Changes in malaria morbidity and mortality in Mpumalanga Province, South Africa (2001-2009) : a retrospective study

Show simple item record Ngomane, L.N. (Lindokuhle Matrue) De Jager, Christiaan 2012-03-14T11:31:39Z 2012-03-14T11:31:39Z 2012-01-13
dc.description.abstract BACKGROUND: Malaria remains a serious epidemic threat in Mpumalanga Province. In order to appropriately target interventions to achieve substantial reduction in the burden of malaria and ultimately eliminate the disease, there is a need to track progress of malaria control efforts by assessing the time trends and evaluating the impact of current control interventions. This study aimed to assess the changes in the burden of malaria in Mpumalanga Province during the past eight malaria seasons (2001/02 to 2008/09) and whether indoor residual spraying (IRS) and climate variability had an effect on these changes. METHODS: This is a descriptive retrospective study based on the analysis of secondary malaria surveillance data (cases and deaths) in Mpumalanga Province. Data were extracted from the Integrated Malaria Information System. Time series model (Autoregressive Integrated Moving Average) was used to assess the association between climate and malaria. RESULTS: Within the study period, a total of 35,191 cases and 164 deaths due to malaria were notified in Mpumalanga Province. There was a significant decrease in the incidence of malaria from 385 in 2001/02 to 50 cases per 100,000 population in 2008/09 (P < 0.005). The incidence and case fatality (CFR) rates for the study period were 134 cases per 100,000 and 0.54%, respectively. Mortality due to malaria was lower in infants and children (CFR < 0.5%) and higher in those >65 years, with the mean CFR of 2.1% as compared to the national target of 0.5%. A distinct seasonal transmission pattern was found to be significantly related to changes in rainfall patterns (P = 0.007). A notable decline in malaria case notification was observed following apparent scale-up of IRS coverage from 2006/07 to 2008/09 malaria seasons. CONCLUSIONS: Mpumalanga Province has achieved the goal of reducing malaria morbidity and mortality by over 70%, partly as a result of scale-up of IRS intervention in combination with other control strategies. These results highlight the need to continue with IRS together with other control strategies until interruption in local malaria transmission is completely achieved. However, the goal to eliminate malaria as a public health problem requires efforts to be directed towards the control of imported malaria cases; development of strategies to interrupt local transmission; and maintaining high quality surveillance and reporting system. en_US
dc.description.uri en_US
dc.identifier.citation Ngomane and de Jager: Changes in malaria morbidity and mortality in Mpumalanga Province, South Africa (2001-2009): a retrospective study. Malaria Journal 2012 11:19. en_US
dc.identifier.issn 1475-2875
dc.identifier.other 10.1186/1475-2875-11-19
dc.language.iso en en_US
dc.publisher BioMed Central en_US
dc.rights © 2012 Ngomane and de Jager; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. en_US
dc.subject Malaria en_US
dc.subject Morbidity en_US
dc.subject Mortality en_US
dc.subject Incidence rate en_US
dc.subject Case fatality rate en_US
dc.subject Vector control en_US
dc.subject Indoor residual spraying en_US
dc.subject Climate en_US
dc.subject.lcsh Malaria -- Prevention en
dc.title Changes in malaria morbidity and mortality in Mpumalanga Province, South Africa (2001-2009) : a retrospective study en_US
dc.type Article en_US

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