Towards malaria elimination in the MOSASWA (Mozambique, South Africa and Swaziland) region

Moonasar, Devanand; Maharaj, Rajendra; Kunene, Simon; Candrinho, Baltazar; Saúte, Francisco; Ntshalintshali, Nyasatu; Morris, Natashia

doi:10.1186/s12936-016-1470-8

Cited by 72 publications

(96 citation statements)

References 5 publications

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“…Acknowledging the threat asymptomatic malaria importation poses to malaria elimination in southern Africa, the MOSASWA (Mozambique, South Africa, Swaziland/Eswatini) cross-border collaboration has implemented two strategies to address asymptomatic malaria importation both in source and sink areas [32]. The first aims to reduce transmission in southern Mozambique by strengthening human capacity to effectively malaria control and improving intervention coverage in Maputo, Gaza and Inhanbane Provinces while the second focusses on detecting and treating malaria infections before they reach receptive areas within KZN.…”

Section: Discussionmentioning

confidence: 99%

High levels of imported asymptomatic malaria but limited local transmission in KwaZulu-Natal, a South African malaria-endemic province nearing malaria elimination

Raman

Gast²,

Balawanth³

et al. 2020

Malar J

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Background: KwaZulu-Natal, one of South Africa's three malaria endemic provinces, is nearing malaria elimination, reporting fewer than 100 locally-acquired cases annually since 2010. Despite sustained implementation of essential interventions, including annual indoor residual spraying, prompt case detection using malaria rapid diagnostics tests and treatment with effective artemisinin-based combination therapy, low-level focal transmission persists in the province. This malaria prevalence and entomological survey was therefore undertaken to identify the drivers of this residual transmission.Methods: Malaria prevalence as well as malaria knowledge, attitudes and practices among community members and mobile migrant populations within uMkhanyakude district, KwaZulu-Natal were assessed during a communitybased malaria prevalence survey. All consenting participants were tested for malaria by both conventional and highlysensitive falciparum-specific rapid diagnostic tests. Finger-prick filter-paper blood spots were also collected from all participants for downstream parasite genotyping analysis. Entomological investigations were conducted around the surveyed households, with potential breeding sites geolocated and larvae collected for species identification and insecticide susceptibility testing. A random selection of households were assessed for indoor residual spray quality by cone bioassay.

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Section: Discussionmentioning

confidence: 99%

High levels of imported asymptomatic malaria but limited local transmission in KwaZulu-Natal, a South African malaria-endemic province nearing malaria elimination

Raman

Gast²,

Balawanth³

et al. 2020

Malar J

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“…Through implementing evidence-based vector control and case management, malaria prevalence in Mozambique decreased by 80% while the incidence in SA and Swaziland decreased by 98%, so enabling these countries to adopt an elimination agenda. [11] Following the achievement of the LSDI, the MoSaSwa (Mozambique, SA and Swaziland) initiative was built on the platform developed by the LSDI [12] and it has already had a great impact on the disease burden in southern Mozambique, enabling the country to target elimination by 2030. The Trans-Kunene Malaria Initiative between Namibia and Angola has successfully reduced malaria in their border regions.…”

Section: Multi-country Efforts To Eliminate Malariamentioning

confidence: 99%

“…The lessons learnt with regards to cross-border collaboration in SA and its neighbouring countries are of great importance and there is some urgency in cementing these successes. [11,12] To sustain the gains made, especially when elimination has been achieved, is when the real challenges will emerge, the most important being sustainable funding in achieving the goal of elimination. Entering the eradication phase is a relatively new frontier for African countries, and a major concern is continued political support and donor fatigue.…”

Section: Sustaining the Gainsmentioning

confidence: 99%

Rolling back malaria in Africa – challenges and opportunities to winning the elimination battle.

et al. 2019

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This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0. A high-level review was conducted of the literature pertaining to the challenges and opportunities for eliminating malaria on the African continent. Although malaria mortality and morbidity are on the decline, the disease remains one of public health importance. Africa has invariably borne the brunt of the disease, recording the highest number of cases and deaths. However, with greater emphasis being placed on the disease by the international community, partnerships have developed to boost malaria elimination efforts on the continent. One such initiative is the Roll Back Malaria (RBM) partnership which aims to facilitate malaria elimination through increasing resources and awareness. Many cross-border initiatives have been established which treat malaria as a regional problem rather than a country-specific one. Accelerated malaria control efforts have led to a 37% decrease in cases and 60% reduction in deaths. Multi-country efforts have resulted in marked reductions of transmission in the region. Although there have been noteworthy gains in curtailing the disease, new challenges have arisen. The main among these are residual malaria and outdoor biting. One of the main drivers of residual malaria is insecticide resistance. Adding to the burden of residual transmission is the discovery of new vectors that may exist at low densities. To exacerbate these issues is the challenge of malaria imported from high-to low-transmission areas. Nevertheless, compared with the historical picture, we are winning the battle against malaria. Countries in Africa are being certified malaria-free. Partnerships have been developed to take forward the RBM Global Malaria Action Plan. Elimination agendas can only be successful if funding remains sustainable, with greater reliance on domestic funding.

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“…If achieved, it would be the first country in sub-Saharan Africa to meet this ambitious goal [1–3]. Swaziland’s malaria burden is primarily caused by Plasmodium falciparum , which is predominately transmitted by the Anopheles arabiensis [4].…”

Section: Introductionmentioning

confidence: 99%

Assessment of climate-driven variations in malaria incidence in Swaziland: toward malaria elimination

Chuang

Soble

Ntshalintshali

et al. 2017

Malar J

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BackgroundSwaziland aims to eliminate malaria by 2020. However, imported cases from neighbouring endemic countries continue to sustain local parasite reservoirs and initiate transmission. As certain weather and climatic conditions may trigger or intensify malaria outbreaks, identification of areas prone to these conditions may aid decision-makers in deploying targeted malaria interventions more effectively.MethodsMalaria case-surveillance data for Swaziland were provided by Swaziland’s National Malaria Control Programme. Climate data were derived from local weather stations and remote sensing images. Climate parameters and malaria cases between 2001 and 2015 were then analysed using seasonal autoregressive integrated moving average models and distributed lag non-linear models (DLNM).ResultsThe incidence of malaria in Swaziland increased between 2005 and 2010, especially in the Lubombo and Hhohho regions. A time-series analysis indicated that warmer temperatures and higher precipitation in the Lubombo and Hhohho administrative regions are conducive to malaria transmission. DLNM showed that the risk of malaria increased in Lubombo when the maximum temperature was above 30 °C or monthly precipitation was above 5 in. In Hhohho, the minimum temperature remaining above 15 °C or precipitation being greater than 10 in. might be associated with malaria transmission.ConclusionsThis study provides a preliminary assessment of the impact of short-term climate variations on malaria transmission in Swaziland. The geographic separation of imported and locally acquired malaria, as well as population behaviour, highlight the varying modes of transmission, part of which may be relevant to climate conditions. Thus, the impact of changing climate conditions should be noted as Swaziland moves toward malaria elimination.Electronic supplementary materialThe online version of this article (doi:10.1186/s12936-017-1874-0) contains supplementary material, which is available to authorized users.

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Towards malaria elimination in the MOSASWA (Mozambique, South Africa and Swaziland) region

Cited by 72 publications

References 5 publications

High levels of imported asymptomatic malaria but limited local transmission in KwaZulu-Natal, a South African malaria-endemic province nearing malaria elimination

High levels of imported asymptomatic malaria but limited local transmission in KwaZulu-Natal, a South African malaria-endemic province nearing malaria elimination

Rolling back malaria in Africa – challenges and opportunities to winning the elimination battle.

Assessment of climate-driven variations in malaria incidence in Swaziland: toward malaria elimination

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