Dealing with malaria in the last 60 years is seen by the author in the perspective of his own experience. His malaria work, which began in 1941, covered the study of the habits of the mosquitoes dwelling in the savanna country of Eastern Colombia and the effect on malaria transmission of the newly introduced DDT residual spraying. The success of the campaign he later directed in Sarawak and Brunei contributed to the launching by WHO of its global malaria eradication campaign. Further successful work in Uganda showed the possibility of effective control and even eradication in highland country but left unsolved the problem of how to interrupt transmission of holoendemic malaria in Africa. The author's work with WHO in the Middle East showed to what extent social and economic conditions could influence the course of a malaria campaign. This was also the experience in America, both in Colombia in the author's early work and later in Mexico during an evaluation of the national malaria programme. Development of insecticide resistance was also encountered in his career and the refractoriness of the European vectors was also observed in his work as a malariologist.
A general malaria survey of Sarawak and Brunei, two of the territories of British Borneo, is described. Contrary to what was expected in view of the climate and the general conditions, the prevalence of malaria in Sarawak and Brunei proved, on the average, to be low. The coastal areas were found to be practically free from the disease, although epidemics have occurred there in recent years. Malaria was found to be endemic in the hilly and mountainous interior. In fact, topography proved to be an important factor in malaria prevalence, the spleen- and parasite-rates, generally speaking, being higher the more abrupt the country. Differences were also observed in the prevalence among the various racial groups, but these were considered to be due to different habits and customs rather than to race itself.Entomological studies showed that Anopheles leucosphyrus Dönitz was the main malaria vector in the interior of Sarawak, A. barbirostris playing a secondary role. A. leucosphyrus balabacensis had already been recognized as the malaria vector in Brunei.The favourable results of a first field trial of residual insecticides are mentioned and plans for a nation-wide malaria-control programme are briefly outlined.
A first experiment on malaria control in the interior of Borneo by spraying with residual insecticides is described. The work was carried out in the isolated, sparsely populated valleys of the Baram River and its tributary, the Tinjar, in northern Sarawak. The experimental area was divided into three parts: a DDT test area, where a 75% suspension of wettable powder was applied at the rate of 2 g of DDT per m(2) of surface; a BHC test area, where a 50% suspension of wettable powder was applied at the rate of 0.10 g of gamma isomer per m(2); and a check area.Entomological investigations made before the spraying operations were started showed that Anopheles leucosphyrus Dönitz, 1901 was the main malaria vector in both the test and the check areas. Out of a total of 7568 A. leucosphyrus dissected, 30 gland infections were detected-a sporozoite-rate of 0.40%. A. barbirostris was found to be a secondary vector throughout the experimental area.THE RESULTS OF INSECTICIDE SPRAYING WERE SATISFACTORY: in the DDT test area, the spleen-rate fell from 51.8% to 25.1%, and the parasite-rate from 35.6% to 1.6%, in 21 months, and a similar reduction in the rates was observed in the BHC test area. In the check area, the spleen- and parasite-rates rose during the period of observations. It is considered that if such a degree of control can be obtained in 21 months, complete eradication can be expected in the near future.Although BHC spraying proved effective, the fact that it has to be repeated every three months makes it impracticable in the interior of Sarawak, where communications are very poor and difficulties of transport very great. DDT spraying, which need only be done twice a year, is therefore to be preferred. The cost of the DDT operations-US$ 0.45 per person protected per year-is comparatively high, owing to the difficulty of communications and to the necessity for spraying not only the village "longhouses", but also the temporary shelters which the semi-nomadic people in the interior of Sarawak build each year in the rice-fields.