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Editorial
. 1999 Sep 11;319(7211):651-2.
doi: 10.1136/bmj.319.7211.651.

Environmental management for vector control. Is it worth a dam if it worsens malaria?

D Brewster
Editorial

Environmental management for vector control. Is it worth a dam if it worsens malaria?

D Brewster. BMJ. .

Abstract

PIP: This article reports a seven-fold increase in the incidence of malaria among children living close to small dams in the Tigray region of northern Ethiopia compared with children in villages distant from the dams. Despite the weakness of a case-control design, the authors of this study convincingly addressed the issue of confounders such as altitude, seasonality, and use of antimalarials. Intensity of malaria transmission does not correlate directly with morbidity and mortality because of the modulating effects of immunity and other factors. Nevertheless, increased malarial infection is likely to constitute a serious health risk to children, particularly in the region of Ethiopia. Some of the environmental management strategies for vector control, which may be applied to dam projects include locating dams at high altitude, using insecticide-treated beds for personal protection, and adopting a range of environmental manipulations. These measures, which incorporate local knowledge and fit local circumstances, are more likely to succeed than adhering to traditional methods. It is in this situation that governments and aid agencies need to make a policy commitment to minimize the adverse health risks of dam projects through the adoption of environmental management strategies for vector control and effective public interventions as part of community development activities.

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