By Dawn Starin

Metal billboard with an antimalarial public health message, Bubaque, Guinea-Bissau, 2010. Photo by Dawn Starin.

The metal billboard in the photo stands in the main marketplace on the island of Bubaque, the second largest in Guinea-Bissau’s Bijagós Archipelago. It depicts a mother and child sleeping under an insecticide-treated mosquito net. Translated into English, the text reads, “Malaria kills more pregnant women and children. Always sleep underneath the mosquito net.” But it’s not clear whether it gets its crucial message across effectively.

Half the global population—about 3.3 billion people—is at risk for contracting malaria, a parasitic infection transmitted by mosquitoes. The disease kills close to one million people each year; 91% of these deaths occur in Africa. A major global campaign, Roll Back Malaria (RBM), was launched in 1998 with a mandate “to implement coordinated action to combat malaria” worldwide; some 500 organizations now take part.

One RBM effort in sub-Saharan Africa (an area that includes Guinea-Bissau) is aimed at getting more people to use insecticide-treated bed nets, since the parasite-carrying mosquitoes are reportedly only active at night. In Africa malaria accounts for one in five deaths in children. 

Pregnant women are also at high risk, as they’re bitten by the mosquitoes twice as often as nonpregnant women. Why? According to a study published in 2000 in the Lancet, pregnant women have a higher body temperature and warmer skin and produce more sweat than do nonpregnant women; those in the last trimester also exhale greater volumes of air. (Read the abstract here.) All of these physiological differences give pregnant women a “larger host signature” and probably aid mosquitoes in detecting them as targets.

According to the RBM Partnership’s latest report, “Every US $1,025 spent on insecticide-treated nets will protect 380 children and save one child’s life each year.” Is the message getting across?

(Editor’s note: For more on Guinea-Bissau’s public health billboards, see this earlier post.)

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