Writings on Malaria |
Ref. 7/2 - 416
To: All members of MTOC
From: Government Entomologist
30th March 1973
This is an addendum to my Agenda Item for MTOC Meeting 2/73. It is based on a study of all case investigation forms for 1972, held in Gizo, and a personal visit to the area.
Records
In my previous paper, I noted that of the 108 malaria cases in the MTOC Annex records all 108 were recorded on our village record cards. However, perusal of the forms held in Gizo showed the following eleven additional cases.
| Zone 44 | 1 Pv at Saranamola in July |
| Zone 46 | (1 Pv at Sariana, in our records as from Saelae but as Pm - same
date In August) 1 Pf at Qaviage in March 1 Pv at Borokune, ? CFU but no previous record, in June 1 Pf at Polo in June 1 Pf at Sariana in August. |
| Zone 47 | 1 Pf at Vurago in May 1 Pv at Saga Saga in August 2 Pv at Vurago, one In February and one in March |
| Zone 48 | 1 Pf at Poro Poro in June |
| Zone 49 | 1 Pv at Sasamunga in January |
Case investigations
These were made for all but 17 of the 119 cases - a commendable performance. Nearly all were classified as indigenous except for those which were relapses.
Some of the "relapses" were in fact a different infection from the previous finding - this is a point to be careful of when making such a classification.
Comments on previous and subsequent movements proved most useful for this study.
Conclusions
There appears to be six foci of malaria between the Zones 46, 47, and 48. These are as follows, with the probable principal village(s) first and secondary ones thereafter.
| 1. | Zone 46 | Vuru Vuru; Siabangara (cases also at Gatapale probably contracted at Vuru Vuru) |
| 2. | Zone 46 | Ogo (some connections with Bubukuana) |
| 3. | Zone 46 | Bumbukuana; Borokuni, Soepa, Saelae, Tagorami and Sariana (connections with Sirobesi, near Ogo) |
| 4. | Zone 46 | Polo and Enara (plus Lokasau?) |
| 5. | Zone 47 | Vurago and Sirondona; Kagaluga (cases at Matalavata and Luluvata originated at Vurago; connections with Chivoko, Pole) |
| 6. | Zone 48 | Poro Poro and Liu Liu; Sibe Sibe; Sipukana, Malevaga, Tareboko, Sage Saga (Zone 47) [a Moli case was from Sibe Sibe, and a Vagara case from Polo. Poro Poro had visitors from Vurago] |
It should be clear that movements between villages along this part of the Choiseul coast are a common feature of life and the above foci may represent the sources of infections or else be particularly receptive areas. For instance, the 1972 falciparum epidemic in Focus 6, above, apparently started in early May and at that time strangers from Vurago, where there were Pf cases in January and February, were from Poro Poro.
For Susuka Region the time between blood slide taken and blood slide examined now is around 14 days for ACD slides with an obvious further delay for PCD slides. The time further elapsing before radical treatment starts is of the order of 14 days or more. Thus time between Blood Slide Taken (BST) and Radical Treatment Given (RTG) is around one month. With a fortnightly scheduled ship this is unlikely to be improved upon. Radio messages to Sirovanga will help somewhat but Sirovanga is a long way from Susuka.
The limited number of cases in Malangono Region appear to have been treated somewhat more rapidly with a BST to RTG interval of two to three weeks.
Recommendations
It is perhaps unfortunate that the load of cases had fallen almost entirely on Susuka Region. A small modification in the Regional Boundary probably is desirable to include Saga Saga and possibly Barabarakasa in the Malangono Region.
What perhaps is most important is that the Susuka Region is given priority over all Western District Regions in terms of staffing and that at all times the staff are at full strength. Without this the sub-regional base at Polo, a most essential one, cannot be maintained. Housing at Polo should be provided as soon as possible for one technician and one FUS man.
The importance of remedial action must be emphasised to the Supervisor and proper FUS ensured.
The Regional Training team are scheduled to visit Choiseul in the near future and this should be very useful.
Dr. B. Taylor,
Government Entomologist
| ©1999 - Brian Taylor CBiol FIBiol
FRES 11, Grazingfield, Wilford, Nottingham, NG11 7FN, U.K. Visiting Academic in the Department of Life Science, University of Nottingham Comments to dr.brian.taylor@ntlworld.com |
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