High levels of imported asymptomatic malaria but limited local transmission in KwaZulu-Natal, a South African malaria-endemic province nearing malaria elimination
| Autor: | Laura Gast, Sipho Msimang, Jaishree Raman, Sifiso Ngxongo, Nicole Dagata, Rebecca Graffy, Ernest Mohulatsi, Nompumelelo Zondo, Tshiama Mwamba, Moses Mkhabela, Givemore Munhenga, Zuziwe Nyawo, Bryan Greenhouse, Ryleen Balawanth, Vishan Lakan, Lyn-Marie Birkholtz, Power Tshikae, Rajendra Maharaj, Sofonias K. Tessema, Bheki Qwabe, Basil D. Brooke, Lindi Sangweni, Devanand Moonasar, George Shirreff, Hazel Makowa |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
lcsh:Arctic medicine. Tropical medicine Endemic Diseases lcsh:RC955-962 Elimination Indoor residual spraying lcsh:Infectious and parasitic diseases law.invention South Africa Asymptomatic carriage Communicable Diseases Imported law Environmental health parasitic diseases Prevalence medicine Humans lcsh:RC109-216 Disease Eradication Artemisinin Asymptomatic Infections KwaZulu-Natal Research Public health Rapid diagnostic tests medicine.disease Vector control Malaria Malaria importation Infectious Diseases Transmission (mechanics) Geography Parasitology KAP Vector (epidemiology) Tropical medicine Residual transmission medicine.drug |
| Zdroj: | Malaria Journal Malaria Journal, Vol 19, Iss 1, Pp 1-13 (2020) |
| DOI: | 10.21203/rs.2.23648/v3 |
| Popis: | Background KwaZulu-Natal, one of South Africa’s three malaria endemic provinces, is nearing malaria elimination, reporting fewer than 100 locally-acquired cases annually since 2010. Despite sustained implementation of essential interventions, including annual indoor residual spraying, prompt case detection using malaria rapid diagnostics tests and treatment with effective artemisinin-based combination therapy, low-level focal transmission persists in the province. This malaria prevalence and entomological survey was therefore undertaken to identify the drivers of this residual transmission. Methods Malaria prevalence as well as malaria knowledge, attitudes and practices among community members and mobile migrant populations within uMkhanyakude district, KwaZulu-Natal were assessed during a community-based malaria prevalence survey. All consenting participants were tested for malaria by both conventional and highly-sensitive falciparum-specific rapid diagnostic tests. Finger-prick filter-paper blood spots were also collected from all participants for downstream parasite genotyping analysis. Entomological investigations were conducted around the surveyed households, with potential breeding sites geolocated and larvae collected for species identification and insecticide susceptibility testing. A random selection of households were assessed for indoor residual spray quality by cone bioassay. Results A low malaria prevalence was confirmed in the study area, with only 2% (67/2979) of the participants found to be malaria positive by both conventional and highly-sensitive falciparum-specific rapid diagnostic tests. Malaria prevalence however differed markedly between the border market and community (p Conclusion If KwaZulu-Natal is to successfully halt local malaria transmission and prevent the re-introduction of malaria, greater efforts need to be placed on detecting and treating malaria carriers at both formal and informal border crossings with transmission blocking anti-malarials, while ensuring optimal coverage of vector control interventions is achieved. |
| Databáze: | OpenAIRE |
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