To prevent malaria, it is necessary to take into account the parasite, the mosquito, the people and the environment. 

Parasite 

  • surveillance of molecular markers to prevent resistance to medicines, so the people who take decisions can know when to withdraw a specific medication, recommend a new one or give one back that worked before, for rotation therapies.  
  • set up laboratories to diagnose and to offer the proper treatment 
  • train lab technicians 

Mosquito 

  • distribution and use of mosquito nets for the beds, impregnated ideally with natural insecticides   
  • use of mesh on windows and mesh curtains on the doors at the houses 
  • use of, ideally natural, insecticide spray inside the houses 
  • attention to the insecticide resistance control programs, such as the Global Plan for Insecticide Resistant Management 
  • insecticide rotation  
  • clean the breeding sites that are close to houses or where people usually go 

People 

  • who is at risk? Anyone bitten by an infected mosquito 
  • who is at higher risk of becoming more severely infected? 
  • babies  
  • children under 5 years
  • pregnant women 
  • people with HIV/AIDS or other diseases 
  • people in rural areas with difficult access to health care centres 
  • displaced people and travellers 
  • where is there more risk of being bitten? 
  • children who go to the wells for water or children who play outdoor in the paddles in the sunset 
  • pregnant women and women who wash cloth in the rivers 
  • people with poor personal hygiene or with poor household hygiene  
  • people working in the field where water can accumulate in agriculture ditches 
  • Education should be part of all malaria control programs and it should reach all levels, children, people without formal education, local health workers and people who take decisions. 
  • Respect the knowledge of the community, such as repellent plants offered by their environment, at the same time as the health workers give them information to protect themselves. 
  • Engage community members to communicate the knowledge and the need of cooperation of the whole community from their culture
  • Attention to the national programs and the WHO control standards 
  • The preventive measures must reach all socioeconomic levels and all the areas, urban and rural, including the most vulnerable people and the people living in remote places 
  • Coordination and organisation at all levels 
  • Attention within the communities for early detection of epidemic foci and helping soon the sick people  
  • Continuous surveillance by the leaders of the community, the health workers and all the community, not just during the mosquito season  
  • Identify the people with malaria and track and trace keeping a record 
  • Special attention to the pregnant women because if the mother gets sick it also affects the baby; the mother can have anaemia, she can lose the baby and she can also die.  
  • Make easy Access to diagnostic tests and health facilities or mobile clinics in remote places, to prevent self-diagnostic that can lead to resistance and to obtain soon the proper treatment
  • Cover arms and legs with clothing, when people are working cutting woods or in agriculture or playing in the field 
  • Avoid going out at the time the mosquito usually bite
  • Use of ideally natural repellent 
  • Taking care while bathing outdoors 
  • There is presence of genes associated to resistance to the medication that is currently most used, artemisinin-based combination therapy (ACT); the risk of an increase of this resistance depends upon education, poverty, displacements and immunity of the population  
  • Personal hygiene and cloth hygiene, to avoid the smell of sweat to attract the mosquito   
  • Strengthen immunity 
  • Fight poverty 
  • Antimalaria medicines to prevent high risk people under medical surveillance: sulfadoxina-pirimetamina
  • Seasonal malaria chemo prevention 
  • Vaccines: in some countries, such as Malawi, the Government, through the Ministry of Health and coordinated by the WHO, and supported by other health organisations, participate in the fight against malaria with the Program of Implementation of the Vaccine against Malaria in the African Region (MVIP). The vaccine RTS, which acts against Plasmodium falciparum, significantly reduces the infections, the severe symptoms and hospitalisations. It can be received in places such as at the Chileka health centre in Lilongwe; the results are good, but the directions of the health workers must be followed and go back to receive 4 doses and at the same time it is necessary to continue with the prevention measures. 

Environment 

  • The risk of resistance can also be due to environmental factors, such as increase in Temperature, which can lead to increased transmission 
  • Eliminate breeding sites for mosquitoes 
  • Clean inside the house and outdoors 
  • Fill puddles and stagnant waters which are formed specially in rainy season 
  • Attention to deforested areas 
  • Use of repellent plants offered by the local environment. In Latin America, some indigenous communities use lemon, eucalypt and tobacco water to spread in the house 
  • To promote biological control proposed by different programs in the world such as the United Nations Program for the Environment (PNUMA), with the use of bacteria, fungi or worms for the adult mosquito or fishes that eat larvae, to protect the ecosystem, but this must be done under control to avoid this fish becoming predator of other species.