Reviewing South Africa’s malaria elimination strategy (2012–2018) : progress, challenges and priorities

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dc.contributor.author Raman, Jaishree
dc.contributor.author Morris, Natashia
dc.contributor.author Frean, John
dc.contributor.author Brooke, Basil
dc.contributor.author Blumberg, Lucille
dc.contributor.author Kruger, Philip
dc.contributor.author Mabusa, Aaron
dc.contributor.author Raswiswi, Eric
dc.contributor.author Shandukani, Bridget
dc.contributor.author Misani, Eunice
dc.contributor.author Groepe, Mary‑Anne
dc.contributor.author Moonasar, Devanand
dc.date.accessioned 2016-09-19T06:24:42Z
dc.date.available 2016-09-19T06:24:42Z
dc.date.issued 2016-08-27
dc.description.abstract BACKGROUND : With a sustained national malaria incidence of fewer than one case per 1000 population at risk, in 2012 South Africa officially transitioned from controlling malaria to the ambitious goal of eliminating malaria within its borders by 2018. This review assesses the progress made in the 3 years since programme re-orientation while highlighting challenges and suggesting priorities for moving the malaria programme towards elimination. METHODS : National malaria case data and annual spray coverage data from 2010 until 2014 were assessed for trends. Information on surveillance, monitoring and evaluation systems, human and infrastructure needs and community malaria knowledge was sourced from the national programme mid-term review. RESULTS : Malaria cases increased markedly from 6811 in 2013 to 11,711 in 2014, with Mpumalanga and Limpopo provinces most affected. Enhanced local transmission appeared to drive malaria transmission in Limpopo Province, while imported malaria cases accounted for the majority of cases reported in Mpumalanga Province. Despite these increases only Vhembe and Mopani districts in Limpopo Province reported malaria incidences more than one case per 1000 population at risk by 2014. Over the review period annual spray coverage did not reach the recommended target of 90 % coverage, with information gaps identified in parasite prevalence, artemether-lumefantrine therapeutic utilization, asymptomatic/sub-patent carriage, drug efficacy, vector distribution and insecticide resistance. CONCLUSIONS : Although South Africa has made steady progress since adopting an elimination agenda, a number of challenges have been identified. The heterogeneity of malaria transmission suggests interventions in Vhembe and Mopani districts should focus on control, while in KwaZulu-Natal Province eliminating transmission foci should be prioritized. Cross-border initiatives with neighbouring countries should be established/strengthened as a matter of urgency since malaria importation poses a real threat to the country’s elimination efforts. It is also critical that provincial programmes are adequately resourced to effectively conduct the necessary targeted elimination activities, informed by current vector/parasite distribution and resistance data. More sensitive methods to detect sub-patent infections, primaquine as a transmission-blocking drug, and alternative vector control methods need to be investigated. Knowledge gaps among malaria health workers and affected communities should be identified and addressed. en_ZA
dc.description.department School of Health Systems and Public Health (SHSPH) en_ZA
dc.description.librarian am2016 en_ZA
dc.description.sponsorship A South African Medical Research Council Malaria Collaborating Centre Research Grant to JR, JF, BB. en_ZA
dc.description.uri http://www.malariajournal.com en_ZA
dc.identifier.citation Raman, J, Morris, N, Frean, J, Brooke, B, Blumberg, L, Kruger, P, Mabusa, A, Raswiswi, E, Shandukani, B, Misani, E, Groepe, M-A & Moonasar, D 2016, 'Reviewing South Africa’s malaria elimination strategy (2012–2018) : progress, challenges and priorities', Malaria Journal, vol. 15, art, no, 438, pp. 1-11. en_ZA
dc.identifier.issn 1475-2875
dc.identifier.other 10.1186/s12936-016-1497-x
dc.identifier.uri http://hdl.handle.net/2263/56734
dc.language.iso en en_ZA
dc.publisher BioMed Central en_ZA
dc.rights © 2016 The Author(s). This article is distributed under the terms of the Creative Commons Attribution 4.0 International License. en_ZA
dc.subject Malaria en_ZA
dc.subject Elimination en_ZA
dc.subject Vector control en_ZA
dc.subject Case management en_ZA
dc.subject Surveillance en_ZA
dc.subject Challenges en_ZA
dc.subject Priorities en_ZA
dc.subject South Africa (SA) en_ZA
dc.title Reviewing South Africa’s malaria elimination strategy (2012–2018) : progress, challenges and priorities en_ZA
dc.type Article en_ZA


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