Decadal epidemiology of malaria in KwaZulu-Natal, a province in South Africa targeting elimination.
Decadal
Imported malaria
Indoor residual spraying
Malaria elimination
Journal
Malaria journal
ISSN: 1475-2875
Titre abrégé: Malar J
Pays: England
ID NLM: 101139802
Informations de publication
Date de publication:
20 Nov 2019
20 Nov 2019
Historique:
received:
04
07
2019
accepted:
11
11
2019
entrez:
22
11
2019
pubmed:
22
11
2019
medline:
11
3
2020
Statut:
epublish
Résumé
Although malaria remains a noteworthy disease in South Africa, the provinces are at differing stages of the malaria elimination continuum. KwaZulu-Natal has consistently reported the lowest number of cases over the past 5 years and it is expected that the goal of elimination will be achieved in this province over the next few years. The study reports on few key indicators that realistically represents the provinces progress over the past decade. Local and imported morbidity and mortality is seen as the key indicator as is malaria in children under the age of five and pregnant women. The only vector control intervention in the province is indoor residual spraying (IRS) and this gives an estimate of the population protected by this intervention. Trend analysis was used to examine the changing epidemiology in KwaZulu-Natal over the past decade from 2008 to 2018. The data used in this decadal analysis was obtained from the provincial Department of Health. Since malaria is a medically notifiable disease, all malaria cases diagnosed in the province are reported from health facilities and are captured in the malaria information system in the province. The results have shown that imported cases are on the increase whilst local cases are decreasing, in keeping with an elimination objective. Preventing secondary cases is the key to reaching elimination. Only 10% of the cases reported occur in children under 5 years whereas the cases in pregnant women account for about 1% of the reported cases. Over 85% of the houses receive IRS and this is also the same proportion of the population protected by the intervention. Several challenges to elimination have been identified but these are not insurmountable. Although there are major impediments to achieving elimination, the changing epidemiology suggests that major strides have been made in the past 10 years and KwaZulu-Natal is on track to achieving this milestone in the next few years.
Sections du résumé
BACKGROUND
BACKGROUND
Although malaria remains a noteworthy disease in South Africa, the provinces are at differing stages of the malaria elimination continuum. KwaZulu-Natal has consistently reported the lowest number of cases over the past 5 years and it is expected that the goal of elimination will be achieved in this province over the next few years. The study reports on few key indicators that realistically represents the provinces progress over the past decade. Local and imported morbidity and mortality is seen as the key indicator as is malaria in children under the age of five and pregnant women. The only vector control intervention in the province is indoor residual spraying (IRS) and this gives an estimate of the population protected by this intervention.
METHODS
METHODS
Trend analysis was used to examine the changing epidemiology in KwaZulu-Natal over the past decade from 2008 to 2018. The data used in this decadal analysis was obtained from the provincial Department of Health. Since malaria is a medically notifiable disease, all malaria cases diagnosed in the province are reported from health facilities and are captured in the malaria information system in the province.
RESULTS
RESULTS
The results have shown that imported cases are on the increase whilst local cases are decreasing, in keeping with an elimination objective. Preventing secondary cases is the key to reaching elimination. Only 10% of the cases reported occur in children under 5 years whereas the cases in pregnant women account for about 1% of the reported cases. Over 85% of the houses receive IRS and this is also the same proportion of the population protected by the intervention.
CONCLUSION
CONCLUSIONS
Several challenges to elimination have been identified but these are not insurmountable. Although there are major impediments to achieving elimination, the changing epidemiology suggests that major strides have been made in the past 10 years and KwaZulu-Natal is on track to achieving this milestone in the next few years.
Identifiants
pubmed: 31747974
doi: 10.1186/s12936-019-3001-x
pii: 10.1186/s12936-019-3001-x
pmc: PMC6868778
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
368Subventions
Organisme : South African Medical Research Council
ID : Intramural Research Fund
Références
Malar J. 2010 Jan 20;9:26
pubmed: 20089158
Malar J. 2014 Aug 23;13:330
pubmed: 25149656
Malar J. 2016 Aug 27;15(1):438
pubmed: 27567642
Malar J. 2016 Aug 12;15(1):409
pubmed: 27520364
Malar J. 2012 Dec 19;11:423
pubmed: 23253091
Malar J. 2016 Aug 18;15(1):419
pubmed: 27538990
Malar J. 2019 Apr 1;18(1):108
pubmed: 30935418
S Afr Med J. 2013 Oct 02;103(11):861-4
pubmed: 24148174
Lancet. 2016 Sep 17;388(10050):1193-201
pubmed: 27520594
Public Health Action. 2018 Apr 25;8(Suppl 1):S8-S12
pubmed: 29713587
S Afr Med J. 2013 Aug 29;103(10 Pt 2):779-83
pubmed: 24079633
Sci Rep. 2017 Mar 06;7:43779
pubmed: 28262811