Public awareness and prevention of malaria in Vanuatu.

Malaria still represents a global health burden; according to the World Health Organization, half of the world’s population are at risk from malaria. Vanuatu is an archipelago of 83 islands situated in the South-west Pacific where Plasmodium vivax and falciparum malaria species are endemic. It has a total population of 221,000. Despite the efforts of the National Vector Borne Diseases Control Programme, which reduced malaria morbidity and mortality in Vanuatu significantly in the 1990s, the incidence of malaria has been increasing again recently. Annual parasite incidence (API) decreased from 196 per 1000 in 1990 to 28 per 1000 in 1999; however, in 2003, the incidence of malaria had risen to the same level as it was in 1992, with an API of 74 per 1000, 756 reported severe malaria cases and six malaria-related deaths. It is likely that the actual figure was three times higher due to lack of coverage of diagnostic services in hospitals. Insecticide-treated nets (ITNs) are one of the most effective methods of malaria prevention. Currently, external funding to the Malaria Control Programme from the Global Fund and Australian Government is being implemented in Vanuatu to decrease the incidence of malaria by increasing the coverage