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Malaria Elimination Country Case Study 2: Moving towards sustainable elimination in Cape Verde

October 11, 2012 - 19:43 -- The Global Heal...

Many countries are nearing — or have already achieved — malaria elimination, as documented by a new series of case studies by The Global Health Group at the University of California, San Francisco and the World Health Organization (WHO) Global Malaria Programme. Having worked in collaboration with ministries of health in affected countries, the two organizations highlight new evidence about what works — and what does not — for reaching and sustaining zero malaria transmission.


William Jobin's picture
Submitted by William Jobin on

The Cape Verde Strategic Plan offers hope for the future.

Although they are small, the islands of Cape Verde do illustrate the difficulties in mosquito or malaria eradication. Fortunately the Ministerio de Saude continues to emphasize Integrated Vector Management, with indoor spraying coupled with anti-larval operations.

At first, success seemed easy in Cape Verde,

“In 1948, Lisbon’s Instituto de Higiene e Medicina
Tropical (IHMT) set up and supervised a pilot
elimination project on Sal, the most arid of the islands
with a population of only 2 700. The project achieved
eradication of the vector after only two years of annual
rounds of IRS with DDT and treatment of breeding
sites. That attack phase was followed by a maintenance
phase, consisting of systematic antilarval operations and
entomological surveillance (22).”

Since then there have been continual recurrences of the mosquito and the disease on Sal and on the other larger islands. After all they face P. falciparum and An. arabiensis. But they have developed a current plan of integrated control.

According to Feachem’s case study, the current Malaria Strategic Plan has a sound foundation in larval management, including larvivorous fish. They also recognize the importance of irrigation and drinking water facilites in causing recurrent outbreaks of malaria. I quote a reference to their current Strategic Plan, now in force:

“After the intense IRS operation finished in the 1960s,
vector control efforts in Cape Verde focused mostly
on larval control. A mixture of different methods was
applied, including the use of temephos insecticide or
larvivorous fishes (such as Gambusia affinis) in known
man-made breeding sites. The intermittent drying of
water reservoirs is regularly promoted, as are protection
of water tanks and the spread of petroleum derivatives
over non-drinking-water.”

Although Cape Verde is not on the African continent, their success in stopping the recurring outbreaks should indicate whether such things can even be contemplated for Africa.

William Jobin Director of Blue Nile Associates