Mozambique uses 4 million mosquito nets in turn from pesticide, in war on malaria

June 20, 2017

Mozambique’s National Malaria Control Programme distributed 4 million LLIN, insecticide-impregnated nets, to protect children and others from malaria as they sleep, the time most malaria-infecting mosquito bites occur. Malaria Consortium photo

Mozambique’s National Malaria Control Programme distributed 4 million LLIN, insecticide-impregnated nets, to protect children and others from malaria as they sleep, the time most malaria-infecting mosquito bites occur. Malaria Consortium photo

Mozambique is one of only ten nations still using DDT for Indoor Residual Spraying (IRS) to fight malaria.

But DDT’s effectiveness diminishes rapidly, as does the effectiveness of the other eleven insecticides generally used for IRS against malaria or other vector-borne diseases. Insecticides are sprayed indoors, and not outdoors, to provide protection where humans are most often bitten, and to prevent non-target mosquitoes and other creatures from being exposed to the insecticides. This prevents harmful pests from developing resistance to the insecticides, and diminishes damage to beneficial species, like food fish.

Instead of spraying, malaria fighters turn increasingly to bednets impregnated with insecticide, known as Long-Lasting Insecticide-impregnated Nets (LLIN). A net provides closer to 100% protection from bites than IRS. A net immediately protects anyone sleeping under it, while IRS must treat at least 80% of nearby homes to achieve more than 50 percent prevention.

While still using IRS, Mozambique stakes its future malaria fighting on nets.

The Malaria Consortium aided in the recent distribution of nets.

Malaria Consortium has successfully completed a mass distribution campaign of over four million long-lasting insecticidal nets (LLINs) across Nampula and Niassa provinces in Mozambique. The nets were distributed almost simultaneously across all districts of each province – 23 districts in Nampula in November 2016, and 16 districts in Niassa in May 2017 – using a new operational model aimed at optimising resources.

Throughout the campaigns, Mozambique’s National Malaria Control Programme was responsible for the LLIN acquisition and led overall planning and implementation through the decentralised structures of the health system. Malaria Consortium’s role consisted of operational support, which included financial management, transport, procurement, logistics, training, management of service providers, efficient use of resources and effective coordination at provincial, district and field levels.

Sonia Gwesela, Malaria Consortium Mozambique Country Director said, “In Nampula Province, a major achievement was that 99 percent of households collected their nets. We successfully delivered 98 percent of the nets in both provinces, coming well above the 90 percent target set by the National Malaria Control Programme.

“With the successful completion of the distribution, we can now focus on a post-distribution communications campaign about the correct use of LLINs,” she concluded.

The Malaria Prevention and Control Project is funded by the Global Fund to Fight AIDS, TB and Malaria and supports the efforts of the Mozambican government to reduce malaria throughout the country through scale up of prevention and control efforts with community involvement. Malaria Consortium is working in partnership with World Vision, Fundacao para o Desenvolvimento da Comunidadeo, International Relief and Development, and the Mozambique Ministry of Health.

Bednets can be twice as effective as IRS in preventing the spread of malaria. Beating malaria also requires upgrading health care for quick diagnoses and quick, complete treatment of malaria in humans, and prevention projects to drain mosquito-breeding places within 50 yards of homes; more prevention of bites means less medical treatment is required.

WHO estimated 5 million people died of malaria in the 1950s into the 1960s. WHO’s Malaria Report 2016 reported malaria deaths fell to less than 430,000 world wide, a more than 90 percent reduction since 1963, mostly accomplished without DDT.

Malaria Consortium on Twitter, @FightingMalaria.

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Poisoning the children: Study shows mothers give DDT to their children from breastmilk

July 29, 2011

Too many in the U.S. bury their heads in the sands about the issues, but researchers in Spain and Mozambique wondered whether indoor residual spraying (IRS) with DDT, to fight malaria-carrying mosquitoes, might produce harms to children in those homes.  They studied the issue in homes sprayed with DDT in Mozambique.

It turns out that young mothers ingest DDT and pass a significant amount of it to their children when the children breast feed.

The study itself is behind Elsevier’s mighty paywall, but the abstract from Chemosphere is available at no cost:

Concentration of DDT compounds in breast milk from African women (Manhiça, Mozambique) at the early stages of domestic indoor spraying with this insecticide

Maria N. Manacaa, b, c, Joan O. Grimaltb, Corresponding Author Contact Information, E-mail The Corresponding Author, Jordi Sunyerd, e, Inacio Mandomandoa, f, Raquel Gonzaleza, c, e, Jahit Sacarlala, Carlota Dobañoa, c, e, Pedro L. Alonsoa, c, e and Clara Menendeza, c, e

a Centro de Investigação em Saúde da Manhiça (CISM), Maputo, Mozambique

b Institute of Environmental Assessment and Water Research (IDÆA-CSIC), Jordi Girona 18, 08034 Barcelona, Catalonia, Spain

c Barcelona Centre for International Health Research (CRESIB), Hospital Clínic, Universitat de Barcelona, Rosselló 132, 4a, 08036 Barcelona, Catalonia, Spain

d Centre for Research in Environmental Epidemiology (CREAL), Doctor Aiguader 88, 08003 Barcelona, Catalonia, Spain

e Ciber Epidemiología y Salud Pública, Spain

f Instituto Nacional de Saúde, Ministerio de Saúde, Maputo, Mozambique

Received 6 November 2010;

revised 19 March 2011;

accepted 1 June 2011.

Available online 20 July 2011.

Abstract

Breast milk concentrations of 4,4′-DDT and its related compounds were studied in samples collected in 2002 and 2006 from two populations of mothers in Manhiça, Mozambique. The 2006 samples were obtained several months after implementation of indoor residual spraying (IRS) with DDT for malaria vector control in dwellings and those from 2002 were taken as reference prior to DDT use. A significant increase in 4,4′-DDT and its main metabolite, 4,4′-DDE, was observed between the 2002 (median values 2.4 and 0.9 ng/ml, respectively) and the 2006 samples (7.3 and 2.6 ng/ml, respectively, p < 0.001 and 0.019, respectively). This observation identifies higher body burden intakes of these compounds in pregnant women already in these initial stages of the IRS program. The increase in both 4,4′-DDT and 4,4′-DDE suggest a rapid transformation of DDT into DDE after incorporation of the insecticide residues. The median baseline concentrations in breast milk in 2002 were low, and the median concentrations in 2006 (280 ng/g lipid) were still lower than in other world populations. However, the observed increases were not uniform and in some individuals high values (5100 ng/g lipid) were determined. Significant differences were found between the concentrations of DDT and related compounds in breast milk according to parity, with higher concentrations in primiparae than multiparae women. These differences overcome the age effect in DDT accumulation between the two groups and evidence that women transfer a significant proportion of their body burden of DDT and its metabolites to their infants.

Highlights

► DDT increases in pregnant women at the start of indoor spraying with this compound. ► Rapid transformation of DDT into DDE occurs in women after intake of this insecticide. ► The DDT increases in breast milk of women due to indoor spraying are not uniform. ► Breast milk DDT content in primiparae women is higher than in multiparae women. ► Women transfer a high proportion of their DDT and DDE body burden to their infants.

“Primiparae” women are those with one child, their first; “multiparae” women are those who have delivered more than one child.

Without having read the study, I suggest there are a few key points this research makes:

  1. Claims that DDT has been “banned” from Africa and is not in use, are patently false.
  2. Spraying poisons in homes cannot be considered to have no consequences; poisons in in very small concentrations get into the bodies of the people who live in those homes.
  3. We should not cavalierly dismiss fears of harms to humans from DDT, because it appears that use of even tiny amounts of the stuff exposes our youngest and most vulnerable children.
  4. Beating malaria has no easy, simple formula.

Women, even poor women in malaria-endemic areas, should not have to worry about passing poisonous DDT or its breakdown products to their children, through breastfeeding.  The national Academy of Sciences was right in 1970:  DDT use should be stopped, and work should be hurried to find alternatives to DDT.

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