Chemoprophylaxis is now only recommended from September to May in the north-eastern areas of Limpopo and Mpumalanga Provinces. The recommended options for chemoprophylaxis have not changed from mefloquine, doxycycline or atovaquone-proguanil.

Corresponding author: D Moonasar (moonad@health.gov.za)Malaria case management is a vital component of programmatic strategies for malaria control and elimination. Malaria case management encompasses prompt and effective treatment to minimise morbidity and mortality, reduce transmission and prevent the emergence and spread of antimalarial drug resistance. Malaria is an acute illness that may progress rapidly to severe disease and death, especially in non-immune populations, if not diagnosed early and promptly treated with effective drugs. In this article, the focus is on malaria case management, addressing treatment, monitoring for parasite drug resistance, and the impact of drug resistance on treatment policies; it concludes with chemoprophylaxis and treatment strategies for malaria elimination in South Africa.

Purpose: To determine whether mothers attending a primary health care (PHC) clinic in the Mpumalanga province, South Africa for post-delivery prevention of mother-to-child transmission (PMTCT) of the Human Immunodeficiency Virus (HIV) follow-up care were adhering to the recommendation of exclusive infant-feeding practices, and to identify possible areas for improvement of the PMTCT of HIV services at the clinic.Setting: A municipal PHC clinic in White River, a semi-urban town in Mpumalanga, South Africa. Design:A cross-sectional descriptive study using a structured infant-feeding questionnaire.Subjects: All mothers attending the clinic for post-delivery PMTCT of HIV follow-up care during a four-month period from 1 November 2007 to 29 February 2008.Results: A total of 33 mothers with infants attended the clinic during the period. All 33 mothers took part in the questionnaire study. Thirty questionnaires were subsequently found suitable for analysis. The mothers were predominantly rural, with low levels of education and no formal employment. Their ages ranged from 22 to 42 years, with a mean of 30.7 years. Fifteen (50%) of the 30 mothers practised exclusive replacement feeding (ERF), 8 (27%) practised exclusive breast-feeding (EBF), and 7 (23%) practised mixed feeding. Conclusion:More than three-quarters of the mothers practised the recommended exclusive infant-feeding methods for PMTCT of HIV, with ERF as the most popular choice. However, the infant-feeding practices could not be generalised as the attendance of mothers for post-delivery follow-up care at the clinic was very poor during the study period. This poor attendance was attributed to frequent non-availability of free formula milk for the programme. Better quality counselling is needed to further increase the adherence to exclusive infant-feeding practices, and to improve the uptake of post-delivery follow-up care. A component of the PMTCT of HIV programme is the modification of infant-feeding practices during the postnatal period to reduce the risk of transmission of the virus through breast milk. [3][4][5][6] This advocates exclusive replacement feeding (ERF) or exclusive breast-feeding (ERB), and avoidance of mixed feeding or partial breast-feeding. 7 This study investigated the infant-feeding practices of mothers receiving post-delivery PMTCT of HIV follow-up care at a PHC clinic in the Mpumalanga province for the purpose of determining whether the mothers were adhering to the recommendation of exclusive infantfeeding practices, and identifying possible areas for improvement of the PMTCT of HIV services at the clinic. It was conducted at a municipal clinic in White River, a semi-urban town in the Lowveld region of the province. The clinic provides PHC services to the residents of the town and surrounding farming communities and rural areas. The clinic is also utilised by the Department of Family Medicine, University of Pretoria, for the training of student doctors in rural health. PMTCT of HIV services has been available at the clinic since...

SYNOPSISLeprosy is still occurring in the Republic of South Africa, but it has been eliminated as a public health problem. The country's leprosy care and control program is being provided as a primary health-care program within the general health-care services. Maintaining health workers' leprosy knowledge and awareness at the primary health-care level is one of the program's goals. In one of the country's rural areas, the availability of good-quality leprosy poster and leaflets at primary health-care facilities has been shown to contribute significantly to maintaining health workers' leprosy knowledge and awareness.