Malaria control in Nicaragua: social and political influences on disease transmission and control activities

被引:25
作者
Garfield, R [1 ]
机构
[1] Columbia Univ, Sch Nursing, New York, NY 10032 USA
关键词
D O I
10.1016/S0140-6736(99)02226-6
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Throughout Central America, a traditional malaria control strategy (depending on heavy use of organic pesticides) became less effective during the 1970s. In Nicaragua, an alternative strategy, based on frequent local epidemiological assessments and community participation, was developed in the 1980s. Despite war-related social instability, and continuing vector resistance, this approach was highly successful. By the end of the contra wart there finally existed organisational and ecological conditions that favoured improved malaria control. Yet the expected improvements did not occur. In the 1990s, Nicaragua experienced its worst recorded malaria epidemics. This situation was partly caused by the country's macroeconomic structural adjustment programme. Volunteers now take fewer slides and provide less treatment, malaria control workers are less motivated by the spirit of public service, and some malaria control stations charge for diagnosis or treatment. To "roll back malaria", In Nicaragua at least, will require the roll-back of some erroneous aspects of structural adjustment.
引用
收藏
页码:414 / 418
页数:5
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