Exploration and Production projects can potentially create adverse health impacts for workers and surrounding communities unless appropriate malaria control programs are designed, implemented and monitored on an ongoing basis.These company based control programs often contain measures that often are not evidence-based and that may actually impair community malaria control efforts.
This paper will present strategies and tools for use in developing effective malaria prevention and control programs through reviewing the current literature regarding:
Bite prevention and vector control
Diagnosis and treatment
These strategies can result in cost effective mitigation of potential adverse health impacts by implementing scientifically based programs developed for the specific malaria risk in the defined geographic area.
A study of 100,336 travelers who visited malaria endemic areas in East Africa showed that less than 2% systematically tried to reduce the risk of infection by using a broad variety of personal protective measures (air conditioning, screens, bed nets, long sleeved clothing/trousers, repellents and insecticides) (Shoepke, 1998).
All workers should receive consistent, standardized educational material and instruction before travel to malaria risk areas and this instruction should be regularly reinforced while working in the malaria risk area.In addition all workers must consult a travel medicine specialist to obtain chemoprophylaxis and begin the prescribed regime within an appropriate time frame before travel.
A recent study in the Mt. Cameroon region found that overall infective biting rates of the three species of Anopheles were one infective bite every other night during the rainy season and once every five nights during the dry season.Anopheles gambiae, the most aggressive species, exhibited biting rates of three per man per night in the rainy season and 5.53 bites per night during the dry season (Wanji, 2003).Pyrethroids are effective against mosquitoes, flies, ticks and chiggers and are the only group of insecticides cleared for use on insecticide treated nets (ITNs) (Croft, 2001).They exhibit high knock down effects and high insecticidal potency at low dosages, combined with relative safety for human contact and domestic handling.ITNs have been shown to reduce the transmission by more than 90 to 95% in areas of intense, perennial transmission. (Gimnig, 2003; Croft, 2000).Results of U.S. troops studied in Somalia showed that soldiers who did not use treated bed nets regularly were 2.6 times more likely to develop malaria (Wallace, 1996). Evidence based medicine guidelines in Canada regarding personal measures to prevent malaria are: insecticide (permethrin or deltamethrin) impregnated mosquito nets, permethrin treatment of clothing, and DEET on exposed skin (Canadian Guidelines, 2000)