1. In dense equatorial forests,which have not
been degraded (where Man is practically absent), the transmission
of malaria is very low or non-existent. This can be explained in
two ways: the major vectors of malaria are not very numerous, the
dense forest is obviously unsuitable for them; furthermore, Man,
with the exception of Pigmies, is practically absent from this
area. There is therefore no reservoir of parasites. Transmission is
poor, around 10 PAIH (bites of anophelines infected by Man) per
annum.
2. In degraded forests,along a river or a road,
the situation is radically different. Deforestation, natural or
anthropogenic, has a strong impact on the transmission of malaria.
The sun’s rays penetrate right into the larval breeding grounds.
Henceforth, these breeding grounds become favorable to the
development of Anopheles gambiae, which may become
very abundant. The conditions of survival (temperature, hygrometry)
being normally favorable for the survival of the adult, the
transmission is very high, frequently in the region of several
hundred PAIH per annum. Transmission is permanent throughout the
year.
3. In savannas, on the contrary, the
seasonal variations are considerable. Transmission takes place
solely during the rainy season and at the beginning of the dry
season. It may be considerable, varying between several hundreds
and tens of PAIH depending on the locality. Frequently, a
succession of vector roles between Anopheles
gambiae and/or Anopheles arabiensis may be
observed in the middle of the rainy season, then Anopheles
funestus at the beginning of the dry season.
4. In the Sahel,the climatic conditions are
usually too harsh to allow the transmission beyond two months in
the rainy season. Locally, especially around lakes, the
transmission period may be extended. The transmission rate is
around one to a few dozen PAIH per annum.
5. In the Sahara,the transmission of malaria is
an abnormal event, and furthermore relatively poorly documented.
Its effect on the epidemic mode is only to be found in the most
favorable locations, i.e. oases, eventually leading to an increase
in reservoir of parasites following the arrival of malaria-infected
immigrants.
6. In irrigated areas,ordinarily linked to
hydro-agricultural developments (for example rice paddies in the
savanna areas), environmental modifications give rise to very
variable repercussions. In all cases, there is an increase in the
density of malaria vectors. But there is not always an increase in
the transmission rate: that depends upon the base transmission
level prior to the introduction of these developments. When this
base level is low, it is not rare to see an increase in the
transmission of malaria. On the contrary, when the base level is
already high, the consequences of the developments on the
transmission rate are low or non-existent.
7. In town,the transmission of malaria is a
perfectly perceptible reality. It is ordinarily around 0.1 to 3
PAIH per annum. These rates are the lowest observed in tropical
Africa. Urbanization alone is responsible for this upheaval in the
epidemiology of malaria. A transmission gradient ordinarily
observed from the most peripheral recent districts, where the
transmission is hardly lower than the neighboring rural area,
towards the older and central districts, where the transmission is
much lower. Nowadays, it is no longer more exceptional to encounter
adult men who have always lived in an urban environment and have
escaped, by chance, any infection by malaria. Without malarial
experience, they are in an immunological state close to that of a
traveler coming from a country free of malaria. It is foreseeable
that this embryonic situation may develop with increasing
urbanization, as much in absolute values as in percentage of the
population concerned, and that these potentially epidemic
situations should be considered as average and long term.
8. It is interesting
to note that it is the value of the transmission rate which
determines the epidemiological context. In fact, by definition,
malaria is called ENDEMIC when its transmission rate
is more or less constant and perceptible for several consecutive
years. On the contrary, it is called EPIDEMIC
when its transmission rate is unusual, either due its intensity
during an exceptional period, or by its location in an area where
it is normally not prevalent.