The malaria control programme divided the two districts (Ingwavuma and Ubombo) into smaller subdivisions called areas and sections. Each magisterial district is divided into areas which are further divided into sections, each approximately 30 km2. This level of display is very useful for highlighting the focused nature of the high risk areas.
Figure 1 shows the average number of malaria cases per sector, 1987-1993 shows the two high risk areas in the region, one in the North-West, close to the Mozambican border, and the other further South near the inland town of Jozini. The former is associated primarily with the influx of infected migrants from Mozambique and with the flood plain of the Pongola river. The latter is associated with the Makhatini irrigation scheme. Comparing Figure 1 (1987-1993) with Figure 2 (1980-1986) shows a low incidence between 1980-1986, largely as a result of severe drought. The increase in cases after 1986 is a result of improved rains, irrigation development, the advent of chloroquine resistance, and increased population migration from Mocambique due to the civil war.
Records are kept of the country and region of origin of the infected people. Many Mozambicans have been tested and found to carry the parasite while in South Africa. Many of these asymptomatic migrants play an important role in starting focal and seasonal epidemics. There has been no malaria control until recently in rural Mozambique. Maps of the imported cases recorded from 1980 to 1993 show that they are focussed around the high incidence areas of the province KwaZulu-Natal and the main entry points for travellers from Mozambique.
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Figure 1. Average Number of Malaria Cases per Control Sector, 1987-1993
Figure 2. Average Number of Malaria Cases per Control Sector, 1980-1986