<P> A 2015 case control study identified a link (odds ratio 3.4) between in - utero exposure (as estimated from archived maternal blood samples) and breast cancer diagnosis in daughters . The findings "support classification of DDT as an endocrine disruptor, a predictor of breast cancer, and a marker of high risk". </P> <P> Malaria remains the primary public health challenge in many countries . In 2015, there were 214 million cases of malaria worldwide resulting in an estimated 438,000 deaths, 90% of which occurred in Africa . DDT is one of many tools to fight the disease . Its use in this context has been called everything from a "miracle weapon (that is) like Kryptonite to the mosquitoes," to "toxic colonialism". </P> <P> Before DDT, eliminating mosquito breeding grounds by drainage or poisoning with Paris green or pyrethrum was sometimes successful . In parts of the world with rising living standards, the elimination of malaria was often a collateral benefit of the introduction of window screens and improved sanitation . A variety of usually simultaneous interventions represents best practice . These include antimalarial drugs to prevent or treat infection; improvements in public health infrastructure to diagnose, sequester and treat infected individuals; bednets and other methods intended to keep mosquitoes from biting humans; and vector control strategies such as larvaciding with insecticides, ecological controls such as draining mosquito breeding grounds or introducing fish to eat larvae and indoor residual spraying (IRS) with insecticides, possibly including DDT . IRS involves the treatment of interior walls and ceilings with insecticides . It is particularly effective against mosquitoes, since many species rest on an indoor wall before or after feeding . DDT is one of 12 WHO--approved IRS insecticides . </P> <P> WHO's anti-malaria campaign of the 1950s and 1960s relied heavily on DDT and the results were promising, though temporary in developing countries . Experts tie malarial resurgence to multiple factors, including poor leadership, management and funding of malaria control programs; poverty; civil unrest; and increased irrigation . The evolution of resistance to first - generation drugs (e.g. chloroquine) and to insecticides exacerbated the situation . Resistance was largely fueled by unrestricted agricultural use . Resistance and the harm both to humans and the environment led many governments to curtail DDT use in vector control and agriculture . In 2006 WHO reversed a longstanding policy against DDT by recommending that it be used as an indoor pesticide in regions where malaria is a major problem . </P>

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