The Malaria Research Programme of the Medical Research Council has developed a new malaria information data capture system (MIS ). This is a user-friendly data entry and reporting system developed according to the requirements of and in collaboration with the malaria control programmes in South Africa. It is implemented using Microsoft Access and a freeware GIS component, and enables faster and more accurate data capture through automatic data validation procedures and dropdown lists.

A standard set of data is captured using this system in each of the three malarious provinces in South Africa in order to enable analysis of the data at a national level. Additionally the system allows for the entry of data specific to each province. Output from the system is automated, with the provision of standard summary reports and of maps displaying the most current malaria situation. Malaria control personnel may query the data in any way that they require, but do not require a high level of computer expertise in order to run the system or obtain output.

The system has been designed to allow inclusion of additional modules in the future as needed, for example to incorporate programme management and vector distribution data.

The MIS is currently in use at four centres in the three South African malarious provinces. In KwaZulu Natal, malaria case data is available at both subdistrict and homestead level in some districts. Mpumalanga reports malaria at subdistrict level, and is currently mapping villages and farms; Northern Province reports and displays its malaria data at both subdistrict and village.  Further development of the system is under way to customise the MIS so that it meets the requirements of the malaria control programmes in both Mozambique and Swaziland. It is proposed that the same standard core set of data be captured in these countries, enabling the analysis of the malaria situation at regional level, as well as producing reports and maps displaying information at a range of levels down to homestead/village/farm level. Approximately 10 years of retrospective malaria case data are computerised for the three South African malaria provinces with 5 years of retrospective data for Swaziland.

All health facilities in South Africa, Swaziland and southern Mozambique have been geo-referenced and mapped, at differing levels of accuracy. Mpumalanga, KwaZulu-Natal and Northern Province all have GPS (Global Positioning Systems) captured facility data sets which have been verified, by the respective provinces, since the Regional Health Management Information System (ReHMIS) database was captured in 1996. The health facilities in Swaziland have been positioned (GPS) while those in Mozambique were captured from an A3 map and need to be verified. Population data are available at enumerator area level (EA) from the 1996 population census for South Africa, while the data in Swaziland and Mozambique is currently available down to district level, for 1997. Figure 1 shows the distribution of the 1996 population, at EA level, in relation to health facilities and districts for the malarious areas of Mpumalanga, as an example of the available data sets.

The further development and maintenance of this system is not budgeted for as part of this proposal and will be funded from elsewhere. This established project will however lend GIS support to the proposed study, both in term of making malaria incidence data available on an ongoing basis for both South Africa and Swaziland and in regard to spatial analysis of data collected.  

Spatial analysis support will be available to all facets of the proposed study, including drug utilisation audit study, health seeking behaviour, in vivo patient geo-referencing and genetic marker frequency mapping.