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Eliminating Malaria Case-Study 7 ELIMINATING MALARIA Case‑study 7 Elimination of malaria on the island of Reunion: 40 years on ELIMINATING MALARIA Case‑study 7 Elimination of malaria on the island of Reunion: 40 years on WHO Library Cataloguing-in-Publication Data Elimination of malaria on the island of Reunion: 40 years on. (Eliminating malaria case-study, 7) 1.Malaria - prevention and control. 2.Malaria - epidemiology. 3.National Health Programs. 4.Reunion. I.World Health Organization. ISBN 978 92 4 1507738 (Classification NLM : WC 765) © World Health Organization 2014 All rights reserved. Publications of the World Health Organization are available on the WHO website (www.who.int) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: [email protected]). Requests for permission to reproduce or translate WHO publications –whether for sale or for non-commercial distribution– should be addressed to WHO Press through the WHO website (www.who.int/about/licensing/ copyright_form/en/index.html). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. Photo credit cover: © iStockphoto.com / © Sapsiwai Design by Paprika-annecy/University of California, San Francisco, Global Health Group. Printed by WHO Document Production Services, Geneva, Switzerland. Publications of the University of California, San Francisco are available on the UCSF web site (http://globalhealthsciences.ucsf.edu/global-health-group), Global Health Group, the University of California, San Francisco, CA, USA. CONTENTS Acknowledgements .............................................................................................................. ix Acronyms and abbreviations .................................................................................................... x Glossary ............................................................................................................................ xi Summary ........................................................................................................................ xvii History of malaria and malaria control ..................................................................................xvii The elimination of malaria, 1949−1967 ..................................................................................xvii Prevention of reintroduction ..............................................................................................xvii Outlook .....................................................................................................................xviii Introduction ........................................................................................................................ 1 Series of malaria elimination case-studies .................................................................................. 1 Malaria elimination initiatives in Africa .................................................................................... 1 Malaria on the island of Reunion ........................................................................................... 2 Country profile .................................................................................................................... 3 Geography, population and economy ...................................................................................... 3 Health system and health of the population ............................................................................... 4 History of malaria and malaria control ....................................................................................... 7 Parasites and vectors .......................................................................................................... 7 Initial introduction in 1868 ................................................................................................... 7 First control measures (1900−1948) ........................................................................................ 7 Elimination during the Global Malaria Eradication Programme ........................................................ 8 Prevention of reintroduction since 1967 .................................................................................. 10 Factors contributing to the changed malaria situation in reunion ...................................................... 15 How did malaria spread to the island? ..................................................................................... 15 How was malaria eliminated? .............................................................................................. 15 Fluctuations in receptivity and vulnerability .............................................................................. 16 Prevention of reintroduction: 1967 to the present ......................................................................... 21 Organization .................................................................................................................. 21 Legislation .................................................................................................................... 21 Case detection and investigation ........................................................................................... 22 Disease treatment ............................................................................................................ 25 Entomological surveillance ................................................................................................. 25 Vector control ................................................................................................................ 25 Health education ............................................................................................................. 26 The cost of preventing reintroduction..................................................................................... 27 Lessons learned and drivers of change ....................................................................................... 29 Political commitment, effective methods and strict implementation of Global Malaria Eradication Programme strategies ...................................................................................................................... 29 Strict prevention of reintroduction ........................................................................................ 29 Outlook ....................................................................................................................... 30 Eliminating malaria | Elimination of malaria on the island of Reunion: 40 years on | Contents vii Conclusion ........................................................................................................................ 31 References ......................................................................................................................... 33 Annex 1: Data sources and methods applied ................................................................................ 37 Annex 2: Population ............................................................................................................. 38 Annex 3: Parasites and vectors ................................................................................................. 39 Annex 4: Reported cases 1967−2010 .......................................................................................... 41 Annex 5: Imported cases and sources of infection 1967−2000 ........................................................... 43 viii Eliminating malaria | Elimination of malaria on the island of Reunion: 40 years on | Contents ACKNOWLEDGEMENTS This case-study is part of a series of malaria elimination Dr Jean-Olivier Guintran, formerly WHO/AFRO/ case-studies conducted by the WHO Global Malaria IST and currently WHO/Vanuatu, drafted the text Programme and the Global Health Group of the of this case-study, which was subsequently developed University of California, San Francisco (UCSH/GHG). in collaboration with Dr Aafje Rietveld of the WHO Global Malaria Programme. The two groups wish to acknowledge the financial support of the Bill & Melinda Gates Foundation in The authors would like to thank everyone who developing the elimination case-study series. contributed to the development of this case-study, particularly Ms Marisol Touraine, Minister of Social The following institutions
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