Daniella Potter
3 minute read
26 Sep 2016
5:03 pm

Intensive control strategies decrease locally acquired malaria

Daniella Potter

South Africa has set a new goal for malaria elimination, in order to have no local malaria transmission.

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The areas where malaria transmission occurs in South Africa, the number of cases of locally-acquired malaria and the number of malaria-related deaths have decreased significantly over the past 15 years due to intensive control strategies.

This is according to the deputy-director of the National Institute for Communicable Diseases, Professor Lucille Blumberg, who said the national malaria control programme had been successful in achieving a number of goals through various interventions.

In South Africa, Blumberg said there are about 12 000 malaria cases per year – about half which are imported cases – which is a decrease from 2001 when there were 57 000 cases reported in South Africa. While South Africa had set a new goal for malaria elimination – in order to have no local malaria transmission, Blumberg said imported cases of malaria were a challenge in tackling malaria in South Africa and would likely continue. “Imported cases of malaria from countries on our borders – this also pertains to South Africans travelling to these countries.”

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Other challenges in tackling malaria in South Africa include low index of suspicion for malaria in persons with ‘flu’ and late presentation to health centres. “An extra day’s delay can make the difference as malaria is rapidly progressive.” She stressed that anyone with a sudden onset of fever or flu-like illness who lived in a malaria-transmission area or who had travelled through a malaria-risk area in the past month has malaria until it is disproved. “They must urgently be tested for malaria using a blood test, results obtained urgently and treatment started ASAP.”

Blumberg further stated that uncomplicated malaria was relatively easy to treat and that the drugs were highly effective, however, complicated malaria was difficult to treat and the death rates could be significant. She further emphasised the importance of health worker awareness to ensure malaria cases are not misdiagnosed as “flu”.

Community awareness about malaria is critically important in order to ensure that control strategies reach targets, according to Blumberg, and she believes that there is always room to improve community awareness of malaria, particularly as the number of cases decrease.

Further, she said indoor spraying of walls of houses in malaria risk areas was a key control intervention and needed community co-operation. However, she mentioned that an ongoing problem was insecticide resistance. Further, resources for malaria control have been reduced due to competing priorities in health.

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A malaria vaccine, RTSS, has completed Phase 3 trials in children in a number of African countries and has achieved a 30% to 37% success rate, and, according to Blumberg, Phase 4 studies will commence to assess the impact of the vaccine when sued in conjunction with the other malaria control measures. The vaccine has only been studied for children and was never intended for use in adults or in countries like South Africa where most cases of malaria are in adults and the malaria-risk is overall much lower than in the higher transmission countries in north Africa.

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Caxton News Service