Abstract:
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 : 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 : 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 : 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.
