Case study No.

1

Agent: Plasmodium Falciparum
Host: Humans and female Anopheles mosquitoes
Environment: Watery breeding places
What control and prevention measures could be adopted to break the epidemic/epidemiological
triangle/cycle of the disease?
Answer:
The epidemiological triangle/cycle for Malaria could me shown as:






Following control and prevention measures can be implemented at the various levels of
the chains of the epidemiological triangle/cycle.
1. Break the chain between host and environment
To break the chain between host and environment for the transmission of malaria
Clear swampy areas and bushes
Ensure proper disposal of waste
Plasmodium
Watery breeding
placess
Humans & Female
Anopheles
mosquitoes (vectors)
Drain water for irrigation around villages and houses (Drain wetlands)
Reduce the ambient conditions so mosquito dies before transmitting the malaria
parasite
Avoid living in marshy areas
Improve housing conditions to reduce contact with mosquitoes
Cleaning of drainage canals

2. Break the chain between host and agent
To break the chain between host and agent in the malaria disease
One can take anti-malaria drugs (For uncomplicated malaria artemisinin-based
combination therapies (ACTs), Severe malaria should be treated with injectable
artesunate (intramuscular or intravenous) and followed by a complete course of
an ACT as soon as the patient can take oral medicines.
Vaccination (There is currently no commercially available malaria vaccine,
despite many decades of intense research and development effort. The most
advanced vaccine candidate against Plasmodium falciparum is RTS, S/AS01.
3. Break the chain between the environment and the agent
To break the chain between the environment and the agent
Spray the breeding sites for mosquitoes
Indoor residual spraying (IRS). WHO Pesticide Evaluation Scheme (WHOPES)
currently recommends 12 insecticides belonging to 4 chemical classes for IRS.
Among these DDT (dichloro-diphenyl-trichloroethane) has a comparatively long
residual efficacy, lasting more than 6 months, and continues to be a widely used
insecticide for IRS.
Outdoor spraying with DDT, Malathion or dieldrin.
Larval source management. For example Larviciding is only recommended for
areas where mosquito breeding sites are few, fixed, findable, and where the sites
are easy to identify, map and treat. Larviciding could be done with DDT, oil or
temephose or even by large scale distribution of larvivorous fish.
Thermal fogging

4. Break the vector and host chain
To break the vector and host chain
One can sleep under mosquito net.
Use of insecticides nets (ITNS)
Long-lasting insecticidal net (LLINS)
Intensive health promotion
Global malaria eradication program (GMEP)
Personal protection measures such as window screens, insecticide treated
hammocks, repellents, and protective clothing.