The most recent information on malaria prevalence in Mozambique comes from  country-wide surveys carried out during 1975/76 and in Maputo town in 1981.The overall malaria prevalence was 43.7%, but in many provinces the parasite rate ranged between 43.5% and 67.7%, indicating hyperendemic conditions. Hypoendemicity prevailed in Maputo City and its peri-urban areas, where malaria control activities have been carried out for some time.

The seriousness of the malaria problem can be appreciated from examination of prevalence data in different age groups. Very high parasite rates were recorded among 0-23 month old children in six provinces, ranging between 63.4% and 75% and high rates in three provinces ranging between 40.8% and 47.2%, while the rate was 6.1% in Maputo and 15.3% in the peri-urban areas. The relative prevalence of malaria parasites was 90.3% Plasmodium falciparum, 9.1% P.malariae and 0.6% P.ovale. Transmission shows two major peaks; one in January and one in April/May. In vivo and in vitro (macrotechnique) studies show high levels of chloroquine resistance in southern Mozambique.

The main vectors are members of the Anophleles gambiae group and the An. funestus group. Four species of the Gambiae group are present: An.gambiae, An.arabiensis, An.merus and An.quadriannulatus. Although DDT has been used in house spraying for many years particularly in the south, adult susceptibility tests carried out in different localities.  During 1978-81 complete susceptibility was shown of the Gambiae group and An.funestus to  agricultural insecticides which have been used for crop protection since 1977-78. These include organophosphate and carbamate compounds or a mixture of the two; organochlorines have been banned from agricultural use.   The status of vector resistance/susceptibility to insecticide is currently being collected in seven countries of southern Africa including South Africa, Swaziland and Mozambique  by both biochemical and molecular tools, with support from WHO/MIM/IDR.

Major antimalarial activities after independence included chemoprophylaxis and malaria vector control in two main urban areas (Maputo and Beira). The Government further launched a countrywide chemoprophylaxis campaign of weekly, fortnightly or 4 weekly (28 days) dosages of chloroquine (5 mg/kg body weight).  School and village surveys were used to evaluate the campaign. There was sufficient evidence that neither the objectives nor the targets of the campaign were met, as high positivity rates and low drug coverages were recorded everywhere.  Currently, appropriate and prompt treatment at clinics and hospitals is the focus for anti parasite measures and vector control is carried out in the major cities only.