Research

Re-defining the extent of malaria transmission in South Africa: Implications for chemoprophylaxis

N Morris, J Frean, L Baker, I S Ukpe, K I Barnes, P Kruger, A Mabuza, E Raswiswi, R Maharaj, L Blumberg, D Moonasar

Abstract


Background. Malaria case numbers reported in South Africa have reduced considerably over the last decade, necessitating a revision of the national risk map to guide malaria prevention, including the use of chemoprophylaxis.

Objectives. To update the national malaria risk map based on recent case data and to consider the implications of the new transmission profile for guiding prophylaxis.

Methods. The geographical distribution of confirmed malaria cases detected both passively and actively over the last six malaria seasons was used to redefine the geographic distribution and intensity of malaria transmission in the country.

Results. The national risk map was revised to reflect zones of transmission reduced both in their extent and their intensity. Most notably, the area of risk has been reduced in the north-western parts of Limpopo Province and is limited to the extreme northern reaches of KwaZulu-Natal Province. Areas previously considered to be of high risk are now regarded to be of moderate risk.

Conclusion. 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.

Authors' affiliations

N Morris, Malaria Research Unit, South African Medical Research Council, Durban, South Africa

J Frean, National Institute for Communicable Diseases, Johannesburg, South Africa; School of Pathology, University of the Witwatersrand, Johannesburg, South Africa

L Baker, Amayeza Drug Information Centre, Johannesburg, South Africa

I S Ukpe, Department of Family Medicine, University of Pretoria, South Africa

K I Barnes, Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, South Africa

P Kruger, Department of Health, Polokwane, Limpopo, South Africa

A Mabuza, Department of Health, Nelspruit, Mpumalanga, South Africa

E Raswiswi, Department of Health, Jozini, KwaZulu-Natal, South Africa

R Maharaj, Malaria Research Unit, South African Medical Research Council, Durban, South Africa

L Blumberg, National Institute for Communicable Diseases, Johannesburg, South Africa; School of Pathology, University of the Witwatersrand, Johannesburg, South Africa

D Moonasar, National Department of Health, Pretoria, South Africa

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Keywords

malaria; prophylaxis; risk map

Cite this article

South African Medical Journal 2013;103(11):861-864. DOI:10.7196/SAMJ.7533

Article History

Date submitted: 2013-09-20
Date published: 2013-10-02

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