For personal use. Only reproduce with permission from The Lancet Publishing Group. THE LANCET Infectious Diseases Vol 2 October 2002 http://infection.thelancet.com 618 Current malaria-control strategies emphasise domestic protection against adult mosquitoes with insecticides, and improved access to medical services. Malaria prevention by killing adult mosquitoes is generally favoured because moderately reducing their longevity can radically suppress community-level transmission. By comparison, controlling larvae has a less dramatic effect at any given level of coverage and is often more difficult to implement. Nevertheless, the historically most effective campaign against African vectors is the eradication of accidentally introduced Anopheles gambiae from 54 000 km 2 of largely ideal habitat in northeast Brazil in the 1930s and early 1940s. This outstanding success was achieved through an integrated programme but relied overwhelmingly upon larval control. This experience was soon repeated in Egypt and another larval control programme successfully suppressed malaria for over 20 years around a Zambian copper mine. These affordable approaches were neglected after the advent of dichlorodiphenyltrichloroethane (DDT) and global malaria- control policy shifted toward domestic adulticide methods. Larval-control methods should now be re-prioritised for research, development, and implementation as an additional way to roll back malaria. Lancet Infect Dis 2002; 2: 618–27 The rise, fall, and recovery of malaria vector control in Africa Current malaria-control strategies emphasise domestic protection against adult mosquitoes with insecticides and improved access to medical services. 1–8 Malaria prevention by killing adult mosquitoes is generally favoured because of the relative ease with which houses can be identified and mapped, as well as the exquisite sensitivity of transmission intensity to the mortality rate of adult female mosquito vectors. 5,9–14 To transmit malaria a mosquito must ingest infectious gametocyte forms of the malaria parasite from an infected person, survive long enough for these to successfully transform into infectious sporozoites, and then bite another susceptible human host. 15 For Plasmodium falciparum, the most dangerous and prevalent human malaria parasite in Africa, this process takes a minimum of 10 days and usually longer. 15 Thus, increasing the mortality rate of mosquitoes entering houses can substantially suppress malaria transmission in whole communities. 16–22 By Historical review Eradication of Anopheles gambiae from Brazil GFK is an ecological epidemiologist at the Department of Public Health and Epidemiology, Swiss Topical Institute, Basel, Switzerland, and adjunct assistant professor at the Department of Tropical Medicine, School of Public Health and Tropical Medicine, Tulane University Health Sciences Centre, New Orleans, Louisiana, USA; UF and LCG are medical entomologists at Mbita Point Research and Training Centre, International Center of Insect Physiology and Ecology, Mbita, Suba District, Nyanza Province, Kenya; IK is the Malaria and HIV/AIDS Coordinator at Rusinga Island Child and Family Programme, The Christian Children’s Fund, Rusinga Island, Suba District, Kenya; and BGJK is a medical entomologist and visiting scientist at the Laboratory of Entomology, Wageningen University Research Centre, Wageningen, Netherlands. Correspondence: Dr Gerry F Killeen, Department of Public Health and Epidemiology, Swiss Tropical Institute, Socinstrasse 57, PO Box CH-4002, Basel, Switzerland. Tel+41 (0)61 2848284; fax: +41 (0)61 2717951; email Gerry.Killeen@unibas.ch Eradication of Anopheles gambiae from Brazil: lessons for malaria control in Africa? Gerry F Killeen, Ulrike Fillinger, Ibrahim Kiche, Louis C Gouagna, and Bart G J Knols Figure 1. The range and physical geography of habitats infested by A gambiae in Brazil. Reproduced from reference 79.