March 2002
This update serves to provide feedback to a range of persons involved in the malaria programmes. For this edition, malaria cases and deaths for the three endemic areas as well as for the rest of the country are presented. The total number of malaria cases reported as per malaria season for 1999/2000, 2000/2001 and 2001/2002 are graphed below. The provinces have been consulted for comments regarding the general trends. However, any further inputs or comments regarding the data are encouraged.
In general, KwaZulu-Natal, Mpumalanga and the Northern Province have recorded a decrease in the number of reported cases for this malaria season in comparison to previous ones. This decrease can largely be attributed to re-introducing the spraying with DDT. The decrease in these three provinces has created a “knock-on effect” resulting in a reduction of overall transmission within in the region as well as within each individual province. The cumulative reduction has resulted in the presence of fewer parasites and therefore a decrease in transmission.
The figures thus far for the 2001/2002 season indicate a decrease in comparison to other years. Figures were low early in the season, with two peaks occurring in November and January. A large percentage of cases are reported from the Mutare and Thoyando districts. The overall decrease in the area can be attributed to several factors. Firstly, additional sprayers (50) were employed and new vehicles (30) were purchased. These additions have resulted in early spraying particularly to high risk areas and greater coverage of spraying has been achieved. High risk areas have received greater protection, earlier. Secondly, DDT has been used for spraying. For this season thus far, 32 deaths have been notified resulting a case-fatality rate of 0.7%. This rate is above that set by Department of Health National Policy.
Overall, the 2001/2002 season has notified fewer cases. From January to March there has been a sharp decrease in the number of notified cases. This decrease may be attributed to the lack of rain and the introduction of spraying with DDT. The Tonga area continues to report a high number of cases. For this period, January – March, 65-70% were reported from this area. The area reports a large number of imported cases. For this season thus far, 9 deaths have been reported resulting in a case-fatality rate of 0.2%.
The figures for this season are considerably lower than those of previous ones. Spraying has taken place over wider areas especially in the low risk areas. Spraying has taken place with DDT. Large decreases in transmission have been observed following spraying e.g. DukaDuka area. In April, treatment with Coartemether began which may have impacted on transmission and possibly resulted in improved diagnosis. The southern areas and Ingwavuma continue to report a large number of cases. A total of 20 deaths have been reported thus far for the season resulting in a case-fatality rate of 0.7%.
The number of cases reported throughout the rest of the provinces has decreased this season. This may be a result of the “overall reduction” in cases within the endemic areas. In addition, there may be late or under reporting. For this season, a large number of cases were reported from the North West Province and the Free State. No deaths have been reported.
Compiled by Caron Johnson with the assistance of the Programme Managers
National Department of Health
Tel (012) 312-0046
e-mail: johnsc@health.gov.za