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Malaria has always been considered a major public health problem in the Philippines. From 1926-1946, malaria was identified as the leading cause of mortality and morbidity having at least two million cases with from 10, 000 to 20, 000 deaths annually (Russel, 1936). The implementation of a nationwide malaria control/eradication program starting 1953, brought down the level of malaria so that it is no longer among the 10 leading causes of mortality. At present, it is still the 10th leading cause of morbidity. In 1991, the malaria endemic population is about 12.0 out of the total 64.5 million. It is endemic in 72 out of 75 provinces in varying endemicity ranging from an Annual Parasite Incidence (API) of 0.62 to 43.8/1, 000 population. Malaria is hypoendemic along the coastal and plain areas and hyperendemic in the foothills and forest fringes. There is generally no transmission in cities, urban areas and big centers of population because of unfavorable breeding condition of the vector. Practically, no transmission is found in areas 3, 000 ft above sea level.
The main mosquito vector, Anopheles flavirostris, breeds in slow flowing clear, partly shaded streams. The secondary vectors are An. litoralis, a brackish water breeder; An. balabacencis, which are mostly confined to forested areas; An. mangyanus, which has the same habitat as the An. flavirostris, but thrives better in forested or heavily vegetated areas and An. maculatus which prefer clear flowing mountain streams exposed to sunlight.
The most common parasite species is Plasmodium falciparum (66%) followed by P. vivax (33%) per 1991 records. P. malariae is rare and P. ovale was reported only once in 1969. The results of 18 years monitoring of drug resistant P. falciparum to chloroquine varies from 28 to 89% classified as RI with some RII level. In the years 1982, 1985 and 1987, 100% P. falciparum resistance (RI) to amodiaquine have been recorded.
The Malaria Control Program objective is to reduce the incidence of malaria to 1/1, 000 population by year 2, 000 and prevent its reintroduction to malaria freed areas. The key strategy is to implement effective vector control measures in areas with API>5/1, 000 population complemented by the rational use of appropriate anti-malaria drugs. In areas with API<5/1, 000, intensified case finding and immediate treatment thru PHC supplemented by an active health information system directed towards personal protection and prevention from malaria. Following these strategies, the national API was reduced from 14.5/1, 000 in 1987 to 7.3/1, 000 population ending 1991.
