Malaria Control Malaria control programmes based on intra-domiciliary spraying
to control mosquito vectors and on effective treatment are in place in the
South
African and Swaziland
sectors. The project extends these malaria control efforts to the Mozambique
sector. Figure 1 indicates the malaria
risk situation in 2002 in the South African, Mozambique and Swaziland sector's
and Figure 2 presents the
area in Mozambique to undergo control. Historically, malaria had a pronounced and detrimental effect
on agricultural and economic development of this area of KwaZulu-Natal Province.
In 1932, all the districts of KwaZulu-Natal Province, bar one, reported cases
of malaria. Huletts representatives had visited hundreds of planters, whose
average workforce was 80, but typically only three were reporting for work.
The Amatikulu sugar mill was only receiving one truck-load of sugar-cane per
day (5 tons) instead of the expected 1 500 tons, due to the workforce being
down from malaria. Control measures were instituted in the Province in 1948
and their success has rendered large areas practically malaria free with resultant
economic development. Control measures in Mozambique since independence in 1975 have
focused around the major urban centers and consist of indoor residual spraying
and treatment for those who report ill to health facilities. Historical data
from 1937/8 (Figure3)
prior to the introduction of control measures indicate that the high prevalence
of infection differs little from the current situation. A house spraying programme
was started in 1962 in southern Mozambique and these data indicate a dramatic
decrease over the 8 year period of control ( Figure
4 ). The Regional
Malaria Control Commission, comprised of members from the 3 countries,
has developed a protocol for the extension of malaria control to southern
Mozambique. Malaria control will be achieved through:
This project is supported by Roll Back Malaria, an executive
programme of the World Health Organisation and has been submitted to international
donors for long term funding. Startup funding has been made available
from the Business Trust, Mozal and the South African Government. Operational Strategy Sustainability of project outcomes The RMCC
membership as outlined encompasses a group of African scientists, public
health professionals and malaria control programme managers with exceptional
experience in communicable disease control in Africa. The expertise base extends
from individuals who have started malaria control programmes in 3 countries
through to extensive experience in research, intervention and health
management Update
on Malaria in Southern Africa January 2003Malaria Control
The project was developed to control malaria in the LSDI development area,
an area of high potential for accelerated tourism development which falls
within a historical endemic malaria area. There is increasing consensus that
even if malaria control measures are optimal in South Africa and Swaziland
(i.e. effective drugs and insecticides in place), disease incidence can only
be further reduced by a regional approach to control. This project addresses
a number of aspects central to increasing the effectiveness of malaria
control in the two highest risk malaria provinces in South Africa and those
in Swaziland by extending malaria control to southern Mozambique.
Community based House spraying programme: Anopheles funestus, Anopheles
arabiensis
Plasmodium falciparum
Case management
Drug policy
The general operational strategy is to reduce the incidence of disease by
the reduction of vectors through house spraying with a pyrethroid insecticide
before the transmission season starts, and by improving case management at
the health facilities. Vector control by house spraying has proved to be extremely
effective in South Africa, with large areas of previous high risk, being free
or relatively free from disease transmission and the negative effects thereof
on communities and development.
The
malaria control component in Mozambique has been implemented in phases (See
map) starting with Zone 1 which is the area extending from the border
with KwaZulu-Natal to Maputo City. Zone 1A covers the area surrounding the
MOZAL plant that has been sprayed as part of their social responsibility campaign.
Zone 2A comprises part of the Boane District, and Zone 2 extends northward
of Zone 1 to approximately ¼ of the length of the Kruger National Park.
Zone 3 lies north of Zone 2. The control programme covers an area of approximately
20 500 sq km.
The project area is an extension and consolidation of the existing malaria
control area around Maputo city and forms part of the broader LSDI malaria
controlled areas of Mpumalanga, KwaZulu-Natal Provinces and Swaziland.
This is a strong factor towards sustainability and a major advantage over
newly initiated control programmes that are spatially isolated from other
control programmes and that do not have the necessary expertise base.
Annual Report for
SA Business Trust 2002
Annual Report for
SA Business Trust 2001 - Executive Summary
Entomological
Aspects of Vector Control
Advice
on Malaria Prophylaxis in pdf format