SWORDE-Teppa Malaria Control Programme
Fighting malaria and poverty in the former Soviet Central Asian Republics, Afghanistan and beyond, with research, capacity building, community education and focussed and sustainable vector control strategies.
Rice fields of Tajikistan
Despite considerable efforts in the Twentieth century to eradicate or control malaria, it is still the most prevalent and most devastating communicable disease of the tropics and subtropics. There are 300-500 million cases each year and up to 3 million deaths. Due to a number of factors, the problem is getting worse in regions previously less affected.
After Africa, South-East Asia and South America, the region incorporating Central Asia, Kazakhstan and Afghanistan is the fourth most malaria affected area in the world. Some one quarter to one half of the combined population of these countries of 62 million are at risk of malaria.
Official figures of malaria cases are unreliable, however experts estimate some there may be as many as one million malaria cases in the region every year. It is a region overlooked and as a result it is fast moving towards being the third most malaria affected region in the world.
As well as a marked increase in cases in recent years, there has also been a dramatic increase in cases of the more dangerous P. falciparum malaria with reports of drug resistance. Approximately 20 million people or more than 30% of the total population in Central Asia and Kazakhstan live in areas at risk from malaria. A further 15 million are at risk in neighbouring North Afghanistan.
If left unchecked this serious situation could also have knock-on effects and spread to countries previously less affected and north to other former southern Soviet republics and Europe beyond.
Malaria transmission areas 2004
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The increase in malaria in the Central Asian and Afghanistan region is mainly a result of recent civil conflicts and wars in some parts leading to the break down of health systems and infrastructures. There has also been a lack of funding and specialist knowledge in terms of malaria research and mosquito control. This has lead to poorly focused intervention strategies, and these factors underlie the continuing problem of malaria in the region. It is apparent that control measures implemented under previous Soviet administrations are no longer sustainable or pertinent to the current situation.
Agricultural practices and human activities have changed significantly, with a huge increase in rice cultivation, blocked drainage canals and poor irrigation systems. There has also been a flux of migrations of human populations and potential malaria carriers within the region and a lack of knowledge of the mosquito species composition and distributions. Though weakened since the Soviet era and civil conflict, public health institutions remain in place and staff can be re-trained in updated, effective methods of vector control appropriate for the current entomological and environmental situation. Thus, unlike malaria programmes in Africa where the goal is to bring the disease down to manageable levels, the opportunity exists to virtually eliminate the threat of malaria from Tajikistan and the rest of Central Asia and bring to down to more controllable levels in Afghanistan through modern focused intervention strategies.
Tajikistan Roll Back Malaria
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Tajikistan, due to its geographic location and malaria makeup with some 200,000 – 400,000 estimated cases, reports of possible drug resistance and the spread of malaria to previously unaffected parts of the country, is key to malaria control in the Central Asian and Afghan region. Malaria and mosquitoes do not respect man-made borders. The only way to control malaria in the region is by cross-border initiatives, training, research, collaboration and interventions.
SWORDE-Teppa is the only specialist vector control organization in the Central Asian region and is heavily involved in a number of malaria projects.
SWORDE-Teppa personnel include the foremost national experts as well as international consultants trained at the London School of Hygiene and Tropical Medicine. We work closely with the community and the local authorities for maximum project potential and effectiveness. Below is a brief description of some of our malaria activities.
Children playing in flooded canal, Farkhor Tajikistan
1. Vector Control Consultancies:
The SWORDE-Teppa training centre in Kurgan-Tyube, Tajikistan, acts as a base and resource centre for malaria control activities in Tajikistan, Central Asia and North Afghanistan. SWORDE-Teppa specialists, trained at the London School of Hygiene and Tropical Medicine and elsewhere, have been and are involved in a number of projects both internally and with other non-governmental organisations, UN organisations, local and national government, institutions and the community. SWORDE-Teppa personnel are responsible for the planning of most of the malaria control programmes in the region over the past six years. SWORDE-Teppa consultants have arranged malaria conferences and workshops in Tajikistan since 1999 and were also involved in a malaria control workshop in New Dehli in 2004. Further conferences and workshops are planned for 2005. Please contact SWORDE-Teppa for more details on how we can help you by providing malaria control consultancy services.
London School of Hygiene and Tropical Medicine
2. Public Awareness and Education Programme:
Public awareness and education are key to the success of any project. SWORDE-Teppa training and resource centre in Tajikistan also acts as a base for such activities. Trained SWORDE-Teppa personnel are heavily involved in a number of initiatives. These initiatives include; workshops and seminars in the centre and at other locations, community focus groups and events, training of trainers, community participation in awareness campaigns, including education about malaria, where it comes from and how you can prevent becoming a malaria statistic. Mass media, newspapers, radio, booklets, posters, children’s theatre, school and university visits are also employed in educating people about the control of malaria.
Mosquito theatre for children
Gambusia Mosquito fish distribution
Leaking irrigation and blocked drainage canals
3. ISTC Project:
SWORDE-Teppa consultants are collaborating partners involved in an International Science and Technology Centre funded three year malaria project, to be implemented by the Institute of Zoology and Parasitolgy, named after Pavlovsky, Dushanbe, Tajikistan. This project is to start in June 2005. The project title is; ‘Complex study of malaria mosquitoes and their natural enemies, elaboration of measures on regulation of number of mosquitoes and decrease of malaria nidi in southern areas of Tajikistan’. SWORDE-Teppa provides technical assistance, some equipment and facilities and monitoring of the project as well as being involved in some aspects of the research.
The number of mosquitoes and their spreading is closely connected with the environment and directly depends on its change. Natural enemies of mosquitoes can significantly decrease their numbers to a safe level.
The most successful enemies of mosquitoes are larvae-eating fish such as food Sazan, Bream, Varicorhinus capoeta heratensis, and non - food: Alburnoides taeniatus, Alburnoides bipunctatus eichuvaldi, and the accidentally imported Chinese species Pseudorasbora parva, Rhinogobius similes and Hemiculter eigenman. Their effectiveness as a means of controlling mosquitoes will be determined during the project. These species will be recommended for applying in malaria endemic areas.
Gambusia fish gets acclimatized in reservoirs of Tajikistan perfectly well. For the recent decades its number in reservoirs of Tajikistan has significantly reduced. Other active enemies of mosquitoes are the insects - entomophag. The overall goal of the present ISTC project is a complex study of bloodsucking mosquitoes and their natural enemies, finding out the most effective natural regulators and elaboration of the recommendations on applying them to regulate number of mosquitoes and to suppress the main sources of malaria (Plasmodium vivax and Plasmodium falciparum) in Southern Tajikistan.
Sewing Centre, Shaartuz, Tajikistan
4. Longlasting bednet Research Project:
Bednets are one of the most effective ways of reducing malaria, if used correctly, by preventing human – mosquito contact. SWORDE-Teppa, together with the local community, INGOs, health authorities and local business people, is implementing a pilot project of manufacturing and marketing of a new type of long-lasting bednet in Tajikistan and nearby countries. The old type of bednets are known in Tajikistan and the other the Central Asian countries and have been used in the past. However, the old type of bednet, although offering some protection from mosquitoes, had several drawbacks. They were difficult to obtain, had to be treated and retreated with chemicals every year, could not be washed, made with smaller holes and therefore less ventilation.
Receiving bednets, Vakhsh, Tajikistan
Despite these factors, and lack of spare resources, many people were eager to obtain or purchase the old type of bednet. The new long-lasting type of bednet conquers all these problems. The new type of bednet will be produced locally in Tajikistan and therefore more easily available and help in some poverty reduction, lasts for eight years or more with no chemical treatment required (the chemicals are already woven into the fabric), can be washed without losing the chemical effectiveness, have larger gauge holes for extra ventilation and are more affordable. Due to improving economics in the region, people now also have a more disposable income to purchase such bednets if available.
The social marketing of these long-lasting bednets and their proper use will help reduce malaria and other diseases in Tajikistan and nearby countries. Subsidised and free bednets will also be available to the most needy and poorer in society. This project supports the WHO RBM initiative, MoH in Tajikistan and other government control strategies, NGOs and the community. The project also involves community awareness and education about bednets and their correct use. Finally and equally as important the project employs local people and generates local funds, therefore helping to reduce poverty in the region.
5. Pyriproxyfen Research Project:
SWORDE-Teppa implements research into a new type of insect growth inhibitor chemical pyriproxyfen. There are many parts of Tajikistan, and elsewhere, where it is not viable to use other malaria control methods. For example in shallow pools (from puddles to very shallow rice fields) where fish will not survive during the heat of the day, pools produced in the summer in river beds, or habits of mosquito species where expensive chemical sprays are inefficient. Pyriproxyfen stops the natural growth of insects such as mosquitoes so that they never mature to adulthood and thus controls the adult female and thus prevents malaria. Together with the health authorities in Tajikistan, SWORDE-Teppa is carrying out research in different locations in the south of Tajikistan to assess the effectiveness of the use of pyriproxyfen as a means of malaria control in the country. Findings and recommendations will be given to the relevant authorities at the end of the research project.
Mosquito fish Gambusia
6. Gambusia Fish Research Project:
The North American Mosquito Fish, Gambusia affinis, consumes large numbers of eggs and larvae of malaria-carrying mosquitoes. For this reason, it was imported into the southern republics of the former Soviet Union in the 1920s to 50s.
Notably, stocks were introduced into the Central Asian Tajikistan, Uzbekistan and Turkmenistan.
The Mosquito fish will live happily in rice-fields, swamps, ponds or ditches.
In more recent times in Tajikistan there has been an increase in mosquito habitats and attempts to reintroduce the Mosquito fish. These attempts have largely failed, due to a number of factors. Together with the local community and authorities, SWORDE-Teppa is implementing research into the use of Gambusia fish and other natural predators in Tajikistan.
Flooded village, Southern Tajikistan
7. Eucalyptus Trees Research
Anopheles mosquitoes breed in many still water sources. Waterlogged areas are often caused by poor drainage. There are many such sites in Tajikistan. Certain species of Eucalyptus trees are able to grow in waterlogged and often saline areas. Eucalypts are very thirsty trees and they have been successfully used in Azerbaijan for malaria control. SWORDE-Teppa is currently starting a project to grow Eucalyptus trees in waterlogged and saline areas of Tajikistan. These are areas where other control measures are less effective, but also in areas where the native trees have long since been cleared and where they is an acute shortage of timber and fire wood. Some eighteen species of Eucalypts are being cultivated from seed to be planted out in selected areas, with very different growing conditions. Working with the community, this project has long-term effects of controlling malaria, growing much needed timber and fire wood, making a cooler habitat and poverty reduction.
Blocked drainage canals and specialist field training
8. Vectrol – Capacity Building Project:
Future malaria control in Tajikistan and neighbouring countries is dependent on training or re-training of national specialists in the field of vector control. SWORDE-Teppa personnel have been involved in training Ministry of Health and other specialists in Tajikistan in malaria control since 1999. SWORDE-Teppa’s new training and resource centre in Tajikistan also acts as a base for such activities. Trained SWORDE-Teppa personnel are involved in a number of initiatives. These initiatives include; conferences, workshops and seminars in the centre and at other locations, technical training, training in English language and IT. SWORDE-Teppa’s established links to LSHTM and other institutions and access to other technical information allow for the most up-to-date exchange of information between international specialists and national specialists and trainee specialists.
Cleared drainage canal, Pyanj Tajikistan
SWORDE-Teppa Laboratory Tajikistan
9. Human Behaviour and Mosquito Behaviour Research Project:
It is clear that human behaviour and the man-made environment, and the behaviour and breeding habits of mosquitoes are vital contributing factors in malaria control. SWORDE-Teppa has been carrying out behavioural surveys relating to malaria since 1999 and continues to do so. This is an ongoing process involving community and local authority education and activities, testing behaviour against new control measures, peoples lifestyle and habits compared to the proximity to adult mosquitoes and their habits and peoples environments and whether they are contributing to mosquito breeding sites, living near such sites, etc. Continuous recommendations are made available concerning such matters at both community self-help level and local authorities.
10. Invitation to Students and
Scientists to take part in Research:
SWORDE-Teppa invites students and scientists to participate in the above projects. Your help is vital to ongoing success of projects and as a means of exchange of ideas. SWORDE-Teppa is also eager to host any students and scientists wishing to carry out their own research in Tajikistan.
The SWORDE-Teppa field centre in Tajikistan is equipped with microscopes, digital cameras, specimens and literature as well as having web access. We can also provide reasonable and safe accommodation, a translator if necessary and transport in country.
Please contact us at firstname.lastname@example.org for further details.