Malaria

Malaria Red Reference Initiative for Southern Africa The Red Reference CD (contact the department to obtain a copy) Africa Malaria Day - 25 April South Africa will join other SADC member-states in a Rally Against Malaria. This is a regional initiative aimed at raising awareness about Malaria - a disease that is killing one million people a year, 90% of whom are from Africa. Most of malaria victims are women and children and it affects at least three of our provinces (KwaZulu-Natal, Limpopo and Mpumalanga). If uncontrolled, it becomes a major economic burden, as most of the malaria risk areas in our country fall within some of our best tourism regions.

Our journey will start in Ndumo area in Northern KZN and the team will drive through Mpumalanga and Limpopo into Zimbabwe and Zambia and culminate in a major Africa Malaria Day celebration in Tanzania on the 25th April. There will be several awareness events on the way and we will join teams from other countries and reach Dar es Salaam as one big SADC family fighting malaria.

SUB-DIRECTORATE: VECTOR-BORNE DISEASES

The Sub-Directorate: Vector-Borne Diseases is responsible for prevention and control of specific Vector-Borne diseases and to ensure a pro-active, appropriate and effective response to these diseases in the interest of the public in South Africa.

Key areas:

• Responsible for control of the malaria vector and parasites.
• To evaluate policy and guidelines developed for the prevention and control of vector borne diseases.
• Designate yellow fever centres.

Malaria:

Introduction:

Malaria is a disease caused mainly by the parasite Plasmodium falciparum. There are 3 other parasite species (malariae, vivax and ovale) that also cause malaria but they are rare in South Africa. The parasite is transmitted to humans by a vector viz, the female anopheles mosquito.

Malaria is mainly transmitted in the low altitude areas of the northeastern parts of South Africa; this includes the lowveld region of Mpumalanga, Northern Province and the northeastern parts of Kwa-Zulu Natal (fig 1 - risk areas)

Malaria transmission in South Africa is seasonal with the greatest number of cases occurring between October and May.

Malaria vectors and Vector control in South Africa:

Mosquitoes' vectorial capacity to transmit malaria lies in the obligatory blood feeding habit of female mosquitoes an their close association with humans and their habitations. In South Africa malaria transmission is by two anopheline species, Anopheles arabiensis and Anopheles funestus group, respectively. As a result thorough knowledge of identity and biology of malaria vectors is central to effective and efficient targeted vector control.

The mainstay of the malaria control programme in South Africa is through insecticide residual house spraying.

Laboratory Diagnosis of Malaria.

With the advent of malaria drug resistance, prompt diagnosis is a crucial component of malaria control and patient management. The gold standard for the laboratory diagnosis of Malaria remains the microscopic test, through the examination of stained thin and thick blood films. However due to the urgency of obtaining a diagnosis and the expertise required to examine blood films, alternative methods for diagnosing malaria have been developed. These are the antigen detection tests, commonly referred to as Rapid Malaria Diagnostic tests (or the rapid card tests). The merit of this technology does not require experienced personnel and the tests can be conducted at the clinics in the malaria endemic areas. The principle of the test relies on the capture of the Plasmoduim falciparum histidine rich protein (HRP), which is secreted by infected red cells. This antigen can be detected in red blood cells, serum, plasma cerebrospinal fluid and urine of patients infected with P. falciparum malaria.

There are other highly accurate, sophisticated methods used for malaria diagnosis, but most of these require experienced laboratory technicians and are expensive, thus prohibiting its use in the endemic areas. These tests include the Quantitative Buffy Coat (QBC) and Polymerase Chain Reaction (PCR).

Figure 1. Map of the Endemic Malaria areas within South Africa

DoH Guidelines: Prophylaxis

Note: these guidelines were published in 1996, and will be updated shortly
You can find the guidelines at www.malaria.org.za

The guidelines are endorsed by the Medical Association of South Africa. 

Compiled by the Department of Health in  collaboration with the Subcommittee for Chemoprophylaxis and Therapy of the National  Malaria Advisory Group.
October 1996

Contact persons

D. Moonasar ; National Department of Health, Sub Directorate Vector Borne Diseases, Private Bag X 828, Pretoria 0001, South Africa, Hallmark 1838, Tel: +12 3120102 Fax: +12 3238626, Email moonad@health.gov.za

Dr Frank Hansford, Senior Medical Officer, Malaria Expert, Department of Health and Welfare Northern Province Tzaneen 0850, Tel 015 3071663, FAX 015 3071663, email mwtrong@mweb.co.za

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