Health Specialist Opposes Use Of Larvicide For Malaria Control

PROF  FRED  BINKAA  Public Health Specialist, Professor Fred Binka, has kicked against the proposed use of larvicide biological agent or chemical, for the control of malaria in Ghana saying that it is inappropriate to use the approach in an environment of high transmission of malaria.

“We are not in a position to use larvicide, it will be a complete waste of taxpayers’ money. We cannot rid mosquito,” he said.

Prof Binka said the best approach for effective malaria control was the scaling up of the use of Insecticide Treated Bednets (ITNs), indoor spraying and effective diagnostic testing and treatment of the disease.

He said those approaches remained “the best in our circumstances”, and expressed regret that the use of ITNs was low adding that not until two years ago when Global Fund helped to increase the number of mosquito nets to 11 million, there was only about 200,000 in use.

Speaking to The Ghanaian Times on Friday, Prof. Binka, who is the Vice Chancellor of the University of Health and Allied Sciences in the Volta Region, said the use of larvicide could only be useful in environment of low transmission of malaria.

The use of larvicide in malaria control has attracted political attention with the member states of Economic Community of West Africa States, (ECOWAS) including Ghana planning to adopt the approach in malaria control, a major public health issue in the sub-region.
Larvicide involves regular application of biological or chemical insecticide to water bodies to reduce number of mosquito larvae and pupae.

The use of this approach in malaria control has not yet attracted the blessings of the World Health Organisation (WHO) because of insufficient scientific evidence of its effectiveness in high transmission environment.

Prof Binka said Ghana had a very high transmission of malaria with so many breeding grounds across the country and it was not suitable to use larvicide because mosquitoes could not be rid off.

He expressed the need for the government to invest more in the tried and tested methods of malaria control by investing more in the use of betnets.
Malaria is a life threatening blood disease transmitted from person-to-person through the bite of the female anopheles mosquito which needs the human blood for her egg and  kills fastest when not treated quickly.

It is a major public health disease in Ghana accounting for 32.5 hospital admission and 49 per cent of under five admissions with children and pregnant women most vulnerable.

Member states of the ECOWAS  in 2009 signed a tripartite agreement with Venezuela and Cuba, to receive support from the Latin America countries, both financially and technically, to expand larviciding activities in Africa by setting up factories to produce larvicide for malaria control.

However, some of the larvicide products that had entered the market have not been received by the WHO Perticide Evaluation Scheme to assess their safety and efficiency.

A review by the WHO Malaria Policy Advisory Committee in 2012 recommended that larviciding should only have limited role in malaria control and only be used in areas where mosquito breeding sites are “few, fixed and findable.”

According to the  WHO website, the world body is concerned that rise in larviciding could result in a diversion of financial resources away from scientifically proven vector control tools to methods whose effectiveness remains uncertain.

The WHO operational manual on larvicidal control management, July 2013 stressed that the approach should be tailored to local environmental condition and should be based on comprehensive feasibility and cost effectiveness study.

‘Promoting the widespread use of larva source management in rural areas of Sub-Saharan Africa would be premature,” according to information on the website.

Studies on integrated malaria vector control with microbial larvicide and ITN in Western Kenya recently showed that though the use of larvicide reduced malaria vector of mosquito larvae and adult by 90 per cent, the effectiveness of the approach for reducing incidence of malaria among vulnerable children remains unproven.

The study revealed that ITNs are firm favourite in malaria control and their protective efficiency is well known with reduction of 40 per cent of human mosquito bite rate. By Salifu Abdul-Rahaman   

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