Historical review of malaria control program in Taiwan

Malaria had been a very serious endemic disease in Taiwan before it was eradicated. There has been a long history of struggle against this disease since the beginning of this century. A large scale chemotherapy program was initiated in 1910 following Koch's method. The inhabitants in the highly malarious area were subject to monthly blood examination and those positive for malaria parasites were compulsorily treated with antimalaria drugs. This program was continued until 1944. Malaria transmission was not interrupted, but the parasite rate among the inhabitants included in the program was maintained at 2% to 3% level for 35 consecutive years, and the number of deaths caused by malaria was brought down gradually from an average of 36 per 10,000 population before 1910(1906-1909) to less than 8 in the 1930s. Throughout the history of malaria control in Taiwan, other control measures were also applied. They were: personal protection, source reduction and antilarval operations. All these methods were proven to be effective, but with limitations. The availability of DDT and other residual insecticides in the 1940s marked a new era for malaria control in the world, as well as in Taiwan. A 6-year malaria eradication program using the DDT residual house spraying method was launched in 1952 and then followed by vigorous malaria surveillance activities which finally eliminated all the remaining foci of transmission. In 1965, Taiwan was registered by the World Health Organization on its list of countries where malaria eradication has been achieved. Although there has been no indigenous malaria in Taiwan, cases have been imported continuously from abroad. In the last 25 years, with the painstaking vigilance efforts, the malaria-free status has been maintained. It is hoped that these efforts will be continued so that malaria will never again come back to Taiwan as an endemic disease.