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have been used for many hundreds of years. The inhabitants of swampy regions in Egypt were recorded as
sleeping in tower-like structures out of the reach of mosquitoes, whereas others slept under nets as early as
450 B.C.
F. Malaria has social consequences and is a heavy burden on economic development. It is estimated
that a single bout of malaria costs a sum equivalent to over 10 working days in Africa. The cost of
treatment is between $US0.08 and $US5.30 according to the type of drugs prescribed as determined by local
drug resistance. In 1987 the total cost of malaria - health care, treatment, lost production, etc. - was
estimated to be $US800 million for tropical Africa and this figure is currently estimated to be more than
$US1800 million.
G. The significance of malaria as a health problem is increasing in many parts of the world. Epidemics are
even occurring around traditionally endemic zones in areas where transmission had been eliminated. These
outbreaks are generally associated with deteriorating social and economic conditions and the main victims
are underprivileged rural populations. Economic and political pressures compel entire populations to leave
malaria free areas and move into endemic zones. People who are non-immune are at high risk of severe
disease. Unfortunately, these population movements and the intensive urbanisation are not always
accompanied by adequate development of sanitation and health care. In many areas conflict, economic crises
and administrative disorganization can result in the disruption of health services. The absence of adequate
health services frequently results in recourse to self-administration of drugs often with incomplete treatment.
This is a major factor in the increase in resistance of the parasites to previously effective drugs.
H . The hope of global eradication of malaria was finally abandoned in 1969 when it was recognized that this
was unlikely ever to be achieved. Ongoing control programs remain essential in endemic areas. In all
situations control programs should be based on half a dozen objectives: provision of early diagnosis, prompt
treatment to all people at risk, selective application of sustainable preventive measures, vector control
adapted to the local situations, the development of reliable information on infection risk and assessment of
living conditions of concerned populations. Malaria is a complex disease but it is a curable and preventable
one.