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Traditionally, engineering and environment-based interventions have contributed to the prevention of malaria in Asia. However, with the introduction of DDT and other potent insecticides, chemical control became the dominating strategy. The renewed interest in environmental-management-based approaches for the control of malaria vectors follows the rapid development of resistance by mosquitoes to the widely used insecticides, the increasing cost of developing new chemicals, logistical constraints involved in the implementation of residual-spraying programs and the environmental concerns linked to the use of persistent organic pollutants. To guide future research and operational agendas focusing on environmental-control interventions, it is necessary to learn from the successes and failures from the time before the introduction of insecticides. The objective of this paper is to describe the experiences gained in Asia with early vector control interventions focusing on cases from the former Indian Punjab, Malaysia and Sri Lanka. The paper deals primarily with the agricultural engineering and land and water management vector control interventions implemented in the period 1900–1950. The selected cases are discussed in the wider context of environment-based approaches for the control of malaria vectors, including current relevance. Clearly, some of the interventions piloted and implemented early in the last century still have relevance today but generally in a very site-specific manner and in combination with other preventive and curative activities. Some of the approaches followed earlier on to support implementation would not be acceptable or feasible today, from a social or environmental point of view. [Copyright &y& Elsevier]

In an environment of growing scarcity and competition for water, there is increasing pressure on the irrigation sector to make irrigation for crop production more efficient and to transfer water to the urban, industrial and environmental sectors. However, irrigation water is extensively used for non-agricultural purposes, including domestic purposes, and an exclusive focus on water efficiency in agriculture could actually reduce the availability of domestic water within irrigated areas. It is argued, based on available literature, that this would have important health implications because in many developing countries the availability of water, rather than the quality of water, is of crucial importance to health. Two case studies are presented from Sri Lanka and Pakistan where people make use of irrigation water for a range of domestic activities. Water resource policies have to take these uses into account to avoid negative health implications for poor disadvantaged segments of the population. Barriers to optimizing benefits of linking the irrigation water supply to domestic needs seem to be institutional and psychological rather than medical, technical or economic. [ABSTRACT FROM AUTHOR]

Background: There are an estimated 258 million international migrants worldwide. In Asia low-skilled workers often emigrate on a temporary basis (2–3 years) without their families. There is significant concern over the mental health and wellbeing of left-behind families in this region. No previous study has examined whether the risk of suicidal behaviour is elevated in left-behind family members. Methods: Cohort study using baseline data from a large randomised controlled trial in Sri Lanka (n = 178,730 participants; 8% households had a current temporary foreign migrant) and prospective hospital presentations of suicide attempts. Using multilevel Poisson regression models, we compared the risk of attempted suicide in households with left-behind and non-left-behind family members. We also investigated whether the sex of the migrant or the age/sex of the household member left behind altered any associations. Results: The risk of an attempted suicide was elevated in female migrant households (IRR 1.60 95% CI 1.38, 1.85), but not male migrant households (IRR 1.01 95% CI 0.76,1.36)) with strong evidence that risk differed for female vs. male migrant households (p-value = 0.005). We found no evidence that the age or sex of the left-behind household member altered the association observed. Conclusions: This analysis suggests that members of households with a temporary female foreign migrant are at an increased risk of attempted suicide, but these findings must be interpreted with caution. The increased risk of suicidal behaviour in these households may be due to factors that were present before the migration and persist post-migration (e.g. household violence, poverty). [ABSTRACT FROM AUTHOR]