the status of malaria in south africa devanand moonasar
TRANSCRIPT
The Status of Malaria in South Africa
DEVANAND MOONASAR
INTRODUCTION
Malaria – Disease -Plasmodium falciparum.
Transmission – Female Anopheles mosquito.
Vectors Anopheles, arabiensis, gambiae and funestus.
Areas low altitude
malaria season October to May
Malaria in South Africa-
• National Department of Health - Policy
• Malaria Advisory Group.
• Vector Sub committee
• Sub - committee for Chemoprophylaxis and Treatment.
• KZN - Department of Health
• NP - Department of Health
• Mp - Department of Health.
Risk Areas
• Low altitude areas of
• Northern province
• Mpumalanga
• North Eastern Parts of KZN.
• Northern Cape (rare)
Annual South Africa Malaria Cases: 1971 to June 2001
0
10000
20000
30000
40000
50000
60000
70000
1971
1973
1975
1977
1979
1981
1983
1985
1987
1989
1991
1993
1995
1997
1999
2001
Year
NO
. OF
MA
LA
RIA
CA
SE
S
No. of cases• Last decade :
Year No. of cases Deaths 1990 6822 35
1991 4693 19
1992 2872 14
1993 13285 45
1994 10289 12
1995 8750 44
1996 27035 163
1997 23121 104
1998 26445 198
1999 ` 51535 402
2000 61934 423
20012001 2034520345 69 69
1999-2000 malaria season vs the 2000-2001 malaria season
0
1000
2000
3000
4000
5000
6000
7000
8000
9000
10000
months
no
of m
ala
ria
cas
es
1999-2000
2000-2001
222222222222222222
191919191919191919
181818181818181818
151515151515151515
161616161616161616
171717171717171717
212121212121212121202020202020202020
131313131313131313141414141414141414
NORTH-WESTNORTH-WESTNORTH-WESTNORTH-WESTNORTH-WESTNORTH-WESTNORTH-WESTNORTH-WESTNORTH-WEST121212121212121212
BOTSWANABOTSWANABOTSWANABOTSWANABOTSWANABOTSWANABOTSWANABOTSWANABOTSWANA
ThabazimbiThabazimbiThabazimbiThabazimbiThabazimbiThabazimbiThabazimbiThabazimbiThabazimbi
PretoriaPretoriaPretoriaPretoriaPretoriaPretoriaPretoriaPretoriaPretoria
EllisrasEllisrasEllisrasEllisrasEllisrasEllisrasEllisrasEllisrasEllisras
NORTHERN PROVINCENORTHERN PROVINCENORTHERN PROVINCENORTHERN PROVINCENORTHERN PROVINCENORTHERN PROVINCENORTHERN PROVINCENORTHERN PROVINCENORTHERN PROVINCE
GAUTENGGAUTENGGAUTENGGAUTENGGAUTENGGAUTENGGAUTENGGAUTENGGAUTENG
SwartwaterSwartwaterSwartwaterSwartwaterSwartwaterSwartwaterSwartwaterSwartwaterSwartwater
NylstroomNylstroomNylstroomNylstroomNylstroomNylstroomNylstroomNylstroomNylstroom
PotgietersrusPotgietersrusPotgietersrusPotgietersrusPotgietersrusPotgietersrusPotgietersrusPotgietersrusPotgietersrus
Louis TrichardtLouis TrichardtLouis TrichardtLouis TrichardtLouis TrichardtLouis TrichardtLouis TrichardtLouis TrichardtLouis Trichardt
PietersburgPietersburgPietersburgPietersburgPietersburgPietersburgPietersburgPietersburgPietersburg
NelspruitNelspruitNelspruitNelspruitNelspruitNelspruitNelspruitNelspruitNelspruit
MPUMALANGAMPUMALANGAMPUMALANGAMPUMALANGAMPUMALANGAMPUMALANGAMPUMALANGAMPUMALANGAMPUMALANGAErmeloErmeloErmeloErmeloErmeloErmeloErmeloErmeloErmelo
MiddelburgMiddelburgMiddelburgMiddelburgMiddelburgMiddelburgMiddelburgMiddelburgMiddelburg
AlldaysAlldaysAlldaysAlldaysAlldaysAlldaysAlldaysAlldaysAlldays
MessinaMessinaMessinaMessinaMessinaMessinaMessinaMessinaMessina
ZIMBABWEZIMBABWEZIMBABWEZIMBABWEZIMBABWEZIMBABWEZIMBABWEZIMBABWEZIMBABWE
111111111
TzaneenTzaneenTzaneenTzaneenTzaneenTzaneenTzaneenTzaneenTzaneen
MahlabatiniMahlabatiniMahlabatiniMahlabatiniMahlabatiniMahlabatiniMahlabatiniMahlabatiniMahlabatini
DoringkopDoringkopDoringkopDoringkopDoringkopDoringkopDoringkopDoringkopDoringkop
KWAZULU-NATALKWAZULU-NATALKWAZULU-NATALKWAZULU-NATALKWAZULU-NATALKWAZULU-NATALKWAZULU-NATALKWAZULU-NATALKWAZULU-NATAL
LydenburgLydenburgLydenburgLydenburgLydenburgLydenburgLydenburgLydenburgLydenburg SabieSabieSabieSabieSabieSabieSabieSabieSabie
Pilgrims RestPilgrims RestPilgrims RestPilgrims RestPilgrims RestPilgrims RestPilgrims RestPilgrims RestPilgrims Rest
HazyviewHazyviewHazyviewHazyviewHazyviewHazyviewHazyviewHazyviewHazyview
HoedspruitHoedspruitHoedspruitHoedspruitHoedspruitHoedspruitHoedspruitHoedspruitHoedspruit
333333333
PhalaborwaPhalaborwaPhalaborwaPhalaborwaPhalaborwaPhalaborwaPhalaborwaPhalaborwaPhalaborwa
888888888
GiyaniGiyaniGiyaniGiyaniGiyaniGiyaniGiyaniGiyaniGiyani
ThohoyandouThohoyandouThohoyandouThohoyandouThohoyandouThohoyandouThohoyandouThohoyandouThohoyandou
222222222
777777777999999999
444444444 555555555666666666
Punda MariaPunda MariaPunda MariaPunda MariaPunda MariaPunda MariaPunda MariaPunda MariaPunda Maria
BarbertonBarbertonBarbertonBarbertonBarbertonBarbertonBarbertonBarbertonBarberton
MbabaneMbabaneMbabaneMbabaneMbabaneMbabaneMbabaneMbabaneMbabane
ManziniManziniManziniManziniManziniManziniManziniManziniManzini
SWAZILANDSWAZILANDSWAZILANDSWAZILANDSWAZILANDSWAZILANDSWAZILANDSWAZILANDSWAZILAND
111111111111111111
LetabaLetabaLetabaLetabaLetabaLetabaLetabaLetabaLetaba
ShingwedziShingwedziShingwedziShingwedziShingwedziShingwedziShingwedziShingwedziShingwedzi
TugelaTugelaTugelaTugelaTugelaTugelaTugelaTugelaTugela
HlabisaHlabisaHlabisaHlabisaHlabisaHlabisaHlabisaHlabisaHlabisa
MtunziniMtunziniMtunziniMtunziniMtunziniMtunziniMtunziniMtunziniMtunzini
DurbanDurbanDurbanDurbanDurbanDurbanDurbanDurbanDurban
SataraSataraSataraSataraSataraSataraSataraSataraSatara
NwanedziNwanedziNwanedziNwanedziNwanedziNwanedziNwanedziNwanedziNwanedzi
KomatipoortKomatipoortKomatipoortKomatipoortKomatipoortKomatipoortKomatipoortKomatipoortKomatipoort
White RiverWhite RiverWhite RiverWhite RiverWhite RiverWhite RiverWhite RiverWhite RiverWhite River111111111111111111
SkukuzaSkukuzaSkukuzaSkukuzaSkukuzaSkukuzaSkukuzaSkukuzaSkukuza
101010101010101010
NdumoNdumoNdumoNdumoNdumoNdumoNdumoNdumoNdumo
IngwavumaIngwavumaIngwavumaIngwavumaIngwavumaIngwavumaIngwavumaIngwavumaIngwavuma
MalelaneMalelaneMalelaneMalelaneMalelaneMalelaneMalelaneMalelaneMalelane
St LuciaSt LuciaSt LuciaSt LuciaSt LuciaSt LuciaSt LuciaSt LuciaSt LuciaMfoloziMfoloziMfoloziMfoloziMfoloziMfoloziMfoloziMfoloziMfolozi
Richards BayRichards BayRichards BayRichards BayRichards BayRichards BayRichards BayRichards BayRichards Bay
MOZAMBIQUEMOZAMBIQUEMOZAMBIQUEMOZAMBIQUEMOZAMBIQUEMOZAMBIQUEMOZAMBIQUEMOZAMBIQUEMOZAMBIQUE
ManguziManguziManguziManguziManguziManguziManguziManguziManguzi
MbazwanaMbazwanaMbazwanaMbazwanaMbazwanaMbazwanaMbazwanaMbazwanaMbazwanaUbomboUbomboUbomboUbomboUbomboUbomboUbomboUbomboUbombo
0 50
Kilometers
100
Towns
1.Tshipese 2. Hans Merensky (Eiland) 3. Groot-Letaba 4. Klaserie 5. Sharalumi 6. Timbavati 7. Thornybush 8. Blyderivierpoort 9. Manyeleli10. Sabie-Sand11. Kruger National Park12. Pilanesburg
Game Reserves:
Low Risk Areas
Malaria all year round: antimalarial drugs* are recommended
Mozambique
No antimalarial drugs arerecommended
Swaziland
No Risk or no data
Travellers are advised totake antimalarial drugs from October through May, particularly forhigh risk people**
Antimalarial drugs* are recommendedall year round
High Risk Areas
Intermediate Risk Areas
Travellers are advised totake antimalarial drugs from October through May, particularly forhigh risk people**
* Mefloquine OR Doxycycline (ORChloroquine PLUS Proguanil)
** High risk people are children < 5 years,pregnant women & immunocompromisedpeople (e.g. WHO stage 3 or 4 HIV, a person who has had a splenectomy, or who is on immunosuppressant medication)
Take precautionary measuresagainst mosquito bites throughoutthe year in ALL RISK areas
13. Ndumu 14. Tembe 15. Kosi Bay 16. Itala 17. Mkuze 18. Sodwana 19. False Bay 20. Fanies Island 21. Hluhluwe 22. Umfolozi
MALARIA RISK MAP FOR SOUTH AFRICA
DOH malaria control policy
• Vector Control mainstay IRS.
• Case management. -Early Diagnosis + Rx
• Community Mobilisation.
• Epidemic Surveillance
Vector control
• IRS - – Pyrethroids– Carbamate– DDT.
• Larviciding:– Temaphos, oils etc
• ITNS- Insecticide Treated nets
Disease management
• Diagnosis:
- Rapid Kits
- Microscopy • Treatment:
- SP- Fansidar
- Coartem (Coartmether + lumefantrene)
- Quinine• Training:
– Healthcare staff in districts
Community mobilization
• Messages on malaria b4 the malaria season
• Radio
• Newspaper
• School plays
• KAP - IMCI
• Training/ informing Traditional healers
Inter-country Collaboration• LSDI - Lumbombo Spatial Development
Initiative
• SAMC - Southern African Malaria Control
• SADC Malaria control policy.
Malaria advocacy
• Government commitment
• Malaria week - Nov 5-9/01
• RBM Launch
• LSDI Launch• .
Achievements
• Decreased malaria 2000/01 by more 35%.
• Re- introduced DDT
• Reviewed and implemented drug policy.
• Scaled up infrastructure
• Inter-country collaborations.
• SAMC - malaria Award
Priorities for coming year.
• Increasing National Capacity for MCP.
• Scale up ITN coverage.
• Launch RBM
• Launch LSDI
• Implement new drug policy in NP,MP.
Malaria Control Partners• South African Medical Research Council.
• South African Institute for Medical Research
• University of Cape Town
• World Health Organization (WHO)
• NP, MP and KZN Provincial Departments of Health.
• www.malaria.org.za