Timor malaria control project, September 28, 1987

Evaluation covers the period 1982-86. Malaria control measures have generally been effective. In East Timor, coverage levels have increased from 11.8% in 1982 to 42.1% in 1986, slightly above the target of 40%. In West Timor, these levels increased from 14.2% to 31.9%, again slightly above the project target of 30%. areas. The project also implemented complementary vector control measures in some areas (e.g., water oiling, drain construction, introduction of larvivorous fish). Overall, the impact of the project has been positive: in 1982 malaria cases accounted for 18.2% of outpatient attendance in East Timor and 18.9% in West Timor, but these rates have declined to 12% and 14.2% respectively. All clinically diagnosed cases received suppressive drug treatment. Two areas of continuing concern are high error rates among field microscopists analyzing malariaometric survey samples and the discovery of the prevalence of chloroquinine-resistant falciparum malaria in East Timor. Although the project has been successful, some doubt remains about the sustainability of these gains. Without protection, Timor will undoubtedly be prone to new outbreaks. Future control stategies should emphasize sending a central-level laboratory team to Timor to determine malaria prevalence through a malariometric survey, applying a single spray cycle in areas currently under operation and a second cycle in problem areas or areas that have not yet been covered, undertaking drug control procedures, including radical treatment of malaria positive cases, and involving the community in anti-malaria activities. USAID/I should consider funding continued TA islandwide and operational costs in West Timor.