Health Challenge: Malaria in West Africa

摘要

Malaria poses an important threat to oil and gas exploration inrnWest Africa. Malaria-related loss of life and productivityrnamong the workforce surpasses all other occupational andrnnon-occupational illness combined. Although an entirernworkforce may be infected by malaria parasites in an endemicrnwork-site, the burden of disease in foreign migrant workersrnwho lack anti-malarial immunity greatly exceeds that onrnindigenous employees. This disease constitutes a medicalrnemergency in expatraite employees workforce and frequentlyrnis life-threatening. Africans who are Duffy blood grouprnnegative are refractory to Plasmodium vivax infection, andrnacquired immunity in holoendemic parts of tropical Africarnlargely limits severe disease to pre-school children. Thesernconsiderations have important implications for therndevelopment of rational antimalaria interventions that arerndesigned to sustain productivity among a workforce ofrnforeigners and nationals in frontier operating environments.rnChemoprophylaxis reduces or eliminates the risk of malariarninfection among the foreign workforce but depletes the naturalrnimmune capacity of the national workforce and creates arndangerous rebound phenomenon. A basic understanding ofrnmalaria epidemiology is essential to an understanding of therndisease, and locally derived ecological concepts are critical forrnthe design of malaria awareness and prevention programs.rnVector populations depend on the suitability of local breedingrnsites. A warm climate favors parasite development within thernvector mosquito. Risk dependends mainly on the lifernexpectancy of the vector mosquito after it has becomerninfectious. Control measures should be aimed at reducingrnvector density and blocking access to human hosts.rnApplications of residual insecticide reduce mosquito survival;rnbut outdoor feeding and resting of some African vectorsrnreduces their susceptibility to insecticides and erodes thernconfidence placed on this very effective anti-malaria measure.rnAdequate water management or source reduction modifies orrneliminates aquatic breeding habitats and reduces mosquitornabundance.