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Malaria in Porto Rico¹

1. Malaria is a serious health problem in Porto Rico mainly in the coastal region where it is common to find from one-quarter to one-third of the population with parasites in the blood.

2. Fever incidence is highest in the fall months of the year when temperature, humidity and rainfall are usually high.

3. Fever incidence, spleen and parasite rates are all necessary for a careful study of the malaria problem. Spleen rates are of the greatest value for rapid determination of malaria incidence—blood examinations probably of greatest general applicability where only one method is to be used.

4. Anopheles albimanus is the important vector.

5. Sugar cane is the principal crop in malaria-infected regions and methods of cultivation influence breeding of mosquitoes.

6. Reclamation of some swamp areas by pumps and for agricultural purposes will be necessary before mosquito control will be possible in many areas. There is an increasing interest in this work.

7. Subsoil drainage is the most hopeful solution of the problem in seepage lands and wet lands not too low. There is a more extensive use of this method of drainage each year.

8. Efficient treatment of the sick is an important part of any campaign.

9. In many regions antilarval work by the use of Paris green alone can be done efficiently and at low cost, but in most areas permanent efficient drainage is first advisable until larvicidal work work can be carried on at a low annual cost.

10. Malaria incidence has not dropped immediately following campaigns but after a year it has been brought to a low figure in some cases, while in others longer periods are necessary because extensive drainage work is necessary.

¹ The studies and observations on which this paper is based were conducted with the support and under the auspices of the International Health Division of the Rockefeller Foundation.