Malaria still kills many people it is caused by parasites carried by mosquitoes of the Anopheles species, which traditionally prefer rural areas. Nevertheless, urban areas are confronted with their specific challenges when it comes to the control and prevention of malaria, due to urbanization, dense population, and environmental changes. This article looks at the reasons why malaria is a challenge in urban areas and suggests practical solutions to tackle this issue. While malaria used to be seen as a rural problem, increasingly cities have many specific challenges when it comes to preventing malaria, as more people are living in cities.
Challenges of Malaria Prevention in Urban Areas
1. Urbanization and Environmental Changes
a. Increased Breeding Sites
Increased urbanization and industrialization rapidly create new mosquito breeding areas due to changes in land use and environmental conditions:
- Pooled Water: Examples include muddy construction sites, empty containers or improperly maintained water retention facilities, which serve as mosquito breeding areas.
- Water management: Waste and drainage systems that are neither designed nor managed efficiently can concentrate low-lying areas with persistent water accumulation.
b. Climate Variability
Urban areas may experience localized climate variations that affect mosquito activity. For instance:
- Mosquitoes: Heat islands – localized areas where cities are much warmer than surrounding rural areas – can alter mosquito behavior and the ability to breed.
- Changes in rainfall patterns due to urbanization can also change the frequency, and extent, of water accumulation.
2. High Population Density
a. Close Proximity of Residents
Unhygienic circumstances brought by intense population density in metropolitan areas caused more bite opportunities for mosquitoes and the spread of diseases among people living close to each other.
b. Mobility and Migration
People moving frequently within cities – and between cities – could also further its diffusion. Meanwhile, migrant populations might also be at an elevated risk if they have limited access to prophylactic drugs and health care.
3. Inadequate Infrastructure
a. Poor Housing Conditions
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- Holes in Windows and Doors: Poorly fitting flyscreens or open windows and doors can allow a home to be invaded by mosquitoes.
- Improper Construction: Housing structures may have gaps or cracks that allow mosquitoes to enter.
b. Limited Access to Healthcare
Some primary and secondary healthcare facilities in certain urban areas may be inaccessible. The following are the challenges:
- Healthcare Disparities: Unequal access to healthcare can mean that malaria is not diagnosed in its early stages.
- Strained Healthcare Systems: Swamped urban healthcare systems can delay diagnosis and treatment.
4. Socioeconomic Factors
a. Poverty
Poverty can impact malaria prevention efforts by limiting access to:
- Preventive Tools: Low-income populations do not have easy access to or the ability to afford bed nets, repellents or other malaria prevention tools.
- Healthcare Services: Financial constraints can prevent timely medical care and effective malaria treatment.
b. Lack of Education
Inaction based on misunderstanding and lack of education about malaria and related prevention approaches can drive the persistence of the disease.
Solutions for Malaria Prevention in Urban Areas
1. Enhanced Mosquito Control Measures
a. Targeted Larviciding
Identification of Breeding Sites: Conduct routine monitoring of hot spots for Aedes aegypti breeding to cull mosquitoes and also to destroy breeding sites.
Larvicidal Treatments: Treat identified breeding sites with larvicides that kill larvae before they reach adulthood.
b. Adult Mosquito Control
Insecticide Spraying: Implement targeted indoor and outdoor insecticide spraying to reduce adult mosquito populations.
Biological control: exploit biological methods of control that can establish the natural predators of mosquitoes.
2. Improving Urban Infrastructure
a. Waste Management and Drainage
Proper Disposal of Waste: All waste (both human and animal excreta) should be placed far from larval breeding locations and properly disposed
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b. Housing Improvements
Mosquito-Proofing Homes: Incentivise and facilitate window and door screens, as well as the sealing of gaps and cracks in housing structures.
Avian Influenza: Include avian influenza control in urban planning and development initiatives to minimize mosquito breeding sites.
3. Promoting Public Awareness and Education
a. Health Education Campaigns
Community Outreach Should also include community outreach programs to teach residents about how to prevent malaria, recognize its symptoms and, if caught early, treat it.
School Programmes: Incorporate malaria education in the curriculum to enlighten children and adolescents.
b. Media and Communication
Public Service Announcements: Use mass media to publicize information on malaria and prevention and
Social Media: Use these tools to reach a wider range of people and communicate on malaria prevention and control.
4. Strengthening Healthcare Services
a. Access to Diagnosis and Treatment
Increase Access to Health Care: Enhance access to diagnosis and treatment of malaria in urban areas by improving health facilities and services at all levels.
Mobile: Take mobile clinics to people, going to remote populations unable to make it to clinics.Diagnostic and Treatment.
b. Training Healthcare Providers
Capacity Building: Train healthcare providers on malaria diagnosis, care, and prevention.
Sur Reporting: Enhance malaria surveillance and reporting systems to better detect and manage outbreaks.
5. Leveraging Technology
a. Geographic Information Systems (GIS)
Mapping and surveillance: use geographic information systems (GIS) to map breeding sites of mosquitos (the vector of the malaria parasite), track the incidence of malaria by the human population, and highlight areas to mitigate the impacts of the mosquitoes.
Data Analysis: Analyze data to optimize resource allocation and intervention strategies.
b. Innovative Tools and Solutions
Smart Traps: Use high-tech mosquito traps to reduce population where it matters Most of these methods are believed to be cost-effective and safe, and at least one has been shown to save money. The World Health Organization has concluded that, due to the ease of use and safety, spraying indoor areas with insecticide remains the preferred method for malaria control. However, as cross-resistance to insecticides by mosquitoes and bugs increases, alternative methods are becoming more important. For example, although the World Health Organization recommends the use of long-lasting, insecticide-treated mosquito nets, using chemical-based products can pose health risks if misused and some people are allergic to them, so they may prefer sleeping bare.
Remote sensing: Use remote sensing technologies to monitor environmental conditions and predict potential malaria outbreaks.
The prevention of malaria in urban areas ought to be seen as a complex matter that takes into account the intricate nature of urbanization, marked by the ‘urban advantage’ and its associated important cultural and socio-economic changes. By drawing interventions from different sectors andplicating mosquito control, improving urban infrastructure, raising public awareness, building up the public health sector, and utilizing technology, cities can curb malaria and ensure public health.
Preventing and controlling malaria in cities requires a multisectoral collaboration among government agencies, physicians’ offices, community organizations, and citizens. Adopting a proactive approach to malaria could help urban areas significantly reduce the burden of disease and improve living conditions for their residents.
