Background: South Africa (SA) started using organochlorines for malaria vector control in the 1940’s and is still dependent on these insecticides in the malaria endemic areas. Indoor residual spraying (IRS) is the current method of choice. Contemporary insecticide exposures, primarily low-level environmental (eg. DDT/DDE) or occupational exposures, are associated with adverse male reproductive health, due to their endocrine disrupting potential.
Aim: Due to the health effects associated with DDT/DDE exposure, the aim was to introduce safer alternatives (innovation), develop study material (education), launch a mobile application (communication) and health promotion (music and drama) as a sustainable approach towards malaria elimination.
Methods: A cross-sectional study including more than 700 young males from a malaria endemic area in Limpopo province, South Africa, showed an association between DDT/DDE exposure and some male reproductive parameters (p=0.05). A field trial was conducted using new materials (polyethylene wall linings) to complement IRS. A book (Sibo fights malaria) was developed to educate primary schools pupils. In addition, music and drama were used to communicate malaria messages and create awareness amongst affected communities. A mobile application (Malaria Buddy) was developed to provide relevant information to travellers in terms of prevention and treatment.
Results: Twenty-eight percent of the participants in this study presented with oligozoospermia (<20 million sperm/mL) and asthenozoospermia (sub-normal sperm motility). Wall linings as an alternative vector control method was introduced during a trial study and were found to be 100% effective (knock down and mortality) as a safer vector control method after four years of field trials. Affected communities and travellers also welcomed the new innovative interventions and the educational and social media tools.
Conclusions: While still dependant on DDT for malaria vector control, affected populations should be educated to limit exposure while safer alternatives are developed. A more sustainable approach is needed towards malaria elimination.