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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
Prevention European theatre & British Dominions[7779] British[911, 13, 17, 25, 30, 44, 66, 73, 8083] French[18, 30, 84]
- 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]
- Australian[24, 55]
- 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
Prevention in German possessions[86, 87] - 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]