Table 5 Approaches to malaria control prior to and during World War One
From: Malaria’s contribution to World War One – the unexpected adversary
Pre – 1914 | 1914 - 1918 | |
|---|---|---|
- Systematic inspection and notification of cases | - Scientific evidence on control strategy required | - Preliminary study of epidemiological conditions [84] |
- Protection against mosquito bites (portable nets) | - Specially trained medical officers and orderlies required [44] | - Appropriate housing |
- Portable mosquito proof rooms | - Availability of malaria diagnostic units with microscopes [9, 44] | - Eliminating parasite reservoir |
- Protection of hands and feet (boots) | - Sanitary sections in field Divisions to supply material for anti-mosquito work [82] | - Small anti-larval measures and measures against adult larva |
- Medicinal skin protection (effect transient) | - Mosquito brigades (in Palestine) | - Quinine treatment and prevention |
- Mosquito reduction (fumigation, traps, fish as larvicides, oiling, drainage, screening breeding water, filling pools, piping to prevent leakage) | - Frequent inspections of anti-mosquito work [82] | - Collective mechanical defences |
- Detection, isolation and specific treatment of all infected soldiers [79] | - Entomological studies of anopheles species [17] | - Bed nets and mosquito protection [84] |
- Prevention by treatment | - Recognition problem of mistaken diagnoses [44] | - Reduction of negligence and scepticism of preventive measures by authorities [18] |
- Personal domestic hygiene | - Siting of camps and evacuation of areas [11] | - Reduction of contradictory instructions on quinine use to avoid chaotic use of quinine |
- Quinine prophylaxis | - Instructions on use of mosquito nets and net design. 45Bivouac netted tents [17], (Figure 11) | - Urine inspection for quinine detection (Tarant’s reagent) to control prophylactic administration of quinine [18] |
- Consider public prophylaxis with quinine (if troops contracting infection outside barracks) | - Mosquito-proof canvas huts [17] | - Malaria specialists as advisers [84] |
- Repeated measurements (malaria surveys) | - Mosquito swats [17] | - Malaria diagnostic units with field laboratories [55] |
- Keeping troops in non-malarial hill areas [79] | - Occasional use of pyrethrum sprays (Lefroy’s fluid) for mosquito control [30] | - Aggressive control of mosquito breeding along front lines [55] |
- Imposition of fines for non-cooperation Legislation on engineering work | - Quinine prophylaxis recommended by Ross and Medical Advisory Committee, but unfavourable response from medical officers [10, 80] | - German[85] |
- High standards of disease prevention | ||
- Drainage operations, although impossible in mountainous terrain, or where campaign was highly mobile (eg, Palestine) [25] | - Emphasis on quininization [85] | |
- Local conditions decided most important activity | - Indian troops exempted from use of mosquito nets on grounds they were unpopular, and they had acquired malarial immunity [66] | |
- Quininization (simplest and cheapest) | - Pamphlets explaining dangers [17] | |
- Supervised quinine therapy and quinine prophylaxis trusted to exterminate malaria even in very badly infected areas, | - Recruitment blood examination for selection of smear negative candidates (West Indies) [13] | |
- Environmental mechanical protection | - Instruction of medical officers on spleen examination technique of Indian troops [73] | |
- Personal anti-mosquito measures | ||
- Reliance on acquired immunity [87] | ||