Malaria transmission and land use management in the Ecuadorian Amazon

Identifying ecosystem determinants of malaria risk for appropriate and sustainable control

Malaria is a major public health problem in Ecuador, where more than 60 per cent of the population is at risk. High-risk areas, which include the northern Amazon province of Sucumbios, have experienced a reemergence of malaria since its virtual elimination in the 1970s.

This re-emergence has been attributed in part to intrusion into the tropical forest by oil companies, facilitating the access of timber companies and colonization of the area. Migration of non-immune populations into the area, combined with environmental modification favouring the invasion of efficient vector species, has brought human and vector into closer association.

An adequate knowledge of local malaria epidemiology and vector biology is a key factor for appropriate resource allocation and effective malaria control. To achieve this goal, a better understanding of the biophysical, socio-cultural and economic determinants of malaria risk in agricultural communities in the Amazon region of Ecuador is needed. Furthermore, participative approaches are required to identify appropriate and sustainable control strategies.

To respond to this need, we are using an eco-epidemiological framework to investigate the ecosystem determinants of malaria risk through participative methods involving a network of 2,000 farmers. Specifically, social, environmental, entomological and clinical studies are being used to understand the relationship between malaria risk and different agricultural systems (cocoa, annual crops and cattle) at the household and community level.

It is not clear how the economic, social and environmental consequences of the agricultural methods commonly practiced in the Ecuadorian Amazon influence exposure to malaria infection. Neither is it clear how malaria is perceived by households and communities engaged in the different types of agriculture. By engaging agricultural communities in the research process this project will incorporate the needs and knowledge of the affected populations within a broader epidemiological framework in order to develop appropriate and sustainable interventions.

Objectives

The overall objective of the project is to identify ecosystem determinants of malaria risk among agricultural communities in the Northern Ecuadorian Amazon and to develop appropriate malaria control interventions.

The project has three specific objectives:

• To create a model of malaria transmission through the characterization of the ecosystem determinants.
• To determine locally appropriate malaria control interventions in conjunction with stakeholders (governments, NGOs, community groups, farmers associations.
• To strengthen local capacities for research and intervention through training and knowledge exchange.

Results and Impact

This project is ongoing. It is expected that, by working in a participatory manner with many stakeholders, including local farmers and regional and national politicians, we will identify policy measures that can aid in malaria control, while at the same time increasing constructive dialogue between farmers and politicians.