Investigating the Resurgence of Malaria Prevalence in South Africa Between 2015 and 2018: A Scoping Review

Abstract

Background: Malaria remains a serious concern in most African countries, causing nearly one million deaths globally every year. This review aims to examine the extent and nature of the resurgence of malaria transmission in South Africa. Methods: Using the Arksey and O'Malley framework, this scoping review includes articles published between the years 2015 and 2018 on the resurgence of malaria occurrence in South Africa. Articles were searched between October 2018 to January 2019 using the following electronic databases: CINAHL, Pubmed, Science Direct and SCOPUS. Grey literature from Google Scholar was also hand searched. Key search terms and subject headings such as climate variables, climate changes, climatic factors, malaria resurgence, malaria reoccurrence and malaria increase over epidemic regions in South Africa were used to identify relevant articles. Three independent reviewers performed the selection and characterization of articles, and the data collected were synthesized qualitatively. Results: A total number of 534 studies were identified. Among these, 24 studies met the inclusion criteria. The results were grouped by factors (four main themes) that influenced the malaria resurgence: Climatic, Epidemiological, Socio-economic, and Environmental factors. Climatic factors were found to be the major factor responsible for the resurgence of malaria, as more than 55% of the selected articles were climate-focused. This was followed by epidemiological, socio-economic and environmental factors, in that order. Grey literature from Google Scholar yielded no results. Conclusion: This study shows that malaria transmission in South Africa is more associated with climate. Climate-based malaria models could be used as early warning systems for malaria over the epidemic regions in South Africa. Since epidemiological factors also play significant roles in malaria transmission, regular and unrelaxed use of Indoor Residual Spraying (IRS) should be encouraged in these regions. Individuals should also be educated on the importance and the usefulness of these deliveries. While some studies have indicated that the vectors have developed resistance to insecticides, continuous research on developing new insecticides that could alter the resistance are encouraged. Furthermore, all efforts to eradicate malaria in South Africa must also target malaria-endemic neighbouring countries.

Modelling Malaria Incidence in the Limpopo Province, South Africa: Comparison of Classical and Bayesian Methods of Estimation

“…Indeed, malaria incidence has been found to be generally low during dry-hot season when vector populations are reduced and spatially restricted. As a result, several of studies on malaria incidence tend to focus on the peak transmission season, which is often the rainy season, whereas the epidemiological picture during the dry-hot season is often neglected ([ 7 , 8 ]).…”

“…This progress is attributed to increased funding, improved use of life-saving interventions and more countries pursuing malaria elimination measures. Although the progress achieved in countries such as Sri Lanka and some Sub-Saharan African countries has been considerable, South Africa remains among countries with high risk of malaria transmission, especially the northern part of the country ([ 7 , 8 , 10 ]). Raman et al [ 10 ] further outlined that South Africa officially transitioned from controlling malaria to the goal of eliminating the disease in 2012.…”

“…However, malaria cases have increased from 6811 in 2013 to 11,711 in 2014, with many cases reported in the Mpumalanga and Limpopo provinces of South Africa ([ 7 ]). It will therefore be expedient to model malaria incidence in Limpopo Province because it is amongst the provinces that account for most malaria cases in South Africa ([ 7 , 8 ]). The present study will employ both classical and Bayesian methods of estimation to assess the effect of climatic factors such as temperature, rainfall, elevation and normalised difference vegetation index on malaria incidence.…”

Exploring public awareness of the current and future malaria risk zones in South Africa under climate change: a pilot study

“…Adding fuel to the fire, climate change is resulting in both an increase in the extent of the South African malaria risk area and the incidence of malaria transmission due to increases in temperature and changes in rainfall patterns (Morris et al, 2013;Abiodun et al, 2020). The spatial distribution of malaria globally is strongly determined by climate (Caminade et al 2014;Cella et al 2019).…”

“…South Africa was one of those countries, with an additional local objective of elimination by 2018 (Baker 2018 ). However, in 2017, South Africa experienced a severe setback in achieving both objectives, reporting 7897 imported and 19,706 indigenous cases of malaria—the highest number of cases reported by any of the 21 identified countries, and more than four times the number of indigenous cases reported in the country in 2016 (WHO 2018 ; Maharaj et al 2019 ; Abiodun et al 2020 ). This increase in numbers was due to a range of factors, including an increase in rainfall, temperature, and humidity following an abnormally mild winter (Baker 2018 ).…”