colony(Bano Bazaar)
Orangl 14KalapulNew KarachiKorunghl 6
Ethnlc group No. examlned SPRZP. * -
l 068
2460
Afghan 2LPathan 70Blhar i 186Hazar l \
I
Unknown l.Slndhl [ 23I lLndustanl ,
Cllnlc patients with positlve smeare were ldentlf led in widespread areas of Karachlbut were concentrated chiefly along the perlurban perlneter (Oranghl 14, New Karachl andllassan Colony along the Llyarl river bed) and in marglnal squatter shacks nithin the clty(1.e., Kalapul along the rallway l lnes). Based ou adequate nurnbers exarnined, Pathans atIlasean Colony and Blharls at Oranghi 14 had the highest ellnlc sllde poeltlvlty ratea-.Case fo1low-up6 showed a hlghly focal nalarla dlstributlon, with zones of hlgh cllnlc SPRscontlguous to negatl.ve areaa (l lke Oranghl 5 and Landl 6). Chloroqulne uae was unlversallydenled.
- Household eensus survey: In the household surveys (Hassan Colony) SPRs were 82 anongPathans conpared wtth l4Z anong Afghans. The SPR for Persian-speaklng Afghan refugees was4Z e.onpared wlth l0Z anong Turklsh-speaktng Afghanl trlbal people (0.05<P<0.1). Thirteenof the 38 Pathan householde eanpled, and 12 of 35 Mghan tentholds had nalarla1' 357" ln bothethnlc. groups had two or Dore caa€s. The mean age of Afghan patlents wae hlgher (16.6 +2 . 9 v s 7 . 6 ! 1 } ' e a r i s a 6 t h e r e w e r e n o P a t h a n a d u 1 t c a a e s . P a t h a n s h . d ! . . . 5 . @ .lnfect lons nore of ten (477, ot casea vs 132 ln Afghans; P - 0.02) and e lght of 52 roalePathans sanpled, compared nlth one of 47 Pathan fenales, had falclparun nalarla. No tolxedlnfectlons (falclparun + 9".") were found ln any patlent. In both cllnlc and householdsurveys, uosC parasltaenl.as occurred ln persons aged 5-35 years.
4. Alternatl.ve nethods of vector control
4.1 Blo logl .ca l contro l
In l raq, Niaz l & I la t I ta t (1973) whl le descr lb lng ant l larval acElv l t ies 1n Basrah town(eee beL6Fluentloned that Ganbusla fieh exlsted ln nany.lrrigatlon canals of paln treegardens. Attenpts w.re r"dEEGnsport and dlstrlbute this flsh in other lrrlgaEloncanale ln the area, but no further lnfornatlon could be traced.
In @r Tablbzadeh, Behbehanl & Nakhal (1970) conprehensively descrLbed the use ofGanbuela flsh ln the rnalarla eradLcatlon prograrnme. The specles ln Iran was identlf led asC. EtF.fnfs holbrookl and the nethods for ratslng, transportlng and dlstrlbutlon of the flshErffiTilE;a::T; nalarla eradlcatlon progranne of Iran introduced Ganbuela as anauxll iary nethod along with resldual house spraylng, detectlon and treatment of malariaca6ea, ma6s drug adnlnLstration and larvicldlng. Slnce ln most areas of south Iran thesetDeaaures were conblned, lt has not been poeslbie to evaluate on a large scale theeffectlveness of any one meaaure. Thus, no conc.lusions can be drawn on the effectlvenessof ganbusla. l lowever, durlng 1967 and 1968 ganbusla was dlstributed and in general theef f lc iency of th ls meaaure was conf l rned. For lnstance, no anophel lne larvae were found lnnuaerous etagnant watere around Kermanshah and Shahabad-Gharb following the introduc-tlon of
vBc, /90.3uAL/9O.3Page 308
f ish to a l l breeding p laces. L ikewise, a conslderable decrease of anophel lne larvae was
ofserved in breedin! pf"" " " in Fars prov ince. For exanple, in a breedlng p lace of 15 000
rZ i . , a v i l lage near Shi raz, where ganbusia was int roduced, no larvae were seen dur ing
May-October 1968, despi te the h igh densi ty recorded in the same per lod in prev ious years.
In contrast , a Large number of larvae was colLected f rorn a snal1 breeding p lace nearby
where no garobusia had been int roduced. In Bahranabad near Bushehr, in two water
col lect ions 3 n apar t , larvae were not found in one which conta ined garnbusia, whi le in the
other where no f ish was evident , there were many larvae. Another good exaoPle of the
ef f ic iency of ganbusia is the marsh of Is lauloo v i l lage near Shi raz. The narsh, 18 km X 12
km, was a large potent ia l breeding p lace and the surrounding v l l1ages had h igh nalar la
prevalence before the in t roductLon of garnbusia in 1967. The v l11age and the rnarsh were
surrounded by rocky h i l1s r . rh ich provided favourable rest ing shel ters for the exophi l lc
vecrors: superpic tus . "d 5 lg1g9i1 is . Y"" ig1: in th is area were ident i f ied_as 999!89i ,
s u P e ' p i c t f f i i 1 i s E i ? @ . I n 1 9 6 7 , o u t o f | 2 7 b 1 o o d s 1 1 d e s c o 1 1 e c t e d f r o ninhabiranrs of Is l ] i lGi -v t f ta f f iposi t ive cases were recorded (about 202) . Thts v i l lage
had been sprayed with DDT in May of that year whie.h was the only attac.k measure applled.
In rout lne surveys ln 1968, no larvae of any s iec les was col lected f ron th ls narsh. In
1968, out of 39 Ltooa s l ides exanlned only 2 were posl t ive. In southern I ran, #! l -ont"d ls t r ibuted in over 3000 pernanent water co l leet lons, and dur lng 1969 over 1.5 rn i l l lon f lsh
were dlstrlbuted. Garobusia has proved of particular value where the prevalent vector
species have been r i f f iopht l ic , and thus l l t t le af fected by res idual house spraying '
T-he breeding places of these vectors have often been Ln areas not sultable for chenlcal
larv ic id ingr as at the edges of s t reams, in areas wi th ver t ica l vegetat lon or ln rocky
pools. To-conclude, the authors pointed out that although the use of Ganbusla should never
be eroployed as the sole aEtack rneasure, a considerable benef it can resiiff iT lts
d is t r lbut ion ln some areas. The decrease in anophel lne densi ty has been qui te s t r lk ing in
soxqe reglons, up to a point where the contact between man and vector has becone very low'
Thls inprovenent has been achieved at low cost sinee Garobusia lncurs 1ow running exPenses
compared with cherulcal larvl.eides and costs in most clG-Iave been confLned to lnlt lal
t ransportat lon and d is t r ibut ion expenses together wi th undeteru ined coats of per iodlc
chee.k ing on the presence of f ish and larvae in breedtng p laees. I t ls essent ia l that once
Ganbus1a have been seeded, a reguJ.ar watch for thelr continued Presence must be
ilff iea. Anong the facrors that reduee the efficlency of @!gg!g' the followlng were
glven:
(a) Ganbusia does not reproduce ln shallow wel1s where the rtater is regularly
dlsturbedffiwas observed in Bandar-Abbas wells whlch breed @.!;
(b) the flsh cannot l lve long enough to reproduce where l lght and oxygen are not
suf f ic lent , as ln c is terns and wel ls ;
(c) raln and floods may wash away the flsh;
(d) after f loods, tenporary breedlng placee are forned in depresslons left ln rlver
beds and as these eventually dry up, Garobusla cannot re-establlsh thenselves;
(e) where the water level ls constantly c.hanglng because of clfunatlc and natural
factors, sotoe plaees nay be left wlthout f ish, thus allowing larval breedlng;
Anophellne breedlng ls not l lntted to Permanent and knosn places where flsh ean be( f )seededl
(e)used fo rwater .
It 16 not always possible to use Ganbus:le lnralslng edlble fish. Inhabitanta may refuse
house pools ' goldf ish ponds or watersGanbuela because theY dlrtY the
I ' 4 € g @ , P o l e v o J e t a I . . . ( 1 9 7 3 ) d e s c r l b e d t h e l n t r o d u c t i o n o fGarnbusla afflnls tri ibrootr irou TaZtk ssR into Kunduz area durLng L97L. rn that year'
r e o g 1 s t s f o u n d 1 o c a 1 g a m b u s 1 a o f t h e s a n e s p e c i e s 1 n s n a 1 1Sovlet and Afghanquantit leB ln Afghanlstan and deternlned lts dtstribution in the country. They were found
in natural ponds and reservolrs near the rlvers PanZ, Amu and Kunduz. The nost probable
orlgln rra6 natural penetration from reservoLrs of southern TaZiklstan lalso etritten
vBc/90.3MAL,/90 - 3
Tadjlkistanl across the rtver Panz and along the rlver Kunduz uP to 60-100 kn' For a
large-sca1e antl larval caopalgn Ln north"""i".n Afghanlstan, the quantlty of local ganbusia
was , ,ot suf f ic ient . Thereior" t r , 1971, to establ lsh reservol rs for rear lng ganbusla and
for l ts d ls t r ibut lon 1n r lce f ie1d", orr" n i1 l lon garnbusla (G:a ' t rg l -brogkl ) were t ransported
froro reservol rs of south TaZik is tan, USSR. Specla l workers ln Afghanistan were t ra lned' a
new gambusla departnent was establlshea at ttre reglonal level, and a manual on the ecology,
rear ing, t ransPortat lon and d is t r ibut lon of gambusla was pr inted and d ls t r lbuted '
For t ransport ing ganbusla f rorn southern TaZlkts tan ln to nor theastern Afghanlstan, the
authors used z inc a l loy conta lners of 40 l l t res capacl ty each, f l l led wi th water up to 802
of l ts vo lune, and lef t open for aerat ion and eool lng ' To avoid loSs of f lsh f ron
sp11lage, the conta iners l rere covered wl th net t lng. In every conta lner t 500 to 1100 f ish
were p laced. The conta lners were f l rs t taken by car to a specla l laboratory to detern lne
the condl tLon of the f ish (presence or absence of d isease), and for every batch of Ganlus la
a cer t i f lcate was Lssued. subsequent ly , a l l eonta lners were ferr led aeross the r lver Pan!
to Sher Khan Bandar where the f ish t " r l ' t . . t t "por ted by vehlc les ln the ear ly norn lng ( the
average teroperatur" """
t6oC) to the reservolr ln Kunduz (60 kn, or three to five hours
dr lve) . A torar of I 002 000 f ish l ras t ransported of which 2052 (0.22) d led ' In Septenber
1971, t ransportat lon over long d ls tances (5-00 kD) I tas tested across Hlndu Kush mounta lns
(altltude more than 3000 o) to :alalaUad valley ln southeastern Afghanietan' A total of
13 500 Ganbusla nas t ransported ln 12 conta lners (500, 1000 and 1500 f leh per conta lner) '
Water temPerature and the nunber of dead fish were ree'orded at 100 k4 Lntervals' The
Journey took 12 hours and the water tenperature rose fron l5oC to 18oC' Of 186 flsh
4.32 d ied. The lnf luence of f lsh densi . iy fn the contaLners on nor ta l l ty was not assesaed'
observations on rearlng, dlstrlbutlon and effectLvenese of gaubusla ltere given a8
fo l l ows :
(a) serectron of leseryolrs fo=r egnPtsi?ieelrne.?nd-91!l lr-F!r9!: Reeervoirs nust be
sl tuaced near goo essenEia l features:- adeguate depth to perolt hibernaElon ln wlnter and not subJec't to drytng ln
sulDmer;- sloPlng banks; and- have ninerous-water plants and enough food for the flsh.
Four prluary reservolre f9r ganbuela rearing were selected near Kunduz town wlth a
total surface area of 55 0OO t'. -Orr"
of the reservolrs vtas a pond wlth 'tagnant watert
the other three were flood-land ponde eupplled wlth water lnfi l tratlng fron the Krrnduz and
Khanabad rivers. A11 fleh brought fro,o i lzttt"t"tt were plac.ed ln theee four ponda' From
these reservoirs, the flsh ltere tranaPorted to secondary rearlng reservolre fron whleh they
nere dlEtrlbuted to rlce flelds. In splte of contlnuous ganbusla removal for dlstrlbutlon'
a denslty c.heek ln Oc.tober l97l showed that the prlmary reservolrs contalned about
6 500 000 fish, lndlcatlng that the denslty had lncreaied nore than sl 'x t loes' and aleo
that all the selected ponls were favourabll for f lsh breedlng' The ponds should'
therefore, contlnue to 6erve as breedlng reservoirs for ganbusla should lt be necessary to
dlstrlbute then ln future. To estlnate the nuuber of ganbusla, a epee'lal trap wae used
wlth a wire net botton (holes not more than 2 nrn wlde) and slde walle of wood' Its length
and wldth were 0.5 m, and the helght 10 cro. The t rap, wl th a p lumnetr-wa' d lpped. l^nto-- the
water to a ehallow aepth and the area of nater surface covered was 0'25 n-' Denslty was
calculated by countlng average number Of flsh in one square meter after checklng several
tfuoes ln different plqces ln the pond. The nunber in a pond was calc'ulated by nultlplylng
the average density/m' by the nunber of square netrea of water eurface' secondary
reservol rs for ganbusl4 rear tng were establ lshed near Baghlanr .Pul lkhurnr i and Dushl ( to ta l
water sur face = 3200 ro. ) . Dur lng-at" - ror* . o f 1971, 29 000 f l 'sh were p laced ln- these
reservoi rs . By the end of Oetober 1971, gaubusia numbers had increased to 740 000'
sec.ondary reeervolrs were also establlehed tn ttre reglons of Balkh, ltaLoana' Kabul and
Jala labad, and 36 000 ganbusla, renoved f ron the pr l iary reservoi rs t were put in to then'
Ganbusla nere dlstributed ln rlce flelds in the reglons of Kunduz, Inan-sahlb' Khanabadt
Talequan, KhoJaghar and Chai-Ab. A tota l o f I 700 000 ganbusla were.p lae 'ed ln 900 000 r ice
f le lds. Fol lowlng th i .s , the area of ganbusia d ls t r lbut ion ln Afghanlstan lncreased widely
and it ls expectel to contlnue into tf,e plalns of the northeastern part of the country'
Observations ln the spring of L972 showei that after an unusually cold winter' the ganbusla
population had partly dled outr but soDe had survlved and had begun to reproduce'
specles are r lce f ie lds ana ponas which are sui table for Gambusia ' The inf luence of
garobusia on nosquito density can be 5udged by conparing tFE;Afrs of .seasonal
changes of
adul t b{r lng act lv i ty and the "" . "orr l1
I t " t tg l " o f - larv i l densiEy in r ice f ie lds ln
Flg. 3f . These observat ions were roade thr iughout the roalar ia t ransmiss ion season of
1g72, 1n two vil lages in the Kunduz area. Near Khondan vil lage in May-June' gambusia was
dlst r ibuted in r ice f le lds. At the end of the summer, the gambugia. f lns i t r
lncreased and
the f ish spread to a lnost a l l r lce f ie lds ' In r lce f ie lds r lear n 'ashidabad v l l lage '
ganbusia nas absent. At the beginning of June, stleT the density of ganbusia was stl l l 1ow
in Khondan, the faival density it n""f, latbad was 2'4 tines that of Khorndan' and the density
of nosquitos blt ing oan in the two vil lages was nearly the same' In Septenber' however'
the larval denslty ln rlce flel 'ds near Rashidabad reached 6 to 7 times the denslty in
Khorodan. The sarne rel.ation applies also to the denslty of nosquitos bit ing man' The
autumn peak of anophellne density practlcally dlsappeared ln Khondan' Conplete elfuoination
of nosql l to larvae was not , however, at ta ined'
vBclgo.3! ,1AL,/90.3Page 310
.oopt"ififfi."q"iio" ln souihern lran as sunmarlzea Ay Zaiu (f 987)' The
(b) In f tuence of garoPusi ra f ish on Ehe,Pain-vgclor : -of .ggl iJ ig : - t : :n pulcherr i rnus and
t y.""io"; t - . " ; ; ; " ; ; i " "nrayed sur faces and rhe lar ter is narura l ry exophi l ic- and is res isEant
ro DDT. Thereforer 'DDi spraying t ras nor been ef fecr lve. ^Th: main breedlT. t i : : : "^of both
Aphanlus dlspar, known to be a larvlvorous flshr 1s wldespread ln rnost countrles of
the Arablar p"r"rr"i i ;,;;;-"; observatlons on lts effectlveness under local condltions have
been conducted except for some lnconcluslve trials ln oroan (for detalls see paragraph I
above). I lowever, "Lr"
countrles are already dlstrlbutlng the flsh as a suppleroentary
measure as in yenei iworttr & South) and UAE, but lts effle'acy has not been ascertalned'
In I ran, another b lo loglcal qontro l agent : RonanornermLe cul1civorax was tested againstflndlngs showed
that :- the average Parasitistr was only 602;- the parasl t lsn level f luetuated great ly between s i tes and t reatments;- it ,nas established in release siles but caused only rolnor reductions ln anophellne
larval populations;- Ln oany rocat lons where stephensl breeds ln \ rater of h lgh sal in l ty , th is parasi t ic
nenatode tras of Do ua€.
To conclude, zaLa ( loc,c i t . ) pointed out that a l though R.-gul lg lvorax has a ro le in
b1o1og1ca1con t ro1o fanophe1 rn " ' o "q ; i i os tnsou the rn r r ! n , l e t : f f i g - t e rmcon t ro1levels are not l tke ly to pers ls t f ro i a few ar t l f lc ia l ly created eplzoot lcs ' On the other
hand, the technieal proceduree of produetlour atorage t.,d tt.t"portatlon nake lt eostly to
use for perlodlc lnnundatlve releases for lunediate e.ontrol. Therefore, this nematode' for
the tLne belng, w111 be of l lnlted ueed ln antl-!0alarla canpalgns ln southern lran'
4.2 Other antl larval Deaaureg
In $Tr Ntazt & Hat ttat (1973) gave a useful-acc.ount on the appllcatlon of o11
larvlcidlng in Basrah area, in the soithern part of the country' Antl larval measures had
been applted ln and around Basrah toltn, Partlcularly ln Port Authorlt les area before the
lnplenentatLon of the nalarla eradicatlon progranme' In faet, antl larval measures had been
the naln weapon of attack durlng world l{ar II and later ln Basrah ar€a' under the rnalaria
eradlcatlon prograDme, larvlcldlng was lntrodueed ln Basrah town in 1964 as a supplenentary
attack nea6ure. U"tf"g f964-1965; the larvlclde ueed was crude and gas o1ls at a
proport lon of 3: I . f ron 1966 onwards, d lesel o11 n lxed wl th 0 '52 l lnseed ot l as a spreader
has been ueed. Throughout the transii""tor, 'eaaon (fron the seeond week of February to the
end of Noveuber, tte oft larvlclde was applled at weekly lntervals' .As reported by AIi
(1937), tenephos has replae.ed the o11 dxlure Ln Basrah and the Southern reglon fron 1986'
However, encouraglng results were obtalned wlth envlronDental oanageDent ln Zakho town in
the Northern reglon of lraq (see paragraph I above)'
iffiroau,:€.d'-by perulssion of Dr R.L. Kouznetsov,Dr N. I . Po levo j ;
WllO Malarlologist, CTD/TDT on behalf of
vBc/9o.3MALI9o.3Page 311
Flg. 30. Influence of Ganbus{a on aqgn"l"," denelty.
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Br.h!.d.b.d (tEburl. absant)
f,tro|dm (gDburlr prcront)
L.r".l a.rtl'ty 1! rlcr f:kllr
- Ruhldrb.d (gEburla abtat)
--- |(hordu (3ubu!1. prcsnt)
l.rlt tlttr3 rotltltt
vBc/90. 3MAL,/90.3Page 312
The report of the Intercountry Workshop on Integrated Vector Contro l ( t tHO, 1987 -
unpubl tshed) nent loned that nalar la presents a publ ic heal th problern in the Northern regic i :o f I raq where the populat lon at r lsk ls about 500 000. Contro l ls based on t reatnent ofa l l detected cases and house spraylng wi th nalath lon of aI1 foc l . This is supplenented bys o m e a n t i 1 a r v a 1 m e a s u r e s i n e J . u d i n g t h e u s e o f @ w h i c h h a s b e e n a c t i v e 1 ylnt roduced into canals and st reatrs s ince 1970. Wherever possib le, engineer ing nethods areused to reduce the aval lable vee. tor breeding s l tes.
In l ran, Javadlan & Acheson (L974) at teropted to evaluate the ef fect of o i1 larv ic id ing
Ln south i l -Khuzestan dur ing 1965-1968. Al l the ru5al areas of southern KhuzesEan had been
treatgd wlgh two rounds of DDT at a dosage of 2 g/n- unt i l 1967 when nalath ion at
2 E/nt replaced the second round of DDT. As a l l areas were under the spraying Progranue,there was no unsprayed area for cornpar ison. For the present s tudy, Abadan rura l areas
under conbined house spraylng and larviciding Itere comPared with areas under house spraylng
only. A11 areas r rere covered by act lve case detect ion. For parasl to logical assessDent ta l l dehestans (= d ls t r lc ts) under comblned xoeasures \ tere coxoPared wi th four in which no
larv lc ld ing rdas carr led out . For entomological s tudiesr the resul ts of sPlay capture lnfive vll1ages ln the first group and ln four vil lages in the second grouP were compared.The resulrs of the lndoor resting densitles of gjsl@l in the tlto areas were graphtcallypresented. L lkewlse, a graph l l lust raEed the APPi recorded ln the t l to areas f ron 1965
through 1968, wl th deta i led nonth ly data tabulated for the same per lod. Br lef ly , dur ingthe 4-year study, there were only two months-when stephensi densltles were hLgher ln thearea under spraylng + larvicidlng than ln those under spraylng only. This was observedonly in 1966 at the beginnlng and end of the season. In general, larvicldlng had apronounced ef fect by keeplng stephensl densi t les low, par t leu lar ly so ln 1968 when at no
l fne d id the lndoor rest ing dd; i? f ' the larv lc lded area exceeded an average of 0. I , / roon,
and was zero for three xoonths. In 1958 too, the area under spraylng only, anophellnemosqultos were found durlng seven roonths and the density was as high as 4/tooa. The annualparasl te lnc ldence (API/ I000 populat lon) in the t l ro areas were c.omPared as fo l lows:
1965 1966Area of spraying + larvicidlng T3't friArea of spraylng only 20.15 2L.75
It is clear that the area under spraylng + larvlcidlng had a lower API than that of
spraylng on1y. The API would have been even lower had a certaln number of lnported cases(fron withtn the country) not been lncluded. In fact, there were 20 caaes recorded ln
Septenber 1968 of whon 17 nere anong a group of lnnlgrant date Packers and were noet
certalnly not all were due to local lnfectlons. I lowever, no doubt some local transnisslon
took p lace.
l. lossadegh, Motabar & Javadlan (1973) also evaluated the effect of larvleidlng and
houee spraylng ln the eame rural area of paln groves near Abadan, southern lran on the
Pers1an Gul f l1 t tora l . The per lod extended f ron 1963 to 1970 lnc lus lve. In 1963, a
oalarla outbreak occurred that necessl.tated the applicatlon of DDT spraylng, although themaln vector ggLensl was resistant to thls lnsectLcide. DDT was sprayed in two rounds
annually (Ua?fr-aiT3eptenber) and ln 1967 oalathlon was eubstltuted for the SePtenber
round. In 1969-19ZO, bOf wae totally replaced by rnalaChton ln two annual rounde. The area
chosen for larvLeldfng evaluatlon fncfuala three dletrlcts: Mlnoo lsland, Moaroareh and
Naeear wlth a population of 10 500, 17 000 and l4 300' resPectlvely l lving ln 43, 27 and 33
vll lages, r."pi"ltvely. Besides flshlng, the vl11agera worked ln the vast PalD groves'
The tir lgatlott systen, nas through sea tides with the water canale and seepages provlding
nunerous breedlnge fo" gggglggj.. Regular larv..lcldlng ltas ang119! in Mlnoo island uslng
gas o11, and f roo f967;m of g ls of l (802) , crud. o11 (202) and Tr l ton x-100 (0.052)
as a spreadlng agent wa6 used. The iesults were tabulated and graphlcally presented using
the level of the API of 1963 as a basis for calculatlng the anount of reductlon ln
eubseguent years ln each of the three dtstricts. The APIs lu 1963 ln Minoo lsland'
Moamareh and Nassar were 28.9, 38.9 and 54.2/L000 populatLon, respeet lve ly . The API in the
lasr two areaa (under DDT spraylng) hardly changed durlng L964'I967, whlle ln Mlnoo lsland
(under DDT spraying + larv l " fa i "g j , the API dropped to 0.2/1000 ln 1967, l 'e ' r 99 '37 '
reduetlon of its oitgtnal level of fgO:. In contrast' the API ln Moamareh and Nassar in
1967 19686',:q6 T:T58 . 0 5 3 . 3 1
vBc, /90.3MAL,/90 ' 3
. Page 313
1967 was reduced by only 302 and 267, teepeetlvely' Howbver, nalathlon spraylng lntroduced
froro 1968 was able to c lear the three " r " . "
o f nalar ia t ransmlss lon ' The resul ts of 1967 '
however, demonstrated that regular o11 larvlciding could drastlcally reduce the parasite
Lncldence ln Mlnoo ls land. I f operat lonal feasibt l l ty such as the avai labl l l ty of o11
supply at low cost a6 ln lran, and the existence of dlsttnguishable vector breedlng places,
o11 larvlcldlng can be an effectlve suppleroentary Deaaure 1n nalaria control '
Ershadi & Manouchehrl (f985) surDmarlzed the results of the use of sanitatlon and
larv lc ld ing in Bandar Abbas c i ty , southern I ran. Dur lng 1981-1983' ProPoxur house spraylng
was dlscontlnued in Bandar Abbas clty, and the only roeasure applied for anophellne breedlng
control eraa exten6ive larvieldlng ,r"itrg a mlxture of fuel oLl, gasoll or tenephos at 10-day
lntervals , and improvenent or sant tat t6n. Dur lng 1981' 1982 and 1983, the densl ty of
s teohensL. the nain vector of nalar la 1n the e. l ty was 0.2, 0.6 and 0 Per roo ' '
respect lve ly . The nurnber of nalar la eaees deteeted ln 1978, 1979 and 1980 were 883' 618
and 746, respect ive ly . Af ter apply lng larv lc ld ing. lF sanl tat lon, the number of nalar la
ca6es derecred aurr i ! l9gr , rggi - "na lgar fe l l ro 4L2r 620 and 125, respect tve ly (about 802
P. vlvax a11d 207 P. ialclparun). Most of the cases detected durlng theee three years were- - -#ffi;;rted. These resulrs, therefore, ehowed that sanltatlon andclassl f led as re l ilarvicldlng of active and poiential breedlng placee ln Bandar AbbaE reduced the vector
populatlon and decreased the nurober of oalarla caae6 ln the clty.
Uotabar, LadonnL 6l Zalo (1986) reported the resul'ts of a fleld trlal to test the
effeet of gactl lus thurlngtengle tt-14 (Teknar) on anophelLne and eulle-lne larvae ln rlce
f 1 e 1 d e l n K a z e r o u ; @ ; e ' a o u t h e r n I r a n . F l v e e x p e r 1 o e n t a 1 p 1 o t s w e r e 8 e 1 e c t e drandomly ln a rlce fleld and three e.oncentratlone of B.t. H-14 were applled: 0'0003' 0'0006
and 0.0012 nl/l l tre were used. Maxlnuu larval oortal$ was observed durlng the flrst 24
hours of exposure. Culleine larvae yrere ltore affeeted than anophellne larvae' AJ'eo, the
lsC- and 2nd-instar larvae showed greater nortallty than 3rd- and th-tnstar larvae' The
pereent larval nor ta l ! . ty were 71.8-81.5 ln anophel lnes and 82.1-100 i 'n cu l lc lnes at 0 '0003
nl/l l tre. The correspondlng pree.ent Eortalltt ls for the concentratlon of 0'0006 nl/I ltre
were g9.4-100 ana 97. i -100r-ana for 0.0012 n l / l l t re they were 89.4-98.5 and l00Z' No
nortallty nas obaerved ln the control plots. It wae concluded that 0.0006 and 0'0003
nl/lttre were the optigun concentratlons for the conErol of nosqulto larvae I 'n the area
studled.
4.3 Integrated vector eonErol
No Lnforoatlon could be traced on lntegrated nalarla veetor eontrol trials or
operatlons based on a conblnatlon of cost-eifectlve and eafe nethods carried out ln
countrles of Aeia west of Indta. 0n1y pragnatlc eeleetlon of a cooblnatlon of Eeasures
vlz: house epraylng, larvl.elding and ifstrfUutfon of Gambusia has been adopted ae ln lran'
It nay not be out of place to r1ention the v1ews of ZaiilTT967) on the proepeet of
inregrated p"st t i.g"t"rrt (fpM) ln iran. Zaln (loe.'ctt ') underllned thet IPM whlch ls
based on eeologie.al lr inctples and lntegrates nultidleclpllnary nethodologles ln developlng
eco6ysEe' oanagement strategles th"t ""E
Praetlcal, effectlve, economl'e and progeetive of
both public hearth and envlronDent (cltfnl Axtell ' 1979) 18 belleved to be the beet
approach to veetor control ln future. ltowever, lt ehould be reallzed that IPM le the
reductlon of pest problens by actlons seleeted on the baeis of vee.tor l l fe systeos studies'
and ecologlcal as well as economlc con8equences of these actlons' IPU ls not nerely the
use of several control rethodologles, but Judlc.lous lntegratlon of dlselpllnes and control
roethods to naxlnlze the resulte. ror thrsl nosqulto nanagenent Progrannes have to be based
nore flrnly on sophlsticated to"qrrl io, t"t ih", and habitai nonltorlng and on the predlctlon
of nathenatical loodele of nosqulto populatton dynanice and the luplenentatl 'on of these
actions. Untll more rellable, unlflro and standardlzed sarnpllng and monltorlng oethods are
devleed, lt ls doubtful whether nuch progreas can be roade ln understandlng troequlto
populatlon dynanlcs and lnplenenting IPM prograDnea' The future role and contrlbutlon of
vector eeologlsts in such p.og."rr"i trag io 6e enphaelzed, and tralnlng of young eeologists
for vector Etudles has to iecelve top prtortty. ln concluslon, ZaLn underllned that we
have not developed the technologlcal. aeans to eontrol nalaria ln all clrcuDstances' There
is an acute shortage of experl.enced staff for stl.oulatlon and prorootlon of reeearch and
tratnlng for nalaria control ln lran. Tralnlng of dlfferent categorl 'es of oedle'al and
health lersonnel as well as coromunlty health workers 1s highly recornnended'
vBc, /90.3ttLAL/90.3Page 314
5. Connunitv PartlclP,atlon
No lnforroatlon could be traced concerning communlty partlcipatlon. ln relatlon to
roalar ia vector contro l Ln countr ies of Asia wlst of India ' "*""pt
for l in t ted at tenpts of
aource reduct ion ln nor thern l raq, Yemen (North) and oman (see under paragraph I above) '
on eelf-help nethods, the report of the wHo/vBC Infornal Consultatlon on the use of
Impregnated Bednets and o iher l la ter la ls for vector-Borne Disease controL (wHo' 1989 -
unpubLlshed) nentloned that health autiorltres ln Afghanlstan are concentratlng on probleros
in Kabur area, where nalar ia ar" . r "or"" ro" i " not a b ig problem due to. the h lgh a l t i tude'
but anthroponotic "rra"n"o,r"
rer"ttarriasis Ls a prlortiy vector-borne disease' The }lalaria
and parasl to logy Inst i tu te ' Kabul ; - ; i ; ; " i "g to-evaluate t t re ef fec l tveness of lnsect lc ide
inpregnatea curtains hung in aoo*.]"i-; i;e;;" of bedrooos to reduce vector/man contact'
The vector of telshnanlasls, pnr"uoil ius l"rFet'tr is peridoroestic and.could be lnvolved in
ouLdoor t ransmlss ion dur ing the hotJ en nost people s leep outdoors ' Therefore ' i t
ls also planned to-".r. irr"t! tn. effectlveness of tnpregnated bednets set up on frarnes over
bede used outdoors ' [ I t would be usefu l to evaluat" t l "o the ef fect of euch devlces on
superpictus, the nal.n vector oe raraii" r" the Kabul area as well as on vectorg of aalarala
i;l"tf,a-eas of Af ghanlstanl '
The same report also rnentioned that nalarla I 's a very lnPortant publie health problen
ln Paklstan and bednets, wlndow and door curtalns are belng uied ln-towns for protectlon
against housef l les and cul le ine nosqul tos, -and. ln.per l -urban areae for protee ' t lon f roro
n a 1 a r 1 a v e c t o r 8 , @ . " , , a . g i " s " # . n v 1 1 1 a g e s c a 1 e t r 1 a 1 1 s b e 1 n g p 1 a n n e d t oevaluate what role lopregnateo o"orrffiii pi"y ln ieduclng the lncldence and prevalence
of roalarla durlng the hot and hunid rnonths of the year whlc'h colncldes wlth the rnalarla
transnLssiorl 8€aao!.
As another sel f -help nethod, Sholdt et a l ' (1988) carr ied out a- f te ld t r la l to test
the effect of lnsectle.lde lnpregr,"i"a-t,"ated cLothes and a new repellent agalnst nosqultos
ln Paklstan. Different treatDent "otUf,,"tfons
of perroethrln-lnpregnated clothlng and I nett
extended duratlon repellent fornulatlon of deet against natural populatlons of oosqultos ln
rslauabad were trled. As surnmalz"a by the authois, observatlons were lnlt lated 2-2 l/2
hours pr lor to sun8et on volunte" t " - t t l appl led the topical repel lent ,S hours ear l ler ' The
nost effectlve treat'ent nas a conblna!1on- of wearlng the peroethrin-lnpregnated clothlng
and applylng the repellent on the "f.fr,.
Thle conbl"it l 'ott provlded I00Z protectlon fron
nosquito bltes, wheieas volunteers wearlng only treated clothlnbg recelved 57"1 Protectlon'
Those applylng only repellent recelved 897 protectlon, but under the. bit lng p'es'ure
observed, thls nas not slgnlftc"ntiy dlfferent frorn, the treated clothlng-repellent
conblnatlon. The volunteers dld ,ro't "orpr.ln
of skln lrrltatlon' odour or plasltl.LzLng
fron wear1ng the per'ethrln treated clotirtng. I lowever, a few comented that the new
repellent fel 't I 'stlcky" and "onethlt
"! ieasi" upon lnti lal appllcatlon' The authors
thought thet the new repell"rrt p"oJ""I to 6e a- signtfic'ant lmprovement over the current
etandard nllttarY rePellent'
vBc/90.3MAL/90.3Page 3I5
POSTSCRIPT
whll,e this docunen! eras being finallzed, it was reallzed that a new reference Itas
ooltted by oversight. A aunmary of ttr" paper of thls reference ls shown below whlch should
be p laced ln Subsect lon ( i l ) , Paragraph I under S!an, af ter the sumrnary of the paper of
S t r l c k l a n d e t a l . ( i 9 8 7 ) , l n - P a g e 2 7 9 .
Fox & Str lck land (1989) r r ied to ver i fy the hypotheses nade by Str ick land et a l '
(1987) regardlng the reason for the predomlnance of P. fa lc lPqrun oy"r .Lg in fecElons
in the four s tudy v11lages in Punjab, Paklstan. Analys is of data obta ined f rom
Gl.ensa-sta lned b lood f i lns.col lected f ron v l l lagers at tending regular outpat ient c l in lcs
f rorn August 1983 to February 1984, showlng n ixed P. fa lc ipar-un and P' ] r iveJr parasl laenlas,
suggest-d that in fect lons wl th the two specles weiE- l rx iependent of each other . There was
no evidence to support the hypothesls that P. fa lc iParun suppressed P' Yival ' A roore
1tkely explanat lon for the seasonal var iat lon- i l sPaaies parasl te rate ls that P. v ivax was
preaootnant ear ly ln the t ransxolss lon seaaon ( ln the spr ing) as a resul t o f la te re lapses.
th" .r".y high arnblent teDperature ln c.ol0blnatlon wlth extreme dryness prevented any malaria
transnllslon ttr the latter half of May to nld July. With the onset of the Eummer rnonsoon
ln Jdly , the naln t ransmieeion season began. Subsequent ly , the ear ly pronlnence ofp. vlvax over p. f:f"$"t* nlght have been related to lts lower crlt ical temperature for
E!'oi6-go"y ana G-Eiff ifncubatlon period. A large proportlon of vll lagers had
ci rculat ing p. v lvax ganetocytes dur lng the ear ly par t of the t ransmiss lon season' whl le
only a snaiflf i ff i lon had i. f"lclp.tut ga6etocytes at the same tlne' Thus,p. falclparun nalarla cranemisslon ff i layed. Conslderlng the reductlon in prevalence ofp. v lvax in October, l t le concelvable fhat most of the suscept lb le lndlv lduals had been
fiff i ff i by that ttne and'had developed specles-speclfic lnnunlty. The same uechanlsu oay
account foi ttre later drop ln P. falclparun paraslte rates ln January, followlng the
lnterruptlon of nalaria transnGsloi-f i-Decenber, due to cool weather condltlons.
Alternallvely, the preferentlal reductlon in P. vivax prevalence ln Septenber nlght be
part ia l ly re iated tL a d l f ferenEla l specles rGlonse to chloroqulne, which was used
intenstv l ly as presumpt lve t reatment ln Ehe study v l l lages. Chloroquine-res is tantp. fa lc ipaiun wae founa to be prevalent ln the area (see Fox et a l . 1985, under paragraph 2
56f6fi-fre uae of chloroquine ln the vl1lage cllnlcs nlght have selectlvely suppressed
P. v lvax.
vBc/90.3MAL/90.3Page 316
CONCLUSIONS (SECTION III B)
The geographical area under rev iew, Asla west of India, coupr ises 1 l countr ies
( f ig . l ) occupyfng more than hal f o f the area designated as the WI iO Eastern Medi terranean
n"eio' iWffOlei{itOll tn" area is rich 1n the anopheline fauna, of which 13 specles are
act ing as maln and second ary or suspected vecto is in countr les where roalar la t ransmiss lon
st i l1 pers is ts on a sroal l or large scale. These have roain ly been deal t wl th ln the preseal
document , vLzi
1n
- macul ipennis s. s. , @!, sgPerPicEgs, .PYlgt-rerr ious- and. steplrqngl in Iraq;
- macu l ipenn is , " " "h"
t d - tha l i
and nul t ico lor 1n I ranl, p , r t " t t " t t i B t t " , h y r c ? n Y s ' " t " P ! ; ! ? i a n d c u l i c i f a c i e s l n A f g h a n i s t a n l
- ff iCgies, [email protected], l l l lerPlcts, subplctis ataaEffi l6Tlating anophelines
Pakistan;- cullcifacies and stePhenli in UAE and Oman;- ffiiluoe [email protected] li ri--s : "Ttb+!l?1",
and .se rsq n! ii ln- EEtGiTfs,:;F.Etr an@enen (North and South).
The two menber of the An. macullpennis conPlex: s?chargvl and Pggullpennis s's' have
1 i n i t e d d 1 s t r 1 b u t i o n 1 n t n e @ a u n d e r r e @ E i n g c o n t i n e d t o n o r t h e r n I r a qand north and northweatern Iran [see detalls under paragraph I ln subsection (1) and nap in
i l ; . - i t - f " r I ranl . The b lonornlcs of sachaqovi as wel l as the aesociat ing sqperPlgguq ln
northern Iraq in particular, where uaffiGnsnlsslon 6ti11 persists, need updatlng'
In countr ies where nala i ia t ransniss ion ceased or has never ex is ted, v tz : Krmal t t
Bahrain and Qatar , s tephensi has been deal t wi th a6 a Potent la l vector '
Although Indta does not fall withln the geographlcal area under revlew' lt has been
f o u n d u s e f u 1 t o i n c o r p o r a t e s t u d i e s c a r r 1 e d o u i t h e r e o n s p e c i e s A a n d B o f t h ecul ic i fac ies complex in re lat ion to malar la t ransniss lon and responae to house spraylng '
Valuable i.nforrnation has been conplled fron fairly new studies- of vector blonomics ln
several countries, but early knowledg" i"" recapltulated wherever only old studies are
aval labLe.
Fairly good knowledge has been accrued fron studies of vector breeding habitats ln
various countries, although In certain lnstances the avatlable tnforoatlon neede updatlng
; ';"; ;;-;i l-;;;b;;i;-;;;"g;"-ii-.""ironmenta1 condltions, as in the case of -s?sharovlt - L ^ - - J r h o a a a ailu"s,s'lli"nil'il;'::l..il]o."n!;"^;il;;.::itli;;i:l.::ll'.n'il31"ll;-.:fffi":'- ' : . ; : : ; : . - - ; ; - " ; . ; ; . 'or
{n Beluchistan. Pakistan, where only o ld knowledges,reeiit@rr cr f "c 1" " and s iepltsng.l . 1" t:t::11:-t"T;.:ikis tan' whe re
i;?iiifi" ffifmrra aiffiffigan & Baily, 1e38).
Saudl Arabia;
The local 8pat1a1 and seasonal dlstrlbutlon of varioue vectors has been well deflned
ln uost countrlea, and ln lran useful rnapplng of the dlstrlbutlon of the nain and secondary
vecrors has been presented (eee Ftg. 3 f ; ; s ieerPlgtus, F18' 4 f91 l$r la t l l ls and Fig ' 13
f o r a 1 1 v e c t o r s ) . S i n 1 1 a r 1 y , S a u d i A r a b 1 a f f i E ' " t . I t t r e a t s T E 6 f f i i J f v a r i o u svectors ln the naln provlncls of Ehe country (flg. 9). The possible changes ln the
dlstrlburlon of a vector would carr-for-p.tioir"a checklng; the best exanple ls the
advance and retreat of stephensl ln lraq, for whlch no clear reason could be traced
(flg. 8). Changes t ' ei ' ff i i f i frtal conditlons lnvolvlng rlce cultlvatlon deprlved
superplctus from lts claesical breedlng places whlch belarne more sul-table for breedlng of
t hepo l1u t1on . to Ie ran t !@- . ' ' i i ' y ' " . 9 " "1nKunduza tea 'no r theas te rnA fgban i s tan(ward , rg72 & Lg77). fi-rffirills exffi-rhe Easrern provlnce of saudl Arabla and
punjab province, patfsFan- 6 "-"oi-"""t
to Play any iole-1n nalarla transnission'
It extends lts dletributton to the foothll l regton of ttre mountalnous tracts of north
Pakl.etan (Akiyana, unpubllshea repoit to WIIO, IfOe), but lts role in malarla lransuisslon
awal.rs inveetigation.' Both ffu*'f.t i i fs and gPerPl;.:ua aE well as d'thall ' whLch act as
secondary vectors along the southweffil slopes o-tlFzagros chatnEGn have shown
refractory response to attack measures due to thelr exophil lc behavlour coupled wlth the
outdoor sleeplng hablts of the people. Recent lnfornation (Mr N. Eshghy, pereonal
cornmunlcatlon, r990) showed that comblned measures of nalathlon house spraying (L969-L977'
vBc/90.3UAL/90.3
age 317
and propoxur (1978-1990), as wel l as larv lc ld lng wl th o11 and/or ter lePhos and d ls t r lbut ion
of 9"rU""i. greatly reduced the denslty of the ttto vectors, and consequently nalarla
tranenlsslon was very nuch reduced.
The d ls t r lbut ion of arablensis , sergent i i and { luv igt i l is In Yemen (North and South)
needs updatlng and the rotE-6ffiETast two specles ln nalarla transmisslon altaLt
deterro inat ion. par t lcu lar at tent lon should be paid to areas of recent developnent of water
resources projects where the three species Eay aggravate the ualaria sltuation'
On vector d lspersal , d i rect ev ldence comes f roro nark/ re lease/recaPture exper lnents
conducted in l ran lnvolv lng stephensi (Quratshi , Faghlh & Eshghy, 1966), and ln PunJab,paklsran, involving g53h"""i.@ & Aslankhan, 1979)r and later cullclfacies and
s t e p h e n s 1 ( R e 1 8 e n , - M ; . i i f f i a - - F A z r a , l 9 8 l ) . T h e n a x i n u r n d 1 s t a n c e t r a v @ t nf f i a . 5 k n v e r s u s 1 . 0 7 k n f r o r n t h e p o 1 n t o f r e 1 e a s e 1 n P a k l s t a n . T h e 1 a s t e x p e r i m e n tin pakis tan gave a theoret lca l maxi rnun f l1ght range (stat is t lca l ly ext raPolated) for
srephensl a"I c"l lg1IgS1.s. greaEer rhan 3 and 8 km, reepectlvely. Probably' dlfferencee ln
ffiatar affi-;fr?-ifre Eype of rerrain accounred for the dl.fference shown between rran
and punjab experlnents. On the other hand, lt ls only by further exPerlments that Ehe
staElst ica l ext rapolat lons can becone val ld .
Whlle estlnatlon of the degree of man-vector contact by dlrect nan-balt capture hae
been successful ln Iran, lt gave dlsappolnting reeults in Pakistan, whether by dlrect
nan-balt capture or by lnan-bilted nets.- Perhaps, the use of a eolltary hunan balt could
not create sufflclent attractlon for rnoequltos arnong large numbers of bovlds and local
lnhabitants ln the surroundlngs. In view of thle failure, the degree of man-Vector contact
I ' a 6 e s t 1 D a t e d 1 n d 1 r e c t 1 y t h r o u g h c o l 1 e c t 1 n g f e m a 1 e s o f g @ a n d g 9 g @ ! f r o nday-tine lndoor restlng shelters and dlvldlng the total by the nuober of hunan occuPant8
and correct the outcooe by the I|BI (Releen & Borehau, 1982). The highest Dan bltlng rate
w a s e s t l ' E a t e d c o b e l . 0 2 5 b 1 t e e / o a n / n 1 g h t f o . . @ 1 n A u g u s t , a n d 0 . 3 2 3b 1 t e s / r o a n / n 1 g h t f o . g g g $ 9 3 9 l 1 n N o v e r n b e r . r u f f i F t s w e r e m a d e 1 n P u n J a b b y u e 1 n gfour hunan balts for dlrect eegimatlon of the degree of nan-vector contact (Mahnood &
Macdonald, 1985), This succeeded In sanpllng appreclable nunbers of grltctfaciee(specles A); the nrxl6un rmn bltlng rate nas l2-.4 attee/nan/nlght r'n ffiG6ffille that
of gSlE! was much less, I.3 bltes/nan/nlght ln ltay.
On vector restlng behavlour, sore old report8 lndlcated exophll lc tendenclee of
sacharovl ."d gre -ln northern Iraq but thls requlres coaflru-atlon. Conflroed
@ot su;;;;f: iG;ttuvtartt le ana a-t\att_has been reported fron rran. Thus' the
three eleciei-?iiored refractory beh?vlourffiDDT spraylng. The problen, as nentloned
above, was overcone by nalathlbn and later ProPoxur spraylng coupled wlth eupplenentary
Deaaurea. Slnllarly, pulcherrlnus and llry ln,Kunduz area' Afghaniatan exhlblted
exophilic behavlour un?ffi!-raytng,A-aiGTill nalarla tranenleslon to perelet. 0n the
o t h e r h a n d , c u t t c i i a c t ' e s . o d @ . - a r e 1 a r ! e 1 y . e n d o p h t 1 l c t h r o u g h o u t t h e l r r a n g e e a n dhad show.ll gooa re!!6fr6ito oor-iliiffif1y untll reslstance to DDT/dleldrin developed. The
probleu hae been orr..cor" after replactng DDT and organochlorlne conpounde wlth al 'ternatlve
lneectlcldea ae shottn In the text.
On host feedlng patterns, lnfornatlon ls avallable for f luvlatl l le and euperplclue in
Iran, f luvlatl l ls ln PLnJab, Pakietan, pglchgrrl-nug li-n'f!t""tsTifr@:ctfacfi lna-
srephenst Ln rran and pailetan, and eieaE;T-iid-l or tnl q. luric@iilex 1n
India. Wlth the exceptl.on of the records of Iran fot SgJlgllSslg and .etephengl(HBI 5.4 - I0z ani t 5 .4 - 20.42, reEPect lve ly) for whlch no detat la of the saDPl lng ElEea
were glven the IiBI recorded ln PunJab, Paklstan wae etrlktngly low (0'5 Z for cull-cl{aclee
and 0i fo. g!.g!!gpgl (Releen & Boreham, 1979). It was queried how nalarla tran8n1861on
could take place ff in'"""n ttrgnry rooptltt" specles. suggestlons ltere' therefore, uade to
lmprove saopllng of nosquitos from dtiferent blotopes and that efforts ehould be nade to
sanple adequate nuobers froo hunan dwel,l lngs (Carrltt-. lones, Borehao & Pant, 1980)'
nvoiatng sanpllng blases wae attenpted (Reisen & Borehan, 1982), and this gave an
appreelably hlgher HBI , 4.82 for g4glfacl"", but a rather low value for stePhqnql , 0'92'
In a further study 1n iunjab (Uatril66Effi6na1d, 1985), the naxirnum IIBI recorded ln
cullclfgcles t"s 3Z and lir ggg$,1 22. In a epeclal study on the host feedtng Patterns
vBc /90 .3MAL/90.3Page 318
of rnenbers of the An. cu l ic i fac ies complex ln India-(Joshi et aL. 1988), there was seasonal
var iatLon ln the I IBI ; the h ighest va lues were recorded ln July , August .and Septernber: l lZ '
gz and 62, respect lve ly . I t should be renembered that l ' lacdonald (1957) regarded
cul lc l fac iea aa a et rongly zoophi l ic species. The I IBI ls usual ly 1ow' of the order of
r 0 - r 5 % , a n d l n o n e o f t h e c o n s l d e r a b l e s e r i e s i n M a d r a s t h e l n d e x r ' a s a s 1 o w a s 2 . 5 l L . l tapparent ly turn6 to nan only when cat t le neal is re lat ive ly scarce ' and under these
clrcurostances rnay perforce feed chiefly on uan'
o n v e c t o r l o n g e v i t y , u s e f u l i n f o r m a E l o n h a s b e e n p r o v i d e d f r o n a g e - g r a d l n g s t u d i e s o nf1uv ia t i1 isandsup! rp i " lg9 i " r . " " l -p " r " i " i . - l ' " :_1 i9n i ' ' 9 "? i "1 i | l9 l . " ' s tan ,s@and srephensi rn ikt'ffiFr"J.i,
-r;*.-r;rernatioi'aTttre vectorial capacitv of
pulcherrlnus tn Kunduz atea, northeastern Afghanlstan showed relatively hlgher values ln
vil lages wlth extensive rice cultlvatlon and sltamPs, whlle the lowest values came from
vl l lages wLth ln tero l t tent dry lng o i r tce or occurr lng in the dr ier-Part6 of Kunduz val ley
where cotton and roalze are nalnly groltn (zat]at, 1971)' Therefore' it would be roore
advantageous Eo etratlfy the Kunduz area lnto eco-epldeolologlcal subsErata' so that the
appropriate roalarla .r""io, control oethods can be Judlciously devlsed for each' Several
studles have been carrled out in punJab, Pakistan lnvolvlng deterninatlon of the
physlologlcal age oi curlcrfaclgs, sieptrensl and the associatlng susPected vector'
s u b p i c t u s . I n K a s u r d i s t r i c t , o t , " ' " @ s p e c 1 e s A w a s i d e n t i f i e d , a p p 1 i c a t i o nof polovodova-s t""ir iq,r" showed ttrat f+Z-6?@usT"ttl"" of this species had oviposited
t h r e e o r E o r e E 1 n e s w h i 1 e o n 1 y 6 Z " i - " . " " t ' " " " i a n d | 2 7 : f W . h a d d o n e s o . I n t h es t u d y v l 1 1 a g e ' o o r e t h a n 9 0 Z L t t t . " n i l T G E s e s w e r e a o " @ } g P r y i n f e c t l o n , a n dit was only culiclfaclqs- that had a physlologlcal age greater than the duration of the
sporogonic cycle;f!=l ' iJgt"t.- i.t frrg into accouni also its high relative abundance'
cu]-lci{acles wae corrfder-ost proUlbte prlnary vector in PunJab' This was confirmed
by the recordlng of a37 aporozolte ttt"- tn -curlclr?.cres whlle stephensi and subpictus Lere
negarive even by delayed diseecrlone (ltatrnooffiTiffit<'il;;; TiiE^l.J-0'ttrer ituffilso
in punJab conrrrnei t irat glrltctfacres ls the priroary vector and that i!:9!"*:1-11:I:.:-s e c o n d a r y ' o r " , ' t . i r e e u u ; f f i o o r a n 1 n s i g n 1 f 1 C a n t r o l e 1 n m a } a r 1 a t r a n s n 1 s s 1 o n .Ilowever, esttnates of vectori"f
". i" l i ty-oi cyrrclfgcies ln other studies ln Punjab showed
exrremely low vaLues, and much fotl i-fot steiEFGG of Relsen & Boreham' 1982 in
Table 9). Even wlth lnproved egtimateg oE:ffifElng rate, the maxlnuo vectorial capaclty
of cutlclfacles wae shown as 0.328 for P. vlvax ana o.zgt lot Hpgf* !YtnT":u,!Macdonald, 1985). Prevlously Uacdonald-(ff i lndlcated that although culiclfacles ls
wldely dlscrlbuted over the hot plalne of India, 1t is not fully taapt"ET6-frI1fr-
te6peratures and aurvlves beet at a"ip"t"t"tee ltell below the summer normal in nost of
Indla. ItB exPectatlon of l l fe durlni the nalarl 'a transrolssion season Ls short' Dlrect
Deaaurenent and the evldence of relative sporozolte and oocyst rates ln nany areas
lndlcates that the dally oortallty t"i ofte" exceed 202, though in the cooler weather at
the end of transoisslon aea6on tn norih of India the oortallty rate nay be much less' The
crlt lcal denelty of qg!-1-9{acie8 fs hfgh. Obeervatlons tn Madras lndlcated that it
e x c e e d e d 1 0 p e r ' " " - f f i a . a o " t I o ' . " f r o u 1 t e 1 e n g t h o f 1 1 f e a n d z o o p h 1 1 l s n s u g g e s tthat ln 8o!0e areas lt nay be 5 bltes/nan/nlght'
R e g a r d l n g n a t u r a l l n f e c t l o n s l n v a r l o u e v e c t o r s , o l d r e c o r d s o f s p o r o z o l t e r a t e a a r eaval.lable to" gg@ and oa.cul-lpennls e's' ln lraq and lran; gl#-1: r:"1;
",ri""or"t,r", ll:FffiffiIe, stephenfin-a ggllglEglgg 1n rran; '.94"1 in Bahrain;
suoerplcru' and ffi:Gffifghanlerang lupeEprctug, cuir46and stePEen:i^in
Quetta, Baluchlstan, Paklstan. Falrly recentlecot$TF sfriozolte rates come froro Oman
for cullclfaclee and stephensl; efgtranretan for pulchgrlgus and llsanus; Paklstan
t iir"ffi ' .'li" r"
".r, r p a s t, r. c6fr-GGp o r o z-t t el[6?1 t lve s pe c lmen s
irere report"a rjfiiiiii;r i; iiie rnr"n p"o"ia"a convinclng evidence that stePJ.tgE-s.1 ls
the prlncipal vector of ualarla in Karachl clty' Aleo records of sporozolte-posltive
speclnene 1" g:;; i i are avatlaure iron Iran in 1965, rhlch ftnally lncrirninated thls
speclee ." . ""ff it;-;";;;;:
The pauclty of -recent lnfornatlon on natural lnfection Ls
most probably due to the tedloue efforts nleded for dlesecttng large numbers of nosqultos
ln order to flnd a sporozolte-PosLtlve speclnen ln areas under adequate anti '-vector
D€8auf€s. It 18 worth trytng ttt" i"t technlques for detectlon of sporozoites ln mosqultoe
but no atteEPt has so far been made to use such technlques ln the-ge-ographlcal area under
revl.ew. In contrast, the technlques of lnmunoradtooetilc a8say (IRMA) was trled
eucceesfully on'epec1ee A and f oi-ttre-l i l culfc+facfes complex in western Uttar Pradesh
vBc/90.3r.rAL/90.3Page 319
India (Subbarao et a l . , 1988a). The overal l ln fect ion rates for specles A and B were 0.82
and 0.082, respectively, thus provlding evldence that. specles A ls the prfuoary vector of
both P. fa lc lparum and ry nalar la in western ut tar Pradesh.
L ln i ted t r ia ls wi th l lght t raps have been nade in the Present geographlcal area: New
Jersey ln Saudl Arabla (1g48=L952), CDC ln I ran (1984-1985), New Jersey and CDC in Paklstan
(Lg76i . I t can be concluded that l ight t raps are usefu l supplementary tools for sampl lng
anophel lne populat lons.
The status of insect lc lde res ls tance ln var lous vectors rev lewed in the Presentgeographical area has been, l is ted and the resul ts of lnvest lgat lons d iscussed.
An. sr rp"rp lc tu6 whlch has long been regarded as suscept lb le appeared to be res is tant to DDT
G-n6itfr-TlEfl l i isran as in rhe adJacent area of the USSR. Sinilarly, pulcherrip\ts
norgheastern Afghanlstan which has been regarded by several authors as suscept ib le to DDT'
appeared wl th pronounced DDT res ls tance in 1973. There are cer ta in records in the rePort
o i - t t te Expert Connl t tee on Insect ic ide Reslstence ( ! [HO, 1986 - TRS No. 737) needing
correct lo ; . An. cu l lc l fac ies was l ls ted as res is tant to Eenephos ln Oroan and UAE, but
these tests werC naffif, a lower doeage of temephos. When the rlght discrlnlnating
d o s a g b o f t e n e p h o s ( 0 . 2 5 p p n ) w a s u s e d 1 n 0 r o a n d u r 1 n g l 9 s 4 a n d l 9 8 6 ' . g @ 1 a r v a ewere found to be sueceptlble to this larvlclde. The other error cqncerns sjlephensi belng
llsted a6 re8l.sEant t,o propoxur ln lran. Recent lnvestigatlons ln lran showed that
stephensi ls conplete ly-euscept ib le to propoxur (Manouchehr l & Yaghoobl-Ershadi , 1988).
fif i ' f f i ial inplicatlons of lnsectlclde resistance necessltated the change of the
lnaect lc lde, v lz ! DDT/dle ldr ln res ls tance Ln stephensi ln I rag and l ran, cu l ic i faglgq and
ctephensl. ln Afghantetan and Pakletan. l ' lalathlon has been the replacement insectlclde ot
Efr6]Ffthough fenitrothlon (Sunlthion) was applled in certaln areas in Iran and
PakLstan. Ifhen malathlon reslstance 1n stephensl ln Iran posed a problem, ProPoxur was the
replacement lnsectlclCe selected. fn Onli l l l i-reelstance ltas recorded at a high level in
cuLlclfaciee and sleplgngl but no lnvestlgatlon has been carrled out on the oPeratlonal
ffrfrTffit ion6 of tf,Ts-mtance after renedylng the operaElonal defects. DDT is scll l
bei.ng used Ln Onan desplte the perslstence of nalarla transnisslon; an alternative
insect lc lde should be sought . In Paklstan, no restscance to nalath lon has been detected in
cul lc i fac lee except Ln two d ls t r lc ts in PunJab, but no ln fornat ion ls aval lable as to
f f i h a s c r e a t e d a p r o b 1 e n 1 n t h e t w o d 1 s t r 1 c t s . o n t h e o t h e r h a n d , @ , g 1 h a sbeen reported res letant to oalath lon ln oany rura l d ls t r lc ts ln PunJab, but th ls specles
haa been regarded as playlng a mlnor role ln nalarla transnlsslon conPared with
cul tc t fac ies, the pr lnary vector . In Indta, cu l lc l fac les specles A was found to be more
;"'scep-to DDT than ipecies B. rshlle uottr-!6ctes were reslstant to dieldrin/HCH.
Fle ld observat lons Ln western Ut tar Pradesh suggested that DDT would be roore ef fect ive than
HCIi in controll lng nalarla transmltted by epecles A, though nalathlon would be the ldeal
eubst l tu te, but l ts h lgh operat lonal cost Ln Indla ls against i ts use (Subbarao, Vasantha &
S h a r n a , 1 9 8 8 ) .
Va|uable knowledge has been accumulated fron epldeniologlcal studies and control
experlence !n eeveral countrles of the geographlcal area under revlew. WI|O/EMRO has
claeeified countrlee of the reglon lnto three grouPs; only countries of the present
geographlcal area are lncluded ln larentheses - other countries of the reglon are not shown
here :
Group l: Countrles wlth natlonwideSaudi Arabi.a and UAE).
nalar la contro l Programmeg: ( I raq, I ran, Paklstant
Group 2: Countries wl.th no nationwlde ualarla control(North and South) and Ooanl
Group 3: Countr les consldered malar ia- f ree: (Bahraln,
Countries of 1@p-l which are vulnerable to tnportatlon of nalarLa need to
strengthen control 6TEEafng of, etephensl as a potentLal vector, acreen forelgn labourers
and detect ch loroqulne res ls tant 'P. fa lc iparun anong lnpor ted cases.
Of countries of glrg!_!, Saudl Arabia (Flg. 9) nade lnpressive Progress ln nalaria
control whlch followed-fficf6ffino-ogress of the country. The pilgrinnage area ls
considered nalarla-free as arabiensls has been cleared frorn Jeddah, l lakkah and surrounding
area6. Slnllarly, the Eastff iEal and northern provlnces are now Prectlcally free
fron nalarla. Areas with lnportant rLsk and lnadequate control occur ln the southern Part
Progranne : Iefghanlstan, Yemen
Kuwal t and Qatar) .
vBc/90.3MAL/90.3Page 320
of the Western province and par ts of the southern province (Asi r sector) . However, the?e
are areas of lnpor tant r isk in the Gizan sector of the Southern province where the most
ef f ic ient nalar ia vector , arabiensis is wldespread. Intensive ef for ts are being roade to
reduce malar ia t ransmiss ion to an a iceptable level . PHC centres are lncreasing throughout
the country and nelr preventive components of PHC are being developed (Governnent/I ' f iro Joint
Assessmen t M iss lon - Na je ra & Fa r i d e t a1 . 1987 ) .
In $[ , according to the progressive evaluat lon uP to 1986, the malar la s l tuat lon
cont inued to anel lorate under at tac i rneasures and widespread survel l lance act lv i t ies (ACD
and pCD), except in the Northern region. The nost recent in format ion nras g l 'ven for the
year tSi6 (Al i , l9B7). Malar la l ransmiss ion cont inued to pers is t ln the f ive l tuhafadadha
of the Northern region, wl th sacharovi and supeqplctgg being th: Tt l l vectors, especia l ly
in rhe ol-d known foci. TransiTsE6-iGas reil iedln Al-Tanim rnuhafadha after conp)-ete
interrupt lon of t ransnlss ion in the past few years. These foc i were deal t wl th pronpt ly .
On the other hand, t ransnlss lon cont inued to be in terrupted in the Centra l , Centra l
Euphrates and Southern reglon, wi th superPictus and/or l tephePqi being the nain vectors,
despite the presence of cases classiGl--G-inported fron withln the country and fron
abroad. However, transmisslon was renewed in two vll lages ln Misan and Basrah nuhafadhast
respectlvely, which was dealt wlth lnnediately. The nalarla eradicatlon programne has been
decentrallzed adrolnistratlvely, but technlcally has remalned to be dlrected frou the
centre. Survei l lance has been st rengthened !o cover a l l par ts of the country. A11 heal th
centres, outpat ient c l ln ics and d ispensar les were inst ructed to take b lood s l ldes f ron
fever and suspected cases. Forelgn workers frorn nalarious countriee continued to be
fo l lowed up and kept under s t r lc t superv ls ion (Ossi , 1983). Iupor ted malar ia has poeed
great problerns to Ehe malarla eradicit lon programme. Thousands of foreign labourers conlng
fron nalarlous countries have been enterlng the country slnce 1977 t'o work ln dlfferent
pro jdcts of the Nat lonal Developrnent Plan (A11, 1985). Anong those etere Parasi te carr lers
repiesent ing a threat to areas where malar ia t ransmiss lon has been interrupted.
Chloroquine-res is tant P. fa lc iparuro cases were detected anong the inpor ted cases, but none
nere reporEed anong the indigenous populaEion.
I" I!"-g (Flg. 25), the antinalarla programtre also nade slgnlflcant Progresspartlcula?Iy-ln the northern part of the country. The northern Part of Zagroe chain with a
population of :S nll l lon has been under the consolidation phase (rnacglipennis _s..s.
f1 tle
r"jo. vector ln the Casplan Sea littoral, while sacharovl and gPsggtui are the princlpal
vector6 in the Central plateau). tn thes" "."."]ff iFttre
roa-IErta cGs are lnported
fron Ehe main endemic foci ln the south or from neighbouring countrles. In the ltest and
southwest wi th a populat lon of 9.7 rn l l l ion, nalar la t ransrn lss ion has been substant la l ly
reduced, despl te the presence of nul t ip le vectors (sScharovl ' superpic tus ' - *9 lhe?* 'f luv iat l l ls and d- thal i ) . I t ls in the area of the southeastern corner ot I ran wlEn a
ffiff i" of :.5TfiEon (Horroozgan, Sistan - Baluchlstan provlncee) that nalarla
t raneniss l .on st l l l pers ls ts (wl th the maLn vectore being stephensl and/or f$ lc l {ac les 'whlle fluvlatl l is, gpgglslus and d'thall act as secondaFEcEors). Ins6ctlcide
r e s t s t @ r r y t 6 l 5 5 t 7 d l e 1 d r 1 n a n d 1 a t e r t o n a 1 a t h 1 o n h a s c r e a t e dflnancial frptTilff i i-to the nalarla vector control progranne by shlft lng to the Dore
expenelve lDsect lc ides ProPoxur ' current ly used ln the south (Zaln, 1987 e 1991) ' Afghan
""i,rg""" and Cravellers fron Pakistan are creating problens for the antlnalaria PrograDme
ln l ian. Afghan refugees estloated at about 2 rnllI lon, movlng throughout the country
seeklng work have coniributed to the spread of the dl-sease. The rnaJorlty of -6445 nalarla
casea classlfled as lnPorted durlng lprtt-Uovenber 1985 were Afghan workers (NaJera &
Zulueta, f986) . Caees of ch loroqulnel res ls tant P. fa lc iparu l tere recorded 1n southeast
rran among Afghan refugees, pakistanls and rranl;;sG;ffi lred to Paklstan or rndia ln
addi t ion to set t led l ranian populat ions (Edr iss lan, 1989 & Edr i 'ss ian et a l ' , 1989) '
Regardlng surveil lance, ACD as observed ln Iran and elsewhere has low productlvlty when
conpared wlth pCD or actlvated PCD. The lnhabltants seek treatnent elsewhere ln rural
dlspensarles but none ln the new PHC centres eo called health houses (Najera & Zulueta'
19g6). The surveil lance agent engaged ln ACD could be better employed in the collectlon of
epldeoiologlcar lnfornation on nalaila and other cotn-unlcable dlseases after the neceesary
tralning. The treatnent of nalarla casea should be done in future by the PHC workers' aE
the new pHC servicea can provlde better care for the nalarla cases than the surveil lance
vBc/90.3MAL/90.3
age 321
agenE6 non engaged ln ACD, who can provide an epldenlologlcal capabll lty now lacklng ln the
rural PIIC servlces.
In Paklstan (F ig. . 26) , nany entoroologlcal s tudies have been carr led out pr inar l ly on
cuffcftqqG-;;;--a gte$gl ln Punjab involvlng the breedlng habltats, swalmlng and ruating
;aTispe{sat, as-ff iFpopulatlon dynanlcs and vectorial capaclty. The naln aln of
these studles eras to col lect background lnfornat ion necessary for p lannlng genet lc contro l
exper lments. Al though no p lans have so far been fornulafed for genet lc contro l , these
studles made a slgnlflcant contrlbutlon to the knowledge of the blononlce of the two
vector6 and associated anophel lnes, and to the deternLnat ion of the inpact of nalath lon and
feni t roth lon spraylng on vector populat lons in the envi ronment of PunJab.
Several old studies by prornlnent workers lndicated that rnalaria ln Punjab le
unstable, wi th 8-year per lodic i ty of epidemlc waves. More recent observat lons lndicated
that the last epidemic wave occurred durlng L972-L973, and predicted that a further wave
should be expected ln the ear ly 1980-s, af ter the nalar ia prevalence fe l l to a very 1ow
leve1 betvreen 1975 and 1977 under rnalath lon spraylng (Zulueta, MuJtaba & Shah, 1980).
Further studles ln PunJab lndlcated that nalarla was enderolc and stable ln vll lages where
perennla l breedlng p la ies of cu l lc l fac les are aval1able s in l lar to the s l tuat lon that
prevalled in Karnal area near-TEw@Indla, during the 1930-s (as reviewed by
i t r ick land et a l . 1987). T lne wi l l show whether the predlct lon of 8-year epldenlc cyc les '
or s tabl l l ty of rnalar ia ln PunJab i8 correct .
Malarla vector control strategy in Pakistan is based on highly selectlve spraylng
wlch nalathl.on accordlng to the epldenlologlcal eltuatlon at vll lage level'. Thle has been
adopted to leduce e*p"ndltore, to encourage the develoPDent of non-chenlcal alternatlve
. nechods and developrlnt of self rellance elnce the bulk of the lnsecticide ls purchased
wLth external resources, and to enaure suetalnabil lty of roalaria control. Every year a
team of experts analyzes the nalarl.a data by vtl lage to aelect v1llages to be eprayed based
prlnclpally on the incldence of P. falclparuu. The malarla probJ-en in Paklstan ls largely
rural lxcept for Karachl where ste-ilEiiflE-Ehe naJor vector. such urban areas whlch have
been negletted tn the past are iff ided ln malarla control strategy whereby vector
control lnvolvee nainly source reductlon and larvlcidlng, while ULV ls reserved for
energency sLtuat lons ( iar ld E Beales, l99O). Case detect lon and t reatment act lv l t lee ln
rural areaa are belng lncreased to reduce the reservolr of lnfectlon. At the Present t loet
75i( of blood slldes are collected by ACD survell lance agents, and presuoptlve treatDent 18
glven pending the results of olcroecoplc exanlnatlon. The capabll lty of nlcroscoplcal
ai.grro"t" of nalarla has been decentraUzed to the dlstrlct level ln the whole country (Per
100 000 popularlon) and lt ls envisaged to reach the baslc health units eventually (per
lO 000 populatlon each). The develolnent of basic health eervlces at the perlphery (Rural
Health Centrea, Baslc ttealth Unlts and Connuntty ltealth Workers) began ln 1978 and 1e
continulng. Tralnlng of staff ie belng lntensifled to deal wlth oalarla and other
parael t lc d leeases a-e wel l as tuberculos ls and leprosy. St l l l r several constraLnte extet t
of which reference wae made to the lack of career structure for health workere/technlclans t
weakness of the referral syste6 (patlents are kePt waltlng and transportatlon fron the
per lphery is lack lng) , and euperv ls lon of baslc heal th unl ts by rhe d let r ic t heal th of f lce
te very seak (Far ld & Beales ' 1990).
Based on the current survell lance ayatem, the oalaria lncldence ln Paklstan has been
reduced f ron an Apr of r3 l r000 ln lg73 ro 0.8711000 ln 1988, but the APr appreciably
tncreased to 1.49/1000 in 1989. The lncreaee in 1989 ls thought to have been due to bet ter
case detectlon through novlng towards PCD away fron ACD. The greatest lncreaae wag
observed in Sind, funSat and Nt{F provincee. Malarla transmlsslon has been enhanced through
the poltt lcal sltuation ln Sind and lnported caaes anong Afghan refugees ln NWFP (Fartd &
Bealee, 1990). The incldence of P. faiciparun ualarla has narkedly lncreased lu PunJab tn
recenE yeara, and thls was correlff iEf,T? appearance of chloroqulne-reslstant
P. fa lc iparun caaea (Fox et a l . , 1985 and Str lck land et a l ' , 1987) ' Records of ch loroqul 'ne
resls tance have been lncreaslng steadl ly at the RI level e lnce 1981, and at the RI I level
slnce 1987. Wlth noving away froo chenlcal vector control, the occurrence of chloroqulne
resls tance ls expected io accelerate unless a l ternat lve nethods of vector contro l are
applled effectlvely, and the use of low dose presurnptlve treataent wlth chloroqulne le
nlnlnized. However, chloroqulne remains an effectlve flrst l lne drug for treatroent of
malarla ln Paklstan, especlally ln vlew of the hlgh lnctdence of ULg oalarla ln nany
vBc/90.3l{Allg0.3Page 322
areas (Far id & Beales, 1990). The rercords of ch loroqulne-res ls tant P, fa lc iparuro havecone rnal.nly fron tests carried out ln Punjab provincel only one ln vivo test was carrledout ln Sukkur, Slnd province in l98l which showed th"t !_:_jgf@ nas susceptlble.There is a need, therefore, to extend the test ing to Slnd, Baluchistan and NWF provlnceswhenever P. fa lc iparun lnc ldence increases.
The last country ln Group I ls UAE whlch organized an ideal programme for control ofnalaria transnLtted by culiclfacies and Stlggl. IReport of the Malaria Advisory Tearo oft he l { eaL th Sec re ta r l a t o f t he A rab S ta tes o f t he Gu l f (Fa r i d e t a1 . , 1985 )1 . The e f f o r t suade since 1980 to control naLarla which enabled the country to bring down the nalariainc ldence to a polnt near eradlcat ion except for cer ta in foc l , have been rewarding.Factors that helped to reduce the nalar ia inc idence are: socioeconomic developnent ;cooperat ion of munic lpal l t ies; extenslon of educat lon; and the aval1abl l l ty of hospi ta lsand PHC centres. Problens arlse fron cases lnported fron neighbouring countrles such asOman as wel l as f ron malar lous countr ies ln Asla and t ropical Afr ica. For vector contro lconbined oeasures have been used, viz:
- temephos larvicldlng as the rnaln nethod;- pyrethro id house spraylng in remote areas;- pyrethrold ULV or fogglng;- blological control wlth Aphanius dlspar.
Of GrouP 2. Afghanlstan presents the nost deter lorat lng nalar ia s l tuat lon in the areaunder review. Since 1980, the nalarla lncidence has been lncreaeing; the API rising fron5 .3 / f 000 i n 1980 to 19 .9 /1000 i n 1984 , and 7 /1000 i n t he f l r s t ha l f o f 1985 (Kovchasov ,1985). The nost ser lous s l tuat lo ln nas aeen ln the Eastern reglon, especla l ly ln Jala labadand Lbghuan rnalaria unlts, where large epidenlcs have developed slnce 1983. In Jalalabad,s lx superv lsory areas (each superv lsory area ls covered by 4-6 survel l lance agents)cover lng 46 v i l lages wi th a populat lon of 42 067, showed an API of .232-674/ IOOO. The sanearea6 were badly af fected dur lng 1984 and 1985 wl th lncreased norbid l ty . Favourablec l 1 n a t 1 c c o n d i t 1 o n s c a u s 1 n g a 1 a r g e i n c r e a s e i n v e c t o r d e n s 1 t y ( s t e p h e n s i a n d @assoclated wiLh Pulcherrlmus and lryrcanus), coupled wtth the fnafflTtyE local nal-ariapersonel to reach the affected areas and apply antlnalarla measures, nere the roain reasonsfor this alarolng epidenlologlcal sl.tuatLon. The sane condltlons have also exlsted inLaghnan unlt where a large epldenic was developing ln 1985 In slx supervisory areas. I ithe Southern region, P. falciparuo lnfectlon shich exLsted for a long tlne and was reducedto a nlnfunun ln L979-I981, showed a sharp lncrease partlcularly in Helnand uni.t since 1982,for which reststance to chloroquLne was suspected.
The ualn reaaona for the setbacks ln Afghanlstan were surmarized as follows(Kovchaeov, 1985):
- The exletlng unsettled condltlons have not pernLtted the nalarla personnel toperforn the planned antlnalarla actlvitLee.
- The sane conditlons caused dtff icultles in transportatlon resultlng ln late arrlvalof the antinalarial drugs and lnsectlcldes at the unlts.
- Due to operatlonal problens, antl-relapse treatment, conplete radlcal treatment,nass drug adnLnlstratlon and full ecale spraylng operatlons could not be carried out.
- The contlnued reductl.on Ln nalarla personnel and the reluctance of the basic healthservlcee (BHS) to partlcipate ln oalarla control were Lmportant setbacks.
- Lltt le has been done to attract cornrnunLty partlclpation.
In 1986, the malarla sltuatlon worsened; the number of cases detected reached422 4L5' glving an API of 47.6/f000 for the whole of Afghanistan whlch ls nearly doublethat recorded ln 1985 (Del f tn l , 1987). The Dost af fected areas are those of the Easternand Northern regions bordertng Paklstan, and the USSR, respectlvely. Large epldenicecontinued to be eeen ln the Eaetern reglon, where the API reached 592.3/f000 ln.Laghnan;368.7/1000 ln Jala labad; 114.3/1000 ln Kunar; and 50.4/1000 ln Gazlabad. lnconplete datarecelved fron vartous provlnces of Afghanlstao in the first f lve nonths of 1987 showed thatfollowing the rtl.nter decllne ln transnl.sslon, the sltuatlon has further deterlorated as theSPR reached,24.52 conpared wl th 13.52 recorded ln the conparable per lod of 1986. Al thoughP. vlvax le the predonlnant specles, the proportLon of !:_lgl@ lnfectlons has aleobeen Lncreaelngr- thus poslng a threat of the spread of l!--€"1"1pa* strains reslstant tochloroqulne. In fact, a case of chloroqulne resistance Ln a local lnhabitant hae beenreported f rom an area border lng Paklstan ln 1986 (Del f ln t , 1989).
vBc/90.3MAL/90.3Page 323
Under the prevall lng condltlone ln Afghanlstan, an effectlve rnalarLa control
progranne based on extenslve house spraying operat lons would be unreal ls t ic . Therefore, 1t
has been Euggested (Del f ln l , 1987) to:
- concentrate house spraying ln epldernlc areaa;- use ant loalar la l druge to reduce nor ta l l ty and suf fer lng, wl th v i l lage t reatment
centres to be created by the comnunl ty and operated by voluntary col laborators;
ln ter8ectora l cooperat lon should a lso be sought ;- antl-vector Eeaaures should be based on larvicldlng;- enhanced cooperatl-on and partlclpatlon of Bl{S ln case detectlon and treatDent
should be st ressed.
In oman, several mlsslons have vielted the country during the past l0 years to assess
the nalaria sltuation and control trlals and advlse on plannlng further expanslon of
ongolng control activlt les. The reconmendatlons nade by varlous uisslons are surnrnarlzed
coiL"c i l . re ly wl th eone addl t lonal connents by the wr i ter as fo l lows:
(a) To enaure ln tersectora l cooperat lon, a Malar ta Contro l CoordlnaElon Board forroed
of n ln ls t r lee, departments gnd agencLes concerned, should be establ ished. Late ly , Sul tan
Qaboos Unlverslty showed interest in cooperatlng wlth the lt lnlstry of l lealth for developlng
coumunlty health approaches and for applied research lncludlng environnental Danagenent
concerning the node of use of irrigatlo,n cenent baslns whlch rePresen! the nain breedlng
places of the rnaln vector6, ggl!€Sftg and.@,1.
(b) Provlslon of sufflcl.ent budget for strengthening of the staffing of the central
Malar la Contro l Sect lon ' (MCS) and nalar la contro l s tat lons at the per iphery.
(c) Recruitment and tralnlng of Onanl nationals ehould be fulf l l led, eo that they. can
aa6upe thel r responslb l l i ty ef f ic lent ly ln the MCS. 0f key professional s taf f needed i8 a
nedlcal officer to be awarded a fellowshlp for a postgraduate courae leading to a Ma8ter
Degree in publlc health (wtttr naJor ln nalarla), to be appolnted as the Dlrector of theI' iCS. The eecond peraon should be a graduate of Sclence or Agricultural Sclences to be
awarded a feLlowshlp for postgraduate studles leadlng to a ltaster Degree ln MedlcalEntonology, to be appolnted as a Deputy Director of the MCS in addltlon to hls naln dutles
of organlzl.ng and lnpleoentlng the entonologlcal actlvit ies of the programe. A thlrd key
person (non-profeestonal) ls the Chtef of Operatlons who can be selected fron anong the
Lxlstlng natlonal staff to be awarded a fellowshlp to obtain a Diplona of SanLtarlans, and
further attend a oalarla and vector control course. In order to Lncrease the capabll lt lee
of other natlonal (non-professlonal) personnel of the MSC and nalarla statlonsr tralnlng or
refresher couraes should be organlzed. The tralnlng ln nalaria should be extended to staff
of publ lc heal th, hoapt ta le and other heal th establ lshnente.
(d) The practlce of naklng thln blood fl lne and the uee of Leishnan staln should be
replaced by thi Btandard exaolnatlon of thlck f1lns and stalntng wlth Giensa. The very
h1!h rate of dlecrepancy between cllnlcally dlagnosed nalarla caaea and the results of
blood fl lo exanlnatlon by health establlshnents does not glve credlbll l ty to the data
obtalned by PCD for evaluatlng the'antinalaria Deasuree, nor for provldlng the treatlngphyslclans wlth an effectlve dlagnostlc tooL to explaln the hlgh lncidence of fevers.
ihlrefore, refresher traLnLng foi laboratory technlclans of health establlshnents should be
organlzed. Thle recomoendatlon has been repeated by nany consultantg. A11 laboratory
technlclane collecting blood slldee froo outpatlents, or- fron ourveys, must record the full
naDe, age, natlonallty and vll lage of each patlent. They should aleo record the sPecies'
the stage of developDent and paraslte denelty (slnply ln synbols), and whether ganetocytes
are present or not. Cerebral or other eerlous coupltcatlons of acute P. f?lcjrearu9lnfettlone adnltted to hospltale should have the paraslte count ln thelr blood nonltored to
see whether the response of oral or parenteral therapy ls favourable. A one-week senlnar
on the pathology, sytlptonatology and conpllcatlone of acute P. falclpafurn lnfectlons should
b e a r r a n g e d f o r t h e b e n e f 1 t o f t r e a t 1 n g p h y s 1 c i a n s . P h y e 1 c 1 6 f f i F a r m e d f o r c e sshould aleo attend. Apart from laboratory servlces ln hoepitalsr at least one tnalarla
nlcroscoplst should be assigned to Publtc l lealth Coropounds and some strateglcally sltuated
Pub1lc Heal th Unl ts .
vBc/90.3MAL/90.3Page 324
(e) In v iew of the problen of DDT res ls tance in cul tc i fac ies and g$.1 in Bat inahregion' it 1s necessary to deternine its extent and opEii-l l6i?l-I ipttcaffiTffi-a11 areasunder DDT spraying. Replacement insect ic ides should be ident i f ied and tested in a f le ldt r ia l . However, res idual house spraying should be l in l ted Eo areas adjacent to val leyswhere the suscept ib i l i ty s tatus and epidero io logical data so warrant . Larv ic id ing wi thtenephos should be regarded as the main at tack measure for the whole country prov ided thatvector suscept ib i l t ty to tenephos is nainta ined. The tota l coverage of the governorates bylarv ic id ing, and the need for ef fect ive superv is lon necessi tate l -ncreaslng the number oflarv ic iders, labourers and sanl tary assls tants in a l l governorates. In energencysi tuat lons, MCS should deploy staf f to apply the appropr late rneasures such as housespraying, space spraying, mass drug adnin is t rat ion and cer ta in envi ronrnenta l measures.Space spraylng and Dass drug adnln is t rat ion of a s ingle-dose t reatnent should be l ln i ted torenote and sparsely populated hanlets where local ized epidero ics usual ly occur , and a lso inepidenlc areas which have not yet been covered by the programme. No control neasuresshould be appl- ied wi thout base- l ine parasLto loglcal and entonological data.
( f ) The epidenio loglcal /entomological evdluat lon of contro l measurea should bestrengthened. The epidenlo logical Earget ehould be a reduct ion of malarLa prevalencerecorded in indicator v i l lages by at least 302 of the level of the previous year , asmeasured in March/Apr i l . Month ly absenteeisro f rom schools ln lnd icator v i l lages has to bemoni tored nonth ly ; any r ise above 52 should be lnvest lgated. The resul ts of PCD f ronheal th establ ishnents, co l lected separate ly f rom each governorate, would be qui te usefu lfor monitoring the nalarla situation. The data should include Ehe total nunber ofoutPat ients, the nunber of c l ln lca l ly d iagnosed malar la cases, and the nunber ofn icroscopical ly posl t ive cases by specles. I t ls iEportant to note that the percentage ofP. fa lc lparum has been increaslng s ince 1979. Thls phenonenon was a lso observed in roanyblood surveys conducted in the Sultanate. Thls very narked change in the paraslte fornulaover I0 years should be thoroughly lnvest igated as 1t nay be a precursor for the ex is tenceof ch loroquine-res is tant P. fa lc iparum. I In fact , P. fa lc iparun chloroqulne res ls tance wa6detected in two loca1 chi l ,dren anong 16 teeted ln DecenbeFlg8gj . Concernlng theentonological evaluat ion, Ehe nonth ly adul t and larval densi t les should not exceed L" l o f .the base- l lne values as tneasured in indlcator v l l lages under opt lnal breedlng condi t lons.The dut ies of t le entonological s taf f ln the 1988 Plan of Act lon are ldea1 and cover a l lthe required aspects of the entonologlcal work but the number of the avallable staff lsl ln l ted (13 ln a l l ) and th is rest r ic ts the act iv i t ies. The aval lable three entonologicalteams who operate fron the MCS central offlce 1n Muscat are sonewhat thlnly spread over 56governorates for undertak ing 414 aurveys in one year . In some cases, par t lcu lar ly wherelocal l t ies far f ron Muscat are lnvolved, such v ls i ts are of necessi ty rather superf lc ia land non-productlve ln glving a proper asaessment. It has been suggested that, under thepresent organizational clrcumstancea, the number of surveys should be reduced so as tolnprove sampllng, and reliabll l ty of data. [Actually, there ls a need for lncreaslng thenunber of entomologlcal staff to forn flve teans (each to be statloned ln the five regionsof the country). The central MCS tean ehould be charged nlth supervisory duties and theentonologlcal component of epldenlological lnvestLgatlons ln problen areas. Thls is lnvlew of the expected expanslon of control actlvlt les and the need for establtshlng soundbaee - l l ne da ta l .
(g) Efforts should be nade to develop non-cheDlcal oethods for nalarla vector controllnvolvlng envlronnental Eanagement. Expanslon of agriculture was declared ln 1988 and 16conttnulng wlth the conaequence of prollferatlon of rrater atorage baslns whlch areovershelning the capaclty of the larvlcldlng programe. Source reductlon was advocated toellnlnate stagnant water ln the course of valleys. To deal with lrater storage baslns whichare the ualn source of breedine of culicifacies and stephensi. aome solutlons were offeredof which the enforcement of a ;dry
ff i repeatedffirtff i iea. Irts acceptabll lty bythe lnhabitants and practicabll lty as a long term measure of control of vector breedlngneed to be thoroughly studledl. Two trlals wlth the larvlvorous flsh, Aphanlus dlspar ftwells and cenent basins, respectively were lnconclusive. A more carefully planned andevaluated t r ia l ie suggested wi th the f ish being reared in local nurser les to be raLsed anddlstrlbuted by the cornmunlty, thus savl.ng the cost of repeated transportatlon of the flshf ron h i l ly area6 and thei r d ls t r ibut lon by the nalar ia s taf f .
vBc/90.3l,rAl,/go.3
(h) Itealth educatlon should 'upport all nalarla control activlt les. ,. ";::::
::t
in tensi f led at a l l levels lnc luding v l l lage schools and other establ lshnents us lng the nost
effectlve nedia and nethod
( i ) Jo lnt assessment by Onan and UAE should cont lnue and coordlnat ion of rnalar la
contro l act lv l t ies ln the t rdo countr les be st rengthened wl th a v iew to achlev lng 6el
targets ln border area8.
The Dost recent lnfornatlon on the roalarla sltuatlon ln Onan and the new atrategy for
nalar la contro l have been provided by Dr !1.A. Far id (personal comnunlcat lon, 1991) - see
Subsect lon ( t l ) under paragraph I above.
In yenen (North) , the la test ln fornat lon aval lable comes f ron eone parasl to logical
survey8 cE]r:ffiiffirrng 19g3-1984 coverlng the four rnaln reglons of the country, but
theee surveys were considered inadequate or lnconplete. Therefore, pre-exls t ing
infornation has been re1led upon but thls needs a thorough updatlng to deternlne the
nalar la s l tuat lon and the responslb le vectors ln the four reglons of the country. Much
remalns to be done to clarify the dynanlcs of ualarla t,ransmission partlcularly tn the
coastal plaln where arablensis, the well known efflcient vector exists. Regardlng nalarla
control, some actlvfff iTaT started ln 1978 have been dlrected tonards the develoPnent
of pCD includlng treaCDent, together with the appllcatlon of vector control neaaures as of
1981. DDT house epraylng has been the Datn vector control Beaaure ln eoEe clrcurqscrlbed
areaa ln the coa6t;l pf"i.t, and nae replaced by tenephoe larvlcldlng as of 1985' No
observatlons have been carrled out to aageaa the fuopact of these vector control Deaaures on
nalarla traneEisslon. The problene faclng Ealaria control ln the country are the l lnlted
resourcea and ,mnpower. It is lnterestlng to note that, ln a few vll lagee, the lnhabltant6
st lnulated by the nalar ia personnel , par t lc lpated ln source reduct ion. I t ls exPected that
community paittcip.tlon d1l be enhanced through the efforts of PllC workers. By a
Mlnis ter la l decree ln 1985, l t was declded to ln tegrate a l l naJor endenic d leeases
(nalarla, schistosomlasls and tuberculosls) lnto the PHC syaten. Plane for step by etep
lntegration rrere proposed ln 1985. Follow-up evaluation of the lntegratlon procese ls
awalted. It ls also necessary to check whether chloroqulne-resistant 3:lgl@reported ln 1989, has made a fur ther sPread.
In yenen (South) , the la test ln fornat ion on the oalar la s i tuat lon covers the per lod
L97g-IgE4. Mafari.# a serlous publlc health probleu. The geophyslcal and meteorological
featurea favour nalarla transgisslon throughout the yearr excePt In areas above 2000 n
altitude and ln the desert. The suboountaln tracts and valleys are Dost affected'
Ilowever, ln all areas exceptlonal ralnfall may cause sporadlc epldenics, whlle transnission
becones restr lc ted tn dry years as observed ln 1983/1984. The naln vector 1" 3: ry 'wlth eergentll playlng a secondary role. Due to lack of tralned health nanpower and
flnanclal r""o,r"""L, i countryrvlde roalarla control Progratntne hae not.Etarted and control
operatLons had to be directed to areas of hlgh endeoiclty and economlcally lEPortant
(Lahej, Ablyan and Hdranut governorateE). Thus, a snall segment of the populatlon at rlsk
i"Uo.ri 'o.r. ifftn) is protecied. Although the rnalarla control servlce renalned as a
vertlcal progranne wtttrtn the general healttr aervlce6, lt has been operatlonally
decentrall zed at governorate level elnce 1980 and gradual lntegratlon at the perlphery wll l
proceed ae PHC centres are establ lshed. Aden c l ty wl th 0 '5 n l l l lon populat lon 1e f ree f ron
nalarla; only in the suburbs eporadlc tranemlssLon may occur. Aden rnunictpality carrles
out effectlve larvtcldlng and eource reductlon, repreeentlng a good example of
lntersectoral cooPeratlon. Accordlng to infornatlon obtained ln 1987 by PCD and fever
surveyg durl.ng epraying oPeratlons, ih" Spn itas about f0-f5Z' DDT house spraying covers
about 100 000 populatlon; the rate of refusals ls rather htgh resultlng ln a coverage not
exceeding 502. Teoephoe larvlcldlng ls applied ln seePages ln valleys.. .tgni!1H=u1:Oli.
has been found to th;ive ln valleys, Uut ln sorne breeding places wlth thlck growth ol argae
and other vegetatlon, f lsh alone r"y trot be sufflclent and need to be supplenented with
larvlcldlng. The lnfact of DDT spraylng and teoephos Larvlcldlng await
;;;;; i l ; i ; ir". if""tonoroglcal evaluaitoi. s1nl1arly, follow-up evaruatl 'on of the
developnent of nalarla control rhrough fhe PIiC sy8ten ls needed. It ls necessary also to
further check the eenslEivity of L ialclparuq to chloroqulne, in vlew of the recent
records of reslstance reporg"a f"T.;l!-Gfr) in 1989. As doubta ltere raised
vBc/90.3ltAL/90.3Page 326
(Fa r i d , 1988 ) , a round the va l i d l tYreported prevlously (Thevasagayan,
ef f lc ient vector is warranted.
of a record of arablensis ln Socotra ls land that was
1987), a fur thei l? f , f f i r the Presence of th is
Regarding the chloroqulne-res is tant P. fa lc iparurnr the Present geographical area
(Fig. 29) , Asla West of lnd ia, unl lke the iETEE l led i terranean Basin (SECTION I I l , A)
rec6rds have shown an increasing inc ldence of th is res ls tance. Apart f rom records of th is
res ls tance detected anong fore ign labourers corn ing f ron nalar ious countr l -es, P. faLciParun
stra ins res is tant to chloroquine have been repor ted f ron several countr ies ln the
indigenous populat lon, vLz Saudi Arabia, 1990; Yemen (North) ' 19891 Oman' i989; I ran '
1983 ;1985 - fgbZ ; A fghan l s tan , I 986 ; Pak i s tan , 1981 , 1985 . I t has been enphas l zed (Na je ra &
Zulueta, 1986 - see thel r repor t on l ran) that the Presence of drug res is tance at the RI or
even lov frequencies of RII levels, does not require a change in the use of chloroquuine
for c l ln ica l t reatment at the per iphery, but i t ls necessary to prov ide second l ine drugs
at the referra l level for t reat ing microscopical ly conf i roed severe or
chloroquine-res ls tant caaes. Thls is essent ia l because of the h lgher r lsks of s lde ef fects
and conslderably h lgher costs of a l ternat ive drugs '
On water- re6ources and other developnent Pro jects, in fornat ion vary ing ln depth and
de ta l l s came f rom Saud l A rab la (Baha r , L979 , 1986 ) , (Fa r l d e t a l . , 1985 ) ; Ye roen (No r th ) '
(Chen Kuo, Del f ln i & Ahned, 1986); I raq (Macan, 1950); I ran (Zaln, Manouchehr l & Ershadi '
ig6f) ; l f ihanistan (Bahar, 1977 and l {ard, 1977)t Paklstan (Ward, L977, Bahar, 1979 and
Rathor , f igZ) . The rnost spectacular auccess-was obta ined f roro the wel l p lanned and
malntalned lrrlgatlon and drainage scheoe in A1-Ilassa oasis of the Eastern province of
Saudl Arabla. Thls schene has led to conplete ln terrupt lon of malar ia t ransniss lon in th is
area. Recent in fornat lon lndicates that th ls success has been susta ined (Joint
Governnent /Wgo Revlev MlssLon, Najera & Far ld et a1. , 1987). In a l l o ther l ta ter resources
and developrnent projects, nore recent observations are needed to see whether the
def ic lencies noted have been renedled, or to what extent the nalar la s l tuat lon has been
af fected af ter construct lon of the scheroes has been conpleted (Yeroen, North l l ran) . AIso,
in forrnat lon is needed on the nalar ia sLtuat lon and l ts contro l ln i r r igat ion and other
developoent projectE in various countries of the present geographlcal area where nalarla
t ransnlss ion stL l l pers ls ts .
On aLternatlve nethods of control, useful lnfornatl.on on the use of Gambusla as a
eole anti larval mea6ure comes f ron north Afghanlstan (Polevoj et al., tSZl]ana-outhanlna &
Quadeer et al. , Lg74), or as a supplenentary measure to house spraylng and larviciding ln
i ran (Tabibzadeh, Behbehanl & Nakhat , 1970). Aphanlus d lsPar 1s wldely d ls t r ibuted ln the
Arablan Penlnsula, but awaits a well planned ana evatuatea trlal to ascertaln its efflcacy
under local conditlons'
On the other hand, larviclding wlth oi1 or tenephos has been applted as a supplenent
to house spraylng as 1n Iran where the efflcacy of these tlto measures was denonstrated(Javadlan t n tn. -ot , 1974, and Mossadegh, l lo tabar & Javadian, 1973). Larv lc ld ing conblned
wlth sanltatlon |n Bandar Abbas clty proved effective ln controll lng stePhensi breedlng'
and consequently greatly reduced the nalaria lncldence in the city (Ershadi & Manouchehrl,
1985). tarvlcfifng wlth tenephos has been the naln Deasure of control of breeding of
cullclfacles and stephensl ln UAE and has been qulte effecEive. lnfornatlon on the
; P F f f i o f e n i f f i E a 1 n a n a g e n e n t D e a s u r e e l s f r a g n e n t a r y . A s i n t h e M e d t t e r r a n e a nSalfn, no Lnfornatlon ts avallable on lntegrated vector control ln the Present geographlcal
area, based on a comblnatlon of cost-effectlve and safe methods. 0n1y pragnatlc selection
of a conblnatlon of antl-vector Deaaures, vlz: house spraylng, larvlcldlng and dlstrlbution
of Garnbusla has been adopted ln lran. Therefore, lt ls t iroe to arrange for trials of
fntEfriFvector control to serve also as denonstratlon areas ln countries where roalarta
transrd.seion persi.sts and current control Deasures are showlng slow Progress. On connunlty
particlpati.on, l l tt le has been done ln the present geographical area. It 16 also tlne to
lntenstly health educatlon ln schools and at perlpheral levels, and stlmulate the
lnhabitanta through PHC workers to undertake neasures of maLarla vector control such as
slnple source reductlon, culturlng and dlstrlbutlon of larvlvorous flsh, and use of
Lnpregnated bed-nets that have been proved safe, effectlve and economlcal.
vBc /90 .3MAL/90.3Page 327
SELECTED REFERENCES
SECTION I I I (B) ASIA WESI OF INDIA
The references of Subsect ion ( i ) VECT0R BIONOMICS AND Subsect ion ( t i ) EPIDEMIOLOGYAND CONIROL 0F MALARIA are arranged by country ln alphabetical order. References dealingwl th roore than one country or a subJect of general in terest are l ls ted f i rs t underGENERAL. Some authors c l ted previous references in re lat ion to thei r s tudies. Such?ffices are narked ln the nargln lrlth letter c. References cited by authors but notseen 1n the or lg inal are narked in the tnarg in wl th an aster lsk. To avoid repet i t lon, forcer ta in references readers are referred to reference l is t o f the PREFACE of VOL. I , orANNEX 2 of the present docunent, as lndicated ln footnotes I and 2 at the end of thisre fe rence l l s t .
As India is outs ide the present geographical area, references of or ig inal papers f roroIndla rev iewed ln the present docunent are shown at the end of th is 1 ls t ' but Indlanreferences c l ted by authors of Paklstanl s tudies are l ls ted under Pakistan marked wi th c .
GENERAL
Brown , A . I . f .A . & Pa l , R . ( l 97 l ) I
Bruce-Chwatt , L .J . ( f980 & 2nd ed. f985 ) lI
c B ruce -Ch t ra t t , L . J . , Ga r re t t - Jones , C . & We l t z , B . ( 1966 ) '
c Chr ls tophere, S.R. ( l9 l l ) The deveLopnent of the egg fo l l lc le ln anophel lnes.Paludisn. 2 t7 2-89 .
c Dav ldson , c . ( 1954 )nature. Nature
Eetlnatlon of the survlval rate of anophellne r0o6quitoes in(London) L742792-793.
c Davldson, G. (1955) Measurenent of the anpul la of the ov lduct as adetermlnlng the natural dally nortallty of Anopheles ganblae.Parasl r . 49 t24-36.
Garret t -Jonee, C. & Shtdrawl , G.R. (1969) Malar la vector la l capacl tyof Anopheles ganblae, an exerclse ln epidenlologlcal entonology.
Sg, 3,!l:s:l-s4s
neans ofAnn. Trop. Med.
D e t l n o v a , T . s . ( 1 9 6 2 ) f
Far ld, G.A. ( f987) Reglonal Malar la Infornat ion. Work lng paper presented to theReglonal Technlcal Consultatlon on Malarla Control and Prlnary Health Care,Anman, Jordan, 27 June-2 July 1987. Wtt0-EI ' t /REG.TEC.CNS.ULC.PHC./4.
c Garret t -Jones, C. (1964)2
of a populat lonBu11. W1d Hl th
Gar re t t - Jones , C . , Bo reham, P .F .L .
IH o r s f a l l , W . R . ( 1 9 5 5 ) '
Macan, T.T. (1950) The anophel lneand Malar la ln the Near East .
;
& P a n t , C . P . ( 1 9 8 0 ) I
nosquitoes of Iraq and north Persia. In, Ag93\.|99-( teeson et a1. , 1950) London School of Hygiene andZ . (pp . f 13 -219 ) . H .K . Lew ls & Co . L td , London .
Macdona ld , G . ( f 953 ) The ana l ys i s o f na la r l a ep lde ro l cs . T rop . D l s .8u11 .50 :87 f -889 .
M a c d o n a l d , G . ( 1 9 5 7 ) l
Macdonald, G. & Gi ickel , C.W. (1964) The malar la parasi te rate and lnterrupt lon oft ransmlss ion. Bul1. I {1d l t l th Org. 365-377.
vBc /90 .3MAL/90.3Page 328
c M a t t i n g l y , P . F . & K n i g h t , K . L . ( 1 9 5 6 ) l
* c
Mer, G.C. (1936) Exper imenta l s tudy on the development of the ovary in. A n o p h e l e s e l u t u s E d w . ( D i P t u . " , c , ' l i " i d a e ) . B u l l . e n t . R e s . 2 7 l 3 5 L - 3 5 9 .
Muirhead-Thomson, R.C. (and Contro l in the TroPicEl london, Ed' Arnold & Co'
Muirhead-Thomson, R.c. ( i958) A p i t shel ter for saropl lng outdoor mosqui to
p o p u l a t i o n s . r y ' 1 9 : l l l 6 - I i l 8 '
pu r i , l .M . ( r951 ) A p rac t i ca l en to roo log l ca l cou rse fo r s tuden ts o f na la r i o l ogy '
I lea l th Bul le t in No. 18; lk lar ia No' 9 , De1hi , India '
Ranachandra Rao, T. (198l r 2nd ed, 1984) The AnoPhel ines of India ' Indlan Councl l o f
Medical Research, New Delh i .
serv ice, M.W. (1986) Lecture Notes on M9d1c9l Entonologv. Blackwel l Scient i f ic
Publ icat ions: Oxford, London, Edinburgh'
soka l , R .R . & Roh1 f , F . J . ( 1969 ,2nd ed . 1981 ) B io rne t r y . I { .H . F reenan & co '
San Francisco, Cal i forn la.
wernsdorfer , w.H. (1980) The inpor tance of nalar ia ln the wor ld ' In : -$alar la ' Par t I '
Ep ideniolo gy, Chemothe rapy' Igghtl"€f and Metaboi lsn' Kreie r' J:?fed'ff i
Vo r t3caaen i c P ress , PP . l - 93 .
Wor ld Heal th Organizat ion (1975) Manual- on Pract ica l Entoroology in Malar la ' Prepared
by the Wtto Div ls lon of l ta lar ia and other Parasl t ic Diseases ' Par ts I & l I '
Geneva. Wt lO Offset Publ icat ion no ' 13 '
Wor ld Healrh OrganizaEion (1980) Resistance of Veqtors of .Dlsease qo-gest ig ides '
Fif rh Report of the WnO fxpe@ology and Control'
Techf i ica l Report Ser l 'es (TRS) No. 655, 1980'
I{orld Healrh organizatlon (1984) Advances in nalarla chenotherapy' Report of a ff i{o
Sc ien t i f i c G roup . Techn l ca l Repo r t Se r l es No ' 7 l I ' 1984 '
wor ld Heal th Organizat lon (1986) Resistance of vgctors and Reservoi rs of Disease to
Pesticides. Tenth rePort of tne WtlO Expert Co
E6;ffit 'echnlcal RePort Series No' 737, 1986'
world Health organlzatlon (1989) The use of lnpregnated bednets
for vector-borne dlsease control ' A report of the wlIO/vBC
h e l d i n G e n e v a , l 4 - t 8 F e b r u a r y t 9 8 9 . l t i n e o g r a p h e d d o c u n e n t
wor ld Heal th organlzat lon (1990) Wortd l la lar ia s l tuat lon, 1988'
qua r t . 43 :68 -78 .
Zahat' A.R. (Lg74> Revlew of the ecology of nalarLa vectors in
Mediterranean Reglon' Bull ' Wld Hlth Org ' 5O2427-440'
AFGITAI{ISTAN
Anufr leva, U.N., Koshelev, B.A. & l larkin, Yu' I ' (1977)-t : l l1t t?l l : "r : t - : : : " :o: : ot
ffi i i ""-gr
o"ing "
rE s-ffiEs re rn - Af ghanl s ran. liedskaya
atazlt. 4624L4-4L6. [In-Russlin with Engtish sunmary) 'P a t a z t t . 4 6
and other naterlalsInforoal Consultatlonwno/vBc/89.89r .
Wld heal th s tat ls t .
the WIIO Eastern
Anufr ieva, v .N. et a l . ( r98I) An exper inent ln the use of nalath lon for contro l o f
Anopheles ln irrigated areas of north-eastern Afghanlstan' l ledskaya Parazlt '
5dffitrn Russian with Engllsh sunnaryl'
vBc/90.3MAL/90.3Page 329
Artemlev, M.M. et a l . (1977) The problen of nalar la and nalar la contro l rneasures - in
northern Afghanlstan. Conmunication 3: Anopheles mosqultoes In rice growing
.i""". Medsfqya parazlt . 46t406-4i: Irnffi-n-wlth Engltsh sunnary].
Badawy, M.S. (1970) Unpubl ished rePort , WHO/EMRO, May 1970'
Bahar, R. (1977) Report on a v ls i t to Afghanistanr 2 l October-2 Novernber 1976'
Unpublished report mlo-EM/MAL/I49. January L977 '
cu l1en, J .R. ( I978) Draf t Assignnent RePort , l6 February- l Apr i l 1978' Malar la
contro l Progranme, Afghanlstan. unpubl ished rePort to WHo/EMRO, 15 March 1978'
Davidson, G. (1955) - see under GENERAL above'
Del f ln i , L .F. (1986) Report on a n lss lon to Afghanistan, 20 Apr l1-23 June 1985'
Unpubl lshed repor t WIIO/EMRO (530) '
Del f in l , L .F. ( f987) Report on a u iss lon to Afghanlstan, Inst i tu te of Malar ia and
parasl rorogy, i "u" i , l l June-7 July 1987. Unpubl lshed repor t , wHo-EuRO (782r '
Del f ln i , L .F. (1989) The f i re t case of Plasnodtun fa lc lp"rgro reststant to chloroqulne
treatnent dlscovered ln the Republ
$ g . 8 3 : 3 1 6 .
Det lnovar T.s. ( L96DL
Dh l r , S .L . & Rah ln , A . ( 1957 ) Ma la r l a and l t s con t ro l l n A fghan l s tan (1950 -1954 ) '
I nd ian J . l l a l a r l o l . t 1 :73 -101 .
Dukhanlna, N.N. 6 ' Quadeer, A, et a l . (1974) Epldenlo loglcal Just l f lcat lon for
supplenentary antimalarla neaaurea ln the ualarla eradlcatlon prograrnme 1n
norrh-easrern Afghanlsran. Mlneographed docunent wno/MAL/74.827-llHO/vBc/74'486'
Eshghy, N. (1977) Asslgnnent report' Malarla Control Progranrne: Entouologlcal
activlt les and suiveys ln south-west Afghanlstan, June-October 1976' Unpubltshed
rePorr wllo-EM/MAL/ 150
Eshghy, N. & Nushtn, M.K. (1978a) Evaluar lon of nalath lon as a reeldual spray for the-
corrtrot of Anopheles cullctf lcles ln the province of HeLnandt aoutheast
Afghanie ra"@ t268-27 4.
Eehghy, N. & Nushln, U.K. ( f978b) lnsect lc lde res leta l : : ,o f , , f? ! l : .1"r?: - :u l l :11 1"
the province oi Hehnand, aoutheaat Afghanlstan, 1976. Fqultolews 38:97-I0I'
Far ld, G.A. ( f987) - see under GENERAL above'
Gar re t t - Jones , C . (1964 )2
Gar re t t - Jones , C . , Bo rehan , P .F .L . & Pan t ' C 'P ' ( 1980 ) l
Iyengar, ! t .o .T. (1954) Vectore of nalar la ln Kabul , Afghanistan ' Trans ' R ' Soc ' TroP'
l ted. I lYg. 48:319-324.
Kovchasov, G. (1985) Assignnent rePort , 3 October 1979-25 october 1985' Afghanistan '
Unpui l lshed repor t , 15 october 1985 (322>'
K u l k o v a , T . A . , E r r n i s h e v , Y u . , V . & P o l e v o l r N ' I ' ( 1 9 7 5 ) S t u d y o f - . q o P h e l = n o s q u l t osensl t iv l ty to lns;ct ic ldes ln Nort -h-Eastern Afghanlstan ' Medskaya Parazl t '
44I6LO-6L2. I f " Russian wl th Engl ish sumary] '
Lewts, D.J. (1958) The recognl t ion of nul l i .parous and.Pa.rous +*! l+; r#=.ganbiae. by
examining the ovar lo les. Trans ' R ' Soc ' TroP' Med' Hyg' 522456-46I '
vBc/90.3MAL/90.3Page 330
c Macdona ld , G . (1957 ) l
c Mu l r , D .A . (1966 ) Tou r No tes , A fghan i s tan , 17 Ju l y - I 8 Augus t 1966 ' Unpub l i shed rePor t
WHO/SEARO.
polevoy, N. I . e t a l . (1973) Exper inent on GaPbusira t ransPorEat ion f ron TaZik ssR into
north-east Afghanistatt ..td lts applicEEl6n in lhe antlmalaria canpaign'
Mineographed document IfI{O/MAL/7 3'7 9 5'
Polevoy, N. I . e t a1. (1975) Malar ia problern and rnalar ia contro l measures in nor th
Afghanistan. CoDr0unicat ion 2: landscape-nalar logenic d is t r ic t d iv is ion of nor th
Mghanistan and reorganizat lon of rnalar ia contro l neasures systeD' Medskaya
p" i . r i . . 44t338-344. I In Russian wi th Engl ish sunnary] .
onorL, E. et ar . (1975) An epidenio loglcal assessDent of the res idual ef fect of DDT
in Anopheles'hyrcanus slnsg lato 1nd-A. l*lcher:l inus (Theobald) in the
northeasterr, ' 69"236'242'
Ramachandra Rao, r . (195r) Malar la contro l us ing lndoor res idual sPrays ln the
Eastern prov lnce of Afghanlstan. Bul l . I {1d l l l th org. 3:639-661.
I lard, R.A. (1972) Chapter three: Medical Entonology, Di .ptera, cu l ic idae.
and Disease in Rural Afghanlstan. Al f red A. Buck et a l . (eds) . York
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ward, R.A. (1977) Recent changes ln the epldenlo logy of malar la_re lat lng to human
ecology. proc. l5 th Inte in. congr. Entonol . I {ashington, 1977.
Wor ld Healrh Organizat ion ( f989) - see under GENERAL above.
world Health organlzatlon (1990) - see under GENERAL above.
Zahar, A.R. (1971) Report on a v is l t to Afghanlstan, 28 July-3 l August 1970'
Unpubllshed report WHO-EM/MAL/102, ltarch l97f '
BAHRAIN
(1938 ) Ma la r i a i n Bahrein Is lands (Pers lan Gul f ) .Inst , India 4t438'452.Survey. J . Malar .
AnJawi , A. (1983) Malar la s i tuat lon ln Bahrain. Publ lc Heal th Directorate, Min is t ry-
oi Health, Bahraln Sgate. (Unpublished report to W11O/EMRO).
c Ch r i s tophe re , S .R . & Sho r t t , H .E . (1921 ) - see unde r l r aq '
De l f l n i , t .F . ( 1977 ) Repo r t on a v l s i t t o Bah ra in ,2g Janua ry -4 Feb rua ty 1977 '
Unpubllshed rePort' WHO/EMRO.
Far ld, C.A. ( f987) - see under GENERAL above'
an dssegsDent on the status of oalaria22 October-7 Noveober 1982. Unpubllshed
Shldrawl , G.R. (1979) Report on a v ls l t to Bahraln, 31 October to l l Noveuber 1978'
Unpubllshed report mro-Elt/MAL/160, February 1979'
In : l lea l thP r e s s ,
IRAI{
c
A f r l d i , ! 1 .K . & Ma j l d ' S .A .C. Anophellne Mosqulto
Oddo, F.L. & Payne' D. (1982) Report oneradlcatlon ln the Bahraln Eolrate,report, lmo/EMRo.
Axte l l , R.C. (1979) Pr inc lp les of ln tegrated_Pest Danagement ( IPM) in re lat ion to
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c Chr is tophers ' S.R. (1911) - aee under GENERAL above'
Det lnova, T.S. ( Lg6Dl
Edr lse lan, Gh. l l . (1974) Blood t ransfuelon induced nalar laT rop . Med . Hyg . 68 :491 -493 .
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ln I r an . T rans . R . Soc .
sero loglcal survey of nalarLaBu l l . Soc . Pa th . Ex .
P. v ivax
Edr les lan, G.H. (1989) Status of the response Plas+99199-fa lc iparun to chloroqulne
and nef loqulne !n lran. ]Ig!-*eogr. !1e9.. 4t:297-303'
Edr lss lan, G.H. [ , Shahabt , S. (1985) Prel f in lnary study of the response ofplasnodlun f"IlEr"r to chloroquine ln Sistan and Baluchestan provlnce in lran.
Trans. R. S*-:-Jrof-. M"a. Hv,g. 792563-564'
Ed r i ss ian , Gh . l t . , Gho rban l , M . & A fsha r , A . ( 1985 ) IFA
in nor th, nor th-west and south-west Par ts of l ran '
78 :349 -359 .
Ed r l ss lan , Gb . I t . , Na ln i , F . & A fsha r , A . ( 1976 )
nalarla wlth suspected long lncubatlon ln5 : 198 -206 .
Seroeplderniologlcal studY ofI ran. I ranian J. Publ . I t l th .
E d r 1 s s 1 a n , G h . t l . e t a 1 . ( l 9 8 9 ) T h e r e s p o n s e o f @ t oand nefloqulne ln Bandar-Abbas and Mlnab area6r Horoozgan Provlnce,
Ir"n. J:-Ig!-@g. 92 z7 5-7e.
Ershadl , l l .R.Y. & Manouchehr l , A.V. (1985)
and larvlctdlng ln Bandar Abbae, IranMalarla control bY the use of( 198t'1983). Irenle4 J:_!g!l.
chloroqulnesouthern
sanl tat lonI t l t h . l 4 : 3 6 .
Eshghy, N. (1977) Anopheles oul t lco lorrnalar la ln l ran. J . Entorool . Soc.
Eshghy, N. (1978) Tolerance of Anopheles etephensl to nalathlon in the provl'nce of
Fare, southern r ran, 1977.@80-583.
E e h g h y , N . & J a n b a k h s h , B . ( 1 9 7 7 ) T h e b i t i n g a c t 1 v 1 t y o f w i n t w oI ran l ' anv l11agessp rayedw1 tho rganophospho rus1neec t1c1d"s . ! 199g@27 t7 56-7 59 .-
Eehghy, N. , Ladonl , l l . & Javadian ' E.to Dalathlon in the Province ofI ranLan J. Publ . I l l th . l4 : l -8 .
Canboullu, and lts role ln the transmisslo,n of
I r an 4 :87 -88 .
(1985) Reslstance of AngPheles stephensl L ls tonFars , sou the rn I r ann 1979 .
Eehghy, N. , Janbakheh, B ' & Uot taght , M. (1977) SuscePt lb i l l ty- i tooU"f"" superpic tus to lns ic t lc ldes ln l ran. Mosqul to News 372490-493.
Eshghy, N. , Javadlan, E. & l tanouchehr l , A.V. (1982) Suscept lb l l l ty of- inophelee f luv lat l l le to lnsect lc ldes 1n eouthern I ran, 1979.
I r in fan J. Publ . I t l th . lLzTL-76.
Eehghy, N. , Horabar, M. & Janbakhah, B. (1975) F le ld t r la ls of Suni th lon (OMS-43) and
oalathlon resldual 6prays for control of AnoPheles stePhens-l nysorensis ln the
Mauasanl area, Eouthern Iran, 1974. Mosquiio Newe 352372-380.
Eshghy, N. , Zaln l , A. & Yazdanpanah, H. (1980) Suecept lb l f f tV of -e+?Eh: l :e- nacut ipennte to insect lcLdee ln I ran, 1877. Mosqul to News 40:510-5f3.
evaluatlon of Sunlthlon (OMS-43) for control of
l, lamasanl , Kazeroun, eouthern lran, 1972.Eehghy , N . e t a l . ( 1973 ) A rea sca le'
adult anophellne nosquttoes 1nI ranLan J . Pub l . H l t h . ' 2 :14 -39 .
Eshghy , N . e t a I . ( 1975 ) B lo log l ca lthe transmiselon of nalarla ln
features of Anopheles f luv lat l l lsI r an . T rop . gPog t . Med . 28 :4 I -44 .
Eshghy, N. er a l . (1983) Ihe b l t lng act lv t ty of AnoPheles { - tha11. in a-
under lnpact of organo-phosphorus spraylng 1n Manasanlr southern
I ran lan J . Pub l . H l t h . t 2 :26 -31 .
and its role 1n
rura l areaI r a n , 1 9 7 8 .
vBc/90.3MAL/90.3Page 332
c Ether lngton, D. & Sel l ick, G. (1946) Notes on the b iononics of AnoPheles sacharovl ln
P e r s l a a n d I r a q . 8 u 1 1 . e n t . R e s . 3 7 : 1 9 1 - f 9 5 .
Far ld, G.A. (L987) - see under GENERAL above.
Fay , R .W. & Mor lan , I 1 .B . (1959 ) A nechan l ca l dev i ce f o r sepa ra t i ng t he
stages, sexes and species of roosqui tos. Mosqui to News L9: I44-L47.
Inst l tu te of publ ic I iea l th Research, Teheran (1965) Progress rePort on
on nalar ia epidenio logy and nalar ia eradicat ion ln I ran. Teheran
I n s t . P u b . l l l t h . R e s , T e h e r a n , N o . 1 4 6 3 ) '
developnenta l
lnves t lgat ions(Publ lcat ion
Javadian, E. & Acheson, !1.A. (1974) An evaluat lonoPerat lons in rura l areas near Abadan, I ran '
l ' lacan, T.T. (1950) - see under GENERAL above'
c I ' tagoon, E.H. (1935) A portable stable traP. Elf : -$-!E. 26:363'372'
Manouchehr i , A.V. & Rohani , F. (1975) Notes on the ecology-of { lgpheles d- thal l
Pat ton in southern l ran. lo@' 692393'397'
of the ef fect of larv lc ld lngI ran lan J . Pub l . H I th . 3 :54 -61 .
Motabar, M. (1974) l la lar la and the nonadlc t r lbes of southern l ran.
en t . n6d e t Pa ras i t o l . 12 :175 -178 .uotaU@. l-ltanouchehrl , A.V. (f975) l lalaria and
Iran. TroP. geogr. l led . 27 z7L-78'
Motabar, H. et a l . (197I) A nedicated sal t proJect ln the Kazeroun area l ran '
lg62'L967. J . TroP. Med. I tvg. 74239-44'
Mulrhead-Thooson, R.C. (1958) - see under GENERAL above.
Mu l l l gan , H .W. (1967 ) Ma la r l a i n I r aq and Pe rs ia . P ro tozoo logy 2 :113 -146 '
l (anouchehrl , A.v. , Djanbakhsh, B. & Eshghl, N. (1976) The bl t lng cycle of
Anopheies g1tt"li, A. fluviatil is and a. stephens,l ln southern lran.ffisma:zzffi+
Manouchehr l , A. , Ghiassedin, M. E Shahgudlan, E.R. (1972> Anoph.q lqs 9- thal i Pat ton,
1905 , a new seconda ry vec to r i n sou the rn l r an .Agn . T rop . Med . Pa ras l t .
66 : 537 -538 .
* g
Manoucheh r l , A .V . , Za in l , A . & Javad ian , g . ( 1975 ) Res i s tance o f
tu iopheies " , t i t " t t . " igg
G11e9 to DDT ln Baluchestan Provlnce ' southern I ran '
1 9 7 4 . M o s q u i t o N e w s 3 5 : 3 1 4 - 3 I 6 .
& Motaghi , M. (1976) SuscePt ib l l l ty of
to lnsect lc ides in nor thern l ran, 1974' Mosqul to NewsIt"r,orr"t
"t t l , A.V. , Zalni, A.
Anopheles naculiPennis36 :5 l - 55 .
l lanouchehr l , A.V. et a l . (1966) School Pu! : - t1 !h: -&_Inst ' Pub' I t l th ' Res '
Teheranr l ran. Scient . Publ i f f i
Manouchehri, A.V. et al. (1974) Resistance of SnoPheles sacharovl Favre to DDT ln
I ran, 1973. I ranian J. -Publ . l l l th . 222O4-2l I '
I, lanouchehri, A.v. et al. (1976) Ecology of Anopheles stephenel Llston ln southern
Iran. L[gP-:lg@g. 28 :228-232'
l . tossadegh, A. , Motabar, !1 . & Javadlan, E. (1973) Evaluat ion and lnveet lgat ion of the
e f f e c t o f o l l e p r a y i n g o n t h e l n t e r r u p t l o n o f n a l a r i a d l s e a s e .Bu l l . Soc . Pa th . Exo t . 66 :92 -100 .
Cah. ORSTOII' ser.
1t6 control Ln
vBc /90 .3MAL/90.3Page 333
Najera, J .A. & Zulueta, J . de (1986) Report on a v ls i t to the Is lanic Republ lc of- I ian, 27 January- l5 February 1986. Unpubl lshed repor t WI|o/EMRo(472).
Quralshi , M.S. ( I .965) Swarrn ing, ruat ing and densi ty in nature ofAnoohe l .es s teDhens i nvso rens l s . J . Med . En tono l . 58 :821 -824 '
Q u r a 1 s h 1 , M . S . & A r t h u r , M . ( 1 9 6 3 ) M a t i n g b e h a v 1 o u r o f @ . Nature( L o n d o n ) 1 9 7 : 3 1 2 - 3 1 3 .
Qura i sh i , M .S . , Fagh lh , M .A . & Eshgh l ' N . {1966 ) F l i gh t
gonotroPhic cyc le, and longevi ty of P"- labeledAnooheles stephensi roysorensis. J . Econ. Entorool .
range, lengths of the
59 :50 -54 .
Report on the development of nalar la eradicat lon in I ran (1958) ' Malar ia Eradicat ion
Organlzat lon, l l ln ls t ry of t lea l th ' Teheran, Septenber 1968'
Tablbzadeh, I . , Behbehanl , G. 6 Nakhai , R. (1970) Use of Ganbusl? f lsh ln the nalar la
eradicatlon prograxotne of lran. Bull. I{]d Hlth org. 43t623-626.
Wor ld Heal th Organlzar lon (1975) )I
World Health Organlzatlon (1984) ) - see under GENERAL above.
IWorld Heal th Organizat lon (1990) t
Zat.at, A.R. (f974) - 6ee under GENERAL above.
Zaln, M. (1987) l ta lar la contro l ln I ran - Preeent and Future.
J. An. ! {osq. Contro l Assoc. 3:392-396.
ZaIm, M. (199f) Inpact of pest tc lde res is tance on the contro l o f vectore in l ran.
Worklng paper preeented at the Expert Conmlttee on Insectlcide Reslstancet
Geneva, 5-12 March f991. CTD/OPR/ECI91.34.
Zaln, M. Manouchehr i , A.v. & Ershadl , u .s . (1983) The l t lnab dan and
hazarde ln Lncreaslng noequl to t ransnl t ted d ieeases. I ranian J.
ZaLa,
i.ts poeslblePubl . l t l th .
A : 4 4 .
!1. et al. (1986) The use of CDC 1lght trap8 and other proceduree for sanpllng
roalar ia vectors ln southern l ran. J . As. !1o8q. contro l A . 2 :511-515.
ZaLaL, A. & l lanouchehrt, A.V. (1973) Preli.nlnary notes on the developroent of DDT
reslstance Ln Anopheles cullclfaclee Glles ln Baluchestan Provlnce' Eouthern
r t . r , . @.22156 -L62 .
ZuluetE, J . de et a l . (1957) Seasonal var tat lons ln euscept lb l l l ty to DDT of
Anophelee nacullpennle ln Iran. 8u11. I{ld lt l th 0rg. L62475-479.
IRAQ
Abul-Hab, J .K. (1956) Observat ions onCullcldae) ln SulelnanlYa Llwa,I : 2 9 8 - 3 1 0 .
the overwinterlng ofNorthern I raq. Bu11.
A. eacharovl (AnoPhellnl 'E;^d--'G;-G;ghdad)
Abul-Itab, J. (1958) The seasonal occurrence of A. euPerplctug_Gt:"."1."ld-*#PqgylFavre 1n suleimanlya Llwa, North rraq' "1ffid-l-Ili lJBaghdad) 2:156-169'
AbuJ.-Hab, -f . (f 960) Obeervationa on the nlght activlEles of AnoPhe-1e9 gachgrov-l .Favrea n d @ G r a s s 1 ! 1 J i : 1 9 1 " , ^ D 1 p t e r a ) 1 n t h e S u 1 e 1 o a n 1 y a L i w a 'Nort@. (Baghdad) 3162-72.
Abul-Hab, J . (1961) Rest lng habi ts of Anopheles suPerPictus- Grassi and
Anopheles sacharovl Favre (cul ic ida.e, Diptera) in Northern I raq.
(Baghdad ) 4 :54 -59 .
Bul l . End. Die.
vBc/90.3MAL/90.3Page 334
Abul- I {ab, J . (1967) overwinrer ing of Anopheles.gupqrPt i tgs-Grassi , in su lefuoanlya and
Klrkuk Llwas in Northern fraq (O
5L2243-250 '
AbuJ.- l {ab, l . (1969) Malar ia vector aurvey in nor th l raq ' 1 ' Provinces of Naynawah
and Dhook . Bu l l . End ' D i s ' (Baghdad ) i l : l 17 -133 '
Abul- l tab, J . & Abdul Lat l f , S. (1985)
Theobald (DiPtera, Cul ic ldae) ln
26237 -46 .
Abul Hab, J . & Al -Kassal , S ' l t ' (1986)
of $g!9!g (DiPtera, Cul ic ldae) Bu I l . End . D i s . (Baghaad ) 27237 -51 '
ro le of general heal th serv ices in malar ia
at tack and consol idat lon phases ' Bul l '
o f Anooheles Pulcherr imusena . D i s . (Baghdad )
rural health services(Baghdad ) 19 :9 -13 .
antl-ualaria spraying on occurrence
the l lterature onln I raq.
Seasona lCent ra l
occurrenceI raq . 8u11 .
lnpact ofl n I r aq .
AbduL-Azlz, A. & Cowdhury, R.R' (1965) The
eradlcaclon programnes ln preparat lon,
End . D i s . (Baghdad ) 7 :4 -10 '
Al i , N.A. (1985) The problen of nalar la lnpor ted
End. Dts. (Baghdad) 26:5-L l '
cases f ron abroad ln l raq. Bul1 '
A11 , N .A . ( f 987 ) Ma la r l a i n I r aq ln 1985 . Bu l l . End . D l s . (Baghdad ) 28 :5 -16 .
A1 T l k r l t y , A .B . (1964 ) Thevectors of nalar la ln
Chr is tophers, S.R. & Short t ' H.E. ( f921) t ' [a lar la in Mesopotamla '
8 :508-529 .
Ether ington, D. & Sel l lck, G. (1946) - see under l ran '
Far ld, G.A. ( f987) - see under GENERAL above'
geographlcal d ls t r lbut ion of S$_specles and
r i aq . s l t t . ena . o t s . (Baghdad ) 6 :91 - l l 7 '
I nd lan J . Med . Res .
anophel lne vectors of oalar l 'a to Lnsect lc ide res is tance
(Baghdad) l 8 :93 -107 .I yenga r , R . (1977a ) S ta tus o f
in l raq. 8u11. End. Dls.
N iaz l , A .D .and the
Iyengar, R. (1977b) Asslgnoent repor t , malar la eradlcatLon Progradne, I raq '
3 Seprenbet Ig72-L2 July f977. Unpubllshed report WIIO E}|/MAL/Is '
Macan, T.T. (f950) - see under GBNERAL above'
Manouchehrl, A.V. (1978) Assignnent rePort nalarla eradlcatton Progranme' Iraq'
l l l tarch-I2 June 1978. Unpubltshed rePort WHO-EM/IALll59.
Manouchehr l , A.V. et a l . ( f980) Status of res l 's tance of anophel lne mosqui toes ln
I raq , 1978 . Mosqu i t o News 40 :535 -540 '
i l ohaen , 2 .H . ,Ouda , N .A . & ZayLa , H . I t ' ( f 989 ) A b ib l l og raphy o f
noequltoes (DiPtera:Cullctdae) and mosguito-borne diseases
Bul l . End. Dle. (Baghdad) 30:9-30 '
Mull lgan, II.W. (L967> - see under lran'
Uulrhead-Ihonson, R.C. (f951) - see under GENERAL above'
(1978) Long-tern p lanned integrat lonnalar ia eradlcat lon Progranne' Bul l '
betneen theEnd . D i s .
Nlaz l , A.D. & I la t l la t ' Y.A.K. (1973) Ant l - larval act iv l t les(Baghdad) L4z6L-72.
Ossi , G.T. (1969) A progrees rePort on oalar ia eradlcat lon(Baghdad ) l 1 :48 -66 .
i n l r aq . Bu l l . End . D i s '
1n I raq. 8u11 . End . D l s .
0ss1, C.T. (1977) Malar la eradlcat lon prograome in I raq L970-L975.(Baghdad ) l 3 :13 -33 .
vBc/90.3MAL/90.3Page 335
Bu l l . End . D l s .
Oss l , G .T . (1978 ) A p rog ress rePor t onqnLD16 . (Baghdad ) 19 :15 -27 .
malaria eradicatlon Progranne kaq-L977 ' Bul1'
Ossl , C.T. (1982) Progress rePort on nalar la eradlcatLon programe I raq
End. Dls. (Baghdad) 20/2L29-23.
Ose l , G .T . ( f 983 ) P rog ress rePor t on rna la r i a eradlcat lon Progranme I raq 1978-1979.
8u11. End. r |s . (Baghdad) 22/23:5-23.
1 9 7 8 . B u l 1 .
Oss l , G .T . (1986 ) Ma la r l a i n I r aq fo r t he(Baghdad) 2212325-23
Pr ingle, G. ( f954a) The ident l f icat lon of
years I984 and 1985 . 8u11 . End . D i s .
the adult anophellne rnosqultoes of I raq and
neighbourlng terrltorles. Eff:-$!, Dls . (Baghdad ) t : 53 -76 .
prlngle, G. (1954b) A sunoary of malarla and ualarla controL ln lraq before 1946.
8u11. End. Dls. (Baghdad) lz2-56
prlngle, G. (1955a) The nattonal canpalgn agalnst oalarla tn lraq: Progress report
lg46-L952. I . 8u11. End. DiE- (Baghdad) l :87- l l7 '
prlngle, G. (1955b) The natlonal canpaign agalnst Dalarla ln Iraq: Progre66 rePort
1946 -1952 . I I . Bu l l . End . D1s . l : 187 -236 .
Pr l .ngle, G. et a l . (1960) The anophel ine larvae of l raq, r r l th a rePort on
A. cullctfaclglr A. nulrlcolor and !,3p9! breedlng ln syrlan deeert sprlng'
EG rT.lEiffi t a a g-4ry3 6- s o .
Pur l , I . !1 . ( f951) - see under GENERAL above.
Rishlkesh, N. (1972) AnoPhe1ee pulcherrlmue Theobald (f902) ae a posslble
nalar la tn l raq.@dad) 13:7-12.vector of
Shthab; K. I . e t af . (1987) Innunologlcal and parasl to logical survey ln areas of I raq
where oalarla traneuleslon has been lnterruPted elnce several year8.
!u11. End. Dts. (Baghdad) 28217'28.
World Health grganlzatlon (1987) Intercountry Workshop on lntegrated Vector Control'
Danascus, iyrlau Arab Republlc, 13-23 October 1986. Unpubltshed rePort
wHo-E!{/vBc | 498, Aprll 1987.
tforld ltealth Organizatl.on (1990) - see under GENERAI above.
c Zaha r , A .R . (1967 ) Repo r t on 'a v l e l t t o I r aq ,22 oc tobe r - l s Novenbe r 1976 .
Unpubl tshed rePort ' TI |0/EMRO', I raq-0011' Ualar la '
Zahar, A.R. (1974) - see under GENERAL above.
Zulueta, J . de et a l . (1968) Recent observat lons on lnsect lc ide reeletance Ln
Anophelee eteohensl ln Iraq. Mosqulto Nens 282499-503'
KU{AIT
'Far id, G,A. (1987) - see under GENERAL above.
c l l l ra , p.R. & Behbehanl , K. (1984) Acetone-f lxed, Gieosa-sta ined th lck b lood f l lns for
the d lagnosle of nalar la . Ann. Trop. Med. Parasl t . 78277-79.
Hlra, p.R. , Behbehanl , K. & Al -Kandar i , S. (1985) lnpor ted oalar la ln Kuwal t . Trane'
R. Soc. Tt rP. M"d. HYgt ! !229I '296.
vBc/90 .3MAL/90.3Page 336
OMAN
Hira, P.R. et a1. (1987) Induced malar ia and ant lbody t i t res ln acute in fect ions and1n b lood dono rs i n Kuwa i t . T rans . R . Soc . T roP . Med . Hyg . 8 l : 391 -394 .
H i ra , P .R . e t a l . ( 1988 ) Aspec ts o f i r npo r ted rna la r i a a t a d i s t r i c t gene ra l hosp i t a lin non-endemic Kuwai t , Arablan Gul f . Eur . J . Epidgrn io l . !2200'205,
Ra tho r , H .R . (1988 A no te f o r t he reco rd on a v l s i t t o Kuwa i t , 2 -L5 Dece rnbe r 1988 .unpublished note, wl{o/El'tRo.
Report of the l la lar ia Advisory Teamr 23 October-13 Decenber 1985. Heal th Secretar iato f t he A rab S ta tes o f t he Gu l f (Fa r i d e t a l . ' 1985 ) ( i n A rab i c ) .
Sher, A. , A1-Motawwa, Y.K. & Al -Owaish, R.A. (1988) 0va1e nalar la : a case repor t f ronKuwa i t . T rans . R . Soc . T roP . Med . I l yg . 822670 .
Bahar, R. (1979) Report on a v is l t to Sul tanate of Oman, 27 l larch- IO Apr l1 1979.Unpubllshed report WI|O-EM/MAL/L66' JuLy L979.
Del f ln i , L .F. (1987a) Assignnent repor t on a miss ion to the Sul tanate of Onan Malar laControl Progranme, 16 October-l4 November 1987. Unpublished report WIIO/EMRO,l e 8 7 ( 8 3 6 ) .
Del f ln l , L . f . ( I987b) Assignnent repor t , Malar la Contro l Programe, ODan, l luecat ,2 March-2 June 1987. Unpubl lshed repor t , wl I0/EMRo, June L987(747).
Far ld, G.A. (1987) - see under GENEML above.
Far id, M.A. & Muir , D. (1985) Malar ia rev iew tean rePort , Oman, 23 March-5 Apr l l1985. Unpubl lshed repor ! WH0-EM/MAL/209' JuIy 1985.
Fa r l d , M .A . , Nas l r , A .S . & Ben the in , F .G .E . (1973 ) Ass ignnen t rePor t , Wt lO l l a l a r l aSurv€y Tean, Sul tanate of Onan, 13 Apr l l to 8 June 1973. Unpubl lshed rePortlIttO-EM/!' lALl 1I8 , 0ctober 1973.
I laas, R. (1979) Asslgnnent repor t , Malar la Contro l , Sul tanate of Omanr 24 Noveober1978 to 4 January 1979. Unpubl lshed rePort $ iO-EM/MAL/f65.
Macdonald, G. & Gi ickel , C.W. ( f964) - aee under GENEML above.
Muir , D.A. (1987) Report on a v ls l t to the Sul tanate of 0man, 23 Novenber- I8 Decenber1986. Unpubltshed report to WHO/EMRO.
Muir , D.A. (1989) ReporE on a v is l t to the Sul tanate of Onan, 2 l Novenber 18 Decenber
1988. Unpubllshed rePort to WIlO/EllRO.
Shldrawl , G.R. (1976) Report on a v is l t to the Sul tanate of Oman, 1-18 Decenber 1975.
Unpubllshed report Wt{0-El't/MAL,/I39, uarch 1976.
Sh id raw l , G .R . (1977 ) Repo r r on a v l s l t t o t he Su l t ana te o f Oman ,5 -21 Ap r i l 1977 .
. Unpubllshed report, l lHo/EMR0.
Shidrawl , c .R. ( f982) Report on a v ls i t to the Sul tanate of Oman, 28 May-16 June
1982. Unpubl lshed rePort WI|O-EM/MAL/193, Decenber 1982'
Sh id raw l , G .R . & G l l l i es , M .T . (1987 ) AnoPhe les Pa l t r i n i e r i r i , l ' eP ' ,( c u i t c t a a e : D l P t e r a ) f r o r n t h e s u 1 t 1 9 : 2 0 l . 2 l l .
I.torld ttealth Organlzation (1990) - see under GENERAL above'
Zajnat , A.R. , Del f ln l , L .F. & Ruebush, T.K. (1982) Report on assessment of the Malar ia
Control Prograrome, Sultanate of Oman. Unpublished report }fHO-EU/MALlL87,
February 1982.
PAKISTAN
* g
c A f r l d l , M .K . , MaJ ld , A . , & Shah , I .A . ( 1940 ) S tud les o f t he
Sl l j rpheles cul lc l fac ies. Par t f f . @
c Ains ley, R.W. (1976) Laboratory eolonlzat lon of the nalar ia vector '
Anophe les cu l l c l f ac ies . Mosqu l t o News 36 :258 '
Aklyana, J . ( I968) Asslgnnent rePort , Malar ia Eradicat lon PrograDne, I {est Pakistan '-
. luiy l96l-June 1968. Unpubllshed rePort WiO-EU/MAL/65'
Akiyana, J . (1973) Interpretat ion of the resul ts of bel ted
J . T r o P . M e d . H Y g . 7 6 2 2 8 3 - 2 8 4 .
Akiyana, J . ( f974) Anopheles nosqui to s tudies in Pakistan
traps. Trans. f i l -Ef r roP. ued. Hyg' 68:14-15'
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I{orklng Group Meetlng on Malarla. Nlcoela, cyprus. 27-29 Novenber 1979.
Unpublished worklng PaPer I{HO-EM/SCT'I{RK'GR'MAL/6'
Bal ley, N.T. (1952) Inprovenente in the ln terpretat ion of recapture data.
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Baker, E.L. et al. (1978) Eplalemlc malathlon poleonlng in Pakletan oalar{a workers'
Lance t t : 31 -34 .
Baker, R. l l . , Sakal , R.K. [ . Rana, K. ( l9SI) Genet lc sexlng for a rosgul to s ter l le nale
r e l e a s e . J . H e r e d . 7 2 t 2 L 6 - 2 L 8 .
Baker, R. l I . e t a l . (1978) Induced chromosonal aberrat lone ln AnoPheles cul lc i fac les '
Mosqui to News 38;370-376.
3aker , R.H. et af . (1980) AnoPheles cul lc l fac les
coDPetlt lveneaa in nature of nales carrying
Ann . En t . Soc . An . 73 :581 -588 .
Bhat la, l { .L . & Kr lehnan, K.A. (1961) A. eul ic l {ac l -es G1lee, 1901, Pp. 147-186'
I n : v e c t o r s o f n a 1 a r 1 a 1 n t n d t a , f f i a 1 S o c 1 e t y o f I n d i a f o r M a 1 a r 1 aana es , 196 I , De lh l ' I nd la '
B ruce -Chwa t t r L . J . , Ga r re t t - Jones , C . & We i t z , B ' ( 1966 ) I
B ruce -chwa t t , L . J . ( 1980 , 2nd ed . 1985 ) l
Bt t t lker , w. (195s) observat lona on the physlo logy of adul t anophel inee ln Asla '
8u11 . I { l d l t l t h Org . 19 :1053 -1071 '
Chr is tophers, S.R. ( l9 f f ) - see under GENERAL above'
* c chr ls tophers, R. ( rgr ta) th lar la in qhe Punjab. sc i .ent l f lc nenolr , Med. & san' Dept"
covr . o i t r rd i " , Supef f i Pr int ing, Calcut ta.
c Cole, L.C. (1949) The neasurenent of ln terspecl f ic associat lon ' ggl l 30:4 lL-424'
vBc/90.3MAL/90.3Page 337
behavlour of adult3 : 2 3 - 5 1 .
t rap net co l lect ione.
uslng outLet and ln let
Glles: natlng behavlor anda complex chromoeonal aberration'
vBc/90.3MAL/90.3Page 338
c D a s ,
* c
* c
c
c
Davidson, c . ( 1954,1955) - see under GENEML above.
Dav i s , E .W. & Gou ld , D .J . ( 1973 ) A po r tab le suc t l on dev i ce f o r co l l ec t i ng adu l tmosquitoes. l losquito News 332246-247 .
Ex te rna l Rev iew Tean o f MCP, Pak i s tan (1977 ) Repo r t by Mu jah id , A .A . , Shah , I .H . ,C h i n , W . , G r e n l e r , R . , B r u c e - C h w a t t , L . J . , M e h r a , T . , E d w a r d s r S . C . , N o g u e r , A . ,D e l f l n l , L , F . , R a f a t j a h , H . A . , C o w p e r , L . T . & Z a h a r ' A . R .
External Review Tean of MCP, Paklstan (1978) Report by Mujahid ' A.A. , Hashin, G. ,V e r n o n , T . M . , B a h a r , R . , D e l f l n i r L . F . , G r e n l e r , R . G . & C o w p e r , L . T .
External Review Tean of MCP, Paklstan (1979) Report by Hashiu ' G. , DtuJahld ' A.A. 'Edwards , S .C . , Ve rnon , T .M . , S t i ve rs , J . & Sh ld raw i , G .
Far id, ! f .A. (1974) Assignnent repor t , l la lar ia Eradicat lon Programme, Pakistan,20 February-l4 Aprll 1974. Unpublished report WHO-E}!/MAL/125, JsLy I974.
Far id, G.A. (1987) - see under GENERAL above.
Fa r i d , G . & Bea les , P .F . (1990 ) Repo r t on a n i ss lon to Pak ts tan , 18 -28 June 1990 .Unpubllehed report, l l l lO/EMRO.
F o x , E . & S t r 1 c k 1 a n d , G . T . ( I 9 8 9 ) T h e i n t e r r e 1 a t i o n s h 1 p o f @ . n dP. v l .vax ln the PunJab. Trans. R. Soc. Trop. Med. Hyg. . 83:47L'473.
Fox, E. et al. (1985) Chloroqulne reslstant Plasrnodiue_fgf3j.Erun: now in PakistaniPunJab. Lancet L:432-435.
Fox, E. et a l . ( f987) Rel lable assessl rent of nalar la prevalence through v l l lagec l l n l cs . T t " r@. 8 l : l l 5 -117 .
Garret t -Jones, C. (1964)2
Garret t -Jones, C. & Shidrawl , G.R. (1969) -
Gar re t t - Jones , C . , Bo reham, P .F .L .6 Pan t ,
Gi l l , C. (1920) The re lat ionehlp of nalar laI : 6 18 -632 .
C111, C.A. (1928) The genesls of epideulce. London:Bal l l lere, T lndal l & Cox.
I t lcks, E.P. & Ma3td, S.A. (1937) A study of the epidenlo logy of ualar la ln a Punjabdi .et r lc t . Recorde of the l la lar la Survey of India. 7zL-46.
Il l tchcock, J.C. (1968) Age conposltlon of a natural populatlon ofAnopheles quadr lnaculatge Say (Dlptera:CuLlc idae) in Mary land' U.S.A.J . Med . En tono l . 5 :125 -134 .
I lusealn, M.Z.Y. (1951) The vectors of nalar la and nalar la t ransolss lon ln Paklstan.Pak ie tan J . I { l t h . l : 69 -71 .
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nalar ia and i ts vectors ln Salerowi th hunan p lasnodia in roosqui toes.
under GENERAL above.
I( l e 8 0 ) '
ralnfal l . Indlan J. Med. Res.
vector of nalar ia ln
rnalarla ln Peshawar.
see
c .P .
and
l lussaln, l ( .Z.Y. & Tal lb l , S.A. (1956) Incr funlnat lon of theFederal Karachl , Pakls tan. Paklstan J. Hl th. 6t65-72.
In ran , M . , S ldd iqu l , M .A . & Taue i f , Z . ( 1977 ) Resu rgence o fPakls. tan J. Med. Res. 16237-43.
* g
: t g
* g
* g
* g
I t 6 , Y . ( f 973 ) A ne thodrecaPture census.
Jackson , C .H .N . (1939 )8t238-246.
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to estlnate a Elnlnua Populatlon denslty wlth a elngle
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Khal lq , A.A. (1936) Epldenlo logy of Malar la {n the Punjab: a New Approach.
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c K r 1 s h n a n ' K . s . ( 1 9 6 l ) A . s t e P h e n s 1 L i s t o n , 1 9 0 r . ' p p . - 3 9 - 5 8 . 1 " : wIndia, 2nd ed. naljifrI:iEEry of India for llalarla and other Mosquito-BorneDlseases , 1961, De lh l , Ind ia .
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La r l , F .A . , Bu rney , M . I . &Lnnunofluoreacence ln
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l {acdonald, G. ( 1957)f
Macdonald, G. e UaJtd, A. (1931) Report on an ln tenslve oala l ia Eurvey ln the Karnal
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Mahmood, F. & Macdonald, M. ( f985) Ecology of roalar la t ransmlss lon and vector la l
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l lashaal, H. (1962) Eptdenlologlcal aasessnent of mal"arla in Shelkhupura and Sialkot
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l.tehta, D.R, (1934) Studlee on the longevlty of aoue lndlan anophellnee' Part I.
Survlval of Anopheles subpictue Grassl under controlled condltlons of
tenperature 4226L-272'
c .Mer, G.C. (1936) - Eee under GENERAI above.
t'Mol lneaux, L. , Dletz, R. & Thornas, A. ( L978) '
Mulrhead-Thoros'on , R.C. (1958) - see under GENERAI above.
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* c
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c Pervez, M. et a l . (1985) Malar ia t ransniss l .on assessed by in fant snear surveyscornpared to entonological technLques. Pakistan J. Med. Res. 24:81-84.
* c Quinn, T.C. & Str lck land, G.T. (1986) Cl ln lca l nanl festat lons of oalar la .Cl in lca l Tropical Medlc lne and Connunlcable DLseases LzL27-L70.
Raf l , S.M. (1955) Rest ing p laces lns lde houses of An. cu l lc l fac ies and [email protected],nalaria vectors of the PunJab. Paklstan J. HlEfris;Ta3ast-
Rahman, M. & Mut ta l lb , A. (1967/L968) Detern inat lon of rnalarLa t ransmiss lon incentra l par t of Karachi Ci ty and lncr in inat lon of A. s tephensi as the vector .Pak l s tan J . H l t h . 17273 -84 .
Rahman, M. et a1. (1967/L968) LSepteober and October 1966.
Rao, V.V. (1947) On gonotrophlcMa la r i o l . l : 43 -50 .
deta i led study of oalar la s l tuat lon ln Karachl dur lngPak i s tan J . H l t h . l 7 :85 -104 .
dlscordance anong certaln Indlan AnoS!g,]g. Indlan J.
Rao , V .V . (1961 ) A . annu la r i s van de r Wu1p , 1884 . , pp . 13 -26 . I n :
1g_$!!g, 2nd ed. National Soclety of Indla for Malarla andD l . sease , 1961 , De lh l , I nd ia .
Vectors of Malar iaother Vector-borne
Rathor , I t . (1987) Predomlnant agr icu l tura l pract ices and thel r bear ing onvector-borne dlsease transrnlsslon in the WHo Eastern Mediterranean Reglon.I{orklng Paper No. 8. In: Effects of Agrlcultural Developnent on Vector-BorneDiseases. Edlted verslons of worklng papers presented at the Annual Meeting ofthe Jolnt WHO/FAO Panel of Experts on Environmental Management for VectorContro l 7- l l Septenber 1987, FAO, Rome. FAO docurent AGL/I { ISCIL2/87.
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Relsen, W.K. (1986) Populatlon dynarnlcs of sone Paklstan mosquLtoes: the lnPact ofresldual organophosphate lnsectlclde spray on anophellne relative abundance.Ann . T rop . Med . Pa ras i t . 80 :69 -75
Reisen, W.K. & Aslarnkhan, l{. (f976) Observatlons on the swarnlng and nating behavloro f @ Gt les Ln na tu re . 8u11 . W ld H l th Org . 54 :155 -158 .
Reisen, W.K. & Aslankhan, M. (1978) Bl t ing rhythns of some Pakistan r losqul toes.Bu l l . en t . Res . 68 :313 -330 .
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Releen, W.K. e Aslanlchan, M. (1979) A re lease-recdpture exper lmeng wl th the nalar lav e c t o r , @ L 1 s t o n , w l t h o b s e r v a t l o n s o n d 1 s p e r s a 1 'surv lvorshlp, populat ion s lze, gonotrophlc rhythn and nat lng behavlour . Ann.T rop . Med . Pa ras l t . 73 t25 I ' 270 .
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Releen, W.K. & Mahoood, F. (1981) Relat lve abundance, renoval sanpl lng and
* g
mark-release-recapture estlmates of AnoPheles cullclfacies and g9!9P@1populat lon s lze at dLurnal rest lng s l tes ln rura l PunJab Provlnce, PaklstanMosqulto News 4L222-30.
Relsen, W.K. & Ml lby, M.M. (1986) Populat lon dynaoics of some Paklstan moequl toes:changes 1n adult relatlve abundance over tlne and space. Ann. Trop. Med.Pa ras l t . 80 :53 -68 .
Relsen, W.K. & Slddlqul , T.F. (1977) The inf luence of conepecl f lc lmatures on theovlpos 1 t I on pref e rence s o f Alolhglg !--9!9-P!9!91 Lls ton andCul lx t r l taeniorhynchus c i l@n by Releen et aI . ( l9sta) I .
Relsen, I { .K. & Siddlqui , T.F. (1979) I lor lzonta l and ver t lca l est inates of lnmatureeurv l .vorship for Culex t r l taenlorhynchus (Dlptera:Cul lc ldae) 1n Pakletan.J. Med. Entouol . f f i
Reisen, W.K. , Aslankhan, M. & Naqvl , Z.A. (1976) Observat lona on the rest lng habl tsand dlel changes ln the ovarlan condltlon of some PunJab nosqultoea(Dlptera:Cul lc ldae) . Blo logta (Lahore) 22279-88.
Re1sen, W.K. , Mahnood, F. & Azra, K. ( I9Sf) Anophelee cul lc i fac ies. Gi les: adul tecologlcal parameters measured ln rural PunJab Provlnce, Pakl,stanr uslng
capture-D.1rk-releaee-recapture and dlseectlon nethods, with c;onParatlveobservaEiona on An. stephenel Lleton 8nd S:-g!g!ggg9. Grassl . Res. PoPul. Ecol.23239-60
Relsen, S.K. , Azta, K. & l {ahoood, F. (1982) Anopheles cul tc l fac ies; (Dlptera:
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Relsen, I { .K. , Mahnood, F. & Parveen, T. ( f979) AnoPheles eubplctue Grassl :observatlona on survlvorshlp and populatlon slze using nark-r'elease-recaPtureand d leeect lon methods. Res. Popul . Ecol . 2LzI2-29.
Relsen, W.K. , Mahmood, F. & Parveen, T, (1980) AnoPheles cul lc l fac ies Gi lee:
a uark-release-recapEure experlrent wlth cffioFTnown age ln Paklstan wlth
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Relsen, W.K. , Mahmood, F. & Parve€o' T. (1982) Seasonal t rendssurvlvorship of Anopheles cullcifacles, Ag9195fgl and(Diptera:CullctaEEJ tn rura-fPunJab provlnce, Paklstan. J.
al . (1976) Observat lona on the d le l act iv l ty Pat terns(Diptera:Cul lc ldae) . Blo logia (Lahore ) 22267'77 -
Re l sen , I { .K . , Ag lan , Y . & S tdd lqu l , T .F .oatlng of some Paklstan ooequltoes
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ln populatlon slzeAn. subplctus-+
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Re isen , I { .K . e t a l . ( l 98 la ) La rva l i n te rspec l f l c assoc la t i ons
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(1981b ) AnoPhe les cu l i c i f ac igs G i l es : MaE ing
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* g Roy, D. I l . (1943) The ro l 'eJ. Malar . Inst . Indla
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fre-d:Eras@F'5
Re isen , W.K . e t a I .conPet i t iveness
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ctrtoroquttte fiEJEE Provlnce, Paklstan, util lzlngUnpublished report wlto-El't/MAl./ I47'
of Anopheles subplctus Grassl as a carr ler of nalar la '
>zffi
T.R. (1940) The AnoPheles of r ice f le lds ln southeastern Madras '
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the ecology of larvae of AnoPheles cul lc l fac ies
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c
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Russel l , P.F. & Rao, T.R. (1942b) On the swarming, nat ing and ovLposl t lng behavior- of
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Russe l l , P .F . & Rao , T .R . ( f 942c ) Obse rva t l ons o f t he l ongev i l y -g !
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Bu1 l . en t . Res .
vBc/90 .3MAL/90.3Page 343
c S h a 1 a b y , A . M . ( l 9 6 5 ) S t u d 1 e e o n t h e a 8 e c o D P o s i t 1 o n o f @ : u 1 i c l f a c 1 e spopulac lone in Indla at d i f ferent phases of developnent of rers is tance Eo
Ann . En t . Soc . A rn . 58 :9 i8 -923 .
DDT.
c Slngh, N. & Yasuno, M. (1971) A devlce for se l f -nark lng nosqui tos. Mineographed
document WHO/VBC/7 f . 330.
c Sokal , R.R. & Rohl f , F.J . ( f969) - see under GENERAL above'
Str lck land, G.T. , Fox, E. & Hadl , I t . (1988) Malar la and splenoroeger ly ln the Punjab.
T rans . R . Soc . T roP . Med . Hyg . 822667 '670 .
S t r i ck land , G .T . e t a l . ( f 986a ) E f fec t o f Fans lda r on ch lo roqu lne res l s tan t
Plasoodiun fa lc iparun in Paklstan. @. 35:6I -65.
Str tck land, G.T. et a l . ( l9S6b) Ef fects of ch loroquine, aoodlaquinre andpy r i ne than1ne -su l f adox ineon@gaDetocy te .1as .@-Med. Hyg. 35t259-262.
Str ick land, G.T. et a l . (1937) Endenic nalar ia ln four v l l lages of the Paklstanl
prov lnce of PunJab. Trans. R. Soc. TroP. Med. I tyg. 8 l :36-41.
Sulenan, M., Reisen, W.K. & Aelaukhan, M. (1977) ObservatLons on the t ine of
at t ract lon of sone rnosqul toee to l1ght t raps. Mosqui to Nel ts 37:531-533.
Suleoan, t ' t . (1988) 'Malar la ln Afghan refugeee in Paklstan. Trane. R. So." . Trop.-
l{ed. $9. 82244'47.
Watta l , B.L. (1961) Dlseect lon records of wl ld-caught anophel lne tosqul toes other
than the reputed vectors of nalar la , pp. 187-231. In: Vectorsr of nalar la , ln
S, 2nd ed. Natlonal Soclety of Indla for l. lalari.a and other l losquito-borne
d l seasee , 1961 , De lh l , I nd la .
c Weathersby, A.B. (1963) Harvest lng mosgul to pupae wl th cold ! r€ l t€ ! . Mosqui to News
23t249-251.
c Wernedorfer , W.H. ( f980) - aee under GENEMT above.
c Wl l l lans, C.G. (1937) The use of Logar l thns 1n the in terpretat lon of cer ta lnentonologlcal problete. S-3Plryl. 24 t404-4I4.
t {or ld l tea l th Organlzat lon (1989)\ see under GENERAL above.
Wor ld Heal th organlzat lon (1990) / r
c Yacob, H. & Swaroop, S. (1944) The forecast lng of epldeulc nalar ia , ln the PunJab.
J .Ma la r . I ne t . I nd la . 5 :319 -335 .
c Yacob, K.B.U. E Swaroop, S. ( f945) Invest lgat lon of the long- tern per iodlc i ty ln
the lnc idence of epidenlc naLar la ln the PunJab. J . Malar . Inqt . Indla. 6:39-51.
c Yasuno, M.P. et aI . (1972) Dlspersal of Culex fat lgans ln Delh l v i l lages.
Mlreographed docuroent l[tolvBc/72.352.
vBc /90 .3lrAL/90 .3Page 344
c Yasuno , l l . , Ra jagopa lan , & Russe l l , S . ( 1977 ) App l l ca t l on o f t he remova l ne thod tothe populat ion est inat lon of Culex fat igans rest ing indoors. Indian J. Med. Res.6 5 ( S u p p 1 . ) 2 3 4 - 4 2 .
Zahar, A.R. (L974) - see under GENERAL above.
c Zulueta, J . de (L977) Assignment Report : Malar ia Contro l Progranme, Paklstan.Unpublished report WHO-EM/MAL / L56.
* c Zulueta, J . de & Hashin Ma1l1ck, C. (1976) Invest igat lon of rePorted cases ofnalath ion in tox icat ion in Kohat Dist r ic t , Nor th West Front ier Province(Pakistan) . Unpubl ished repor t , wt lo /EMRo.
Zulueta, J . de, Muj taba, S.M. & Shah, I .H. (1980) l la lar la contro l and long- ternper iodlc i ty of the d isease in Pakistat . Tt .7 4 t624-532
QATAR
Far ld, M.A. (1980) Report on a comprehenslve malar ia survey in Qatar '24 Septeubet-27 October 1980. Unpubl lshed repor t to the l {eal th Secretar iat ofthe Arab States of the Gul f ( In Arabic) .
Far id, l t .A. (1984) Asslgnment repor t , Malar la Contro l Ln Qatar , l - l0 February 1984.Unpubl ished repor t I IHO-EM/MAL/201, June f984 ( In Arabic) .
Far id, G.A. (1987) - see under GENERAL above.
Kaay, I l .J . van der (1967) Tour notes on a v is i t to Qatar , f ron 23 to 30 Apr l l 1967.
Qatar , Ju ly 1967. Unpubl tshed repor t , lmO/EMRo.
Sh id raw i , G .R . (1978 ) Repo r t on a v i s i t t o Qa ta r , 1 -6 Oc tobe r 1978 . Unpub l l shedreport, mIo/EMRo.
Wor ld l {eal th Organizat lon (1983) Malar ia Survel l lance: Qatar . Wkly EPlden. Rec.5 8 ( 4 3 ) : 3 3 3 .
SAUDI ARABIA
Af i f l , S.E.D. (1959) l {a lar ia eradlcatLon p l lo t proJects wi th specia l reference toSaudi Arabla. Unpubl ished work ing paper EM/ME.Tech. 2/LI , 19 October 1959,presented at the Second Regional Conference on Malaria Eradicationr Addle Ababat16-21 Novenber, 1959.
Annual Report (1983) Klngdon of Saudi Arabla, Min is t ry of Heal th, Di rectorate ofPreventive Mediclne, Malarla Control Service: Malaria Control Progranne ln theKingdon, February 1983.
Annual Report (1984) Klngdon of Saudl Arabia, Ministry of Health, Asslstant Deputy
for Preventlve l.tediclne, Malarla Control Servlce: Malarla ControL Progranne in
the Klngdon, 1404-1405 H, 1984.
Bahar, R. ( f979) Man-nade nalar ia ln the Eastern Medl terranean Region. Scient l f lc
Working Group Meetlng on Malaria. Nlcosia, Cyprus, 27-29 Novenber 1979.
Unpubllshed worklng paPe r IIIIO-EI'{/ SCT .WRK. GR. MAL/ 6 .
Bahar, R. (1986) The lnpact of a l ternat lve englneer lng pract lces in water resources
development pro ject on cost-ef fect tveness of vector contro l prograDmes. l {ork ingpaper pMO/pE/Vp/86.7. Jotnt IIHO/FAO/UNEP Panel of Experts on Environmental
l.tanagenent for Vector Control. Slxth Annual Ueeting, Geneva,8-12 Septenber 1986.
vBc/90.3MAL/90.3
age 345
Daggy, n.U. (1959) Malar ia in oases of Eastern Saudl Arabia. As. J . T.ogLE!L: .gIg.
82223-278.
Far ld, G.A. (1987) - see under GENERAL above.
L in, N.H. (1986) Asslgnoent repor t , Malar ia Contro l Progranne, Satrd i Arabia, I August
L967-28 February 1986. Unpubl lshed rePort ' WH0/EMRO.
pe f f l y , R .L . ( 1959a ) I nsec t i c i de res i s tance l n anophe l l nes l n Eas te rn Saud i A rab ia .
Bu l l . W ld H I th Org . 20 :757 -776 -
pe f f l y , R .L . ( I 959b ) D ie ld r i n - res l s tan t Anophe les f l uv la t l l { 9 l n l i as te rn Saud i
Arabla. Mlneographed docunent WHO/I4AL/239, L5 August 1959'
Report of Jo int Government /Wt l0 Malar la Revlew Mlss lon to Saudi Arabia (Najera, J .A. &
Far id, G.A. et a1. f987) Saudi Arabia, 5-23 July 1986. UnpubJ[ lshed rePort
wllo-EM/MAL / 2L4E,. JanuarY 1987.
Zahar, A.R. & Dabbagh, I l .S. (1959) A rnalar ia Eurvey ln nor th neatern Part of Saudl
A rab la . 8u11 . End l D i s . (Baghdad ) 3 : l l t - 128 .
Zahar, A.R. (1974) - see under GENERAL above.
UAE
Annual Report , l ta lar la Contro l Act lv l t les ln Unl ted Arab Enlrates (1979) Mln ls t ry of
Heal th, UAE.
Annual .Report , Malar la Contro l ln UAE (1980) Mln ls t ry of Heal th, l la lar la Contro l
Un i t .
Far ld, G.A. (1987) - see under GENERAL above.
Report of the MalarLa Advi.sory Team, 28 October-I3 Decenber 1985. I lealth Secretarlat
of the Arab Statea of the Gul f (Far ld, U.A. et a l ' ' 1985) ( I r r Arablc) .
Whlte, c.B. (1980) Asslgnnent report. Insect.6 and Hyglene at A1-A:Ln, Unlted Arab
Enlrares, 19 Apr l l : Ig l t "y t ia0. Unpubl lshed repor t WHO-EM/ES//282, Novenber 1980.
Zahar, A.R. (1969) Report on a nalar la Eurvey tn the nor thern Trur : ta l State6 '
22 March-ll Aprii. 1969. Unpubtlehed report WIiO-E}|/MAL/83, Norrenber 1969.
TEMEN (NONTN * SOUTIT)
Afr tdt , A.K. (1984) Revlew of nalar la e l tuat lon and of research act lv l t lee carr led
out ln the control of rnalarla ln Deoocratlc Yeoen. llorking paPer
EU/I{KP.IMP.}IAL.CNT.AFR/5.2, preEented at the workshop of the IDProvement of
Malarla Control through Applled Fleld Reeearch, Jordan, 3l ltrrrch-l2 Aprl1 1984'
Chen Kuo, Del f ln l , L .F. & Ahned, N.U. ( f986) Asslgnnent rePort ' I tea l th asPects of the
Marlb dao and lrrlgatlon pro3ect. Yenen, 5-24 October 1985. lJnpubllehed report
!fl{o-El{/vBc/48, l,tarch 1986.
Del f ln i , L .F. (1986) Asslgnnent repor t , Malar la contro l ln Yenen,
14 Septenber-25 Noverqber 1985. Uniubllehed report m{O-E}t/t lAL|?LZE, March 1986'
vBc/90.3I ' |AL/90.3Page 346
Far ld, G.A. (1987) - see under GENERAL'
Far id, G.A. (1988) Malar la in socotra Is land, Democrat ic Yeroen, 21 March-A Apr l1
1988. Unpubl ished rePort , WHO/EMRO'
c Kouznetsov, R.L. (1976) Dist r ibut . lon of anophel ines in the Yemen Arab Republ ic and
i ts re lat ion to malar ia. Mloeographed documenS 1nt11g/MAL/76.879.
Maf f i , M. (1971) On sone larvae of the Myzonyla ser ies col lected in Yemen.
Parasslgg]5!g . L3z449-454 '
Ma t t i ng l y , P .F . & Kn igh t , K .L : ( 1956 ) The nosgu i t oes o f
( N a t . I t i s t . ) E n t . 4 : 8 9 - l 4 l '
c Mount , R.A. (1953) Medical n lss ion to the Yeuen, southwest Arabia, l95 l ' Geonedical
observat ions. Arn. J . Trop ' ! ted ' Hyg ' 2zL-L2'
c Nasl r , A.S. (1984) Asslgnment rePort . Malar la contro l Prograrnne, Democrat lc Yemen'
Unpubllshed report ff i IO-EU/MAL/200, January 1984'
Thevasagayam, E.S. (1987) Asslgnrnent rePort , Malar la Contro l Programme' Deoocrat ic
yenen, 6 February-3 l.tarch 1987. Unpublished rePorc I{HO/EMRO' March 1987 ' (692)'
c Thur laux, M.C. (197f) Notes on the epldeuio loq\-ot^ malar la ln the Yenen Arab
Republlc. Ann. Soc. belg. Med' TroP ' 5L2229-238'
World l{ealth Organlzatlon (1990) - see under GENERAL above.
Zahar, A.R. (1985) PART L Docurnent VBC/Ss.3-MAP/85.3 SECTION (F) SOUTHIIESTERN
ARABIA, PP. 237-240.
A rab la . Bu l l . B r i t . Mus .
l . See reference l ie t2. See reference I18t
l n V O L . I , P P . t 1 - 1 2 .ln the present docuoent . .
of1n
PREFACEANNEX 2
vBc/90 .3UAL/90.3Page 347
INDIA
Bray, I l . , G111, G.S. & Kl l l1ck-Kendr lck, R. (1984) Current and Pos$1ble future- - technlques
for ldent i f icat lon of b loodrneals of vector haenatophagus ar thropods'
Mloeographed docuroent lf iro/vBc/84.905.
Choudhury, D.S. et a l . (1983) Resurgence of nalar la in Gadarpur PHt l d is t r lc t '
Naln l ta l , Ut tar Pradesh. Indlan J. Malar lo l ' 20249-58'
Joshl , H. et a l . (1988) Host feedlng Pat terns of AnoPheles cul lc l f rac les species A
and B. J . Aro. Moeq. Contro l Assoc ' 42248-251'
Raroachandra Rao, T. (f984) - aee under GENERAL above'
sharma, v .P. 6 ' Mehrotra, K.N. (1986) Malar la resurgence ln Indla: r r cr l t lca l s tudy '
Socia l Scl . Med. 222835-845.
sharma, v.P. et al. (1983) Studles on the true lncidence of malariia ln Kharkhoda
( i te t r tc t Sonepat , t taryana) and Klchha (Dlst r ic t Naln l ta l ' U. ,P.) Pr funary Heal th
CentreB. Indlan J ' . Malar1o1. 2022L-34.
Sharna, V.P. et a] . (1986) Iopact of DDT and HCl t spraylng on rnalar la t ransnlss lon ln
.riu.g"" wlth DDT and HCI{ reslgtant Anopheles cullclfacies. Lodlan J. Malarlol.
23227-38.
Subbarao, S.K.1 Vasantha, K. & Sharna, V.P.sibllng epecles A and B to DDT and llCllcontrol. l{ed. & Vet. Ent. 2t219'223.
(1988) Response of 4ggltn India: lnpl lcat lons
heles cul lc l fac les
Subbarao, S.K, et af . (1987) Seaeonal Preval .ence of s lb l lng specLes A and B of the
t"tot Anophelee cullclfacies ln viltages around Del'hl' f391g.]a!9!g!9l'2429-L5.
Subbarao, S.K. et a l . ( I988a) Suscept lb l l l ty of Anopheles cul lc l faeles speclee A and
B to plasnodlun v1vax and Plaenodlun falctpqrutn as-aEtected by lnrnunoradLonetric
" " " " y 2 '
Subbarao, S.K. et a l . (1988b) Anophelee cul lc l fac lee s lb l lng specles conposi t l 'on and
t te reLat tonehlp to nalar ' 4 :29-33'
S u g u n a , S . G . e t a 1 . ( l 9 8 3 ) @ e p e c 1 e s c o n p l e x 1 n T h e n p e n n 1 y a rr lver lne t ract , Tant l @. 77:455-459'
ZavaLa, F. et a l . (1983) Clrcumeporozol te prote lns of nalar ia parasl tea conta ln a
elngle iomunodomlnant regl.on wlth tno or nore ldentical epltopes. J:-bIgl '157 -.1947-1957 .
vBc/90.3MAL/90.3Page 348
A}TNEX T
Ltst of Dosuments issued on:
VECTOR BIONOMICS
IN
THE EPIDEMIOLOGY AND CONTROL OF MALARIA
PART I
TI{E I{ITO AFRICAN REGION
E THE SOUTITERN WI{O EASTERN MEDITERRANEAI{ REGIONI,2
VBC/84.6- | , lAP/84.3 ( f09 pp.) cover lng the fo l lowlng:
PREFACEINTRODUCTIONACKNOITLEDGEMENTS
SECTION I: UALARIA VECTORS OF THE
SECTION II: AN OVERVIEW 'OF }IALARIASITUATION
AFROTROPICAL REGION - GENERAL INTORMATION
CONTROL PROBLEMS & THE RECENT MALARIA
VBC/85.1-MAP/85. f (225 pp.) cover lng the foLlowlng:
SECTION III; VECTOR BIONOMICS, MALARIA EPIDEUIOLOGY AND CONTROL BYGEOGRAPHICAL AREAS
(A) WEST AFRICA and ANNEXES I & II
VBC/85.2-MAP/85.2 ( f36 pp.) cover l .ng the fo l lowlng:
(B) EQUATORIAT AFRICA(C) SOUTIIERN AFRICA
vBc/85.3-uAP/85.1 (244 9p.) coverlng the followlng:
(D) EAST ATRICA(E) EASTERN OUTER ISLA}IDS(T) SOUTHIIESTERN ARABIA
I. Prepared by A.R. Zahar, Foroer I{I l0 Entonologlst.2. A l inlted nunber of coples ls avallabJ.e, requests Justlfylng the need for a aet of theee
docuoents should be addressed to the Dlrector of Control of Troplcal Diseases (CTD)
DlvlEion, I l l lO, Avenue Appia, l2ll Geneva, Swltzerland.
vBc/90,3MAL/90.3Page 349
AI{NEX 2
SELECTED REFERENCES ON I'IALARIA
QUANTITATIVE EPIDEMIOLOGY
B a i l e y , N . T . J . ( 1 9 8 2 ) o f D i seases .
Char les Gr l f f ln & Co. Ltd.
neva,
Bruce-Chwatt , L .J . (1g76) Mathenat lca l nodels in the epldenlo logy and contro l o f nalar la '
Trop. qeos. t ' led . 28 : I -8.
Dletz, K. , Mol lneaux, L. & Thonas, A. (Lg74) L nalar la nodel teBted ln the Afr lcan-savannah .
Bu l l . l l l d H l t h Org ' 50 :347 -357 '
Duter t re, J . (1976) Etude d-un nodele epldenlo loglque appl ique au paludl 'erne ' Ann' Soc '
be lges Med . . . 1 !g . 56 :127 - I4 l '
F lne, P.E.M. (1975) Super lnfect lon - A problen ln fornulat lng a problen (an h ls tor lca l
c r l t l q u e o f M a c d o n a l d - s t h e o r y ) . T r o P . D t s . B u t l . 7 2 z 5 6 5 - 5 7 L .
Garret t -Jonea, C. ( f964) Prognosls for ln terrupt lon of oalar la t ransuis{ t lon through
asses6!0err . o i the nosqi l to-s vector ia l capacf ty ' ry ' Lond' 20t i :1173-1I75 '
Garrett-Jonea, C. 6' Grab, B. (1964) The assessnent of lnsectlcidal lupar:t on the
nalar la nosqul to 's vector la l capacl ty , f ron data on the ProPort lon of parous
fena les . Bu l l . l l l d H l t h 0 rg . 31 :71 -86 '
Macdonald, G.. (1957) The Epldeniology and control of Malarla. London, o:rford unlverslty
P re ss .
Macdonald, G. (1973) Dynanlcs of TroPlc?l Diseases ' Bruce-Chwatt , L 'J ' ' l Gl 'anvl l le ' V 'J '
(eds.) London, Oxford Univer ls ty Press '
M o 1 1 n e a u x , L . & G r a n n 1 c 1 a , G . ( l 9 8 o ) T h e G a r k i E r 9 J e c t . R e s e a r c h o " c ! q j l r y { + : g -ControL of Malaria ln the sua:rn iE-Tlailzation'
Mol lneaux, L. , Dietz, K. & Thonas, A. (1978) A fur ther eptdenlo loglcal 'evaluat lon of a
nalarla nodel. Bull l{ ld lt l th 0rg ' 56"565-220'
*MoskovskiJ, S.D. (f950) The naln laws governlng the epldenlology of oalarl 'a' Moecow'
I I n Rues lan ] . (Seen by t l t l e on l y ) '
t toekoveklJ, S.D. (1963) The dynaulcs of oalar ia eradicat lon ' In : Proc ' 7 th Int ' ConS'
t .o-p. uea. lL far . ruo dL Janelro, Vol ' 5 , Pp 2L9-22O'
ttoskovskiJ, S.D. (1967) A further contrlbutlon to the theory of ualarla eradl'catlon'
Bul1. wld Hl th org. 362992'996'
NaJera, J .A. (1974) A cr l t lca l rev lew of the f le ld appl icat lon of a BatheEat lca l nodel of
nalarla eradlcatlon. 9u11' Wld lt lth Org ' 502449-457 '
Onor l , E. & Grab, B. (19S0) Indlcators for the forecast lng of nalar la epldeolcs '
Bul l . I { ld Hl th Org. 58:91-98'
pul l , J .H. ( f976) La not lon de r lsque dans lee-nal 'ad les parasLta l res^at 'ec reference
parr lcur lere au paludleroe. Rjv. ip ldento l . Sante publ . , Par ts 24t221'229.
vBc/90.3UAL/90.3Page 350
pul l , J .H. & Grab, B. (1974) A s inple epidenlo logical nodel for evaluat ing Ehe malar ia
lnoculat lon rate and the r lsk of in fect lon in in fants. BuI l . W1d wg.5 l : 507 '516 .
Rao, N.R. et a1. ( f976) Transmlss ion dynarnlcs of malar ia. Par t I I I . Quant i ta t ive studi 'es
A conputer s lnulat lon approach to measurenent . J . Con. Dis. 82246'254-
R lbe i ro , H . (1981 ) Sob re a capac ldade vec to r l a l dos Ano fe les ( I nsec ta , D iP te ra '
Cu l l c i dae ) na t ransu l ssao de pa lud tsno . Bo1 . Soc . Po r t . En t . 16 : l - 6 .
I r n Po r tuguese ] .
Rose , R. (19lf ) The Preventlon-91-l 'tglgrlg. 2nd ed. London, John Murray.
vBc/90.3MAL/90.3Page 351
EntonoIosical*
ETC
HBI
EIR
Parael to loglcal & others
ABER
SPR
PR
PHC
RH
ANNEX 3
ABBREVIATIONS
Pyrethrun spray col lect lon
Exl t - t rap col lect lon
Unfed fenalee
Fed or fully engorged fenaleE
Half-gravld fenalee
Gravld feoales
Iluroan blood Lndex
Entooologlcal lnoculatlon rate
Annual blood examlnatlon rate
Annual paraelte lncldence
Sl lde posl t lv i ty rate
Parasl te rate
Prlnary Health Care
Relatlve hunidity
PSC
UF
HG
vBc/90.3MAL/90.3Page 352
ANNEX 4
CORRIGENDUM TO DOCI'MENT VBC/90. 2.T1AL/ 90.2
Page 210 : The eeventh, e ighth and n inth references should read as fo l lows:
Gad' A. !1. et a l . (1964) A survey of nalar l .a ln Slnai . J . Egypt . Publ . Hl th. Assoc.39 z l47-163.
Gad, A.M. et a l . (1982) F le ld s tudles on anophel lne nosquLto larvae ln Egypt(Dlptera:Cul lc ldae) I . Di f ferent types and character ls t lce of the breedlngplaces ln relation to the abundance of anopheline specles ln Egypt.
J . Egypt . Publ . Hl th. Aesoc. ! (Specla l issues 5 e 6) z54L-562.
Gad, A.M. et a l . (1987) The d is t r ibut lon and ecology of the noequLtoee in the Red SeaGovernorate, Egypt . J . Egypt . Soc. Parasl to l . L7z2O7-22L.
