The unfortunate thing is that these methods have rarely been applied in places such as Africa for along time (Killeen et al.,2002).
It is worth noting that the effective of Indoor Residual Spraying (IRS) with DDT or any other suitable alternative when compared with other control techniques for malaria ( such as impregnated bed nets as well as improved access to anti-malarial drugs) shows great variation and is dependent on the specific local conditions (Sadasivaiah, et al.,2007)
A study by the World Health Organization revealed that the mass distribution of the impregnated mosquito nets (insecticide treated) as well as artemisinin-based drugs led to a reduction in the number of deaths in Ethiopia and Rwanda, two countries which had a high level of malaria burden. The use of Indoor Residual Spraying (IRS) with DDT is noted to have not played a role in the reduction of mortality in these countries (WHO, 2008; Brown,2008)
Vietnam is also noted to be enjoying a decline in the number of malaria cases a fact which has resulted in a 97% reduction in the mortality rate after they abolished the use of DDT in their anti-malarial campaign to a program which is based on the prompt treatment, pyrethroid based insecticides as well as bed nets (WHO,2000).
In Mexico, there has been the adoption of affordable and yet effective chemical as well as non-chemical strategies for the control of malaria and their success leas to the shut down of various DDT manufacturing plants in Mexico due to a general lack of demand for DDT (IPEN,2008).
Even though there has been a general increase in the number of malaria mortalities as a consequence of DDT ban, several other factors are noted to have played part in the rise in the number of cases. Goodman and Mills (1999) reviewed 14 studies on the effectiveness of malaria in sub-Saharan Africa that discussed insecticide-treated nets, chemoprophylaxis for the young children, residual spraying, intermittent treatment of the expectant mothers, hypothetical vaccine as well as changing frontline drug treatment. Their work indicated that the general lack of information lead to poor decision making on the cost as well as the outcomes of various interventions. Their work indicated that there is little data on the cost-effectiveness' of the various malaria control techniques. Lack of evidence on the effects as well as costs of the packages of measure were pointed out. The work indicated that the cost-effectiveness estimates of spraying DDT were never accurate and the obtained estimates were never good predictots of the level of cost-effectiveness of the existing programs.
Another study carried out in Thailand indicated that the cost per case of malaria prevention by means of DDT spraying method was 21% more than the cost per case of the prevented malaria by means of lambda-cyhalothrin -- treated nets (Kamolratanakul, et al.,2001).This cast a lot of doubt on the proposition that DDT is the most cost-effective method of preventing malaria. Similar results were obtained in Mexico when then director of Mexico's control program for malaria declared that it is close to twenty five percent cheaper to spray houses with pyrethroid-based sprays as opposed to DDT base ones.
As suggested by Corin and Weaver (2005), amore comprehensive approach of evaluating the cost-effectiveness as well as efficacy of a given malarial control program is multifactorial . This is because it should not just measure cost in monetary terms but also the total number of saved lives and the level of ecological damage as well as effects on human health. Corin and Weaver (2005) pointed out that the detriment nature of DDT to the environment and human health exceeds the beneficial decline in the cases of malaria. The benefits are noted just to be higher in an epidemic scenario.
Barat (2006) compared a total of four highly successful malarial control programs in Brazil, Vietnam, Eritrea and India indicated that non-of the programs endorsed a given single strategy. They however mentioned the various success factors that included; conducive conditions in a country, a targeted and yet technical approach that employed a package of highly effective tools, good leadership, community involvement, control of finances, decentralized form of implementation, technical as well a programmatic support from various a partner agencies a s well as adequate financing.
Curtis (2009) indicated that mosquitoes which are resistant to DDT are generally susceptible to the synthetic and natural pyrethroids.
For the sake of sustainability, it is better to ban DDT since it might save life today and harm lives tomorrow due to that fact that it acculturates in the body and then gets transmitted along the food chain. It is necessary for the cheaper and more effective alternatives to be promoted and adopted at the individual, organizational and national level. This means that people must learn how to live with malaria rather than how to eradicate it totally since that is close to impossible.
Governments must therefore encourage the non-DDT-based malarial control strategies by;
Doing away with the taxes as well as tariffs levied on bed nets, pesticides as well as antimalarial drugs. The government must also emphasize on the adoption of appropriate and effective technologies such as the use of affordable and culturally acceptable plants to repel Anopheles mosquitoes.
DDT usage should be banned worldwide due to its bad effects on human and the environment (fish and birds). However, in emergency situations such as a malarial epidemic, it can be used in controlled amounts as suggested by McGinn (2002). Malaria is a terrible disease which can wipe an entire generation if not well controlled. It is therefore the role of everyone in the community to work towards ensuring that the global malarial epidemic is eliminated of means of affordable and yet sustainable solutions '
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