The prevalence of malaria in the five districts of Limpopo Province, South Africa, 2015 - 2017

Authors

  • M T Lamola School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, South Africa; South African Field Epidemiology Training Programme, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa; School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, South Africa https://orcid.org/0000-0003-4657-9073
  • A Musekiwa School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, South Africa; South African Field Epidemiology Training Programme, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa; School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, South Africa
  • A de Voux Division of Epidemiology and Biostatistics, School of Public Health, University of Cape Town, South Africa
  • C Reddy School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, South Africa; South African Field Epidemiology Training Programme, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa; School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, South Africa
  • M Morifi Division of Public Health Surveillance and Response, National Institute for Communicable Diseases, National Health Laboratory Service, Johannesburg, South Africa
  • P C Mutevedzi Emory Global Health Institute, Emory University, Atlanta, GA, USA

DOI:

https://doi.org/10.7196/SAMJ.2024.v114i5.1821

Keywords:

Prevalence , Malaria, Retrospective studies, Imported, South Africa

Abstract

Background. In South Africa (SA), malaria is endemic in three of nine provinces – KwaZulu-Natal, Mpumalanga and Limpopo. During 2010 - 2014, SA reported that ~47.6% of all malaria cases were imported. Contemporary estimates for the prevalence of malaria in the five districts of Limpopo Province are limited, with unknown proportions of imported malaria cases. We estimated the prevalence of malaria, and the proportion of imported malaria cases in the five districts of Limpopo, from January 2015 to December 2017.

Objective. To measure the prevalence of malaria in Limpopo Province, the proportion of malaria cases that are imported and to determine factors associated with malaria from January 2015 to December 2017.
Methods. We retrospectively reviewed data routinely collected through the Malaria Information System and Laboratory Information System of the National Health Laboratory Services, and assessed associations with age, sex and district, using a multivariable logistic regression model.

Results. From 2015 to 2017, a total of 43 199 malaria cases were reported, of which 3.5% (n=1 532) were imported. The prevalence of malaria in Limpopo Province was the highest in 2017, at 331.0 per 100 000 population. The highest malaria prevalence district was Vhembe, with 647.9 in 2015, 220.3 in 2016 and 659.4 in 2017 per 100 000 population. However, Waterberg had the highest proportion of imported malaria cases 28.5% (437/1 532). In adjusted analyses, ages 15 - 49 years (adjusted odds ratio (aOR) 1.58, 95% confidence interval (CI) 1.48 - 1.68, p<0.001) and <1 year (aOR 1.55, 95% CI 1.37 - 0.74, p<0.001) were at higher odds of having malaria compared with ages ≥65 years.

Conclusion. These findings highlight the significant burden of imported malaria in Limpopo Province. There is a need for strengthened surveillance and control programmes in neighboring countries (such as Mozambique, Zimbabwe and Botswana) to reduce the importation and spread of malaria in this region.

References

World Health Organization. Malaria: Key Facts 2023. Geneva: WHO, 2023. https://www.who.int/ news-room/fact-sheets/detail/malaria (accessed 6 September 2023).

World Health Organization. Malaria 2023. Geneva: WHO, 2023. https://www.who.int/health-topics/ malaria#tab=tab_1 (accessed 6 September 2023).

World Health Organization. Malaria programme managers meeting to review progress on implementation of the regional action framework for malaria control and elimination in the Western Pacific 2016 - 2020, Manila, Philippines, 25 - 27 June 2018: meeting report. WHO, 2018.

World Health Organization. Malaria 2023. https://www.afro.who.int/health-topics/malaria (accessed 7 September 2023).

Eikenberry SE, Gumel AB. Mathematical modeling of climate change and malaria transmission dynamics: A historical review. J Mathematical Biol 2018;77(4):857-933. https://doi.org/10.1007/ s00285-018-1229-7

World Health Organization. Key points: World Malaria Report 2017. Geneva: WHO, 2017.

Huang Z, Tatem AJ. Global malaria connectivity through air travel. Malar J 2013;12:269. https://doi.

org/10.1186/1475-2875-12-269

Monroe A, Williams NA, Ogoma S, Karema C, Okumu F. Reflections on the 2021 World Malaria Report and the future of malaria control. Malaria J 2022;21(1):154.

Raman J, Morris N, Frean J, et al. Reviewing South Africa’s malaria elimination strategy (2012 - 2018): Progress, challenges and priorities. Malaria J 2016;15(1):438. https://doi.org/10.1186/s12936-016-1497-x

Dlamini SK. Diagnosis and treatment of imported and odyssean malaria. S Afr Med J 2014;104(5):344.

https://doi.org/10.7196/samj.8306

Coetzee M, Kruger P, Hunt RH, Durrheim DN, Urbach J, Hansford CF. Malaria in South Africa: 110 years of learning to control the disease. S Afr Med J 2013;103(10 Pt 2):770-778. https://doi. org/10.7196/samj.7446

Morris N, Frean J, Baker L, et al. Re-defining the extent of malaria transmission in South Africa: Implications for chemoprophylaxis. S Afr Med J 2013;103(11):861-864. https://doi.org/10.7196/ samj.7533.

World Health Organization. Update on the E-2020 initiative of 21 malaria-eliminating countries. Geneva: WHO, 2018.

National Department of Health. South African guidelines for the prevention of malaria. Pretoria: NDoH, 2018.

National Department of Health. Republic of South Africa malaria elimination strategic plan 2012 - 2018. Pretoria: NDoH, 2012.

World Health Organization. Overview of malaria elimination. Geneva: WHO, 2018. http://www.who. int/malaria/areas/elimination/overview/en/ (accessed 13 September 2018).

National Department of Health. Malaria elimination strategic plan for South Africa 2019 - 2023. Pretoria: NDoH, 2019.

National Institute for Communicable Diseases. Standard operating procedures: Reporting of notifiable medical conditions (NMC). Pretoria: NICD, 2018.

National Institute for Communicable Diseases. Malaria alert May 2017. Johannesburg: NICD, 2017. http://www.nicd.ac.za/index.php/malaria-alert-03-may-2017/ (accessed 12 May 2018).

Silal SP, Little F, Barnes KI, White LJ. Predicting the impact of border control on malaria transmission: A simulated focal screen and treat campaign. Malar J 2015;14:268. https://doi.org/10.1186/s12936- 015-0776-2

Statistics South Africa. Mid-year population estimates 2018. Pretoria: Stats SA, 2018.

Government Provinces. Limpopo socio-economic review and outlook 2018/19. Polokwane: Provincial

Treasury, 2019.

World Health Organization. Global technical strategy (GTS) 2016 - 30. Geneva: WHO, 2015. http://

www.who.int/malaria/areas/global_technical_strategy/en/ (accessed 13 July 2018).

World Health Organization. 10 facts on malaria. Geneva: WHO, 2016.

World Health Organization. Malaria elimination: A field manual for low and moderate endemic

countries. Geneva: WHO, 2007.

Macdonald G. Epidemiological basis of malaria control. Bull World Health Org 1956;15(3-5):613-626.

National Institute for Communicable Diseases. High number of malaria cases. Pretoria: NICD 2017.

http://www.nicd.ac.za/high-numbers-of-malaria-cases/ (accessed 15 August 2019).

Southern African Development Community. The SADC malaria report 2017. Madagascar National Malaria Control Programme, 2017. http://www.health.gov.za/index.php/component/phocadownload/

category/422-malaria-2017?download=2529:sadc-malaria-report-2017 (accessed 30 August 2019).

World Health Organization. Malaria: Key facts. Geneva: WHO, 2019. https://www.who.int/news- room/fact-sheets/detail/malaria (accessed 30 August 2019).

Baird JK, Jones TR, Danudirgo EW, et al. Age-dependent acquired protection against Plasmodium falciparum in people having two years exposure to hyperendemic malaria. Am J Tropical Med Hygiene 1991;45(1):65-76. https://doi.org/10.4269/ajtmh.1991.45.65

Jenkins R, Omollo R, Ongecha M, et al. Prevalence of malaria parasites in adults and its determinants in malaria endemic area of Kisumu County, Kenya. Malar J 2015;14:263. https://doi.org/10.1186/ s12936-015-0781-5

Karim MA, Kabir MM, Siddiqui MA, Laskar MSI, Saha A, Naher S. Epidemiology of imported malaria in Netrokona District of Bangladesh 2013 -2018: Analysis of surveillance data. Malar Res Treat 2019;2019:6780258. https://doi.org/10.1155/2019/6780258

Ikeda T, Behera SK, Morioka Y, et al. Seasonally lagged effects of climatic factors on malaria incidence in South Africa. Sci Rep 2017;7(1):2458. https://doi.org/10.1038/s41598-017-02680-6

Gerritsen AA, Kruger P, van der Loeff MFS, Grobusch MP. Malaria incidence in Limpopo Province, South Africa, 1998 - 2007. Malaria J 2008;7(1):162.

Mathiba RM, Mathivha LR, Nethathe GD. Artesunate compared with quinine for the treatment of severe malaria in adult patients managed in an intensive care unit: A retrospective observational study. South Afr J Crit Care 2019;35(1)12-17. https://doi.org/10.7196/SAJCC.2019.v35i1.345

Frean J. Malaria control in South Africa – challenges and successes. S Afr Med J 2007;97(11 Pt 3):1193- 1197.

Schlagenhauf P, Chen LH, Wilson ME, et al. Sex and gender differences in travel-associated disease. Clin Infect Dis 2010;50(6):826-832. https://doi.org/10.1086/650575

Manierre MJ. Gaps in knowledge: Tracking and explaining gender differences in health information seeking. Soc Sci Med 2015;128:151-158. https://doi.org/10.1016/j.socscimed.2015.01.028

Yousaf O, Grunfeld EA, Hunter MS. A systematic review of the factors associated with delays in medical and psychological help-seeking among men. Health Psychol Rev 2015;9(2):264-276. https:// doi.org/10.1080/17437199.2013.840954

Galdas PM, Cheater F, Marshall P. Men and health help-seeking behaviour: Literature review. J Adv Nurs 2005;49(6):616-23. https://doi.org/10.1111/j.1365-2648.2004.03331.x

Teo CH, Ng CJ, Booth A, White A. Barriers and facilitators to health screening in men: A systematic review. Soc Sci Med 2016;165:168-176. https://doi.org/10.1016/j.socscimed.2016.07.023

Reuben R. Women and malaria – special risks and appropriate control strategy. Soc Sci Med 1993;37(4):473-480. https://doi.org/10.1016/0277-9536(93)90282-9

Maharaj R, Morris N, Seocharan I, et al. The feasibility of malaria elimination in South Africa. Malaria J 2012;11(1):423.

Downloads

Published

2024-05-09

Issue

Section

Research

How to Cite

1.
Lamola MT, Musekiwa A, de Voux A, Reddy C, Morifi M, Mutevedzi PC. The prevalence of malaria in the five districts of Limpopo Province, South Africa, 2015 - 2017. S Afr Med J [Internet]. 2024 May 9 [cited 2025 Jun. 13];114(5):e1821. Available from: https://samajournals.co.za/index.php/samj/article/view/1821

Most read articles by the same author(s)